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What Is a Sponsor in Addiction Recovery? 

As a mentor and friend, a sponsor supports every part of your recovery progress, and plays a vital role in guiding your recovery journey. Whether by answering questions, holding you accountable, or just listening, they can help you commit to healing. Sponsors can help in any phase of recovery, especially when you’re newly sober.

Having a sponsor in addiction recovery isn’t mandatory. However, most 12-Step programs encourage you to find one. To do that, it’s important to understand the purpose of this relationship.

What Does a Sponsor Do?

A sponsor does a lot of different things, but their primary role is to offer guidance. In most 12-Step programs, a sponsor is a senior member1 who has been sober for at least a year. With personal experience in recovery, they can help you learn how to work the 12 Steps. 

Sponsorship is one of the key differences between 12-Step vs. non-12-Step programs. Studies show sponsorship leads to better recovery outcomes.2 Once you connect with your sponsor, you can come to them with any questions about addiction and the program itself. For example, say you have a few tough weeks and miss a couple of meetings. Expect a call from your sponsor to get you back on track. Your sponsor’s job is to hold you accountable, encouraging you to do the work to attain and maintain your sobriety.

Qualities of a Good Sponsor

A good sponsor is there for you but also knows when to let you figure things out for yourself. You should always feel comfortable reaching out to them for help. Here are some qualities to look for in a sponsor:3

  • They can guide you in the right direction: Your sponsor can answer your questions about membership, the 12 Steps, and addiction. They’ll also encourage your program attendance and participation. A good sponsor knows you’re responsible for yourself and capable of making your own decisions. Still, they’ll give you a nudge to keep you moving forward if you ever need it.
  • They set boundaries: It’s always okay to ask your sponsor for support. But a good sponsor lets you know when contacting them is appropriate. You can agree on times and ways to connect that work for both of you. 
  • They listen and offer support: Your sponsor is there to advise and support you—but they’re not your therapist. A good sponsor knows when a professional should step in. They may even connect you with outside resources.
  • They’re patient: Addiction recovery takes time. A good sponsor understands that you’ll face challenges as you adjust to sobriety. They’ll keep supporting you even when you’re having a hard time.
  • They understand you: With an understanding sponsor, it’s easier to ask for help. You might seek someone with a similar background to yours. Maybe you’re a mom of 4. A sponsor who has been through motherhood and addiction might understand you on a deeper level. But everyone’s needs are different. Sometimes it’s better to find a sponsor with a different history of addiction. You never know what you can learn from a new perspective. Considering your unique recovery goals can help you find the right fit.

What Does a Sponsor Not Do?

There are some things your sponsor shouldn’t do.4 Even if you like them as a person, you should be wary if your sponsor shows any red flags: 

  • They impose their personal views on you: Your sponsor shouldn’t judge your recovery process. They might have similar experiences, but only you know what’s best for you. A sponsor should never urge you to make a decision based solely on their own beliefs. 
  • You’re already close with them: It’s not a good idea to have a loved one as your sponsor. You should be able to trust your sponsor and open up to them. Sometimes, personal relationships can lead to bias.
  • They exploit you: Your sponsor should never try to take advantage of you. Anyone in early recovery is in a vulnerable space. Your sponsor should understand that and do everything they can to empower you.
  • They’re not engaged in the program: If your sponsor regularly misses meetings, or you question their sobriety, they likely aren’t the best person to help you.
  • They believe they have every answer: A good sponsor isn’t afraid to say, “I don’t know.” If you feel like your sponsor always thinks they’re right or never considers another way, they might not be a good choice.

If you notice red flags like these, reach out to trusted members of your support network, both in and outside of AA. You can also talk to your therapist. And remember: you always have the right to change sponsors. AA’s literature on sponsorship5 specifies: 

We are always free to select another sponsor with whom we feel more comfortable, particularly if we believe this member will be more helpful to our growth in A.A.

How to Find a Sponsor

Typically, the process of finding a sponsor is informal. You might notice someone in the 12-Step program you admire. Maybe their outlook on sobriety inspires you, or they seem very open and honest. All you have to do is ask them to be your sponsor. Then, they can either accept or decline.

As a newcomer, you can also ask around the program. At some meetings, the leader may ask people who want to become sponsors to raise their hands. You can also ask people you meet if they know of anyone interested in taking on that role.

Your Responsibilities as a Sponsee

Just like your sponsor, you’ll have certain responsibilities in this relationship. Here are some tips to be a good sponsee:

  • Show up: Attending meetings regularly helps you stay on track. Try to let your sponsor know in advance if you have to miss a meeting.
  • Respect your sponsor’s boundaries: After you and your sponsor agree on boundaries, it’s important to honor them. Your sponsor has their own responsibilities outside of your recovery process. Of course, there may be times when you need to call them out of the blue. But this is an opportunity to practice building respectful relationships. Recognizing the other person’s needs is an important part of that process.
  • Work the 12 Steps: Show your sponsor that you’re just as committed to your recovery as they are. You can do this by working the 12 Steps of Alcoholics Anonymous or another 12-Step program. Sometimes you might leave meetings with assignments. Dedicate time to work on your sobriety outside of the program. Then, talk to your sponsor about your progress.
  • Don’t overshare: It’s easy to overshare as you become more comfortable with your sponsor. There’s nothing wrong with seeing your sponsor as a friend. But your sponsor isn’t your partner, your parent, or a clinician. They’re just one person in your wider support network. 

In most 12-Step programs, your sponsor plays an integral role. Still, many people reach sobriety without a sponsor at any point in addiction recovery. It all depends on what makes the most sense for your recovery process. 

Learn more about sponsorship and 12-Step rehab programs that might be a good fit for you.

Frequently Asked Questions About AA Sponsorship

What’s the role of a sponsor in my recovery?

A sponsor serves as a mentor and guide, providing crucial support throughout your recovery journey. They offer guidance, answer questions about addiction and the program, and help you work the 12 Steps. While having a sponsor isn’t mandatory, it’s highly encouraged in most 12-Step programs for better outcomes.

What qualities should I look for in a good sponsor?

A good sponsor should be knowledgeable and able to give guidance, while also maintaining healthy boundaries and encouraging your personal responsibility. A good sponsor listens, offers support, and understands the challenges of addiction recovery. Finding someone who understands your background and recovery goals can be beneficial.

