What Is the 12th Step in AA?

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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Understanding the 12th Step in Alcoholics Anonymous

Alcoholics Anonymous is a group that helps those struggling with alcoholism. Better known as AA, it serves as a type of outpatient treatment program. Members attend meetings where they talk about their struggles and concerns as well as their accomplishments. When you join, you agree to follow the program’s 12 steps. You move to the next step once you complete the one before and graduate when you complete them all. Now is a good time to learn about AA, such as how it works and the steps.

What Is Alcoholism?

Alcoholism is an alcohol use disorder (AUD) that occurs when individuals cannot control their drinking. While there are other types of alcohol use disorders, alcoholism is the most serious one. According to the National Institute on Alcohol Abuse and Alcoholism, more than 29 million people over the age of 12 had some form of AUD in the last year. It more commonly affects men than women. Also, roughly 11% of everyone with AUD is white. AA and other 12-step programs provide those with AUD a way to treat and cope with their alcoholism.

Symptoms of Alcoholism

Knowing the signs of alcoholism can help you decide if a loved one has a drinking problem. You may want to look for the signs in your life, too. Common signs of alcoholism include:

  • You cannot control or limit how much you drink
  • You have urges or cravings for alcohol
  • You tried to stop drinking in the past but could not
  • You cannot handle your commitments or obligations because of your drinking
  • You spend a lot of time either drinking, finding alcohol, or trying to recover from your usage

Alcoholics may also engage in risky or dangerous behaviors when they drink, such as having sex without using protection or driving while intoxicated. Another symptom is that you need to drink more alcohol to feel the effects that you want. This happens when you develop a high tolerance. Withdrawal symptoms can start within six hours of your last drink and include:

  • Racing thoughts
  • Headaches
  • Anxiety
  • Trouble sleeping
  • Nausea

Confusion, sweating, anxiety, and high blood pressure are other signs of alcohol withdrawal that can occur for up to 72 hours after you stop drinking. 

Alcohol Withdrawal

Alcohol withdrawal happens when someone who drinks heavily stops drinking. The symptoms can range from mild and easy to handle to severe enough that the user may need medical intervention. 

What Is AA?

Bill W. was an alcoholic who joined the Oxford Group with his wife Lois in the 1930s. After using the group’s resources, he became clean and sober. During a trip to Akron, Ohio, though, he had trouble keeping his cravings under control. A member of the Oxford Group put him in touch with some locals who helped him stay sober. Bill W. and a man known as Dr. Bob came up with the idea of taking sobriety one day at a time in 1935, which members now refer to as the founding date of AA.

The Big Book

One of the core parts of the AA program is The Big Book. Written by the founders and released in 1939, the book describes the experiences of both Dr. Bob and Bill W. along with the experiences of other members. It also includes multiple chapters:

  • How AA works
  • The role of families in the process
  • Information for spouses and employers
  • The future vision for the member

The Big Book is available in more than 70 languages today. You’ll also find an online version. Many alcoholics also experience withdrawal symptoms when they stop using alcohol.

12 Concepts

The 12 Concepts are a series of ideas created by Bill W. that the group adopted in the 1960s. It simply describes how the group works and the commitment it has to its members. The concepts include ensuring that every member gets their voice heard and that the group puts members first but also puts priority on society. Though AA has the same number of concepts and steps, the two things are different. The concepts are what the organization as a whole follows, the steps are what the members must do as they work on their sobriety.

12 Traditions

Also found in The Big Book are the 12 Traditions that are part of AA. They describe some of the ways members and leaders work together. Some of the 12 Traditions include:

  • God is the ultimate authority over AA
  • Every group within the organization must support itself
  • AA only focuses on internal issues and not external ideas
  • It’s open to anyone with an alcohol problem 
  • All members must remain anonymous

How AA Works

Alcoholics Anonymous is a 12-step program that acts as a form of outpatient treatment. It is open to anyone who knows they have a problem and wants to stop drinking. AA is also open to those with multiple substance abuse issues or addictions as long as they also have a drinking problem. Members must attend AA meetings, but they can choose between speaking in front of the group or just listening. Those new to the program may find it helpful to attend at least one meeting per day for the first week or month.


AA offers both open and closed meetings. A closed meeting is only open to current members and potential members. This helps members feel comfortable talking in front of the group and sharing information about their lives. Any member can volunteer to stand in front of the room and talk about anything on their mind. They may discuss some of their recent struggles or the accomplishments they had, such as remaining sober for a year or longer. It may take some time before you feel comfortable speaking before other members.

