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Cocaine Anonymous

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Cocaine Anonymous (CA) is a twelve-step program formed in 1982, November 18th for people who seek recovery from drug addiction. It is patterned very closely after Alcoholics Anonymous (AA), although the two groups are unaffiliated. While many C.A. members have been addicted to cocaine, crack, speed or similar substances, C.A. accepts all who desire freedom from "cocaine and all other mind-altering substances" as members.[1]

C.A. uses the book Alcoholics Anonymous[2] as its basic text. Complementing this are the C.A. published works of members storybook titled Hope, Faith and Courage: Stories from the Fellowship of Cocaine Anonymous Volume I & II, A Quite Peace and The Twelve Step Companion Guide.[3] and the AA book Twelve Steps and Twelve Traditions.[4]

C.A. was formed in Los Angeles, California in 1982 by an anonymous member who worked in the film industry and saw a number of people who had difficulty finding help from anyone knowledgeable about the special difficulties presented by cocaine addiction. Cocaine Anonymous World Service Office, Inc. was later established in Los Angeles in 1987 and located there until July of 2024. Currently located in Phoenix, Arizona.

Co-Anon (formerly CocAnon) is a program for families of cocaine users, analogous to Al-Anon for the friends and family of alcoholics, also not associated with Cocaine Anonymous.[5]

Evidence

A 2020 Cochrane review found that clinically delivered twelve-step facilitation for alcohol use disorder led to higher rates of continuous abstinence than other established treatments such as cognitive behavioural therapy, with similar results on other outcomes; it covered alcohol only.[6] For illicit drugs, including cocaine, a 2017 Campbell systematic review found twelve-step programmes were neither better nor worse than other psychosocial interventions, and described the evidence as weak.[7]

An earlier Cochrane review, published in 2006, found that no experimental studies unequivocally demonstrated the effectiveness of AA or twelve-step facilitation.[8] Because people choose whether to attend, observational studies are vulnerable to self-selection bias; a 2014 re-analysis of randomised trials that addressed this still found that increased AA attendance led to more days of abstinence for most samples.[9] Dropout is common: in a study of 2,778 men treated for substance use disorders, 40% of those who had attended twelve-step groups had stopped by one year after treatment.[10] Researchers have also questioned court mandates to attend meetings, citing ethical issues and possible loss of civil liberties.[11] Research on AA's mechanisms suggests that much of its benefit comes through social factors, such as changes in members' social networks and confidence in staying sober in social settings, and through helping others, rather than through specific beliefs.[12][13]

Addiction is a serious and often long-term condition. The US National Institute on Drug Abuse says that 40 to 60% of people treated for substance use disorders relapse, comparable to relapse rates of 50 to 70% for hypertension and asthma, and that relapse indicates a need to resume or change treatment rather than treatment failure.[14] The World Health Organization estimated that about 400 million people lived with alcohol use disorders in 2019, and that the proportion of people with substance use disorders in contact with treatment ranged from under 1% to no more than 35% in reporting countries.[15] At the same time, NIAAA states that most people with alcohol use disorder recover or markedly improve,[16] and a 2017 nationally representative US survey estimated that 9.1% of adults (about 22.35 million people) had resolved a significant alcohol or drug problem, about half of them with some form of assistance, most commonly mutual-help groups.[17]

Medical bodies advise that withdrawal should be planned with medical help. The NHS says that for people physically dependent on alcohol, stopping overnight could be harmful, and that severe withdrawal symptoms such as seizures need emergency care.[18] NICE warns that stopping benzodiazepines suddenly can cause withdrawal effects that are very serious and even life-threatening.[19] NICE guidance says that assisted alcohol withdrawal is usually community-based, and that inpatient or residential withdrawal should be considered for people at higher risk, such as those with previous withdrawal seizures or delirium tremens, or who need to withdraw from alcohol and benzodiazepines at the same time.[20] For opioid detoxification, NICE recommends methadone or buprenorphine as the first-line treatment.[21] Twelve-step groups are widely used for longer-term support after treatment; the NHS lists mutual aid groups such as AA and SMART Recovery among longer-term support options.[18]