What are red flags to watch out for in a sponsor?

While sponsors are meant to support your recovery, there are certain warning signs to be aware of. A sponsor should not impose their personal views, exploit you, or be disengaged from the program. It’s also important to avoid choosing a sponsor who is a close friend or family member to maintain objectivity. If you notice any red flags, seek support from other trusted people in your support network and consider changing sponsors.

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What Is the 13th Step of AA?

While there are only 12 official steps in Alcoholics Anonymous (AA), you might hear about an unofficial “13th Step.” This term refers to a romantic or sexual relationship between an AA veteran and a new member. 

Even if your feelings are real, these relationships can be very harmful. People just joining AA are typically in the early stages of sobriety. This is a vulnerable time. Long-term AA members can easily take advantage of newcomers, whether they mean to or not. 

You have the right to feel safe in your recovery. If an AA member makes you uncomfortable, check in with your support network. This might include your therapist, your sponsor, or other AA members with whom you have a trusting relationship.

Taking the 13th Step or “13th Stepping” 

The 13th Step isn’t just about sex.1 There’s a power imbalance between people in different stages of healing. AA veterans often have authority within their group, especially over new members. By dating or having sex with people in early recovery, 13th Steppers take advantage of their position.

Many people are vulnerable when they first join AA.2 If drinking has damaged your past relationships, you might be socially isolated. At the same time, most AA newcomers are still learning how to set healthy boundaries. So you might turn to long-term members for advice and emotional support. 

At first, 13th Steppers may seem like trustworthy role models—and many veteran AA members have the best intentions. But others use 12-Step meetings to look for newcomers they can pursue. And because most 12-Step groups are relatively informal,3 it can be hard to hold members accountable.

Who’s Considered a 13th Stepper?

It’s important to note that anyone can be a 13th Stepper.4 The term refers to the power dynamic between long-term and recent sobriety. Age, gender and other aspects of identity can add to a 13th Stepper’s apparent authority.

Are Any Intimate Relationships Possible Within AA?

While some 13th Steppers actively prey on people who are new to the program, these dynamics aren’t always black and white. For example, some experienced AA members may feel genuinely attracted to a new member. And for many people in recovery, it’s easier to date people who share your history of addiction. It could even seem like starting an intimate relationship within AA will support your healing process.

However, 13th Stepping isn’t that simple. It puts AA veterans in a sponsor-like role that can boost their self-esteem. It can also make newcomers feel indebted to their partners. Often, these dangers outweigh any potential benefits. 

If you’ve been sober for some time, you might be able to date someone with a similar history. When you meet on equal terms, the power dynamics of the 13th Step may not apply. But any romance within AA can still affect your recovery. Even relationships between peers can end dramatically. In that case, seeing each other at meetings could be painful. If you decide to date someone else in recovery, it’s safer to make sure each of you has your own sober support network.

The Dangers of 13th Stepping

When you’re new to the 12 Steps, AA meetings are a place to find support, solace and community. The 13th Step has the opposite effect. When veterans prey on newcomers, dating in early recovery can increase your risk of relapse.5 

Takes Time and Energy Away From Recovery

It’s standard advice in AA to abstain from starting a new romantic relationship6 for the first year of recovery. During that time, it’s essential to focus on yourself. New sexual relationships take up a lot of time and energy. As comforting as that can be, they also distract you from healing.

Increases Stress

Even positive relationships increase stress, which is a major contributor to relapse.7 And going through a breakup is even more stressful. It can also jeopardize your emotional safety within your AA group.

Alienates Newcomers From AA

13th Stepping is predatory. When AA veterans make sexual advances, they put unfair pressure on new members. The new person might feel like if they say no, they’ll have to leave the group. That cuts them off from valuable community support. 

Puts Newcomers at Risk

13th Stepping isn’t only distracting and isolating; it can also cause outright harm. There are documented cases of predatory AA veterans assaulting newcomers. Monica Richardson’s film The 13th Step8 describes many of these cases, exposing how some AA members take advantage of people in early recovery.

13th Stepping is not only dangerous, but indicates a need for additional professional help. If someone shifts from managing their addiction to predatory behavior, this could be a sign of other behaviors that require attention.

How to Best Navigate a 12-Step Program

A 13th Stepper’s predatory behavior is never the newcomer’s fault. But if you join AA, you can still take certain precautions to keep yourself safe during early recovery. 

Consider a Break From Dating and Intimacy

Dating and intimacy can distract you from the healing process. By taking a break, you prioritize your own needs. You can use this time to get to know yourself in this new phase of your life. When you’re ready to date again, you’ll have a much clearer sense of what you want in a romantic relationship.

Get Community Support

If someone in AA makes you uncomfortable, talk to other members you trust. Consult the literature, ask your sponsor, and check in with loved ones. You can also ask your therapist what they think. When other people know what’s happening, they can hold both you and the other group member accountable.

Learn About Sponsorship

Sponsors are there to help you work the Steps.9 They shouldn’t coerce you to make a particular decision, and they should never have sex with you. In this dynamic, even consensual sex is harmful. If your sponsor acts inappropriately, you have every right to end the relationship and find a new sponsor. 

Observe and Report Predatory Behavior

12-Step veterans with good intentions don’t make advances on newcomers. If you notice someone making sexual advances—toward you or another new member—keep your distance. You can also talk to other group members about what’s happening. If that doesn’t help, you can leave and look for a different 12-Step group in the area or online. 

Find a 12-Step Program That Works for You

The 13th Step can cause serious harm. It’s important to be aware of this dangerous dynamic, so you can focus on your healing process. People seeking support for addiction recovery deserve to feel safe in AA. 
Every 12-Step group is unique. If you think the 12 Steps would be a good fit for you, search 12-Step rehab programs to begin your recovery journey.

Frequently Asked Questions About 13th Stepping

Who is considered a “13th Stepper?”

Anyone can be a 13th Stepper. This refers to the power dynamic between long-term 12-Step members and those in early recovery, irrespective of age, gender, or identity.

Are any intimate relationships possible within AA?

