The information on DF concerning the twelve-step fellowships, Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) is patchy at best, and often highly prejudicial. I am starting this thread to try to provide a more balanced point-of-view and to give members the opportunity to make an informed choice about whether these recovery groups would be beneficial to them. This thread is for information on the twelve steps. Please use the thread N.A. or not N.A?: that is the question. For or against 12-step recovery? to argue your views, pros and cons. I'd be really glad if people posted how NA in the USA or other countries differs from NA in the UK, etc. There is a fairly prevalent view that these groups are cults, religious in nature, and this position is usually backed up by pointing to the 12 steps (of which more later) and observing the mention of the word "God". I shall start by outlining the principles of "The Programme" as it is often called. Abstinence First and foremost it should be unequivocally stated that these are abstinence-based programmes. AA advocates total abstinence from alcohol and NA from all mood-altering drugs (except caffeine and nicotine). That does not mean you have to be abstinent to attend a meeting, simply that a majority of members will be abstinent, and this is what they will expect you to aim for. In NA the literature says "The only requirement for membership is a desire to stop using". In AA "using" is replaced by "drinking". Let me clarify what this means. These programmes frown upon controlled using or drinking, or rather AA's "Big Book" (the programme's "Bible"), says something along the lines of "if any man can turn round and drink like a gentleman, our hats are off to him", but then clarifies that such a man is not properly an "alcoholic". Similarly in NA a man who can control his using of any drug is not properly an addict. Those on substitute prescriptions (methadone, buprenorphine (subutex, suboxone), etc.) are considered no more clean than those using heroin. In NA alcohol is also classified as a drug. This leads to the somewhat strange situation where someone 10 years off opiates is said to have "relapsed" if he has a small glass of port at Christmas. There is no distinction between a lapse and a relapse, and emphasis is put on obtaining large contiguous chunks of "clean time" or time sober. Henceforth I shall limit my discussion to NA. I shall outline the differences between NA and AA later on. This might be seen as arse-over-elbow as AA was the parent fellowship, but this is drugs-forum, and my own experience, though of both fellowships, is greater of NA. The programme is often said to rest on four legs, meetings, steps, sponsor and service. For someone at a first meeting, there will almost certainly be some odd language, some of which I shall decrypt for you here. This may put some off, lending credence to the cult hypothesis. But go to a gym and you'll hear talk of abs, reps, quads, lats, sets, etc. which to the uninitiated might sound like gobbledygook. Gym-goers do not belong to a cult! NA meetings So what should one expect from a first NA meeting? First off, NA is free, although a pot is passed, usually at the end, for voluntary contributions. These go for paying for the venue, printing literature, running helplines, bring NA into hospitals and prisons etc., and other things. Usually there will be tea and coffee on offer. In the more organised meetings there will be a greeter who's job it is to welcome people, especially newcomers, but even if there is no greeter, in most meetings a newcomer will be welcomed anyway, offered a cup of tea or coffee, and chatted to before the meeting starts. Then the secretary of the meeting will start the meeting proper. Although meetings differ, at least in England, for the majority of meetings, the format is fairly standard. Usually the meeting will be started with a moment of silence to remember the "still suffering addict", i.e. the addict who has not "found" NA yet. Then it is customary for everyone to introduce themselves. This is a case of "Hi. I'm/My name is X and I'm an addict", where X is a first name. Then there are a series of readings from cards. These are often laid out on chairs, or handed out. If offered a card, you do not have to accept if you do not wish to read; alternatively, don't sit on a chair with a card on it! These describe "Who is an addict?", "What is the NA programme?", "Why are we here?", "How it works", and sometimes "The 12 traditions of NA" (these describe how NA is organised. Do not concern yourself with these for now.) The preamble over, the "main share" will start. Main shares vary enormously in content, but usually they are a life-story, focusing on the sharer's drug use, and on how he (s/he or they if you prefer) found NA and managed to achieve abstinence for such and such a period of time. They might include descriptions of any relapses along the way. Usually a main sharer will have several months or years of abstinence to his credit. If said sharer is "conscientious", he will describe how he "works the programme", which will usually involve having (and using) a sponsor, working the steps, doing service, and of course attending NA meetings. He may refer to his higher power or to God. These two are for many one and the same, but a higher