The principles of A.A. & N.A.: Is total abstinence helping or hurting addicts?

12 step support groups believe that total abstinence is the only means to complete recovery. But, can this notion be more harmful than beneficial for some individuals in recovery? More on why no one should be stigmatized for their drug replacement and maintenance, here.

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Why are we turning away addicts who are seeking help?

“If you cannot help another addict don’t harm them.”

This is a mantra I heard in both the Alcoholics Anonymous (A.A.) and Narcotics Anonymous (N.A.) halls. It’s got me thinking.

Recently, I have pulled away from both fellowships. Now, don’t get me wrong, both of them have gotten me to where I am today… but I cannot align with some of the way the groups conducts themselves.

But should people really be ineligible for A.A. and N.A. support meetings if they are on addiction maintenance medications, smoke marijuana, or are going for moderation rather than cessation? Share your feedback and questions in the comments section at the bottom of the page. We try to respond personally and promptly to all legitimate inquiries.

All or nothing: A.A. rules and guidelines for meeting attendees

I have to admit, I have not versed myself with the traditions and principles of A.A./N.A…. but I am pretty sure NONE of them say turn an addict seeking help away.

Countless times I have seen addicts trying to get help but shunned from the halls because they are on drug replacement therapy, or they are smoking pot to ease the side effects of withdrawals. Hell, I have even heard people get ridiculed over “chewing their booze”… a.k.a. taking psych meds.

Did I miss the memo where every participant of A.A. and N.A. are doctors? No? Didn’t think so. So please, for everyone’s benefit, stop acting like them. No one can define your recovery. Only YOU can define YOUR OWN recovery.

Countless times I have seen addicts DIE because they tried the “program” time and time again and never got the help they needed because they were not being taken seriously. “Oh but SHE’S on drug replacement therapy”…


People are DYING out there and we have stipulations on who lives and who dies?

Drug replacement therapy vs. A.A./N.A. abstinence

Drug replacement therapy has helped many addicts stay alive as opposed to dying alone in a gutter with a needle in their arm. Some addicts simply just cannot put down their drug of choice, attend meetings, and stay clean. Some can and my hats off to those, but as you can see by the rising opioid epidemic.. not all can.

You know how a lot of these addicts became addicts? Their doctors gave them opiates and opioid medications when they were not needed. The over prescribing of paink killer meds has been a direct contributor to the rising number of opiate addicts.

It has been proven that Drug Replacement Therapy (DRT like buprenorphine and methadone) helps addicts abstain from their drug of choice. This gives the addict a chance to create a solid foundation, gain some coping skills (which we know we ALL lack), and build a network. Once these things are established the patient and their sponsor can talk about getting off of the drug replacement therapy all together.

Biased treatment and stigma

The problem that I have seen with the above scenario is that people judge and ridicule anyone coming into the halls on DRT. They aren’t allowed to hold positions, talk in meetings, and some people won’t even sponsor them.

Shame on us!

Instead of criticizing the way that these addicts choose to get clean we should be celebrating the fact that they are no longer risking their lives every day, multiple times a day, to get high.

For the states where Medical Marijuana is legal, this has also become an option for addicts getting off of harder substances. I have also seen addicts with 10+, 20+ years clean that have suffered with their chronic illnesses for all that time and now that medical marijuana is legal, they are no longer suffering but are now being pushed out of the halls where they are so many people they can still help.

Q: Does treating chronic illness with medical marijuana really make these people unable to help other suffering addicts?
A: No. So stop treating them that way!

Addiction recovery inclusion – NOT exclusion

Sorry for my language but I am very passionate about this.

Is the idea to create a world of abstinent people from the minute they put down drugs?


Are we trying to reduce the body count?

Personally, I am trying to reduce the body count. I want as many addicts to LIVE LIFE. I believe everyone is with me on that. So let’s bring our minds collectively together to figure out how to make those types of addicts feel welcomed.

How do we open our minds and hearts so that everyone, regardless of the way they are medicating, or easing their symptoms? I talk strongly because I care. Please continue the conversation if you care.

Do you have questions or comments about this opinion?

What do you think about the eligibility rules for A.A. and N.A. attendees? Feel free to express your opinions and post your questions in the comments section at the end of the page.

We welcome your feedback and try to provide a personal and prompt answer to all legitimate inquiries. In case we don’t know the answer to your question, we will refer you to professionals who can help.

About the author
Kayla is a freelance writer and entrepreneur with a passion for helping people overcome their addictions. After having been an addict herself, she decided she wanted to give back to those still struggling. Her expertise include: Medical Marijuana, Drug Addiction, Drug Abuse, ACOA, Meditation, DRT, law reform for non-violent drug offenders, overcoming grief, the 12 steps, NA, AA, plus more. She has contributed to many blogs trying to raise awareness to this epidemic.