Open meetings are different because they’re open to the general public. They are less common than closed meetings because they take away the anonymous aspect. Members can bring their families and friends to open meetings. You can look up local meetings online and see if they are open or closed before you attend.

AA Sponsors

In addition to meetings, AA pairs alcoholics with sponsors. This concept dates back to the early days of the program as Dr. Bob served as Bill W.’s sponsor. AA sponsors are members who completed the 12 steps and want to help others. They usually completed the steps at least one year ago and are comfortable with their sobriety. AA usually warns against choosing a sponsor of a different sex as it can lead to stress, anxiety, or confusion. If you develop romantic feelings for your sponsor, you may have a difficult time focusing on your sobriety.

Success of AA

AA is one of the more successful treatment options for alcoholics. One study found that the 12-step program was 60% effective. Another found that it reduces treatment costs by an average of $10,000 per person. In a study of male clients seeking help from the VA, clients who completed a 12-step program stopped drinking by a rate twice as much as those who used other treatment options.

One possible reason for the higher success rates is that AA includes a social aspect. When you attend meetings, you spend time with people who were once in your shoes. They know all about your struggles because they faced the same ones. You also know that anything you share will stay in the room. Members should never disclose anything you say or even tell others how they know you. Inpatient treatment centers may require that you attend meetings with people addicted to other substances rather than focusing on alcoholism.

The 12 Steps

The most important part of AA is the 12 steps. You’ll see the steps listed in The Big Book along with essays that go over each one. Step One asks you to admit that you have no power over your drinking and that you cannot manage your life. The other steps include:

  • You believe in some type of higher power
  • You’re willing to let the higher power lead you
  • You know you did things wrong in the past
  • You are willing to make amends to those you hurt 

Making amends is one of the more difficult steps to complete. You start with a personal inventory in which you list everyone you harmed as a result of your alcoholism. The list might include your spouse, children, and other loved ones. Alcoholics may cheat on their partners or put their drinking above everything else. The only time you can skip someone you hurt is if making amends will somehow harm them. For example, you may cause more emotional pain to a loved one who cut off contact with you when you try to apologize.

Step 12

Step 12 is the final step in AA. You must take your time working through the previous steps. Some members spend a year or longer moving through the program before they reach it. It simply states that working through the steps will foster a spiritual awakening in you and that you’ll carry the AA principles with you. AA expects members to use these principles when they interact with others, talk about their alcoholism, and do other things.

AA believes that the lower steps will foster a big change in you. You’ll learn how to think and act differently. While this applies to your drinking, it also applies to your relationships. Not only do you learn how to change your behaviors and attitudes towards alcohol, but you also learn what to do when a craving hits. Instead of drinking, you might call your sponsor or attend a meeting. This step acknowledges that you’re ready to make a lifelong commitment to AA and help others when needed, too.

12 Step Calls

Once you complete the final step, you have the right to go on 12-step calls. This is a call members make during an emergency and when they feel they have no other option. AA refers to this type of call as one where an individual’s life is at stake. The call can come through in the middle of the night or at any other time of the day. Members often work in groups of two.

During a 12-step call, you meet in a quiet place and essentially have a small meeting. You can supply AA pamphlets and provide other information at the same time that you talk about how AA helped you. AA also encourages members to take a copy of The Big Book and provide one if needed. These calls can involve existing members or those who realize they have a drinking problem. 

When handling an emergency call with a member, you need to make sure they feel comfortable before you leave. You give them a safe spot to talk about their challenges. Other calls can come from alcoholics ready to get help as well as their loved ones. Their loved ones may ask you to help stage an intervention and encourage them to get help. You’re responsible for going over the steps and talking about the benefits of AA. If you receive a call from an individual who wants help, you can take a similar approach. Keep in mind that you do not go on these calls until you successfully complete the 12 steps.

Start on the 12 Steps Today

Alcoholics Anonymous is one of the most successful 12-step programs for people who abuse or misuse alcohol. While inpatient programs often include the steps, you can also complete them as part of an outpatient program. Defining Wellness Centers can help you find the right facility for you or a loved one. While some steps are easy to complete, others take more time, such as the 12th step. This is the step you’ll carry and use for the rest of your life. Contact us to get help choosing an inpatient or outpatient treatment plan that includes the final step in Alcoholics Anonymous.

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If you are ready to take the step towards a new life, call Defining Wellness today and learn more about how we can help you.