power, i.e. a power greater than ourselves (see the 12 steps later, specifically step 2) can just be NA, or the particular NA group. These concepts are left vague and God is always qualified in the steps with "as you understand him". For the atheist wishing to fit in, God could just be nature, the universe, or some non-monotheistic concept. Not all main sharers talk about God, or even believe in God, but some do. If this is a first meeting, and you get a religious zealot sharing, remember this is just HIS story. NA is a broad church (bad analogy!). Usually main sharers express gratitude to NA, and often go so far as to say NA saved their lives. Shares as people may be exciting or dull, inspiring or otherwise. Once the main share is over, they usually last about 20-30 minutes, the secretary will thank him for sharing, and talk briefly himself, identifying with similarities and then will open the meeting for sharing from the floor. [there may be a cigarette break if the meeting is a non-smoking meeting]. Here anybody may share back, usually identifying with the main sharer, and/or talking about their own problems/situations/successes etc. The last 10 minutes are often reserved for newcomers or people who find it difficult to share. When the sharing time is over, the pot is passed (the 12 traditions are sometimes read at this point, not the beginning) and the meeting is closed with the serenity prayer "God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference" sometimes followed by "keep coming back, (it work if you work it, so work it you're worth it)". Often this is done holding hands, which can be strange for a neophyte. Often people hug after this; hugging is quite common in NA, and can be a source of discomfort to some. It is not obligatory, although non-huggers are rare. The meeting then disbands, although often people go for coffee, and a newcomer might well be invited, or given phone numbers of other members. This is more likely if a newcomer shares himself, even if just to say that this is his first meeting, and he finds it bewildering, or wants to stop using. The 12 Steps So what on earth are the 12 steps and how do you "work" them? A little copy and paste will give us: The 12 steps of narcotics anonymous 1. We admitted that we were powerless over our addiction, that our lives had become unmanageable. 2. We came to believe that a power greater than ourselves could restore us to sanity. 3. We made a decision to turn our will and our lives over to the care of God, as we understood Him. 4. We made a searching and fearless moral inventory of ourselves. 5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs. 6. We were entirely ready to have God remove all these defects of character. 7. We humbly asked Him to remove our shortcomings. 8. We made a list of all persons we had harmed, and became willing to make amends to them all. 9. We made direct amends to such people wherever possible, except when to do so would injure them or others. 10. We continued to take personal inventory, and when we were wrong promptly admitted it. 11. We sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us, and the power to carry that out. 12. Having had a spiritual awakening as a result of those steps, we tried to carry this message to addicts and to practice these principles in all our affairs. Many people on seeing these steps are put off by the like of "powerless", "unmanageable", "sanity" (so I'm INsane now?), "God" and "power greater than ourselves". Many, if not most NA members had difficulties with these concepts at first. Let me soften the blow. A "using addict" (as opposed to a "recovering addict") is powerless over his addiction means that he can't stop. Often the idea of being powerless over "people, places and things" is discussed. My understanding of this is that people can't always be controlled and shit happens! unmanageability is the idea that one is not in control of one's life when using. One is forced to lie or rob or break one's moral code to obtain drugs. Sanity is derived from a latin word meaning health. One is clearly not healthy (physically or mentally) if one is addicted. God and Higher Power I have discussed higher powers (often abbreviated to H.P.s) earlier, but will say a few words about NA and religion. NA is not religious (even though AA is firmly routed in Christian tradition, specifically the Oxford group) and a lot of members would aspire to spirituality rather than religion. However I can understand that steps 3 and 11 would at a first reading seem daunting or weird to an atheist or someone traumatised by bad experience of religion. Although for those who choose to follow a 12-step path, these are questions the individual must solve, let me posit a couple of brief ways to understand these in a more secular context. Maybe one could see these steps as an attempt to align one's conscious self with one's subconscious; maybe to achieve enlightenment or find one's own Buddha-nature; maybe to find one's true will. Meditation and Prayer (why not doing yoga asanas as prayer if that's your thing?) are simply tools to achieve greater harmony. I think it is vitally important to point out that NA is not a bunch of happy clappies, or Christians, although neither happy clapping nor Christianity is a bar to membership. NA members have carte