Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are the most popular type of addiction support group. There are many similar groups that cater to different demographics, including both offshoots of AA and NA that specialize in certain drugs of abuse, such as Cocaine Anonymous (CA), as well as groups with completely different recovery approaches, like SMART Recovery.
Support groups can be part of virtually any phase of recovery. They can be part of medication-assisted treatment (MAT) once the person has become physically stable. They can be a major form of support while the person is in active therapy, such as outpatient or residential treatment. They are often a vital part of aftercare plans.
Group members can learn an immense amount from peers who are going through a similar process as they overcome addiction to drugs or alcohol. Participants can achieve a high level of understanding that cannot be provided by other forms of treatment.
What Is a Support Group?
Support groups are an integral component of many mental and behavioral health treatments, including addiction recovery.
Meeting in groups guided by a specific leader — either a trained counselor, social worker, or peer leader — helps many people find empathy and understanding among others who are going through a similarly difficult time. These groups may also be called mutual support groups or self-help groups.
In addiction recovery, support groups are intended to complement the effects of rehabilitation. They aren’t intended to replace therapy. Instead, they offer a support structure to extend sobriety and recovery once you have completed rehabilitation.
Types of support groups that are available include:
- 12-step groups that meet in various locations about once per week.
- Support groups in clinical settings like hospitals or outpatient clinics.
- Mutual support groups for friends or family of those overcoming addiction, like Al-Anon.
- Online support groups, from specific websites with forums to social media support groups.
What Are the Benefits?
The common experiences of support group participants mean that members usually feel understood and supported. Participants may have similar experiences or behavioral or mental struggles. They may have experienced similar side effects from the substance of abuse. They may have similar struggles with friends, family members, or coworkers, and they may share the same worries about the future.
Support groups can be especially important for people who have few, if any, friends who have struggled with substance abuse. Addiction can be isolating, and if you feel like no one understands what you’re going through, it can be an incredibly lonely experience. Support groups can help you see that you are not alone.
If you don’t have many sober friends, relapse is more likely. Forming new social bonds with people who are abstinent from drugs or alcohol means you are less likely to relapse.
There are a few potential downsides to attending a support group. Some of the risks include:
- Disruptive or conversation-dominating members.
- Conversation that is dominated by negative experiences, griping, or complaining, which can add to your personal stress.
- Lack of confidentiality or someone breaks the confidentiality of the group.
- Interpersonal conflicts.
- Inappropriate or unsound medical advice from members or group leaders.
- A competitive atmosphere when talking about problems, or one-upmanship.
A Brief History
The most famous support group in the world is Alcoholics Anonymous; it’s also the first addiction support group.
While the seeds of the idea of the peer support group can be traced to a psychiatric hospital in France in the late 18th century, the idea of patients helping patients fell out of favor for decades. In 1935, a meeting between two men who struggled to overcome their alcohol abuse led to the idea of AA.
These men decided that supporting each other’s efforts through regular meetings and prayer could work. Very soon, they formed a group of likeminded people who had gone through similar struggles with alcohol.
Adding peer support to clinical settings did not resurface until around 1965, when trained counselors and professionals working in community mental health began to add group meetings to mental health clinics. In 1967, Emory Cowen proposed that the very idea of community mental health required nonprofessional peers working in the development, implementation, and evaluation of these programs.
By the 1970s, the mental health consumer movement empowered former participants in the mental health system to help each other via peer support and to organize to collectively advocate for their care.
How Do They Work?
Support groups allow peers to hold each other up during the recovery process. This can start as early as detox, as long as you are stable. In some cases, you may not attend a support group until after rehabilitation is complete, and you are creating a daily routine that does not involve drugs or alcohol.
While there are not many medical studies on the efficacy of peer support groups, those that exist show that people who participate in mutual support during and after rehabilitation report higher satisfaction with the overall course of their treatment. Support group participants who struggled with homelessness or other challenging or stressful living situations reported lower rates of relapse.