Safeguarding concerns

Journalists have reported cases in which people used open twelve-step meetings, where members are not screened, to target vulnerable newcomers, including through romantic or sexual approaches, financial exploitation and isolation from friends and family.[22][23] CA uses the AA book Alcoholics Anonymous (the "Big Book") among its main literature.[24] The book was first published in 1939; AA itself notes that one chapter was written when there were few women in AA,[25] and in 2024 AA published a Plain Language Big Book for readers who find the original language hard to follow.[26]

See also

References

  1. ↑ Cocaine Anonymous (2007-11-13). "And All Other Mind-Altering Substances". Archived from the original on 2009-03-04. Retrieved 2007-11-15.
  2. ↑ Alcoholics Anonymous (1976-06-01). Alcoholics Anonymous. Alcoholics Anonymous World Services. ISBN 0-916856-59-3.
  3. ↑ Cocaine Anonymous (January 1993). Hope, Faith and Courage: Stories from the Fellowship of Cocaine Anonymous. Los Angeles.: Cocaine Anonymous World Services. ISBN 0-9638193-1-3.
  4. ↑ Alcoholics Anonymous (2002-02-10). Twelve Steps and Twelve Traditions. Hazelden. ISBN 0-916856-01-1.
  5. ↑ Cohen, Sidney (1985). The Substance Abuse Problems. New York: Haworth Press. ISBN 0-86656-368-7. OCLC 6666765.
  6. ↑ Kelly, John F.; Humphreys, Keith; Ferri, Marica (2020). "Alcoholics Anonymous and other 12-step programs for alcohol use disorder". Cochrane Database of Systematic Reviews. 3 (3) CD012880. doi:10.1002/14651858.CD012880.pub2. PMC 7065341. PMID 32159228.
  7. ↑ Bøg, Martin; Filges, Trine; Brännström, Lars; Jørgensen, Anne Marie Klint; Fredriksson, Maja Karrman (2017). "12-step programs for reducing illicit drug use". Campbell Systematic Reviews. 13 (1): 1–149. doi:10.4073/csr.2017.2.
  8. ↑ Ferri, Marica; Amato, Laura; Davoli, Marina (2006). "Alcoholics Anonymous and other 12-step programmes for alcohol dependence". Cochrane Database of Systematic Reviews (3) CD005032. doi:10.1002/14651858.CD005032.pub2. PMID 16856072.
  9. ↑ Humphreys, Keith; Blodgett, Janet C.; Wagner, Todd H. (2014). "Estimating the efficacy of Alcoholics Anonymous without self-selection bias: an instrumental variables re-analysis of randomized clinical trials". Alcoholism: Clinical and Experimental Research. 38 (11): 2688–2694. doi:10.1111/acer.12557. PMC 4285560.
  10. ↑ Kelly, John F.; Moos, Rudolf (2003). "Dropout from 12-step self-help groups: prevalence, predictors, and counteracting treatment influences". Journal of Substance Abuse Treatment. 24 (3): 241–250. PMID 12810145.
  11. ↑ Speiglman, Richard (1997). "Mandated AA attendance for recidivist drinking drivers: policy issues". Addiction. 92 (9): 1133–1136. doi:10.1111/j.1360-0443.1997.tb03671.x. PMID 9374010.
  12. ↑ Kelly, John F.; Hoeppner, Bettina; Stout, Robert L.; Pagano, Maria (2012). "Determining the relative importance of the mechanisms of behavior change within Alcoholics Anonymous: a multiple mediator analysis". Addiction. 107 (2): 289–299. doi:10.1111/j.1360-0443.2011.03593.x. PMID 21917054.
  13. ↑ Zemore, Sarah E.; Kaskutas, Lee Ann; Ammon, Lyndsay N. (2004). "In 12-step groups, helping helps the helper". Addiction. 99 (8): 1015–1023. doi:10.1111/j.1360-0443.2004.00782.x. PMID 15265098.
  14. ↑ "Treatment and Recovery". Drugs, Brains, and Behavior: The Science of Addiction. National Institute on Drug Abuse. Retrieved 2026-10-02.
  15. ↑ "Over 3 million annual deaths due to alcohol and drug use, majority among men". World Health Organization. 25 June 2024. Retrieved 2026-10-02.
  16. ↑ "Treatment for Alcohol Problems: Finding and Getting Help". National Institute on Alcohol Abuse and Alcoholism. Retrieved 2026-10-02.
  17. ↑ Kelly, John F.; Bergman, Brandon; Hoeppner, Bettina B.; Vilsaint, Corrie; White, William L. (2017). "Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy". Drug and Alcohol Dependence. 181: 162–169. doi:10.1016/j.drugalcdep.2017.09.028. PMC 6076174.
  18. ↑ 18.0 18.1 "Alcohol support". NHS. Retrieved 2026-10-02.
  19. ↑ "Should I stop my benzodiazepine or z-drug? (NG215 patient decision aid)". National Institute for Health and Care Excellence. Retrieved 2026-10-02.
  20. ↑ "Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence (CG115)". National Institute for Health and Care Excellence. 23 February 2011. Recommendations 1.3.4.2 and 1.3.4.5. Retrieved 2026-10-04.
  21. ↑ "Drug misuse in over 16s: opioid detoxification (CG52)". National Institute for Health and Care Excellence. 25 July 2007. Recommendation 1.3.1.1. Retrieved 2026-10-04.
  22. ↑ Glaser, Gabrielle (24 June 2013). "Twelve Steps to Danger: How Alcoholics Anonymous Can Be a Playground for Violence-Prone Members". ProPublica. Retrieved 2026-10-02.
  23. ↑ Cunha, Darlena (22 September 2015). "'I was fresh meat': how AA meetings push some women into harmful dating". The Guardian. Retrieved 2026-10-02.
  24. ↑ "Tools of Recovery". Cocaine Anonymous World Services. Retrieved 2026-10-02.
  25. ↑ "To Wives" (PDF). Alcoholics Anonymous (4th ed.). Alcoholics Anonymous World Services. 2001. p. 104.
  26. ↑ "Plain Language Big Book: A Tool for Reading Alcoholics Anonymous" (PDF). Alcoholics Anonymous World Services. 1 November 2024. Retrieved 2026-10-02.