blanche to explore these concepts. One solution for the atheist is to identify God with the acronym Good Orderly Direction. Sponsors and Sponsorship Working the steps is done with a "Sponsor". He is like a mentor, and should usually be of the same sex as you are. A newcomer is encouraged to choose a sponsor, someone one has something in common with, respects, and who has more clean time. A sponsor should also have a sponsor of their own and be "working the steps". Not everyone has a sponsor, and asking someone to be one's sponsor can be a little daunting. It should also not be rushed into. Sponsors are there for telephone conversation or visiting when the sponsee feels like using or is having a hard time, or just to touch base. Also a good sponsor's "job" is to guide a sponsee through the steps. This more formal aspect of "working the steps" consists usually of written work centred around the steps. About 10 years ago NA bought out a "step-working guide" that had a list of questions a sponsor could use to guide a sponsee through the steps. Service in NA Doing service simply means committing to a regular "job" at a meeting. These usually include making tea, collecting the money (treasurer), chairing the meeting (secretary), a literature secretary and Group Service Representative (GSR), and maybe a greeter. The GSR represents the group at the area level, which usually involves buying literature and keyrings for the group and taking any excess money to support wider NA service, as well as representing the group's views in any decisions made by the area. The literature secretary brings the literature in and sets it out before the meeting. Usually literature is free to newcomers. AA v NA AA is similar to NA except there is usually just one reading from the "Big Book" (called simply Alcoholics Anonymous). In most AA meetings the amount of sober time is greater than equivalent clean time in NA. The tempo is, generally speaking different (slower, calmer, some would say more mature), and the average age is higher. I understand these are somewhat crass generalisations, but I stand by them as a rule of thumb. Pros and Cons of NA OK, so let's look at the positives and negatives of NA. NA provides a great place to network socially, and feel at home. A good NA group can be incredibly supportive and welcoming, and for a battered addict, getting a cup of tea and a hug and a smile can mean the world. Undoubtedly many people have success with the programme, as evidenced by many members with years of clean time. One can go to a meeting feeling alone in the world, and the realisation that there are others like one can lift the dreaded isolation that plagues so many addicts, and lessen anxiety. The fellowship is worldwide, and so one can find like-minded individuals almost anywhere. It is rightly said "there is a lot of love in NA". On the negative side, NA can be dogmatic and monolithic. Abstinence is the only way to go, and working the programme is the only way to get it. There are a couple of fudges such as "if you can get away with controlled using, you're not an addict". All drugs are lumped together, so an ex-heroin user who takes LSD or peyote for a spiritual experience has simply relapsed. I never could quite understand why caffeine are nicotine are not considered mood-altering drugs (from which NA members must "abstain in order to recover"). There's a guilt-trip inducing distinction between "staying clean" and recovering. Someone simply staying clean is not doing enough if he is not "working the programme". This is a valid distinction at some level. Being angry, lonely, and an arsehole while clean is not fulfilling, but "working the steps" is often seen as the only means of betterment. Other recovery philosophies are pooh-poohed despite scientific evidence to the contrary. Despite the literature saying honesty, open-mindedness and willingness are needed in order to recover, these principles are lacking regarding other methods of getting and staying clean, or the ability to reduce drug / alcohol use to sensible levels. I think this is a necessary evil for a fellowship such as NA. Perhaps the oft-repeated sentiment that drug use inevitably gets worse after relapse (simply not universally true), and that for an addict drug use inevitably ends in "goals, institutions and death" are useful fictions [Life inevitably ending in death notwithstanding]. To "dilute" the message would only serve to confuse, and there is evidence that people with serious drug problems benefit from abstinence. To conclude I shall state my own position to allow the reader to asses better if I have slipped from fair and objective exposition. I was a member of NA (I escorted my cat) for about 3 to 3 1/2 years. I managed periods of abstinence of just under 2 years and just under 1 1/2 years. I was an NA zealot, but I found it increasingly hard to belong to an organisation that was not entirely honest with itself. As I write this I am a mere 74 days off everything (no drugs or alcohol or cigarettes for the cat, but he drinks tea and coffee), and am not certain I will not go back to NA one day. I miss it. I made some wonderful friends, and I sometimes curse the fact that I am so bloody-minded. However I know that spontaneous remission from addiction happens, and that NA is not the only way to recover.