The 12-step recovery program is a cornerstone in the treatment of drug and alcohol addiction. Started in the 1930s, it was the first popularized treatment methodology to acknowledge addiction as something other than a choice.
Today, Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are organizations dedicated to helping people worldwide achieve sobriety through a series of graduated steps and regular meetings. Research supports the efficacy of 12-step programs like AA and NA, though several studies indicate a gender divide on who is more likely to benefit from such a program. In some cases, a 12-step program might not be as effective as other therapies, when used alone, and in other cases, it is an excellent complement to other forms of treatment.
Pros Of The 12-Step Recovery Program For Drug And Alcohol Addiction Treatment
A 12-step program like AA or NA provides a framework of steps in acknowledging the addiction, accepting the consequences of the addiction, ways to mend at least some of the damage done while using, and encourages the building of a network of support through a service-oriented 12th step. For the large number of people AA and NA provide support to, it’s a self-sufficient organization supported by donation. Someone wishing to seek help through a 12-step program can do so at no cost. And with cost of treatment being a primary barrier for most people, 12-step programs can offer a life-line of much needed support.
Sponsorship is another benefit of the 12-step program. Someone within the program can choose to work with a person who has been through the steps and has remained in sobriety for at least five years. While not a therapist, a sponsor can offer a level of support unique to the program, in that they have survived addiction and successfully completed the program.
Evidence supports the effectiveness of AA and NA, though few studies have been concluded due to the high level of anonymity of these programs. One of those studies, sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), examined the effectiveness of three different treatment types in reducing overall drinking, including the 12-step, cognitive behavioral therapy (CBT), and motivational therapy. While all three treatment types showed promise, the 12-step program resulted in the most significant long-term impact.
The 12-step program affords participants an immediate and broad network of support within their existing community. The nature of the program encourages continued participation in regular meetings, and at different levels, including sponsorship.
Cons Of The 12-Step Recovery Program For Drug And Alcohol Addiction Treatment
While the traditional 12-step program has proven effective for many, there are some drawbacks to this form of treatment. The 12-step model emphasizes the powerlessness of the individual in battling addiction, and studies have found this approach to be less effective for women.
Research indicates men and women begin drinking for different reasons. While men tend to drink to feel more powerful and to decrease inhibition, women are more likely to drink from a place of numbing or pain reduction. They do not report feeling more powerful while drinking. As a result, women tend to see improved outcomes with cognitive behavioral therapy over the 12-step program, as well as programs like the trauma recovery empowerment model (TREM), which seek to empower women toward skill-building and coping with past sexual and physical trauma.
Another con of the 12-step program, especially for humanists or atheists, is the program’s fundamental adherence in the belief of a higher power. While this higher power is sometimes interpreted as the program itself, this reliance on an outside power to guide the process may not be a comfortable notion for everyone.
Other drawbacks of the 12-step program involve the lack of emphasis on physical recovery. Addiction comes with adverse health effects and withdrawal symptoms that are not addressed by the 12-step model.
Some are also uncomfortable with the very public nature of 12-step programs in asking participants to acknowledge their addiction in a group setting. For someone with a co-occurring mental disorder, the experience of talking about their drug or alcohol use in a group setting can increase symptoms of the disorder.
Pros and Cons of the 12-Step Recovery Program for Addiction Treatment:
Pros
- Self-sufficient organization operating on donation only, not cost to individual
- Provides level of sponsorship support, unique to the program
- Evidence supports long-term effectiveness of the 12 step program
- Built-in broad social network of support
Cons
- Not an empowerment model, so less effective for women seeking treatment
- Reliance on a higher power, individuals are powerless to affect change without this higher power
- Lacks emphasis on physical aspects of recovery, including withdrawal or detox period
- Social aspects of program may increase symptoms of co-occurring mental disorders
Every year brings forth additional awareness of the complexity of addiction and improvements in recovery programs to increase long-term success rates. The traditional 12-step program can be used alone, or may be a good compliment to a more comprehensive approach to treating drug and alcohol addiction.
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