Summary

Twelve-Step programs, encompassing both peer-led fellowships and professional interventions, originated from Alcoholics Anonymous and are rooted in the spiritual principles outlined in the Twelve Steps. Over the past century, Twelve-Step programs have played a pivotal role in the field of alcohol and drug addiction recovery, and their cultural influence extends beyond the addiction landscape in the United States. Empirical evidence largely supports Twelve-Step programs’ efficacy for substance use-related outcomes, including increased abstinence rates, decreased consequences, and enhanced well-being. However, the Twelve-Step model has faced enduring criticism regarding its religious undertones, the disease model of addiction, and perceived lack of inclusivity. The effectiveness and relevance of Twelve-Step programs will continue to be shaped by ongoing research, critical evaluation, and efforts to meet the diverse needs of individuals in recovery.