Further reading

  • Crits-Christoph, P.; Gibbons, M. B. C.; Barber, J. P.; Gallop, R.; Beck, A. T.; Mercer, D.; et al. (2003-11-01). "Mediators of outcome of psychosocial treatments for cocaine dependence". Journal of Consulting and Clinical Psychology. 71 (5): 918–925. doi:10.1037/0022-006X.71.5.918. PMID 14516240.
  • Maude-Griffin, P. M.; Hohenstein, J. M.; Humfleet, G. L.; Reilly, P. M.; Tusel, D. J.; & Hall, S. M. (1997-11-01). "Superior efficacy of cognitive-behavioral therapy for urban crack cocaine abusers: Main and matching effects". Journal of Consulting and Clinical Psychology. 66 (5): 832–837. doi:10.1037/0022-006X.66.5.832. PMID 9803702.
  • Weiss, R. D.; Griffin, M. L.; Gallop, R. J.; Najavits, L. M.; Frank, A.; Crits-Christoph, P.; et al. (2005-02-01). "The effect of 12-step self-help group attendance and participation on drug use outcomes among cocaine-dependent patients". Drug and Alcohol Dependence. 77 (2): 177–184. doi:10.1016/j.drugalcdep.2004.08.012. PMID 15664719.

Need support? This page covers a topic that some readers may find difficult. If it affects you or someone you know, you do not have to deal with it alone. Help is available from the NHS and from free, confidential helplines: see Where to get help at the end of this page, or the Wellness hub. If anyone is in immediate danger, call 999.

Where to get help

If you are worried about your mental health or someone else's, these services can help. The numbers below are for the United Kingdom.

  • Emergency: if someone is in immediate danger or has been seriously hurt, call 999.
  • NHS 111: for urgent help or advice that is not an emergency, call 111 or use NHS 111 online. It is free and open day and night.
  • Your GP: a GP can talk with you about how you are feeling and can refer you to services, including NHS Talking Therapies.
  • Samaritans: call 116 123, free, day or night, to talk to someone who will listen.
  • Childline: children and young people under 19 can call 0800 1111 free, or talk online at childline.org.uk.
  • Shout: text SHOUT to 85258 for free, confidential text support at any time.
  • Outside the UK: Find A Helpline is a free directory of helplines in other countries.

For support in other countries, and for more services, see the Wellness hub and Pip's support guide.


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