While it may seem tempting to date someone with a shared history of addiction, the dangers of the 13th Step, such as power imbalances and emotional dependencies, often outweigh the potential benefits. It’s crucial to prioritize your recovery and seek support from your own sober support network.

What are the dangers of the 13th Step in AA?

Engaging in the 13th Step can lead to risks like increased vulnerability to relapse, diverting your focus from recovery, heightened stress levels, potential emotional harm, and isolation from a supportive AA community. It’s crucial to be aware of these dangers and take necessary precautions to safeguard your well-being in early recovery.

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What Is the Success Rate of Alcoholics Anonymous?

Even if you’re just starting recovery, you’ve probably heard of the 12 Steps. This philosophy started in Alcoholics Anonymous (A.A.), and has grown into countless other 12-Step groups and rehab programs. For many people, the 12 Steps are central to the process of healing. 

But how effective are the 12 Steps, really? Some people swear by them—but they’re not right for everyone. When you’re planning your recovery, it’s important to choose the best possible approach for you. That could include 12-Step rehab, alternative treatment, or something else entirely. 

What is Alcoholics Annonymous?

Alcoholics Anonymous (AA) is an international fellowship of men and women who have struggled with alcohol addiction. AA is a non-profit organization that operates on a voluntary basis, and its members support each other in their journey towards sobriety.

The program is based on the twelve steps, which are spiritual principles that guide individuals towards a new way of living. The steps involve admitting powerlessness over alcohol, making a moral inventory of oneself, making amends to those harmed by addiction, and seeking spiritual guidance.

AA meetings are held regularly and provide a supportive environment for members to share their experiences, strength, and hope with each other. Members are encouraged to work with a sponsor, who is someone further along in the program and can provide guidance and support.

AA does not endorse or promote any particular religion or belief system and is open to anyone who wants to stop drinking. The anonymity of members is respected, and the organization is self-supporting through contributions from its members.

Understanding the 12 Steps of AA

Alcoholics Anonymous (A.A.) began in the 1930s.1 It was co-founded by Bill Wilson—or Bill W.—and his colleague Dr. Bob. Both men were in recovery from alcohol addiction when they met. Through their friendship, they realized how crucial peer support was for their sobriety. Over time they developed the 12 Steps and began hosting meetings for other people in addiction recovery.

The 12 Steps themselves are specific actions a person can take to heal from addiction. Step 1, for example, reads “We admitted we were powerless over alcohol—that our lives had become unmanageable.” Members of these groups encourage each other to follow these steps toward ongoing sobriety. 

Sponsorship is another core tenet of A.A.2 and other 12-Step groups. Members with some experience in recovery can sponsor newer participants. In these 1:1 relationships, sponsors offer support and fellowship. You’ll cultivate a close relationship with your sponsor, so you can call on them for help at any point in your healing journey. 

Faith-Based Recovery

This approach is faith-based, meaning that participants express their faith in a higher power. Despite its roots in Christianity, the 12-Step philosophy welcomes people of any and all religious backgrounds. In Step 3, for instance, members submit themselves “to the care of God as we understood Him.” If you find comfort in spirituality, the 12 Steps might be a good fit during addiction treatment.

Free Meetings Around the World

12-Step groups like A.A. are best known for their free, peer-led meetings. According to the A.A. website, anyone who “wants to do something about their drinking problem”3 is welcome. During a meeting you might pray, listen to a guest speaker, share your story, or hear from other members. Every meeting is a little different, and there are countless sessions to choose from. These meetings take place all over the world—you can even find them online.

The 12 Steps in Rehab

You can follow the 12 Steps on your own, in a peer-led meeting, or in formal addiction treatment. Many rehab programs are based on these ideals. Patients talk about the Steps in individual therapy and in group sessions. You might even attend peer-led meetings, either in your rehab or in the nearby community. If you start following the 12 Steps in rehab, you can easily join a local group once you complete treatment and return home. 

How Effective Is A.A.?

Data shows that A.A. is as effective as other types of addiction treatment.4 But it’s not right for everyone. For example, one study found that A.A. had a 42% success rate, compared to the 35% success rate of cognitive behavioral therapy (CBT). But Deborah Becker, a correspondent for NPR, explains that there’s a lot of nuance behind these numbers. “The thing that the researchers point out is that AA is free,” she says. “You don’t have to make an appointment. It’s open to everyone. And I think that is what they’re saying, is that it saves money, it’s very accessible, and it’s showing these long rates of continuous abstinence.”

Other experts agree that the length of treatment plays a role. While A.A. and other approaches have similar success rates in the short term, the 12 Steps have higher long-term success rates.5 But researchers are still gathering data on this issue. We don’t know, for instance, whether other free, peer-led support groups are as effective as A.A. 

Non-12-Step Support Groups

Not everyone draws strength from spirituality, or from fellowship with groups of people. You might prefer 1:1 relationships with care providers or a small circle of loved ones. What’s more, A.A. encourages members to be completely sober.6 If you’re taking a harm-reductionist approach to recovery,  A.A. might not be a good fit. There are many other free, peer-led recovery groups to choose from. 

SMART Recovery

In SMART Recovery, SMART stands for Self-Management and Recovery Training. These groups are based on scientific principles instead of encouraging faith-based recovery. Members work toward self-empowerment through behavioral techniques. 

Like A.A., this is a fellowship of people seeking recovery from addiction. Unlike those in A.A., SMART recovery facilitators have some formal training.7 They’ll offer concrete advice to help you plan your recovery. As member Jan L. writes, “If you are ready to do the work, and that’s a very big IF, SMART Recovery tools begin to work on day one.8 You do not have to come for weeks before you see progress.”

Secular Organizations for Sobriety (S.O.S.)

Secular Organizations for Sobriety, or S.O.S., is a network of groups that take place online and around the world. This non-profit also helps people begin new meetings to support people through addiction recovery. While not every group in S.O.S. shares the same ethos, none of these meetings are religious.

LifeRing Secular Recovery

Members of this organization heal “through the lens of LifeRing’s 3-S philosophy of Sobriety, Secularity, and Self-Help.” They support each other by candidly sharing their experiences and practical tips for recovery. 

LifeRing participants strive to “strengthen the Sober Self” in free meetings,9 which take place both in person and online.

