Coin, chip, key tag, medallion: “It’s not a badge of membership,” according to those distributing them at recovery meetings throughout the world, but as markers of clean time, sobriety medallions are the rabbits' feet of those recovering from alcoholism and addiction.
In 12 Step meetings, they come in various forms: predominantly, Alcoholics Anonymous (A.A.) groups distribute plastic chips, while in Narcotics Anonymous (N.A.), they give out key tags. But sobriety medallions aren’t limited solely to 12 Step organizations: Many other support groups for recovering addicts and alcoholics distribute them as well. Even at Cornerstone of Recovery, patients who complete various levels of addiction treatment receive them.
They are, according to Cornerstone Extended Care Director Julie Hamlin, a token of achievement and a source of comfort.
“It’s a reminder that you’ve accomplished something, and that you’re taking part in this journey,” Hamlin says. “When they complete residential treatment, they have a coin-out ceremony, and their peers offer them encouragement and positive affirmation. If they choose to continue treatment in the Intensive Outpatient Program, they’ll get another one when they complete it.
“It’s just a way of letting them know that they’ve completed something, but also that they’re just starting something — this recovery journey that will continue, if they so choose, after they leave Cornerstone. More than anything else, it’s a way of showing them that they’re part of a family. If they keep it in their pockets, it’s a reminder that they’re never alone. They know they have someone they can call, someone they can reach out to, when times get tough, and that brings people a lot of comfort, just having that with them.”
Sobriety medallions: Predecessors throughout history
Good luck charms and trinkets have been a part of human culture for centuries, so it’s only natural that such traditions would make their way into recovery circles. They symbolize both attachment to a particular tradition and the belief that fortune favors those who carry them, according to Richard Wiseman, a professor of psychology at the University of Hertfordshire and author of the book “The Luck Factor.”
““The fact that they come up in every culture through time shows how much luck and superstition is embedded in our DNA,” he told National Geographic . Whether they work or not, he added, is often arbitrary — but the belief that they work can lead to improved outcomes by those who carry them, he pointed out.
“In a series of experiments, researchers have asked people to solve anagrams, carry out golf putts, et cetera, both with and without their favorite charms,” Wiseman said. “People obtained higher scores when they had their charm with them. The idea is that the charms reduce anxiety and that, in turn, helps performance.”
While amulets, charms, tokens and baubles of all shapes, sizes and forms can be found throughout the world, several have emerged over the years, especially in Western culture, as particularly potent. The horseshoe, for example: “Its magical properties are often attributed to its material — iron was thought to drive evil away – and other times, to its shape, similar to the crescent moon or a pot filled with luck (that’s why it’s often hung with its open end up),” according to the Toronto Times .
Four-leaf clovers are another totem believed to generate good fortune, Dr. Stephen Prescott, president of the Oklahoma Medical Research Foundation, told KFOR-TV : “Saint Patrick was said to use the shamrock, the three-leaf clover, to teach about the Holy Trinity. Whereas the four-leaf version is supposed to stand for faith, hope, love and luck.”
While the three-leaf variety of Tifolium repens, a.k.a. white clover, is common — trifolium, after all, is Latin for three leaves — only one specimen in 10,000, Prescott added, has four leaves. It’s rarity adds to its mythical power, he added.
Finally, the rabbit’s foot has a strange and arcane history as a good luck charm. While some folklorists trace its roots back to the Celtic people of the British Isles — who were thought to admire the nature of rabbits to burrow underground, thus bringing them closer to benevolent spirits — they became popular in America in the early 20th century, according to a story in the quarterly magazine Modern Farmer : “By the 1880s, rabbit’s feet were a popular trinket to purchase in places such as New Orleans. The rabbit had an important place in West African folklore, same as it did in Mexico and China and Brittany … (a)nd so it remained a major part of what’s variously called Hoodoo or Conjure, referring to the type of spirituality that evolved from the slave trade moving Africans to the US.”
The origin of sobriety medallions
In recovery circles, sobriety medallions aren’t officially sanctioned by the governing bodies of major 12 Step organizations like A.A. and N.A. In fact, sobriety medallions were first addressed at the 1958 A.A. General Service Conference : “In regard to the attitude of the movement as a whole toward the use of so-called AA ‘chips,’ ‘tokens,’ ‘lapel emblems’ and similar devices, the consensus was this was a matter for local autonomy and not one on which the GSC should record a definite position in behalf of the movement.”
It remains a matter of local autonomy, and A.A. plainly states on its website : “A.A. does not have specific sobriety coins or other tokens that are used throughout the Fellowship. Individuals and local groups that choose to use sobriety tokens to mark sobriety anniversaries may purchase them from various sources, and the manufacture and style of these may vary from region to region, and even group to group. Because all A.A. groups are autonomous, the customs and practices for celebrating periods of sobriety remain a matter of local choice.”
However, the use of a coin as a marker of sobriety can be traced back to the early days of A.A., when Sister Mary Ignatia began working with Dr. Bob Smith, considered one of the co-founders of the program, “to help admit alcoholics into St. Thomas Hospital in Akron, Ohio, starting in 1939. She surmounted obstacles to personally care for thousands of alcoholics over the next several decades, both in Akron and later at St. Vincent Charity Hospital in Cleveland.” 
According to the historical book “Dr. Bob and the Good Oldtimers,” Sister Ignatia was fond of giving these patients, upon their release from St. Thomas, “a Sacred Heart medallion, which she asked them to return before they took the first drink. She would occasionally give out St. Christopher medals as well, but she would tell the recipient not to drive too fast. ‘He gets out after 50 miles an hour,’ she warned.” 
