Narcotics Anonymous is the second-largest Twelve Step fellowship in the world, serving people whose primary issue is drug addiction rather than—or in addition to—alcohol. With over 70,000 weekly meetings in 144 countries, NA represents an essential recovery resource for professionals working with clients who use drugs.
Understanding NA's approach, culture, and how it differs from AA helps recovery professionals make appropriate referrals and support clients effectively in Twelve Step recovery.
What is Narcotics Anonymous?
Narcotics Anonymous is a nonprofit fellowship of people recovering from drug addiction. Founded in 1953 in Los Angeles, NA adapted AA's program for drug addiction, establishing itself as abstinence-based and focused specifically on the disease of addiction regardless of specific substances.
NA's core text, the "Basic Text," articulates a key philosophical difference from AA: NA focuses on addiction as a disease rather than on any particular substance. The First Step in NA refers to addiction, not to a specific drug: "We admitted that we were powerless over our addiction, that our lives had become unmanageable."
This means NA welcomes anyone who wants to stop using drugs—regardless of which drugs they used. Someone whose primary drug was heroin sits alongside someone whose issue was prescription pills or cocaine. The common thread is addiction, not the chemical.
What About Alcohol?
This is a common point of confusion. Many people whose primary issue is drugs also drank, and many alcoholics also used drugs. NA considers alcohol a drug and welcomes people for whom alcohol was part of their addiction. However, NA encourages members to focus on addiction rather than specific substances.
In practice, someone whose primary and only issue was alcohol would likely find AA a better fit culturally, but NA doesn't exclude them. Someone who used both drugs and alcohol can choose either fellowship (or both) based on where they identify and feel most comfortable.
The NA Program
NA's program closely parallels AA's, with adaptations reflecting its broader focus on addiction:
The Twelve Steps of NA
- We admitted that we were powerless over our addiction, that our lives had become unmanageable.
- We came to believe that a Power greater than ourselves could restore us to sanity.
- We made a decision to turn our will and our lives over to the care of God as we understood Him.
- We made a searching and fearless moral inventory of ourselves.
- We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- We were entirely ready to have God remove all these defects of character.
- We humbly asked Him to remove our shortcomings.
- We made a list of all persons we had harmed, and became willing to make amends to them all.
- We made direct amends to such people wherever possible, except when to do so would injure them or others.
- We continued to take personal inventory and when we were wrong promptly admitted it.
- We 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.
- Having had a spiritual awakening as a result of these steps, we tried to carry this message to addicts, and to practice these principles in all our affairs.
Key NA Principles
Addiction as a Disease – NA views addiction as a progressive, chronic disease that affects physical, mental, and spiritual well-being. This perspective shapes how members understand their experience and recovery.
Any Clean Time is Valuable – NA emphasizes that recovery is possible for anyone and that any period of abstinence has value. "Just for today" is a central slogan.
Complete Abstinence – NA's program is abstinence-based. "Clean" in NA means abstaining from all mind-altering substances, including alcohol and marijuana. This is more restrictive than some other approaches.
The Therapeutic Value of One Addict Helping Another – NA emphasizes that addicts helping each other is uniquely powerful—something that people who haven't experienced addiction cannot replicate.
NA Meeting Culture
NA meetings share structural similarities with AA but have developed their own culture and feel:
Meeting Formats
- Speaker meetings – One member shares their story
- Discussion meetings – Topic-based group discussion
- Step study meetings – Working through the Twelve Steps
- Literature meetings – Reading and discussing NA literature
- Newcomer meetings – Oriented toward people new to recovery
Cultural Differences from AA
More diverse substance histories – Members may have used vastly different drugs, creating broader shared experience but sometimes less immediate identification.
Often younger average age – Drug addiction frequently manifests earlier than alcoholism, and NA meetings often skew younger than AA.
Different jargon – "Clean" rather than "sober," "clean time" rather than "sobriety," "using" rather than "drinking."
Sometimes rawer stories – Drug addiction pathways often involve more criminality, homelessness, and health consequences, which shapes the stories shared.
Variable culture by location – NA meetings vary significantly in feel and culture by location, even more than AA.
Sponsorship in NA
Like AA, NA uses sponsorship as a core recovery tool. A sponsor is a member with more clean time who guides a newer member through the steps and provides ongoing support.