Peer support also helped to engage groups who were historically difficult to engage, like people struggling with significant mental illness and co-occurring substance abuse. When members of these high-risk groups participated in peer support groups after rehabilitation, they were more likely to adhere to a post-discharge plan for abstinence, doctors’ appointments, and other components of ongoing treatment.
Is a Sponsor Required?
While AA and 12-step groups are famous for requiring new members to have a sponsor, not every group uses the buddy system. Many online support groups, for example, allow people to join and ask questions or leave comments. They can get help for their problems, but they are not required to check in with a specific person.
That said, the sponsor model has helped many people seek guidance and support from someone who has gone through the program or who is simply further ahead in the recovery process. Sponsors generally need to have a solid amount of sober time under their belts before they commit to helping a person who is new to recovery.
AA has a religious bent to it since many of the 12 steps require a belief in a higher power. While the higher power doesn’t necessarily have to be God in the Christian sense, many people are uncomfortable with the Christian basis of the 12-step approach.
As a result, several secular and nonreligious versions of the 12-step model or simply group support have popped up. These secular addiction support groups do not incorporate God, religion, or spirituality into their approach:
- SMART Recovery: SMART is an acronym for Self-Management and Recovery Training. This organization (smartrecovery.org) uses a four-step program.
- Obtain and maintain motivation.
- Learn to manage urges.
- Handle emotions, thoughts, and behaviors.
- Find and strike balance in life.
SMART Recovery primarily involves a nonconfrontational approach to finding personal motivation in recovery.
- Secular Organizations for Sobriety (S.O.S.): The only requirement of this group is that members maintain abstinence from all substances of abuse. The group emphasizes the importance of rational decision-making to fuel ongoing sobriety.
- Rational Recovery: This group uses established principles to understand addiction’s impact on the brain and how participants can alter their thought patterns to change their behaviors. The organization views addiction as a voluntary behavior rather than a disease.
- Women for Sobriety (WFS): This group is intended to specifically help women in recovery. The core tenant of the group’s approach is that a person’s actions directly follow their thoughts, similar to the behavioral model used in cognitive behavioral therapy (CBT). Learn more at womenforsobriety.org.
How to Find a Group
If you are going through detox and rehabilitation to overcome an addiction, and you are looking for a support group to supplement your rehabilitation program or to attend once you have completed the program, ask the leaders of your current addiction rehabilitation program for advice. Administrators and clinicians will know which programs to offer based on your specific needs.
You can also talk to your physician, nonprofit organizations that specialize in managing support groups, or even search online to find a group near you. If you are struggling with too many or too few options, the Substance Abuse and Mental Health Services Administration (SAMHSA) has both an online treatment finder and a hotline you can call for help.
Questions to Ask
If you find a support group and want to attend but are unsure if it is the right group for you, getting answers to some questions can help. Here are some questions you can ask a group leader:
- Is the group designed for people overcoming addiction to a specific substance, like alcohol, opioids, or cocaine?
- Does this group meet only for a set period of time to accomplish specific goals? Or is it an ongoing group?
- Where does the group meet, what time, and how often?
- Who is the facilitator or moderator? Is the person a group member, trained by the organization, a social worker, licensed counselor, or medical professional?
- Is there no group moderator at all?
- What are the guidelines for confidentiality?
- What are the ground rules for group participation?
- What is a typical meeting like?
- Is the meeting free to attend? Are there any organizational fees?
Groups to Avoid
Some support groups can be harmful to participants. While these groups are rare, look out for red flags that signify something is off.
Do not attend support groups that:
- Make specific promises involving cures. There is no cure for addiction.
- Have high fees to attend the group. Most peer support groups are free. Some request only small donations from members, such as $1 per meeting, if they are available to pay.
- Involve advertising or pressure to purchase specific products.
- Offer tangential services for more money.
A Complete Approach to Recovery
It is important to remember that support groups are just that — there to offer support. They support the treatment that medical professionals have already given. They are not intended as the sole form of recovery from addiction, and they aren’t a replacement for therapy.
Working with a physician, licensed therapist or counselor, social worker, or another medical professional to understand the role of support groups in your specific treatment plan ensures that you get the best support all around.