Women for Sobriety (WFS)

Unlike other non-12-Step groups, Women for Sobriety (WFS) offers far more than free, peer-led meetings. WFS is a non-profit organization that also performs addiction research, outreach, and helps establish mutual aid networks. They also hold meetings for women in recovery, both in person and online, as well as online chat rooms. Their services are open to all women, including trans women. 

Moderation Management

Moderation Management (MM) takes a harm-reductionist approach to recovery. In other words, these groups don’t require or even recommend that members be totally sober. As one member of their online community writes, “MM has given me something I’ve been missing10 for a long time: Hope. Hope that I can do this. I can’t imagine a life entirely without alcohol, and now I know I don’t have to. Armed with the tools necessary to feel empowered, I can abstain. And I can moderate. And I can make that decision for myself.”

MM specifically focuses on moderating alcohol use, rather than drug use. These meetings are a good fit for people trying to drink less, who don’t want to cut alcohol out of their lives entirely. 

Alternative Treatment Approaches

While group meetings can be helpful, they’re just one part of an effective recovery plan. Many people also need more formal treatment. That could be as simple as seeing a therapist, or as comprehensive as attending residential rehab. 

If the 12 Steps align with your values, you’ll have many rehab programs to choose from. But just as many rehabs take a different approach to addiction treatment. 

Evidence-Based Treatment

This type of care is founded on robust scientific research. Western medicine includes countless evidence-based treatments for physical and mental health. For example, an evidence-based rehab program might offer:

Most evidence-based care follows predefined treatment protocols. But your provider may still recommend changes based on your exact needs. If you’d like to take this scientific approach to recovery, talk to your doctor or therapist about which specific therapies might be the best fit.

Holistic Treatment

Also called integrated, complementary, or alternative treatment, holistic rehab incorporates a variety of therapies. From acupuncture to naturopathic medicine, these modalities honor each client’s mind, body and spirit. 

Holistic therapies come from global traditions of healing. Some of them, like meditation, are also evidence-based treatments for addiction.11 Others are available in rehab while experts continue to research them. These approaches aren’t offered as a substitute for evidence-based care. But in combination with other treatments, they can be crucial parts of your recovery process. 

Is 12-Step Treatment Right for You?

The 12 Steps work well for people who draw strength from their faith and community. If these values fit well with yours, A.A. or a similar group might be the right way to approach healing. 

If this philosophy is central to your process, you can begin recovery in a 12-Step rehab program.

Frequently Asked Questions About A.A. Success Rates

What is the success rate of Alcoholics Anonymous (A.A.)?

The success rate of A.A. is comparable to other types of addiction treatment. One study found that A.A. had a 42% success rate, compared to the 35% success rate of cognitive behavioral therapy (CBT). However, the length of treatment plays a role, and the 12 Steps have higher long-term success rates. It is important to note that A.A. is free and open to everyone, and shows long rates of continuous abstinence.

How effective is A.A. in addiction recovery?

A.A. is as effective as other types of addiction treatment. However, it’s not the right approach for everyone. It’s important to choose the best possible approach for you, which could include 12-Step rehab, alternative treatment, or something else entirely.

Are there any non-12-Step support groups for addiction recovery?

Yes, there are many non-12-Step support groups for addiction recovery. These include SMART Recovery, which is based on scientific principles instead of faith-based recovery, and Secular Organizations for Sobriety (S.O.S.), a non-profit organization that helps people begin new meetings online and around the world.

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Sober Women of History

Sober women have contributed to the recovery movement in America since it first began. Their early contributions helped make the recovery space more accessible and acceptable for women. 

Women also advocated for gender-specific treatment, support groups, and 12-Step meetings. Their work is still felt around the world today. Some rehabs cater to just women, too. 

Women in Recovery Who Made a Difference

Each and every woman in recovery makes a difference. Women who challenged the stigma of addiction and recovery early on paved the way for continued advocacy, fresh recovery programs, and support. 

Betty Ford (1918-2011)

Former First Lady Betty Ford left a large mark on the addiction treatment scene and the stigma surrounding it. After a battle with opioid and alcohol addictions, an intervention, and treatment, Betty realized she was in a unique position to make a difference. 

First Lady Betty Ford helped create her own treatment center, the Betty Ford Center, designed to help both men and women find recovery. Betty Ford Centers have since expanded across America. 

The Betty Ford organization merged with the Hazelden Foundation in 2014. Hazelden pioneered the Minnesota-model of treatment1, which focuses on 12-Step treatment. Their merge broadened the impact of Betty’s first decision to make her addiction known and use her notoriety to help others.

Jean Kirkpatrick, Ph.D (1923-2000)

Jean Kirkpatrick, sociologist, formed Women for Sobriety in 1975. She attended 12-Step AA (Alcoholics Anonymous) meetings throughout her recovery process. After finding a need for women-focused treatment, she created a solution herself: Women for Sobriety2. 

Women for Sobriety groups meet across America now. Dr. Kirckpatrisck’s history of repeated relapses, research, and life-long determination brought a gift to the world many women continue to enjoy. 

Elizabeth Taylor (1932-2011)

American actress Elizabeth Taylor lived a lavish, seemingly ideal life. But after a spinal surgery and other health conditions, she became addicted to prescription pain pills3. She also struggled with alcohol addiction. 

Elizabeth Taylor made the decision to publicly announce her admittance to Betty Ford Center, Betty Ford’s first treatment center. By doing so, Elizabeth gave permission for other celebrities to do the same. She also normalized treatment for women—even pretty, successful ones like her.

As a Hollywood Icon, Elizabeth Taylor embodied who many women wished they could be. So seeing her go to rehab, openly admit it, and then go again after a relapse may have been more impactful than she’ll ever realize.  

Nora Volkow (1956-Present)

Nora Volkow, current director of the National Institute of Drug Abuse (NIDA), changed the way we see addiction. Her work in brain imagery showed that addiction isn’t a character flaw or personal failing. Rather, it’s a tangible change in the brain. 

Her work contributed heavily to the disease model of addiction4. This revolutionized the old idea of addiction being something to punish. Now, for many, it’s something to treat.

