Founded in Los Angeles, California in 1982 by a group of people who were seeking a specific 12-step group for cocaine users, Cocaine Anonymous (CA) is a 12-step support group that primarily focuses on those who struggle with cocaine addiction; however, people who are addicted to other substances are welcome to participate. The founders used Alcoholics Anonymous (AA) as a model, and AA assisted the group in its early years. Over time, word spread in the media, and the group received inquiries from all over the United States on how to start local chapters. Today CA has meetings in at least 25 countries, as well as online meetings.1,2,7
CA does not have affiliations with any religious, educational, or political groups, nor is it owned by a company or outside organization. CA describes itself as an anonymous fellowship of individuals who are volunteers. Similar to AA, CA charges no fees and the only requirement to be a member of CA is a desire to not use cocaine or other drugs.1 The CA program follows the 12 steps and 12 traditions which were first created by Alcoholics Anonymous. This means that as a member you work through a defined set of steps, often with the help of a sponsor.
The 12 Steps
CA states that its only purpose is to offer help to those wanting recovery from addiction. CA uses a 12-step model of recovery from substance abuse. The 12 steps are:3
- We admitted we were powerless over cocaine and all other mind-altering substances—that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- 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 the result of these Steps, we tried to carry this message to addicts, and to practice these principles in all our affairs.
The purpose of working the 12 steps is to lead a person with an addiction to a spiritual awakening, free from substance abuse. The 12 steps emphasize that addiction is not curable, but it is possible to stop actively using. Cocaine Anonymous emphasizes unity and helping others who suffer from addiction.3
The 12 Traditions
The 12 traditions are operating guidelines for CA chapters. These are based upon the 12 traditions of AA, and include:3
- Our common welfare should come first; personal recovery depends upon CA.
- For our group purpose there is but one ultimate authority — a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
- The only requirement for CA membership is a desire to stop using cocaine and all other mind-altering substances.
- Each group should be autonomous except in matters affecting other groups or CA as a whole.
- Each group has but one primary purpose — to carry its message to the addict who still suffers.
- A CA group ought never endorse, finance, or lend the CA name to any related facility or outside enterprise, lest problems of money, property and prestige divert us from our primary purpose.
- Every CA group ought to be fully self-supporting, declining outside contributions.
- Cocaine Anonymous should remain forever nonprofessional, but our service centers may employ special workers.
- CA as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.
- Cocaine Anonymous has no opinion on outside issues; hence the CA name ought never be drawn into public controversy.
- Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, television and films.
- Anonymity is the spiritual foundation of all our Traditions, ever reminding us to place principles before personalities.
The 12 traditions more specifically define how CA groups should operate. They are essentially a set of rules that govern the overall operation, including the leadership structure, individual groups, finances, membership, press, and meetings. They keep members focused on the work at hand and do not allow groups to stray from the CA mission.
How Effective Is CA in Recovery?
A slogan from the 12-step groups is, “if you work it, it works.” All 12-step groups, including CA, have thousands of members who cite testimonies of how the 12-step programs helped them get clean and maintain sobriety. Anecdotal evidence, however compelling, is not adequate support for the efficacy of CA, or any other recovery service.
Research has demonstrated that those who suffer from a substance addiction and attend 12-step meetings experience more promising drug and alcohol use outcomes than those who don’t.8 Among people with a substance use disorder, those who participated in NA or AA had higher rates of abstinence than those who didn’t participate in these groups.8 These findings may apply to Cocaine Anonymous considering CA follows the same 12 steps, has the same literature, follows the same traditions, and has the same overall philosophy and goal that the other two groups do. Furthermore, a study involving people with cocaine addictions showed that active 12-step involvement (although it didn’t specify which group) in any month predicted a reduced rate of cocaine use in the following month.8 Individuals who increased their 12-step involvement within the first 3 months of treatment had better cocaine use outcomes in the 3 months following.8
Lastly, a different study revealed that 12-step group involvement also improved outcomes for women, ethnic minorities, and adolescents.4
Can It Work If You Aren’t Spiritual?
CA and other 12-step groups discuss the concepts of spiritual awakening and a Higher Power. The purpose of the 12 steps is to turn one’s life over to a Higher Power. But CA, like all 12-step groups, emphasizes that Higher Power does not need to mean God or any religious entity for that matter.
The concept of spirituality and a Higher Power in CA is important, but CA literature acknowledges that the concept of God in a traditional sense is off-putting to many people, who perhaps do not practice a religion.
CA explains that Higher Power is something greater than the self. The idea of turning over an addiction to a Higher Power is the acknowledgement that self-management of an addiction is not working and that something else can provide a solution. CA itself can even operate as the Higher Power, as many people put their trust and faith in the 12 steps and fellow members.
CA notes that some members do see this Higher Power as a traditional God, while others see it as a spiritual force in the universe; however, some people do not choose to define a Higher Power. As CA notes:
- Be open-minded.
- CA is a spiritual program, not a religious one.
- All you have to do is to be willing to believe.
- Your Higher Power can be the group as a whole.
- You start with belief; your experience will come.
There are many atheists and agnostics in 12-step groups, and many of them, just like spiritual people, have found lasting recovery through the 12-step programs such as CA.
However, according to a 2002 study, atheist or agnostic people were less likely to attend a 12-step group and remain in the program.6 It was found that there is no difference in outcomes for those who are atheist and those who considered themselves spiritual who participated in a 12-step group. So, evidently, people who are not comfortable with the spiritual component of CA may be less likely to stay with CA, but are just as likely to still benefit from the program if they do choose to stay.6