12-Step Privilege: Unpacking the Recovery Knapsack

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12-Step Privilege: Unpacking the Recovery Knapsack

By Adam Sledd 01/18/18

The 12-step community enjoys massive privilege in our systems of treatment and recovery support, and has gone unchallenged for the better part of a century. 

Image: 
A wall with barbed wire transforming into birds flying away.
In our relatively short history, we have removed many obstacles to treatment and recovery. It is important that we do not become the obstacle.

We have all heard it said that “the disease does not discriminate.” People of all ages, races, genders and cultures are affected by substance use disorder. However, some people have a much easier time navigating our systems and finding the resources and support they need to sustain long-term recovery. Usually, these advantages can be attributed to privilege. People with financial or healthcare privilege have easier access to higher quality treatment. Those of us with white privilege are less likely to be incarcerated. People with gender privilege don’t have to worry about residential accommodations getting in the way of treatment.

Many of us in the recovery community have committed ourselves to combating privilege and trying to make treatment and recovery more accessible to everyone. Most of us have given lip service to the idea that there are many pathways in recovery. However, one of the biggest systems of privilege is right under our noses every day. The 12-step community enjoys massive privilege in our systems of treatment and recovery support, and has gone unchallenged for the better part of a century. Many of the recovery community’s social justice champions live every day of their recovery without recognizing their own privilege.


As you read the list below, think of the advantages of belonging to a 12-step fellowship. Would you have the same advantages had you chosen another pathway in recovery? Do you feel that you deserve them more than other people because 12-step recovery is superior? If you are a member of a 12-step group and you question, justify or deny this privilege, perhaps this will help.

Peggy McIntosh’s seminal work, Unpacking the Invisible Knapsack, has helped a generation of white people understand and begin to address their privilege. I have altered a few of McIntosh’s elements of privilege for the 12-step community, and provided examples for some.

    1. I can, if I wish, arrange to be in the company of people in 12-step programs most of the time.
      Anywhere you look for people in recovery, you will find 12-step members. This is because they are churned out by the thousands by rehabs that favor 12-step facilitation. (see below)
    2. When I look for a recovery meeting in my community, I can be sure to find a 12-step meeting.
      There are 12-step meetings every day, from early in the morning to late at night. Other programs are not as widely available to their participants. As a result, people who prefer other methods often have to attend 12-step meetings.
    3. If I talk to a non-recovering person about my 12-step program, they will have heard of it and have some idea of how it works.
      People on the outside of the recovery community are familiar with the 12-step process, especially the part about making amends. This makes people think that everyone in recovery owes something back to society or family members or friends, whether they do or not.
    4. When I tell people I’m in recovery, they assume correctly that I'm in a 12-step program.
      Most people, when they think of recovery, think of people sitting in a circle of chairs in a church basement, listening to someone tell their “story.” People in 12-step recovery will usually ask a “test” question to see if you are in a fellowship ("Are you a friend of Bill?" "What's your home group?"); if you don’t answer correctly, you may get a funny look or condescending reaction. 
    5. I can assume that people in positions of authority who are in recovery are in 12-step programs.
      Have you ever met a cop, a judge, or other person in authority who was in recovery? There’s an excellent chance that they were 12-step members.
    6. I can talk to other recovering/recovered people and they will not doubt the quality or stability of my recovery based on the way I achieved it.
      The reverse of this--expressing doubt about someone's recovery based on the fact they achieved it in a different way than you-- is a form of gaslighting, and it happens to people who don’t subscribe to 12-step programs. The dominant paradigm is that people in recovery have to have a “program” in order to have good recovery.
    7. If I want to be of service to others in recovery, I have many opportunities to do so through 12-step programs.
      It’s one of the most admirable aspects of the 12-step community; however, opportunities to volunteer outside of the 12-step fellowship are few and far-between. This is also a double-edged sword and source of stigma, as people in recovery are expected to be “in service” to atone for their perceived shameful behavior.
    8. If I ask to participate in any community discussion about substance use issues, I can be assured of a seat at the table.
      Bereft of any professional qualifications, a person who holds themselves out as active in the local 12-step community is automatically considered an expert on substance use disorder and recovery.
    9. I can be pretty sure of getting a job in the treatment field with other people who are in 12-step recovery.
      Dog whistles happen in job interviews too; a person from a 12-step fellowship is undoubtedly well-connected to others in recovery who staff the local treatment center. In addition, 12-step members rarely have to go against their own personal beliefs in the workplace, since 12-step philosophy dominates the treatment system.
    10. 12-step groups are commonly given free or heavily discounted rates on rentals of space and other materials in order to function.
      Most churches and other community spaces rent space to 12-step groups at unheard-of rates that another organization would be hard-pressed to obtain.
    11. I can shop for recovery literature, materials, accessories, or paraphernalia and be sure that 12-step programs will be represented.
      Have you ever shopped at a store that sells recovery paraphernalia? Try to find a recovery t-shirt, keychain or medallion that doesn’t have 12-step slogans or imagery on it. Go ahead, I’ll wait.
    12. I can view movies and TV shows about recovery and be sure that 12-step programs will be represented.
      12-step fellowships and their members are featured in nearly every book, film, or other media production depicting people with substance use disorder. This adds to the common public perception that everyone in recovery is in a 12-step fellowship (see #3 and #4). Dog whistles to 12-step members are also ubiquitous. The TV show My Name is Earl was one huge dog whistle.
    13. When nationally recognized figures in the recovery community speak publicly, I can be sure that they will use 12-step recovery language with which I can identify.
      If you attend any kind of rally or public event dealing with recovery, even if speakers are careful about their own anonymity, 12-step language, slogans and concepts will undoubtedly be part of the presentation.
    14. When I learn about the history of the recovery movement, I am told that people from 12-step programs made it what it is.
      Most of the early pioneers of recovery were 12-step members. These people are to be admired and respected; however, this does bestow privilege on their descendants in recovery.
    15. 12-step recovery contains concepts and language from a privileged spiritual pathway.
      The basic texts of 12-step programs are replete with language from the most dominant, privileged spiritual pathway in the country. Therefore, people who were already spiritually and culturally privileged have that privilege reinforced when they enter a 12-step program. Those from other faiths, or from no faith, are forced to adjust their thinking to the language used; this is the most frequent reason people give for seeking alternatives to 12-step programs.
    16. If I present myself for substance use treatment, I can be sure that the treatment facility I attend will embrace and endorse 12-step recovery.
      People from 12-step programs who come to treatment are familiar with the content of the clinical programming at most rehabs. Those who come to treatment from other pathways are likely to be told that they were “doing it wrong.”
    17. If I should need recovery housing, I can easily find a place that accepts 12-step membership as valid for the requirements of the residence.
      The vast majority of recovery houses require daily 12-step meetings, as well as sponsorship and attendance at in-house meetings. Those from other groups are either not admitted to the house or forced to adapt.
    18. I can travel to another country and be sure of finding a 12-step meeting.
      It’s a strength, no doubt; there are 12-step meetings in nearly every civilized country.
    19. I can openly criticize other methods of recovery and others will support me.
      Spend a little time on social media, and you will see this in action. Medication-assisted recovery and other “alternative” pathways are regularly disparaged, and there is nearly unlimited support from fellow 12-step members.
    20. I can dismiss criticisms of 12-step programs and others will support me.
      Sure, 12-step recovery gets criticized also; but again, there are thousands of people who will rush to its defense.