Women in Alcoholics Anonymous (AA)

Alcoholics Anonymous (AA) provides a resource for Americans struggling with alcohol addiction. While it didn’t specifically exclude women, they weren’t welcomed in the same way men were. Usually, women were seen as the supportive spouse, attending just for their husbands’ sake. Or, women were villainized for their addiction. 

Some of the very first women in AA decided to change that.  

Florence R. (?-1943)

Florence was one of the very first members of AA5. She joined one of the pioneering groups in New York, wrote the first section written by a woman in the Big Book, and tried to start an AA group in Washington. 

Though she didn’t succeed, and eventually returned to drinking, Florence made AA meetings somewhere women could go, too. Those early members became family to her—something that still happens to this day.

In Florence’s case, just showing up to meetings made her an early AA icon. Despite her sobriety not lasting, she still made AA meetings a more accepting, open place for women.

Marty Mann (1904-1980)

Marty supported the disease model of addiction, a brave move at a time when it wasn’t yet proven. She was one of the first women to bring awareness to addiction6 as something to heal, not punish. Marty fought against the stigma women in particular received: that they were promiscuous, uncontrollable, and without value. Instead, she advocated for recovery through acceptance.

Marty Mann also founded the National Council on Alcoholism and Drug Dependence. She encouraged other women to get help, and those in the LGBTQ+ community. As a gay woman, Marty Mann bridged gaps between 2 underserved communities and the help they deserved. 

Dr. Ruth Fox (1896-1989)

Dr. Fox became the first medical director of The National Council on Alcoholism in 1959. She was one of the first psychoanalysts to take alcoholic patients. And she pioneered the use of Antabuse7 to treat alcohol addiction, which we still use today.

Dr. Ruth Fox also founded the American Medical Society on Alcoholism and Other Drug Dependencies. 

Dr. LeClair Bissell (1928-2008)

Dr. Bissell co-founded the American Society of Addiction Medicine (ASAM)8. Like Marty Mann, she helped change the way the public saw addiction, women in recovery, and gay women. Dr. Bissell followed the 12-Steps of AA, published books on recovery, 

LeClair also advocated heavily for alcoholism in professionals, specifically medical professionals. 

All these women changed the way women and the world see recovery. They made healing seem like a safe option for women who were scared, embarrassed, and without hope–but wanted out.

Those options for recovery still exist today, for men and women. And we have a lot of people to thank for that.

Find a Recovery Program Today

Much has changed from the early days of AA and recovery as a whole. While the stigma surrounding addiction hasn’t yet disappeared, these early women in recovery diminished it bit by bit. 
Thanks to them and many others around the world, ethical, women-focused recovery programs exist globally. You can browse our list of women-only rehabs and see photos, reviews, insurance information, and more.

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Is My Loved One Using Cocaine? How to Tell If Someone Is Using Cocaine

Cocaine doesn’t have to control your loved one. The first step to their recovery might be recognizing signs of use, and then you can help them find a rehab for cocaine addiction. 

You both have resources for recovery. But the more you know about cocaine use, and how to spot it, can help you help the ones you love. 

How to Spot Cocaine Use

Spotting cocaine use can be tricky. It has a seemingly endless list of slang names and pseudo-identities, making it hard to decipher what your loved one might be talking about. They could hide their behavior with more than sneaky names, too. But there are signs to look for1. 

Physical Signs

  • Dilated pupils
  • Lack of appetite—it might seem like they barely eat
  • Rapid weight loss
  • Poor sleep
  • Disheveled appearance, lack of hygiene 

Emotional And Mental Signs

  • Paranoid without reason
  • Hyperactivity—“bouncing off the walls”
  • Irritability
  • Anxious, more so than usual 
  • Extreme startle reactions, like jumping at the sound of a cabinet shutting

Along with knowing the signs of cocaine use, you can also familiarize yourself with the street names for cocaine.

Slang Names for Cocaine

The nicknames for cocaine2 might surprise you. They’re creative, to put it positively. And they change based on the form of cocaine (crack, regular cocaine) and what it’s mixed with. 

There’s a lot to keep track of, but knowing even just a few can help.

  • Snow
  • Stardust
  • Stash
  • Bouncing Powder
  • Coke
  • Coca
  • Flake
  • Devil’s Dandruff
  • Florida Snow
  • Joy Flakes

You can also educate yourself on cocaine itself, and how it affects the mind and body.

What Is Cocaine?

Cocaine comes from the leaves of the coca plant1. It grows in South America. From there, it’s smuggled all across the globe.

Cocaine causes a rush of euphoria3, which can last 2-20 minutes. This rush comes from a build up of dopamine in the brain—dopamine stacks up on the transmitters meant to receive it4, causing an intense flood of pleasure. 

Neurotransmitters like dopamine jump between nerves and target cells. If the receptors aren’t working, all the received dopamine has nowhere to go—causing the high. Altering the usual transmission of dopamine can actually change the structure and function of your brain over time. 

The crash, or comedown, from this high can quickly prompt a redose, sometimes until supplies or money run out. This is considered a binge1.

You can ingest cocaine in multiple ways1. Some snort the white powder up their nose. Or, you might mix it with water and inject the mixture into a vein, using a syringe. If it’s crack cocaine, you can smoke it.

Is There a Difference Between Cocaine and Crack?

Chemically, no. Cocaine and crack are the same thing5, just in different forms. Crack isn’t any cheaper, either6. But it is more potent, easy to ingest, and wildly addictive.

Crack looks like rocks, or crystals. It’s a smokeable version of cocaine5, derived from the same coca plant as cocaine. 

For crack cocaine, you might see some of these slang terms:

  • Rock
  • Moon Rock
  • Apple Jack
  • Dice
  • Sleet
  • Yahoo
  • Yale
  • Top Gun
  • Base, Basing

Mucous membranes absorb cocaine and crack cocaine7. You have a huge plane of mucous membrane in your lungs—the alveoli responsible for bringing oxygen to your blood. The inhaled crack smoke absorbs into the alveoli in the lungs rapidly, causing a nearly immediate high.

A crack cocaine high fades faster, though. To avoid the crash, people might keep smoking until they run out of crack. And the more they ingest, the more likely they are to overdose and have negative long-term effects8. 

