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“Aren’t AA and NA basically the same thing?” This question comes up often, and it’s easy to see why. Both Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are 12-step programs helping people recover from addiction through peer support, regular meetings, and spiritual principles.
Yet despite their similarities, these programs have distinct approaches that can significantly impact your recovery experience. Whether you’re seeking help for yourself or supporting a loved one, understanding these differences helps ensure you find the environment that best supports your journey.
AA emerged first, founded in 1935 by Bill Wilson and Dr. Bob Smith, two alcoholics who discovered they could maintain sobriety by working together and helping others. Their approach crystallized into the 12 steps, with the influential “Big Book” published in 1939.
NA came later, established in 1953 by Jimmy Kinnon and others who recognized the need for a similar program specifically addressing drug addiction. NA was directly inspired by AA but created to fill a gap for those who felt out of place in alcohol-focused meetings.
Why it matters: AA’s longer history has given it more time to establish traditions and widespread acceptance. This historical head start often means more available meetings and resources in many communities. NA, developing during an era when drug addiction carried even greater stigma, evolved with a more deliberately inclusive approach to all substances from its beginning.
“When I first looked for help in 1985, I could find AA meetings everywhere, but NA was just getting established in our town. Today, both are widely available, but that historical difference shaped how each program developed locally.” – Recovery historian Mark S.
AA members identify as “alcoholics” and celebrate “sobriety.” The language centers specifically around alcohol:
“Hi, I’m [name], and I’m an alcoholic.”
“I’ve been sober for [time period].”
“We admitted we were powerless over alcohol…”
NA members identify as “addicts” and celebrate “clean time.” The language deliberately avoids specifying substances:
“Hi, I’m [name], and I’m an addict.”
“I’ve been clean for [time period].”
“We admitted we were powerless over our addiction…”
Why it matters: These language differences reflect fundamentally different approaches. For someone whose primary struggle was with drugs other than alcohol, NA’s terminology often feels more authentic and inclusive. Conversely, those who struggled primarily with alcohol might connect more with AA’s specific focus.
AA’s focus remains primarily on alcohol. While many AA members have experienced problems with other substances, the program’s explicit purpose is “to carry its message to the alcoholic who still suffers.” Discussion typically centers on alcoholism, with other substances mentioned in relation to alcohol problems.
NA’s approach makes no distinction between substances, considering addiction itself the disease, regardless of substance(s) used. As commonly stated in NA: “A drug is a drug is a drug.” This philosophy includes alcohol as simply another drug.
Why it matters: This distinction creates very different meeting environments. In traditional AA meetings, sharing about drugs other than alcohol might be gently discouraged or redirected toward alcohol. In NA, members freely discuss any substance—from heroin to alcohol, cocaine to prescription medications—without hierarchy.
“In AA, I sometimes felt I had to translate my story to focus on the drinking parts, even though pills were my real problem. In NA, I could talk about my full experience without filtering.” – Jamie, 5 years in recovery
AA meetings often follow more standardized formats with established readings and structures. Many meetings include reading from AA literature, especially the Big Book. There’s often a stronger emphasis on studying the program literature during meetings.
NA meetings typically:
Embrace slightly more casual formats
Focus more on personal sharing rather than literature study
Often use different readings and meeting-opening traditions
Frequently incorporate more contemporary language
Why it matters: These format differences can significantly impact how comfortable you feel in meetings. Some people prefer AA’s more structured approach with its emphasis on program literature, while others connect more with NA’s often more conversational style.
AA’s primary text, “Alcoholics Anonymous” (the Big Book), was largely written in the 1930s by Bill Wilson. Its language reflects that era with more formal phrasing and gender-specific language (though later editions include more diverse stories). Its focus remains specifically on alcoholism.
NA’s “Basic Text”, published in 1983, uses more contemporary language and deliberately speaks to addiction broadly. Compare these parallel passages:
AA Big Book: “We alcoholics are men and women who have lost the ability to control our drinking.”
NA Basic Text: “We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions, and death.”
Why it matters: Many find one text more relatable than the other based on their personal experiences, language preferences, and which substance(s) they used. The literature sets the tone for how members understand and talk about recovery.
AA meetings often include:
NA meetings frequently include:
Why it matters: While both programs welcome anyone seeking recovery, these demographic patterns can affect whether you feel your experiences are understood and relatable to others in the room.
“The conversations in NA more commonly include experiences with the legal system and harder drugs. There’s often more raw dialogue about trauma and the extremes of addiction, though this varies by meeting.” – Recovery coach Thomas L.
AA step work traditionally emphasizes:
NA step work typically features:
Why it matters: The step-working process is central to both programs, but the different approaches can significantly impact your recovery experience. Some people connect more with one program’s approach to this spiritual growth process.
AA sponsorship often:
NA sponsorship frequently:
Why it matters: The guidance relationship is crucial in both programs, but the subtle differences in approach can affect how comfortable you feel with the sponsorship dynamic.
AA’s stance historically has been more cautious about medication use, particularly mood-altering prescriptions. While the official position acknowledges that prescribed medications are a matter between member and doctor, some individual AA groups or members may discourage medication use more strongly.
NA’s approach typically:
Why it matters: For people using prescribed medications (especially psychiatric medications or medication-assisted treatment), feeling accepted and understood regarding medication use can be crucial to remaining in a recovery program.
“When I needed antidepressants early in recovery, I encountered mixed messages in AA. In NA, there seemed to be more understanding that properly prescribed medications weren’t compromising my recovery.” – Alex, 7 years clean and sober
AA maintains a primary focus on alcohol, with other addictive behaviors generally discussed in relation to alcoholism. While many members experience multiple addictions, the program itself centers on alcohol recovery.
NA takes a broader addiction approach that more easily accommodates discussion of:
Why it matters: Many people struggle with multiple addictive behaviors or find that addressing one substance leads to struggles with another. The program’s openness to discussing these patterns can significantly impact recovery success.
The most important takeaway is that these differences aren’t about which program is “better”—they’re about finding the recovery environment that best supports your specific journey.
Consider:Many people find value in attending both programs, especially initially, to determine which better meets their needs. Others find that different programs serve them at different stages of recovery.
Remember that individual meetings within both fellowships vary enormously. Some AA meetings may feel more like typical NA meetings and vice versa. This highlights the importance of trying multiple meetings of either type rather than judging either fellowship by a single experience.
Ultimately, the best program is the one where you feel most able to be honest, connect with others, and grow in your recovery. For many people, that might even be both.
Note: This article provides general information about typical differences between AA and NA. Individual meetings and regions may vary significantly from these generalizations. The most accurate way to understand the differences is to attend multiple meetings of each type in your area.
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