While it isn’t clear whether Sister Ignatia pioneered the practice of sobriety medallions to mark the beginning of a recovering alcoholic’s sober journey, there is evidence that the tradition might even predate A.A. itself. According to a historical piece on the recovery website The Fix , “Many attribute the celebration of the sober birthday practice to the Oxford Group, a nondenominational Christian fellowship both Bill and Bob belonged to for a time. Oxford Groupers, however, would count the time since their ‘spiritual’ rebirth instead of time since their last drink, as the fellowship was not primarily concerned with recovery from alcoholism.”
Sober birthday commemorations
There are other pioneers of 12 Step recovery who deserve a mention when it comes to the history and tradition of sobriety medallions. According to the website Big Book Sponsorship , Clarence H. Snyder — whose personal story, “Home Brewmeister,” is in the Big Book of A.A. — “carried a medallion made from a silver dollar and a watch fob up until just before his death on March 22, 1984. It has been dated back into the mid-1940s, if not before, and the holes represent 46 years of sobriety.”
The A.A. website itself  gives much of the credit to Doherty S., “who originally brought A.A. to Indianapolis. Doherty himself, in a letter to Bill, seems to indicate the practice originated in Indianapolis in 1942.” Writer Nell Wing, the website continues, references it 20 years later: “The chip system might have begun in Indianapolis … reference was made in a letter from Doherty to the start of giving out ‘chips’ and ‘tokens.’ This was in 1942. I imagine this would be about right, because most of the early groups started in 1940 and it would take about a couple of years to think of anniversaries and marking any time of sobriety. I asked Bill about this and his memory is that the system started in Indianapolis."
By many accounts, the tradition of giving sobriety chips is attributed to an A.A. group in Elmira, New York, beginning around 1947 , but less than a year later, the practice had begun to spread. Some writers attribute the distribution of “chips” to the fact that sober alcoholics played a lot of poker in their early clubhouses, but there’s no definitive proof of that claim. Regardless, however, in a letter to the A.A. newsletter Grapevine in 1948, Charlotte, North Carolina resident “R.G.W.” wrote, “No, I don't believe that the ‘chip system’ will keep anyone sober. Only a Higher Power can do that. But we are a nation that lives by symbols; what is the American flag but a piece of bunting, unless fully appreciated on what it stands for? Frankly, I hate poker. Yet, I wouldn't trade a mile-high stack of green stuff for my precious blue pocket piece.” 
The custom continued to grow as part of A.A., N.A. and other organizations that wanted to give its members a combination of positive reinforcement and a sense of accomplishment, and by 1975, the practice had even been recognized by psychologists who studied the 12 Step method for its ability to help addicts and alcoholics. In a 1975 paper for the journal American Psychologist, criminologist and social worker Alexander Bassin described  the chip system as “a behavior modification technique,” and noted that the practice served, in a sense, as a talisman to ward off relapse, especially the alcoholic “keeps the chip in the same pocket in which he or she keeps money to buy alcohol. Each time he is tempted to buy alcohol, he comes into contact with the poker chip and is reminded of the AA plan of being abstinent for one day at a time.”
Sobriety medallions at Cornerstone of Recovery
So how do sobriety medallions work? It’s different for each program, and different still for each meeting. They’re usually distributed at the end or at the beginning of 12 Step meetings, and certain milestones — usually year or multiple-year observances — may be special occasions, in which the recipient is given time to speak or is the primary meeting speaker.
Various colors are assigned to various lengths of sobriety. Typically, A.A. chips include: white to start or renew a commitment to sobriety; yellow for 30 days; red for 90 days; blue for six months; green for nine months; and a bronze chip for one or more years. N.A. key tags are: white to begin or restart the program; orange for 30 days; green for 60 days; red for 90 days; blue for six months; yellow for nine months; “glow in the dark” for one year; gray for 18 months; and black for two or more years. In addition, some N.A. members may choose to pick up a metal coin to mark their annual observances.
It’s important to note, however, that while picking up a key tag or chip can be something those in recovery look forward to, they’re not the purpose of sobriety: “Most aren’t getting sober for key tags, but these mementos are positive reinforcers of your work and daily reminders to keep on the path to long term sobriety.”  Whether they hang on a key ring or are kept in a pants pocket, they serve in many ways like the traditional good luck charms of cultures both ancient and contemporary.
However, receiving them — whether in a recovery meeting or upon completion of treatment at Cornerstone of Recovery — is almost a sacred thing, according Chris Brewster, Assistant Director of Extended Care who came through Cornerstone as a patient in 2005. It’s been 15 years, but he remembers vividly his coin-out ceremony when he completed the residential program.
“That meant I got to sit in there and hear my peers say good thing about me, things that were probably true but I didn’t believe were true,” he said. “For the first time in my life, I felt like I had really accomplished something great — and looking back on it now, it was the biggest accomplishment in my whole life. The bottom line is that completing treatment and staying sober is the best thing I’ve ever done.”
And to mark it with sobriety medallions — then, and every year on his sober anniversary — is a consistent reminder: of how far he’s come, and that the journey doesn’t have an end point.
“It keeps me right-sized. It gives me an opportunity to thank the people before me for paving the way, and it gives me the opportunity to give hope to those who come behind me,” he said. “It just reminds me that I’m a part of something greater than I am, and that I just need to keep doing what I’m doing.”