Limits of the traditional twelve-step program for autistic folk

Anyone who is even vaguely familiar with the addiction recovery community will likely have come across the twelve-step program in one form or another. Alcoholics anonymous, cocaine anonymous, narcotics anonymous, the list goes on. There are many different groups employing the twelve-steps, and it is often what addiction treatment services suggest to service users to support their goal of recovery.

That last point is a problem for autistic folk. The big book of alcoholics anonymous claims that the program is suitable for anyone, but in my experience, the twelve-steps are quite inaccessible to those of us who are autistic.

So what makes the twelve-steps inaccessible?

The first issue I had was the talk of a “higher power”. I fall on the side of agnosticism and atheism, relying on a higher powers felt absurd to me. The twelve-steps involved a lot of praying, and I couldn’t reconcile that with my own beliefs. In my opinion, this also reduces accessibility to the LGBT+ community, of whom many are autistic, because of religious trauma that they may have experienced.

The social aspect was also incredibly difficult for me. Before and after meetings involved a lot of small talk and hugging. Those of us with a touch aversion will already understand my issues, and I can imagine that most, if not all Autistics can appreciate the horror of being faced with small talk. Just thinking about it used to make me anxious.

The rooms are often lit with bright white lights, in old buildings that smell weird, filled with extremely uncomfortable fold-up chairs. You are expected to sit in these rooms for an hour to an hour and a half, without being too fidgety. Leaving to go to the bathroom too often is regularly met with suspicion.

While the structure of the twelve-steps can be helpful for planning and goals, the homework set by sponsors as you work through the steps can often clash with executive dysfunction issues. Until these issues are addressed, the twelve-step program will never be fully accessible to Autistics.

The whole experience left me having regular panic attacks at meetings, and when I thought about meetings.

Of course, other Autistics may have a better experience of the program. As addicts, we must utilise all of our experiences to find recovery, and what ever works for us (and doesn’t cause further harm) is valid. It does concern me however that these programs are considered a “go-to” intervention by many treatment services. It’s especially problematic when you consider that twelve-step programs generally will not allow academics to study their efficacy (supposedly to protect the anonymity of its members).

For me personally, I learnt an awful lot about my addiction through the twelve-steps, but had to ultimately support my recovery through other means; but once again, if it works for you, I would never seek to take that away from you. My main issue is that the twelve-steps, like most addiction related things, does not account for autistic addicts, of whom I believe there are more than we realise.

Until the addiction community makes itself accessible, lives are in danger. It’s time for autistic addicts to declare their existence.

Published by David Gray-Hammond

David Gray-Hammond is an Autistic consultant and trainer, educating on the topics of Autistic experience, mental health, and drug and alcohol use. He has several years experience in this area as well as personal lived experience. You can find out more about his consultancy services at

6 thoughts on “Limits of the traditional twelve-step program for autistic folk

  1. Thank you for sharing this, David. This is so important for us in the Twelve Step community to hear. One of my best friends is an addict with ASD; we met in one of the fellowships, but his activity has tapered off over time for several of the reasons that you’ve cited here. I really don’t know what else to say or what else to add because this is all rather new to me, but I thought you might like to know that there is someone else out here who can relate. Keep sharing!


  2. Thank you oh so much David for your contribution. I’ve been in sobriety for nearly 7 years, I’ve worked the steps, done everything I’ve been told and have no desire to drink whatsoever. I find meetings extremely mentally painful! I do not enjoy them; I do not see the purpose of them; I do not see how attendance will keep me sober; I do not fit in; I’ve not formed one solid relationship within the rooms in seven year and had no clue what I was/am doing wrong.
    I’ve recently been diagnosed with being on the autistic spectrum and am exploring the possibility/probability that this is why I cannot cope with social situations…never have. Previously I blamed my avoidance of social situations on being extremely shy. I am middle aged and have stumbled through life. I spent my entire life people pleasing and being manipulated by others, I desperately want to change this and feel like I am now learning fundamental life skills (with help from a mental health team) which I never grasped as a child and young adult.
    Perhaps this is my destiny… to work with people on the spectrum with their sobriety? I’d really like to connect with others and I would be extremely grateful if you could point me in the right direction. Many blessings.


      1. I am not sure if I am suppose to use the above email or write in this box!

        I would really like that David. My ex-sponsor had been on at me to start sponsoring and I tried to explain why I am unable to do that at the moment. How can I teach another person about something I don’t fully understand myself? After many years we parted ways yesterday. It really saddens me but she was unable to answer my questions and I was unable to continuously, blindly do what she told me to do when I don’t understand the point of it all.
        I am passionate about learning and growing and would feel extremely blessed if I could continue to do so and help others along the way with support and sharing the knowledge I have gained on my journey. In fact, I would consider it a great privilege to be able to do so.


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