Do 12-Step Programs Work? – Nov.19, 2020

12-step recovery programs have been foundational in the treatment of drug and alcohol addiction since they were first developed in the 1930s. Today, these programs, like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), help people all over the world on their road to sobriety through a series of steps and meetings. But, do 12-step programs work for everyone? While they are very effective for many people, for some, a 12-step program might not be as effective as other therapies, or as a sole therapy. At One Community Health in Sacramento we believe in individualized treatment plans to overcome an alcohol or opioid addiction. 

What is a 12-Step Program?

A 12-step program provides a framework of 12 steps to work through in a community setting, with the goal of becoming sober. The steps include acknowledging an addiction, accepting the consequences of the addiction, attempting to mend at least some of the relational damage caused as a result of the addiction, and encouraging the building of a network of support for sustained recovery. AA, Al-Anon, and NA are the most well-known 12-step programs, but there are programs for a large variety of addictions worldwide. 

What are the Steps?

AA and NA’s 12-Step approach follows a set of guidelines, known as “steps,” toward recovery. Each step can be revisited at any time as needed. The 12 Steps, according to AA are:

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

Do 12-Step Programs Work?

As we said earlier, these programs are life-changing for some people, but may not be effective for others. The following are some of the pros and cons of 12-step programs to help you decide if you think this may be the right fit for you. 

Pros

• Cost. Cost can be a significant barrier to many seeking treatment programs. AA and NA are accessible to all. Meetings are either free or ask for a small donation. 
• Mentorship. 12-step programs provide a mentor that has worked through the steps to help guide your sobriety.  
• Community. They are community-oriented. Having the support of others can help with sustained sobriety and provide an important sense of belonging. 
• Convenience. There are meetings held multiple times a day all over the world. Wherever you live, you can generally find a meeting near you. 

Cons

• May be less effective for women. The 12-step model focuses on the individual’s powerlessness in battling addiction. In the case of alcoholism, studies have found this approach to be less effective for women. Research shows that men and women begin drinking for different reasons. Men are more likely to drink to feel more powerful and to decrease inhibition, while women are more likely to drink to numb pain.
• Spiritual approach. The program’s strong emphasis on the belief in a higher power might not work for everyone. 
• Neglects physical aspects of healing. Addiction can have serious health effects and withdrawal symptoms that don’t get addressed in the 12-step model.
• Some may be uncomfortable in group settings. The 12-step model is very public in nature. Participants are asked to acknowledge their addiction in a group setting, which can be problematic for many, especially those with mental health conditions. 

Research 

Because the 12-step model is based on anonymity, there isn’t a plethora of scientific research available. So it’s hard to tell exactly how effective it is. However, its widespread use and anecdotal evidence from recovering participants suggest it can be extremely effective.

According to a 2020 literature review conducted by a researcher at Stanford University, AA was found to be significantly more effective than other therapies. It was also found to be more effective than not using any therapy at all. None of the studies found AA to be less effective than other interventions. 

Substance Abuse Help in Sacramento

At the end of the day, the answer to this question depends on the individual. The 12-step model is very effective for some. However, if it doesn’t work for you that doesn’t mean something is wrong with you. The good news is, there are other therapies that can be used instead of or in conjunction with a 12-step program. 

At One Community Health in Sacramento, we understand what you’re going through. We don’t judge you. Instead, we will welcome you and support you. It’s what we do. Call 916-443-3299 to learn more about our substance abuse treatment services.