Just as in other privileged communities, there are members of the 12-step community who will call this idea divisive and make impassioned calls for unity to avoid the discomfort of acknowledging their privilege. This is a normal defensive reaction; however it is important to move past it and get to the real work. The whole point of understanding and acknowledging one’s privilege is not to feel guilty or defensive; but rather, to promote equity in the recovery community so that more people can find recovery through diverse pathways. Defensive reactions take many forms; here are a few to avoid:

      1. “If you want more alternatives to 12-step recovery, why don’t you start your own fellowship?”
        Starting meetings is a good thing, but other pathways in recovery cannot be expected to match the strength and advantage of the 12-step fellowship overnight.
      2. “Why do you have to attack 12-step recovery in order to promote equity?”
        Pointing out privilege is not putting anyone down or attacking 12-step recovery. It is simply asking for those with power to help those without. It is often said that “Equality feels like oppression to the privileged.”
      3. “The recovery community needs to come together. Talking about privilege is divisive.”
        The whole point is that we are already divided along lines of privilege. One of the characteristics of privilege is that it’s nearly invisible to those who benefit from it. Only the privileged can afford to put unity ahead of equity.

So, now that you have recognized your privilege, how can you take responsibility for it? Again, I have compiled some commonly accepted ideas from a number of sources and modified them slightly to fit the context.

      1. Educate yourself. Learn as much as you can about other recovery methods and groups, and don’t automatically expect people from those pathways to do the work of educating you.
      2. Really get to know people from other recovery pathways. Know them as people, not just avatars for their recovery method.
      3. Listen to people and advocates from multiple other recovery pathways when they speak. Listen without responding.
      4. Empathize with people from oppressed pathways. This does not mean sympathize. Empathy means being with a person and understanding and sharing their feelings and concerns.
      5. Amplify. After listening and feeling, use your privilege and access to amplify voices of those in oppressed recovery groups.
      6. Challenge others in your privileged group who perpetuate stigma and stereotypes about other methods of finding recovery. Let them know that this is not OK.
      7. Work to offset, counteract, and neutralize your privilege and the systemic inequity. Use your privilege to open doors, forge new paths, and lift up members of the oppressed recovery pathways.

We in the recovery community are some of the most passionate advocates there are. In our relatively short history, we have removed many obstacles to treatment and recovery. It is important that we do not become the obstacle.

Peggy McIntosh, “Unpacking the Invisible Knapsack,” Working Paper 189. “White Privilege and Male Privilege: A Personal Account of Coming to See Correspondences through Work in Women’s Studies” (1988)

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