The Effects of Cocaine Use

Cocaine use can lead to heart problems8, like cardiac arrest and strokes. Inhaling it as crack can cause respiratory conditions. Snorting it could completely degrade your nasal passage over time. 

Short-term, the effects of cocaine could range from paranoia to seizures9. And rarely, cocaine can cause sudden death after just one use. 

Repeated use takes up more and more money and time. And the more it’s used, the more your brain changes. Addiction and tolerance to the drug can set in quickly1. 

Cocaine use can also have unpredictable effects, usually caused by what it’s been cut with. The cutting agent could be harmless, but that’s not always the case.

What Is Cocaine Cut With?

Dealers may cut cocaine to up their profit10, selling a “watered down” version to unsuspecting buyers. Powder cocaine could be cut with baking soda, caffeine, sugars, or anesthetics. Visually, you’d likely never know it wasn’t pure cocaine.

But cocaine could have harmful additives. Levamisole, a veterinary drug that kills parasites10, has made its way into 70% of cocaine in America. It causes necrosis11, which kills and rots the skin. 

You can also mix cocaine with other drugs for new, sometimes preferred, effects.

Cocaine Mixtures

Users seeking a different high mix cocaine with other substances, like marijuana and tobacco. Nicknames for these mixtures include Woo-Woo, Woolies, Candy Flipping, Cocoa Puffs, and Boy-Girl.

Certain blends, like alcohol and cocaine, are notably more dangerous. Cocaine and alcohol react12 and form a heart-toxic chemical, cocaethylene. Heroin and cocaine mix to form a speedball9, or an opiate and depressant blend. But cocaine wears off faster than heroin, potentially slowing your breathing to null as the full sedative effect of heroin hits.

No mixture is predictable, or safe. Neither is cocaine by itself. But, for single and blended use, you can find recovery. 

Treatment for Cocaine Addiction

Cocaine addiction often requires a multi-pronged approach—detox, therapy, and medications13. And the more research scientists do, the better these options become. There’s even a cocaine vaccine in the works14. 

Your loved one will most likely need to detox from cocaine in a safe, clinically monitored setting. There, they’ll have constant supervision, comfort medications, and begin the therapeutic healing process. This could be at a detox center or a residential rehab with on-site detox. 

Once cocaine has left their system, inner healing work can begin.

Therapy for Addiction

Therapy can address and heal the causing factors of addiction. It can also motivate and empower your loved one to commit to their recovery, even when it gets hard. 

Behavioral therapies like cognitive behavioral therapy (CBT) can challenge unhelpful thoughts and beliefs15. You’ll learn to shift your perspective of yourself to one that’s more positive. Rather than thinking “I’ll never get better”, CBT would challenge the thought with “Why not?”.

Dialectical behavioral therapy (DBT)16 addresses black-and-white thinking. Your loved one can accept the problem of cocaine use and know they can get better. DBT can help with relapse too, as it helps patients identify unhelpful thoughts that could lead back to old coping mechanisms. 

The 12 Steps

The 12-Step program offers a place for members to connect and recover in a respected treatment program. Members follow 12 steps together, learning responsibility, accountability, and forgiveness. And the 12 Steps can run in and out of treatment—you don’t have to be in rehab to find a local group to attend. 

The 12 Steps are often called AA (alcoholics anonymous) meetings. For cocaine use, you’ll likely see them called CA (cocaine anonymous). Each uses 12-Step practices to help members stay accountable and sober.

Aftercare

Contingency management (CM) can inspire greater dedication, during and after residential treatment. CM programs usually give out money, snacks, or vouchers as a reward13. And since you’ll actually get a reward for staying sober, attending recovery meetings, and going to treatment, you might find yourself more motivated to do it. 

Your loved one can also keep attending 12-Step meetings as a form of aftercare. If they go to a residential rehab, they might have the opportunity to attend alumni groups, too. 

Continued therapy and medications, if prescribed, can both contribute to long-term success. That’s why they’re both common forms of aftercare for cocaine addiction. If your loved one goes to rehab, they might offer continued 1:1 therapy with the same therapist. If not, they’ll likely connect you to further therapy as part of their discharge service.

Find Power Through Recovery

If you think your loved one is using cocaine, know that they, and yourself, have recovery resources. They can find new power and hope through recovery—addiction isn’t the end. 

You can browse our list of rehabs for cocaine to see pricing, reviews, insurance, and photos of each facility. 


Family members, you can check out these support groups: Co-Anon, Families Anonymous, and Stronger Together.

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The Serenity of Healing in Irish Rehabs

If you’re looking for a naturally restorative place to start recovery, a luxury rehab in Ireland could be the perfect fit. With a quiet countryside and history of relaxing recreation, Ireland offers a calm environment for care. And among its lush greenery, you can feel safe as you begin the challenging work of healing.

Peaceful Healing on the Emerald Isle

Preparing for rehab can be hectic at best. You’ve made a big decision, and your whole life is about to change. Even good changes can be disruptive, which is why many patients prefer to go to rehab in tranquil settings. And thanks to a few key features, Ireland is one of the most peaceful countries1 in the world.

Therapeutic Greenery

Ireland’s nickname, “The Emerald Isle,” perfectly describes its lush green surroundings. The refreshing air coming off of the Atlantic Ocean brings moderate weather year round. The rich landscape sits under gray skies, nourished by consistent rain and mist. 

For many people, this climate is the perfect environment for healing. In fact, having a naturally beautiful view reduces pain2 and anxiety levels—even if you can only see it through a window. But in most of these programs, you can also explore the outdoors during your time in rehab.

Tee Up for Recovery Success

Ireland has a rich history of golf, with over 300 world-renowned golf courses. So if you’re an avid golfer looking to perfect your swing as you heal, some Irish rehabs, like RósGlas Recovery, offer tee times in addition to therapy sessions.

Finding Harmony

Ireland is known around the world for its spirited folk music. In that tradition, rehabs like RósGlas Recovery boast music therapy programs. And this treatment isn’t just for skilled musicians. You might even listen to music, instead of making it yourself. Music therapy lets you relax, express yourself, and appreciate the local culture. Irish folk music encourages you to celebrate who you are at your core—including your strengths, weaknesses, and everything in between.

