AA vs NA: The Similarities and Differences

If you are struggling with drug or alcohol addiction, it is common to struggle with feelings of loneliness and isolation. Groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) can provide a community of support as you work through recovery. These organizations have been pivotal in helping millions of people attain and sustain abstinence. As you might expect, AA and NA have similarities as well as differences.

Brief History

The Oxford Group, an evangelical Christian fellowship that flourished in the United States and England in the early 1900s, had a strong influence on the origins of AA. The Oxford Group was non-denominational, and its members focused on erasing sin from daily life. The group did this by having members share their experiences with one another, make amends, examine themselves, make restitution for harm done, and engage in prayer. These actions eventually became staples of AA. Currently, AA does not align itself with any religious organization, and participants are encouraged to use their own conception of a “higher power” or God.1 AA marked its 85th anniversary in 2020 and has grown to include approximately 2 million members in the United States.

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NA, which emerged in the 1950s, stems from AA and expanded on the AA program to develop its mission and philosophy. NA currently has active members in about 130 countries. Although NA was derived from AA, they are not affiliated with each other.2

Philosophy and Mission

AA and NA, like other 12-step programs, are predicated on abstinence from substances of misuse. These programs encourage members to look outside themselves (a higher power) for strength. The higher power does not have to be God but can be any force outside of yourself, even the recovery program itself. The programs purport that the essential keys to recovery are designated by the acronym HOW: honesty with yourself and others, open-mindedness (exploring new ways of thinking and behaving), and willingness (to acquire new thought patterns and behaviors).2

Both organizations use the serenity prayer, which goes like this: “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.”2

Both organizations also use the 12-step framework that guides members through their recovery.

The 12 Steps

The 12 Steps are individual actions that the programs believe members should tackle to create a sober life. The 12 AA and NA steps are:2

  1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory and, when we were wrong, promptly admitted it.
  11. 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 the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

The steps are done sequentially and can be repeated as needed. To help with progression through AA or NA steps, you are encouraged to choose a sponsor. A sponsor is an experienced AA or NA member who can provide you support and guidance through the program.1

The programs also have unique parts to their philosophy and mission.

Alcoholics Anonymous

  • In AA, some participants use God as an acronym for Good Orderly Direction and obtain guidance from any source that helps them.1
  • AA considers alcohol addiction to be a type of allergy, meaning the body cannot tolerate alcohol, and this allergy cannot be cured.1
  • AA has a foundation of voluntary service: those struggling with alcohol addiction helping each other to abstain.3

Narcotics Anonymous

  • NA addresses all substances of misuse, not a specific substance.
  • NA is made up of what the organization refers to as a “fellowship of individuals.”
  • NA believes its therapeutic and healing value come from relationships developed between the members, all of whom identify as having substance use disorders.

In addition to the 12 steps, which help free the individual, NA has 12 Traditions of NA that help free the group. The organization believes that all will be well with its members as long as the ties that bind them together are stronger than those that would tear them apart. The 12 traditions include:2

  1. Our common welfare should come first; personal recovery depends on NA unity.
  2. For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
  3. The only requirement for membership is a desire to stop using.
  4. Each group should be autonomous except in matters affecting other groups or NA as a whole.
  5. Each group has but one primary purpose—to carry the message to the addict who still suffers.
  6. An NA group ought never endorse, finance, or lend the NA name to any related facility or outside enterprise, lest problems of money, property, or prestige divert us from our primary purpose.
  7. Every NA group ought to be fully self-supporting, declining outside contributions.
  8. Narcotics Anonymous should remain forever nonprofessional, but our service centers may employ special workers.
  9. NA, as such, ought never be organized, but we may create service boards or committees directly responsible to those they serve. 10. Narcotics Anonymous has no opinion on outside issues; hence the NA name ought never be drawn into public controversy.
  10. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films.
  11. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.

Meeting Structure

AA and NA programs encourage meeting attendance and “recovery work” that includes reading the literature, meeting with other program members between meetings, working the 12 steps, having a sponsor, sponsoring other members, and coordinating logistics for meetings.4

In large metropolitan areas, meetings are available almost 24 hours per day, 7 days per week. They are usually held in public spaces such as libraries, YMCAs, and places of worship. Meeting attendance can range in size from two to three members in small communities to hundreds in metropolitan areas.4

Meeting types and formats can differ. For instance, both open and closed meetings are available. Open AA meetings are open to anyone in the community, not just those with an alcohol use disorder. Anyone interested in learning more about AA or alcohol use disorders can attend. Closed meetings are not open to the general public, only to those struggling with their alcohol use. All meetings are free, and there is no intake process. In addition, there is an expectation of privacy and anonymity: you do not discuss with others what happened in the meeting, what was shared, and who other attendees were.