NA's approach to sponsorship is similar to AA's, though some cultural differences exist:
- Emphasis on working all Twelve Steps, not stopping partway through
- Sponsors share experience with addiction broadly, not just with specific substances
- "Temporary sponsors" are common for newcomers while they find a long-term sponsor
Who Does Well in NA?
People whose primary issue is drugs – Those who identify primarily as drug addicts rather than alcoholics often feel more at home in NA.
People who used multiple substances – NA's focus on addiction rather than specific substances resonates with polysubstance users.
People who want peer support from others with drug histories – The identification that comes from shared experience with drug addiction specifically can be powerful.
Younger people – NA's often younger demographic can help younger clients feel they belong.
People open to spiritual approaches – Like AA, NA has a spiritual foundation that works well for those open to it.
Who Might Struggle with NA?
People on medication-assisted treatment – This is complex. NA's official position acknowledges that medications prescribed by physicians aren't the same as using drugs. However, local meetings and individual members sometimes hold stigmatizing views about MAT. Some NA communities are more accepting than others.
Secular individuals – Like AA, NA's spiritual framework can be a barrier for thoroughly secular people.
People whose only issue was alcohol – While NA welcomes them, they may feel less identification and be better served by AA.
People in areas with few NA meetings – NA has fewer meetings than AA in most areas, potentially limiting access.
NA and Medication-Assisted Treatment
The intersection of NA and MAT (buprenorphine, methadone, naltrexone) deserves specific attention for professionals:
NA's World Services has published clarifying statements acknowledging that medication-assisted treatment is a medical decision between patients and doctors. NA doesn't take positions on outside issues including medical treatment. A person on MAT can be an NA member.
However, reality in meetings is more varied. Some meetings and members are fully accepting of MAT. Others hold views that MAT isn't "real" recovery or that people on MAT shouldn't share in meetings. This can range from subtle attitudes to explicit statements.
For professionals working with clients on MAT who want NA involvement:
- Acknowledge the potential challenge directly
- Help identify MAT-friendly meetings if possible
- Encourage clients to give multiple meetings a chance
- Validate that hostile attitudes, if encountered, reflect individual opinions, not NA policy
- Have alternatives ready if NA isn't workable
Practical Information for Professionals
Finding Meetings
NA's meeting finder is available at na.org. Most urban areas have multiple meetings; rural areas may have limited options. Online meetings have expanded significantly and provide alternatives when local meetings are scarce.
Making Referrals
When referring clients to NA:
- Clarify whether their primary identification is with drug use or alcohol (or both)
- Discuss the spiritual component honestly
- If applicable, discuss potential MAT-related challenges
- Encourage trying different meetings
- Provide concrete meeting information (times, locations, online options)
Integration with Treatment
NA works alongside professional treatment. Many treatment programs introduce NA meetings during treatment and help clients establish NA connections before discharge. This bridge-building improves the likelihood of sustained NA engagement.
For clients in individual therapy or outpatient treatment, NA provides:
- Community support between sessions
- Peer relationships with people in recovery
- Structure and accountability
- Sponsorship for step work
- A recovery identity and community
The Evidence Base
Research on NA specifically is less extensive than AA research, though growing. Studies suggest similar benefits to AA: reduced substance use, improved quality of life, and benefits that increase with engagement. The specific mechanisms—social support, behavioral change, spiritual development, cognitive shifts—likely overlap with AA.
The 2020 Cochrane review finding AA effective for alcohol use disorder doesn't directly apply to NA, but the shared program suggests plausible similar mechanisms.
NA and Multiple Pathways
Like AA, NA isn't the only path to recovery from drug addiction. Alternatives include:
- SMART Recovery
- Refuge Recovery / Recovery Dharma
- LifeRing
- Medication-assisted treatment (with or without peer support)
- Professional treatment without peer support
- Religious recovery programs
For clients uncomfortable with NA's approach, these alternatives provide options. The key is finding what works for each individual.
Help Your Clients Find NA Meetings Near Them
SobaSearch maintains a substantial database with good nationwide coverage of NA (Narcotics Anonymous) meetings across the United States. Enter a zip code to find meetings in your client's area.
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