Discover Your Ideal Treatment Approach in Ireland

Ireland is more than just a peaceful place to start recovery. Its rehabs also offer a wide variety of therapies, including personalized treatment plans. Here, you can find a center that aligns with your values and recovery goals. 

Private and Personalized Treatment Programs

To encourage recovery on your own terms, many Irish rehabs treat only small groups of clients. And some, like RósGlas Recovery, treat just one client at a time. With this approach, you’ll receive highly personalized care. 

Individualized treatment and strict confidentiality go hand in hand. This type of rehab is a great fit for high-profile clients who need total privacy during recovery. From the safety of a protected environment, you can focus on what matters most: your own healing journey.

Irish Rehabs Address Co-occurring Disorders

Healing from co-occurring disorders is a dynamic process. And in a rehab that specializes in this type of treatment, you’ll find more sustainable success. 

At rehabs like Smarmore Castle, for example, you’ll find comprehensive care for drug addiction, behavioral addiction, and mental health diagnoses. For example, you might attend therapy that addresses both shopping addiction and depression at the same time. Rather than treating these conditions separately, you’ll address the root cause of everything you’re going through. 

Robust 12-Step Programming

Alcoholics Anonymous (AA) has a strong presence in Ireland.3 In fact, there are over 750 AA groups throughout the country. And many Irish rehabs, like the Rutland Centre in Dublin, use the same 12-Step approach in their residential programs. 

When rehabs use 12-Step facilitation (TSF), their treatment program is structured around the 12 Steps. Most of the time, that means you’ll attend AA (or other 12-Step group) meetings as part of your schedule. And outside of those meetings, your other treatments will explore the same themes. For example, in 1:1 therapy, you might define your recovery goals based on the 12-Step framework. 

Going to a 12-Step rehab can ease your transition to the next stage of recovery. Whether or not you stay in Ireland after treatment, AA and other 12-Step meetings are available all over the world. You can even attend them remotely. Regular meetings can help you maintain the same routine you developed in rehab, even when other parts of your life are in flux.

Getting There

If you’re traveling abroad to rehab in Ireland, your journey probably won’t be too complicated. You can find non-stop flights into Dublin from many major European and North American destinations. And if you’re coming from a different region, you can fly into London Heathrow and then travel to Ireland by plane, train, or boat. 

Once you’re on the Emerald Isle, public transportation is widely available through rail travel and buses. Many Irish rehabs also offer private pickups from the airport to simplify your journey. But even if you make your own way there, it’s always best to have a travel companion on your way to rehab.

Settle Into Healing in Ireland

Recovery presents challenges, no matter where you go to rehab. But in Ireland, you can face them in a peaceful, supportive environment. With Ireland’s beautiful scenery, cozy weather, and culture of kindness, you’ll be able to take a deep breath—perhaps your first one in a while. 
To learn more about each program’s pricing, treatment approach, accommodations, and more, search our collection of luxury rehabs in Ireland.

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12-Step vs. Non-12-Step Recovery: Which Is Best for You?

Rehab is designed to provide structure as you begin the process of recovery. There are countless ways to heal, and it’s important to choose a framework that meets your specific needs. While many people benefit from 12-Step rehab programs, others prefer a more holistic approach to addiction treatment.

Recent research shows that 12-Step programs have a hugely positive impact,1 and may even be “the most effective path to abstinence.” However, there is some question as to why this is true. For example, 12-Step programs offer social support,2 which is essential during recovery, but is not unique to this philosophy. At most inpatient rehab programs, you’ll be able to build community with or without following the 12 Steps.

It’s also important to note that spirituality is a component of every 12-Step program. If you’re not interested in faith-based recovery, these groups may not be right for you. Various rehab facilities offer different 12-Step groups, such as A.A. and N.A., as well as non-12-Step programs. Before choosing which residential rehab you’ll attend, it’s best to learn as much as you can about the available options.

What Is 12-Step Recovery?

Alcoholics Anonymous is the best-known 12-Step program.3 A.A. is “an international fellowship of men and women who have had a drinking problem. It is nonprofessional, self-supporting, multiracial, apolitical, and available almost everywhere. There are no age or education requirements. Membership is open to anyone who wants to do something about his or her drinking problem.”

Members of A.A. attend group meetings,4 most of which have a similar format: initial announcements are followed by a reading of the 12 Steps5 and the 12 Traditions.6 Then a member will share their story. This may be followed by a group conversation, or more structured time for other members to describe their experiences. This structure is simple but effective. As one member writes, “I always feel a little better after it’s over.”

Many 12-Step groups follow similar formats, such as Narcotics Anonymous, Cocaine Anonymous, Marijuana Anonymous, and Al-Anon, which is intended for people who love someone who struggles with substance misuse. These groups define the 12 Steps slightly differently, but all share a similar philosophy.

The 12 Steps

The 12 Steps are a list of actions that group members undertake during the process of recovery. In this process, members normally begin by admitting they have a problem. Then, you’ll connect to a higher power, sometimes called “God as we understand him.”7 Although 12-Step groups are historically rooted in Christianity, they welcome people of all faiths, including people who don’t ascribe to a specific religion. Nevertheless, the spiritual aspect of this philosophy isn’t right for everyone.

In the process of connecting with a higher power, members then make “a searching and fearless moral inventory”8 of themselves and their lives. This ruthless honesty lays the groundwork for the great changes that come with recovery. By admitting your struggles to yourself, to another person, and to your version of a spiritual source, you may come to a new understanding of your emotional experience.

In Step 9, participants seek to make amends9 to any people they may have hurt, “except when to do so would injure them or others.” Through this process, members begin to consider the effects their actions have on their communities. There is a difference between intent and impact. As you learn more about yourself, you’ll also learn how to meet your needs in a healthy way, while participating in a supportive community.

One goal of the 12 Steps is to achieve a spiritual awakening. Step 12 refers to this directly: “Having had a spiritual awakening as the result of these steps,10 we tried to carry this message to alcoholics, and to practice these principles in all our affairs.” Members are encouraged to meditate, pray, and cultivate an ongoing spiritual practice.

In these groups, you’ll be encouraged to “work the steps” throughout the process of recovery. As you encounter new challenges, you may return to the steps again and again, not always in numerical order. In stressful times, these strategies can help you focus on your goals, avoid relapse, and make the healthiest choices available. The 12 Steps are more than a checklist; they can become a way of life. However, the steps themselves are just one component of recovery. The social aspect of 12-Step groups is also an essential part of the process.

