The 12-step structure pioneered by Bill Wilson and Alcoholics Anonymous has proven to be a highly effective program for ‘viral’ marketing and peer-group assistance  for medically-related conditions, when measured in terms of social impact, lateral growth, impact-to-investment ratio, and perceived benefit for its participants.

12-step programs commonly address conditions that are now considered health-related. These include addiction, alcoholism, and compulsive behaviors indicative of personality disorders.  In addition to AA, well-known 12-step programs include:

• Narcotics Anonymous
• Gamblers Anonymous
• Debtors Anonymous
• Al-Anon (family and friends of alcoholics)

Millions of people in the United States and worldwide participate actively in 12-step programs.

Characteristics of 12-Step Programs

12-step programs share a number of characteristics:

• They are based on the concept that people who suffer from a given condition (alcoholism, addiction, other compulsive behaviors) have a unique ability to help one another – and, by so doing, to help themselves overcome their own compulsions and remain free of them
• They believe that successful recovery from their condition must, in their model, include a ‘spiritual’ dimension (which can be defined as metaphysical/supernatural, or as merely psychological/associative, depending on the belief system of the individual)
• They are self-sustaining and do not accept outside contributions (from non-participants)
• They are self-governing; each individual meeting is autonomous, except regarding the issues that involve the larger group as a whole
• They do not have a professional class (doctors or other health providers) or a managerial class (except for small groups that administer central offices for coordinating activities, establishing broad rules for the association as a whole, and publishing group literature)
• They believe that a specific program of self-investigation, ‘inventory,’ review of defects, and daily follow-up work are essential factors in long-term recovery

Alcoholics Anonymous® is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for AA membership; we are self-supporting through our own contributions. AA is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our primary purpose is to stay sober and help other alcoholics to achieve sobriety.

12-step programs are predicated on the belief that addictions and compulsive behaviors are a disease of the “mind, body, and spirit,” and that recovery must therefore address all three dimensions.  Therefore, physical abstinence (“body”) must be paired with a structured program of self-investigation (“mind”) and belief in a Higher Power (“spirit”) – although the latter need not be “God,” and there are agnostic/atheist subgroups within 12-step programs.

12-step programs also believe that recovery efforts must not be based on financial motivations.  They therefore refuse outside contributions, and do not permit the existence of a professional class within the programs. 

12-step programs do not believe in advertising, or in public declarations of support from members in the mass media (hence the “anonymous” part.)  They believe that members should be recruited by “attraction, not promotion.”  This word-of-mouth approach (which in 21^st-Century parlance is known as “viral marketing”) has been very effective for A.A. and Al-Anon, in particular.

The “business model” for 12-step programs can therefore be summarized as follows:

• Peer-to-peer assistance only; no professional counselors or providers
• No solicitation of funds other than “passing the hat” at meetings
• No public advertisement; viral marketing/”attraction-not-promotion” only
• No public controversies, dispute with other types of programs, or involvement in “outside issues” (e.g. public policy)

Speaks to multiple leverage points.

• Alliances:
• 12-step programs are a powerful model for lateral alliances at the individual level
• 12-step programs have been able to work with missions, charities, churches, and others to form new allegiances
  
• Healthcare as a public good leading to new social contracts
• The peer-group support structure of A.A. et al. represents a unique and effective form of “social contract”
• Sobriety (or abstention from drugs, gambling, etc.) is seen as a “public good”