Even though the origins and strategies of Narcotics Anonymous (NA) are closely intertwined with those of ALCOHOLICS ANONYMOUS (AA), NA has devised its own unique adaptations to them. There is no question that NA's roots were in the AA program, but it soon came to realize its uniqueness and had to give AA's program its own "spin." Briefly sketched—an energetic, relatively new AA member, while doing twelve-stepwork in 1944, recruited an alcoholic who was also an abuser of MORPHINE (he used this drug to avoid hangovers). The AA program helped the recruit with alcohol, but not with morphine. He soon found himself an involuntary patient in the U.S. PUBLIC HEALTH SERVICE HOSPITAL in Lexington, Kentucky.

In the meantime, his AA sponsor, who was much puzzled by AA's help with alcohol but not other drugs, was transferred to Frankfort, Kentucky, near the Lexington Hospital. He (dubbed "Houston" in a Saturday Evening Post article) reportedly repeated to himself, "I was convinced that the TWELVE STEPS would work as well for drugs as for alcohol" (Ellison, 1954:23). As a result, Houston called on Dr. V. H. Vogel, the director of the Lexington Hospital, and told him of his convictions and his partial success with his AA "pigeon." Further, he offered to start a group directed at drugs in the hospital and Dr. Vogel agreed. The first meeting was on February 16, 1947. Weekly meetings have gone on ever since.

In 1948, an addict known as Dan returned to the hospital from New York City for the seventh time; after a period of severe withdrawal, he began attending the meetings begun by Houston the year before. Dan, Houston, and Houston's former AA "pigeon" spent many hours together apart from the regular meetings. From these discussions Dan experienced a miraculous change, focusing enthusiastically on the twelfth step of AA. In high spirits, he returned to New York hoping to form the first group outside Lexington Hospital—and to call it Narcotics Anonymous. Dan looked up others whom he had known at Lexington and suggested weekly meetings. Only three responded: a barber, a house-painter, and a waiter. No organization was then willing to provide them with a room for a meeting until the Salvation Army provided one. Slips plagued the first few months, but three of the original four remained committed. Slowly, the group grew in size despite disputes over policy—for example, should withdrawal from drugs be done "cold turkey" at home or within institutional care? The group finally decided to encourage the latter.

As NA emerged, it faced a dilemma. On the one hand, it wished to use the basic AA strategies and program that were directed solely against alcohol. On the other hand, it attracted, as did AA itself, many who abused a rather wide variety of drugs besides alcohol. At first, NA attracted mainly HEROIN users; later, abusers of BARBITURATES, AMPHETAMINES, and MARIJUANA began to appear at meetings. As the NA groups spread from New York City to other cities, AA groups began to thrash out a policy on the matter that further encouraged the formation of NA groups. The policy came to be known as "cooperation, but not affiliation" between AA and NA. The result was that AA freely offered their steps and traditions to NA for adaptation but steadfastly clung to their singleness of purpose—namely, to encourage alcoholics only to join. Thus, NA had to deal with a variety of drugs, not a sole prominent one, such as alcohol.

In their meetings, NA members tended to focus on the differences between the various drugs they had abused, thereby creating considerable chaos. Slowly, however, they decided on a radical change in the wording of step one. Rather than "We admitted we were powerless over drugs," they decided on "We admitted we were powerless over our ADDICTION." In other words, what all members had in common was a belief that they suffered from a disease of addiction. They pass on their experiences and hopes to the addict who still suffers; they do not become embroiled in the differing features of the various drugs to which members were addicted. In this respect, they are quite different from Cocaine Anonymous, a group that focuses on only one drug, cocaine.