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  1. The only requirement for participation in A.A. or N.A. is the desire to stop using and s new way of life. I don’t believe in turning people away at meetings and they shouldn’t be stigmatized if they are on a drug reduction program. But ultimately the idea of these programs are total abstinence! Should we have people running meetings or being a treasureer not clean and sober., Or perhaps sharing misinformed ideas or contradictory opinions to the tenants of these groups? I think not. I think some people need to be ” weened” off of methadone and alcohol too depending on their physical and mental health, because they could die. But to not expect for the addict or alcoholic to not be abstinent in a reasonable time frame is counter productive and could cause them to die in the process. The program ” works if you work it” , not changing it around to our personal liking. The individual has to have a inner desire for a new way of life drug and alcohol free. If not they are only prolonging the misery , trail of destruction and possible death! If a person had diabetes would they only take their medication or stay on their diet 2 or 3 days a week? No, if they wanted to live they would do as their doctor instructs them. So for the still suffering alcoholic or addict can they really afford just ” one more drink or hit” , I don’t think so. This types of thinking is like playing Russian Roulette!

  2. Ok AA does not require anything, anyone can attend an open meeting, and a closed meeting only requires that you be an alcholic. Aa defines sobriety as the freedom from alcohol thru the practice and teaching of the 12 steps. Aa world service has alwYs referred people to the tradition that states aa has no opinion on outside issues when asked about the orgs stance on a specific drug or drugs in gen. My prob with NA is that asking complete abstinence from all drugs yet excluding members use of nicotine products. Drug says nicotine is a dangerous drug highly addictive, affects the brain thus mind alt. It’s not NAs fault big tobacco has had an active marketing campaign spanning over 100 years.

  3. My daughter is going to NA and has been clean from cocaine for 6.5 months and alcohol for 4 months. She is active in NA and has a sponsor. She confided in one girl about smoking medical weed. Since then this girl has made her life a living HELL!! My daughter is devistated!! This girl has told EVERYONE she can in the rooms of NA. My daughter is not perpared “AT THIS TIME” to share this with her sponsor, or anyone for that matter. Myself I’m a recovering Alcoholic for 16yrs. My heart is breaking for her because of all the gossip. This has gotten completly out of control. I would LOVE to hear your thoughts.
    Thank you so much for taking the time to read this.

    1. Hi Shelley. Sometimes it’s best to ignore such kinds of belittling gossip. I suggest that your daughter consults with her sponsor, and speaks openly on the support meetings about her personal problems. There’s no need to explain herself about the gossips.

  4. Where do I start?
    1. 12 step meetings are NOT “support groups.” They promote recovery based on complete abstinence.
    2. Please do not suggest that any addict is “ineligible” for a 12 step group. Tradition 3 states that the only requirement for membership is a DESIRE to stop drinking/using. I have been attending 12 step meetings for 15 years & have NEVER seen a person turned away from a meeting based on them still using, drinking or being on prescribed medication. In fact I have never seen anyone turned away from a meeting for any reason, but am aware of very rare occasions when it has happened.
    3. It is my experience (& i can only talk about my experience) that replacement therapy (methadone/subutex) was entirely ineffective looking at the whole course of my addiction, though of course these medications are essential as part of a detox.
    4. It is just factually incorrect to state that these medications are “proven” to help addicts refrain from their drug of choice. The research is at, best, contradictory.
    I used drugs & alcohol to the point where medical professionals gave me less than a year to live if i didn’t stop using. The 12 steps is a specific spiritual programme of recovery & is incompatible with a person still using. However, I was on anti-depressants for a year after getting sober & went through the 12steps. I no longer need to take them. I have also sponsored others on prescribed medication such as anti-depressants.
    It sounds like you have attended meetings in which these distinctions aren’t understood.

  5. I am sad to hear about your negative experience in AA and NA. I have been to NA meetings and can day I don’t like them at all as they model themselves after AA and the twelve steps, however not one of them really practices the 12 steps. I have never seen anyone with any real clean time. AA however is the exact opposite. The meetings I go to focus on the steps and more importantly DO NOT TURN AWAY ANYONE, NOR DO THEY JUDGE THOSE ON OTHER PRESCRIBED MEDS, NARCOTICS OR NOT. Sorry your experience wasn’t the same.

  6. Thank you! I feel I should say that I am not saying anything negative about the program… really about the people IN the program who feel they can dictate what recovery looks like. I am blessed to be able to share my writing with 🙂

  7. This is awesome. Such truth rings in this article. You can hear the passion. I too turn away from N.A and A.A because of all the stigma. Judging when In all reality nobody has the same way of recovery. Everyone is different.

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