Social Support in 12-Step Programs

Experts agree that social support—or a lack thereof—has an extremely significant impact on people with substance use disorders.11 Some researchers have even postulated that “opioid addiction serves as a substitute for social attachment.” In one study, a subgroup of substance users exhibited “severe negative affect and intense craving” when exposed to perceived social rejection.

This evidence suggests that without community, people in recovery may be especially vulnerable to cravings. Whether or not those cravings lead to relapse, one thing is clear: strong interpersonal relationships are an important part of healing. Because 12-Step groups include a built-in community of people on a similar journey, they may help members get the support they need. Programs like A.A. even encourage members to become sponsors,12 actively supporting people at earlier points in the healing process.

In most residential rehabs, you’ll be in a cohort of people who share some of your life experiences. If your program is based on the 12 Steps, you’ll have even more structured opportunities to give and receive peer-to-peer support. For example, the program at Genesis House is firmly rooted in this philosophy. They treat substance misuse as “a three-fold disease: spiritual, physical, and emotional.” Residents are introduced to the 12 Steps as soon as they arrive. They continue to engage with the steps in individual therapy, and in the evenings they “are transported to local AA/NA meetings…where they will network with others in recovery and learn more about how to stay sober.”

What Is Non-12-Step Recovery?

Although 12-Step groups are extremely valuable for some, they’re not the only way to get community support. One study found that “social networks that support recovery lead to enhanced treatment outcomes and sobriety13 regardless if this support stems from family, peer groups, or 12-Step programs.”

Non-12-Step programs are ideal for people who don’t ascribe to a spiritual practice, or those who simply want a different kind of structure. There are countless approaches to recovery from substance misuse, such as evidence-based treatment, individualized treatment, and experiential therapy. And even without faith in a higher power, it’s possible to heal in a holistic way.

For example, The Holistic Sanctuary in Baja California is a rehab facility with a “natural holistic healing program.” Clients do yoga, receive daily massages, and eat an organic diet. This approach “involves healing the patient’s spiritual health through meditation, catering to their physical health through exercise, and improving their psychological wellbeing through counseling.”

There are as many ways to heal as there are people with substance use disorders. Many clients benefit from a combination approach, attending 12-Step groups while also participating in different therapeutic modalities.

“In the same way that medicines and psychotherapy can go together, AA and 12-Step can go together with in-depth psychotherapy and medications when indicated.”

– Dr. Thomas Gazda, Medical Doctor, Soberman’s Estate

Finding the Right Approach to Treatment

If you’re not sure whether 12-Step treatment is the right fit, you can talk to the admissions team at a rehab center to learn more. These questions may help you find out whether a program aligns with your specific goals for recovery:

  • In this program, is attendance of 12-Step groups mandatory?
  • How much time will I spend in individual therapy, compared to time spent in groups?
  • Do all your one-on-one therapists use the 12 Steps as a framework for recovery?
  • Will I be able to choose my own therapist?
  • Do your 12-Step groups include a sponsorship program?
  • In your philosophy, what does it mean for clients to connect with a higher power?
  • Does your program welcome people of all faiths?
  • Do you connect alumni with local support groups and/or 12-Step meetings after they complete inpatient rehab?

If at all possible, it’s best to know the answers to these questions before you begin residential treatment. The more information you have, the better you can plan for life during and after rehab.

Attending 12-Step Groups After Rehab

​​By design, 12-Step programs are extremely accessible. They’re free, they take place internationally, and they’re open to people at every stage of recovery. A.A., in particular, offers both open and closed meetings.14 Open meetings are available to anyone, including friends and loved ones of alcoholics, who do not have substance use disorders themselves. Closed meetings are only open to people who have substance use disorders, or those who believe that they might and want to learn more.

This accessibility can be especially important for people who have recently completed rehab. When you first graduate from a residential program, you may be in a vulnerable emotional state. Rehab is only the first chapter of a much longer healing process. When you arrive home afterward, you’ll begin establishing new routines, returning to some parts of your life, and letting go of others. Attending group meetings can help you stay grounded while encouraging you to form new relationships with people who live nearby.

A Step in the Right Direction

Whether or not 12-Step recovery is right for you, there’s a great deal to learn from this philosophy. For example, the process of healing from substance misuse is not a solitary one. There are certain aspects of recovery that must be your responsibility, but no one lives in a vacuum. By connecting with the people around you and finding peers who have survived similar struggles, you can learn a great deal about what it means to live a healthy life.

Like any other healing process, the 12 Steps can be a-linear. As you begin recovery, be patient with yourself. There are some lessons you may have to learn more than once, in new contexts or at different times of your life. That type of repetition is normal and even healthy. As you continue to change and grow, it can be helpful to ground yourself with a list of goals or strategies that you’d like to focus on throughout recovery. There may be 12 of them, or 2, or 37. The important thing is to find a way of healing that aligns with your unique values.

To continue exploring various treatment philosophies, you can learn more about luxury rehabs that offer 12-Step programs and non-12-Step treatment.

Frequently Asked Questions About 12-Step vs. Non-12-Step Rehab

What’s the difference between 12-Step and non-12-Step rehab programs?

12-Step rehab programs, like Alcoholics Anonymous (A.A.), follow a structured framework involving admitting a problem, connecting to a higher power, making amends, and achieving a spiritual awakening. Non-12-Step programs offer alternative approaches to recovery, focusing on evidence-based treatments, holistic healing, and individualized therapy.

Are 12-Step groups mandatory in all rehab programs?

The attendance of 12-Step groups varies at different rehabs. Some programs make it mandatory, while others offer a choice between 12-Step and non-12-Step options. It’s important to inquire with the rehab you’re considering about their specific approach to ensure it aligns with your preferences and goals for recovery.

Can non-religious people participate in 12-Step programs?

Yes, 12-Step programs welcome people of all faiths and those who don’t ascribe to a specific religion. While spirituality is a component, it’s not limited to a particular faith. These programs encourage participants to connect with a higher power as they understand it, which can be interpreted in a way that aligns with personal beliefs or values.