I haven't touched cocaine or heroin in sixteen years. People sometimes ask me which group is the right one, like there's a correct answer printed on the back of the box. There isn't. There's the one you'll actually walk back into next Tuesday.
So here's the plain version first. Narcotics Anonymous (NA) is a twelve-step fellowship. Other people who used run it, it's free, and the goal is complete abstinence from every drug, alcohol included. SMART Recovery is secular. Also free. Meetings are led by trained facilitators and built around practical tools for cravings, thinking and motivation. Neither one is treatment, and neither one replaces a doctor if your body is dependent. Both are a room where you're not the only one.
What is Narcotics Anonymous, in plain words?
NA is people who used, talking to people who used. That's the engine. You sit, you listen, somebody shares something you thought only you had ever felt, and something in your chest loosens a bit.
According to NA's own description of its program, membership is free and NA makes no distinction between drugs, alcohol included. So if you quit heroin but figure a few beers are fine, NA will tell you that's still using. Some people need that line drawn hard. Some people hate it.
The program is the Twelve Steps. You work them over time, usually with a sponsor, someone further along who you call when it gets ugly at two in the morning. The steps talk about a power greater than yourself. Some people hear God in that. Some hear "the group." Some can't get past it at all, and that's usually the moment SMART comes up.
It's big. NA says its members hold more than 79,000 meetings a week in 122 countries. In Québec, Narcotiques Anonymes Québec runs French-language meetings across the province and has a help line at 1 855-LIGNE-NA (1 855 544-6362). Outside Québec, the NA meeting search finds rooms near you, or online ones.
One thing to know going in: people introduce themselves as addicts. "Hi, I'm so-and-so, and I'm an addict." For some people that's the first honest sentence they've said in years. For others it feels like a life sentence. I've felt both about that word, on different days.
What is SMART Recovery?
SMART stands for Self-Management and Recovery Training. It's built on what they call the 4-Point Program: building and keeping motivation, coping with urges and cravings, managing your thoughts, feelings and behaviour, and living a balanced life.
That third point is where it gets useful. You learn to catch the thought ("one time won't hurt, I've earned it") and argue with it. It feels a lot like the stuff a therapist would give you as homework, because it comes from the same family of ideas.
SMART Recovery describes itself as evidence-informed, with no religious content, and focused on skills instead of labels. Meetings are free, led by trained facilitators, online and in person, and they say you can use SMART alone or alongside other approaches. Nobody makes you call yourself anything.
The catch, for us here: as I write this, SMART's Canadian site shows a "coming soon" page, and I didn't find French-language SMART meetings in Québec. For now, the easy way in from here is the online meeting finder, in English.
So what's actually different?
God, or not. NA is spiritual, not religious, but the higher-power language is there and it doesn't go away. SMART has none of it.
Who runs the room. NA is fully peer-run. Nobody's in charge, which is beautiful and also means the quality of a meeting depends a lot on who shows up. SMART has a trained facilitator steering.
What you call yourself. NA uses "addict." SMART avoids labels. Pick the one that doesn't make you want to leave.
How the hour feels. NA meetings are mostly people sharing their story, one after the other, no cross-talk. SMART meetings are closer to a workshop. Someone brings a problem, the group works a tool on it.
Size. NA is everywhere, French included, any night of the week. SMART is smaller, especially here.
Which one has better evidence?
Honest answer, the research is lopsided. The strongest study of twelve-step help is a 2020 Cochrane review of AA and twelve-step facilitation, which found it worked as well as other treatments like CBT on most outcomes and did better on staying continuously abstinent (Kelly et al., 2020). But that's alcohol, not cocaine or heroin, and it's AA, not NA. For SMART, I couldn't find a review of the same size. Maybe it works just as well. Fewer people have studied it, so nobody can say yet.
So the evidence doesn't pick for you. You do.
How do I choose?
Go to a few of each, if you can. Not one. Rooms vary a lot. A bad first meeting tells you about that room on that night, and that's all it tells you.
Then ask yourself one question after: did I want to come back? If yes, that's your answer for now. You can switch later. Lots of people use both. Lots of people use one plus therapy, which I'd push for if anything else is going on in your head (I wrote about that in dual diagnosis).
And if you sit in a meeting and feel like bolting, that's normal. I've wanted to bolt out of plenty of rooms in my life. Stay till the end once. Leave at the break the second time if you have to. Just go back.
What neither one is
Neither group is detox. If you're physically dependent on opioids, alcohol or benzos, stopping can be dangerous, and you need medical help, not a meeting. I wrote about that in getting through opioid withdrawal safely. In Québec, Drogue : aide et référence at 1 800 265-2626 is free, confidential and open 24/7, and they can point you to treatment near you.
Neither one is therapy either. Group therapy is a different animal, with a professional running it. There's more on that in what group therapy is really like. And if you want to know what the long road looks like, I wrote about sixteen years clean.