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Examples of types of meeting formats include discussions in which every attendee speaks for a few minutes and speaker meetings where one or two people share their stories from a podium. A typical meeting structure begins with reading the 12 Steps and reciting the serenity prayer at the end for those who wish to do so.3

AA and NA online meetings are also now available.

Literature

In addition to some differences in philosophy, both AA and NA each have their own literature.

Alcoholics Anonymous

AA has two primary texts: Alcoholics Anonymous (The Big Book) and Twelve Steps and Twelve Traditions. The Big Book was first published in 1939 and has had three updated editions. Today, more than 25 million copies have been sold, and it has been translated into 48 languages. It includes a history of the program, a description of how meetings work, and a description of the 12 Steps.4

Twelve Steps and Twelve Traditions covers the principles of individual recovery and group unity in the AA fellowship. It also includes a description of the 12 Steps that are central to the program.3

Narcotics Anonymous

NA literature is written by NA members themselves and provides a message of hope to those still suffering from addiction. The latest book, Guiding Principles: The Spirit of Our Traditions, has tools and questions to help facilitate discussion and inspire action. It is a collection of members’ experiences and ideas on how to work together.

Program Membership

Membership for AA, NA, or any 12-step program is informal; the only requirement is that you have a desire to stop using addictive substances. Membership records are not kept.4

There is no cost to join AA or NA, though some groups do accept voluntary donations to meet their expenses (e.g., a token rental fee for regular use of a room at a YMCA, to cover refreshments, etc.).4

Making AA and NA Part of Treatment

AA and NA are not substance misuse or mental health treatment programs; these organizations do not employ mental health professionals. Their goal is to simply provide support by your peers also dealing with addiction.5

However, AA and NA are compatible with treatment provided by mental health professionals, and many therapists refer their patients to AA or NA meetings during and following professional care. NA makes a point to state that it does not take positions on anything outside of its specific sphere, neither endorses nor opposes any other organization’s philosophy or methodology, and welcomes the cooperation of healthcare professions.5

It is recommended that participation in self-help groups such as AA and NA serve as a supplement to drug addiction treatment, and attending AA has shown to lead to abstinence for adults and adolescents.6,7 If you attend AA or NA meetings more frequently, you are more likely to abstain from opiates and alcohol compared to those who do not attend at all or attend less frequently than once per week.8

For assistance with finding the right AA/NA program and/or substance use treatment providers near you, please call 800-839-1686Who Answers? for 24/7 help.

Resources

  1. Kass, N. (2015). The philosophies and practices of Alcoholics Anonymous from a psychodynamic perspective [unpublished doctoral dissertation]. The University of Pennsylvania. Retrieved from https://repository.upenn.edu/cgi/viewcontent.cgi?article=1076&context=edissertations_sp2
  2. Narcotics Anonymous World Services, Inc. (1986). NA White Booklet. https://www.na.org/admin/include/spaw2/uploads/pdf/litfiles/us_english/Booklet/NA%20White%20Booklet.pdf
  3. Gross, M. (2011). Alcoholics Anonymous: still sober after 75 years. American Journal of Public Health, 100(12), 2361-2363. Retrieved September 17, 2021, from https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2010.199349
  4. Laudet, A. B. (2008). The impact of Alcoholics Anonymous on other substance abuse-related twelve-step programs. In L. Kaskutas & M. Galanter (Eds.) Recent developments in alcoholism (Vol. 18). Springer, New York, NY. https://doi.org/10.1007/978-0-387-77725-2_5
  5. Narcotics Anonymous World Services, Inc. (2014). Information about NA. https://www.na.org/admin/include/spaw2/uploads/pdf/pr/information_about_na.pdf
  6. Vederhus, J., & Kristensen, O. (2006). High effectiveness of self-help programs after drug addiction therapy. BMC Psychiatry, 6(35). https://doi.org/1186/1471-244X-6-35
  7. Krentzman, A.R., Robinson, Elizabeth, A.R., Moore, B.C., Kelly, J.F., Laudet, A.B., White, W.L., Zemore, S.E., Kurtz, E., & Strobbe, S. (2010). How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) work: Cross-disciplinary perspectives. Alcohol Treatment Quarterly, 29(1), 75-84. https://doi.org/1080/07347324.2011.538318
  8. Gossop, M., Stewart, D., & Marsden, J. (2008). Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment for drug dependence: A 5-year follow-up study. Addiction, 103(1), 119-125. https://doi.org/1111/j.1360-0443.2007.02050.x Abstract retrieved from here.

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