The Role of Spirituality in 12-Step Recovery

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Spirituality is the general term for a worldview that places an emphasis on interconnection and the presence of larger forces beyond the realm of the individual human being. This worldview differs from a strictly religious orientation, which seeks to describe reality in terms of a specific set of organized beliefs. In a study published in 2013 in the Journal of Addiction Medicine, researchers from New York University explored the role of spirituality in narcotic addiction recovery programs based on a 12-step model. These researchers concluded that a spiritual outlook can play a vital role in the effectiveness of 12-step narcotics treatment.

Spirituality Basics

Spirituality does not correspond to a particular set of beliefs. Instead, it corresponds to a range of personal beliefs that feature such things as an embodied or disembodied higher power, a sense that life has a special goal or purpose, an expansive and inclusive view toward interactions with other people, and an ongoing desire for personal mental/psychological evolution and growth. Activities commonly associated with a spiritual worldview include prayer, ritual, involvement in community service, purposeful exploration of life’s “big questions” and involvement in conversations or organizations centered on larger issues beyond material survival. Some people with a spiritual orientation follow the tenets of a particular religious tradition, while others do not follow such tenets or combine the tenets of two or more religious traditions.

Twelve-Step Program Basics

Twelve-step programs are mutual aid or self-help programs intended to help people recover from the effects of some sort of substance-based or non-substance-based addiction. Participants in these programs mark their recovery by their progression through 12 successive steps that emphasize specific addiction-related issues. One the most well-known steps in the typical program is a spirituality- or religion-based acknowledgment of some sort of higher power as a key factor in the recovery process. As a rule, 12-step groups also ask their members to remain abstinent and avoid participating in substance use or non-substance-based addictive behaviors. Membership in such a group is typically ongoing, and participants continue to support each other over extended periods of time.

Current Findings

One of the most well established 12-step programs in the U.S. and throughout the world is Narcotics Anonymous (NA), an organization that has over 58,000 individual chapters. According to the results of a study published in 2013 in the Journal of Studies on Alcohol and Drugs, the single most common drug of addiction/abuse among NA participants is actually cocaine. However, addiction to narcotic drugs as a whole still affects Narcotics Anonymous members more often than addiction to cocaine or any other single drug. The vast majority of NA participants have a previous history of treatment for alcohol or drug abuse/addiction. In addition, the overwhelming majority of participants use the term “spiritual” to describe themselves, while only roughly one-third of participants use the term “religious” to describe themselves.

MORE: How to Find a 12-Step Program

In the study published in the Journal of Addiction Medicine, researchers from the NYU School of Medicine examined the impact of spirituality on the treatment outcomes of people enrolled in 12-step programs for narcotics addiction. In particular, they focused on 527 members of Narcotics Anonymous who responded to a questionnaire that covered spirituality in the context of a range of psychological, social and mental issues that could potentially have an impact on the recovery process. The average participant in the study had been substance-free for roughly six years.

After reviewing the results of the completed questionnaires, the researchers found that the average Narcotics Anonymous member has a much stronger orientation toward spirituality than the average member of the adult general public. In line with the conclusions reported in the Journal of Studies on Alcohol and Drugs, the researchers also found that spirituality is significantly more prevalent among NA members than adherence to a specific religious tradition. In addition, the researchers concluded that two specific aspects of spirituality—a feeling of strong connection with other NA participants and a sense of spiritual renewal or blossoming—are significantly associated with a reduced craving for narcotics or other substances during the recovery process. Conversely, the biggest pull toward increased substance cravings during recovery is a depressed mental/emotional state.


The authors of the study published in the Journal of Addiction Medicine believe that the presence of a spiritual outlook substantially increases the chances that a member of a narcotics-oriented 12-step program will remain substance-free over time. Rather than working on its own, spirituality achieves its beneficial effects in combination with the emphasis on abstinence that typifies Narcotics Anonymous and similar organizations.

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