Drug-focused twelve-step fellowships

Domain V · Systemic, relational, group & community

What it is

What these are. Narcotics Anonymous (NA), Cocaine Anonymous (CA), Crystal Meth Anonymous (CMA), Heroin Anonymous (HA), Marijuana Anonymous (MA), Pills Anonymous (PA) and Nicotine Anonymous (NicA) are peer-run mutual-aid fellowships adapted from the Alcoholics Anonymous Twelve Steps and Twelve…

Format

• The fellowships have no clinical phases or session counts. Two parallel tracks are described below: (A) the member's path as the fellowships publish it, and (B) the clinician's linkage pathway, built on the MAAEZ structure plus.
• Milestones. Keytags (NA), chips at 1 week, 30, 60, 90 days, 6, 9, 12, 18 months and cakes yearly (CA), medallions (PA), free virtual chips and app sobriety counter (MA).

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Shame spirals, retraumatisation, or unsafe contact plans.
• Client attending only for signatures (explore motivation); verification dominating sessions.
• Client collecting numbers but never calling (rehearse a first call); calls used for drug contacts (review).
• Rote reports; MAAEZ advises speaking privately with reluctant members rather than confronting them in group.
• Over-rigid avoidance cutting off all supports; success is fewer high-risk exposures and a growing sober network.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.