Jack has reached step five - "admitted to God, to ourselves, and to another human being the exact nature of our wrongs" - and at the behest of his sponsor has approached Jamieson, a stranger, to ask him to listen to his admissions.

After Jamieson agrees to listen, Jack lists his various wrongdoings, which include fighting with another student in fourth grade for no reason, stealing alcohol from his mother, buying alcohol for a homeless man, cheating at Brown University, smuggling cocaine over the Canadian border, lying to his employer, and lying to his wife.

[8] Writing in The New York Times, Gabino Iglesias described "The Fifth Step" as "a literary shanking — it's fast and violent in equal measure.

[12] A mixed review was received from the website EverythingStephenKing.com, which described "The Fifth Step" as "a nice story, well told" - noting "King's ability to create believable characters and situations has not diminished over the years" - but also as "forgettable", with a predictable ending.

[13] Reviewing You Like It Darker for Bloody Disgusting, Jenn Adams suggested that "The Fifth Step" would "likely prove terrifying to those in Alcoholics Anonymous" but "feel[s] slight and may not evoke the same powerful response in readers without similar life experiences.