AA and Twelve Step Programs should Play an Integral Role in Treating Addicts
> 7/25/2006 11:06:40 AM

Writing for the Cochrane Library, a group of medical study reviewers have concluded that Alcoholics Anonymous and other 12-step programs are no more effective than other types of intervention at treating alcoholism. To read the review's abstract, one might take away the impression that medical research and the field of psychiatry may not support these types of programs, well there is some truth in this. Psychiatry has a long history of discrediting itself by prescribing addictive drugs and frequently ignoring serious sustance abuse in the people who seek help. These unfortunate trends have changed a little in the past 10 years as many psychiatrists see the value in twelve step programs. It is studies like this, however, that raise the old suspicions of anti-twelve step sentiment among psychiatric practitioners.

The reviewers here looked at 8 total studies that included over 3000 participants, but the nature of this relatively small sample for a meta-review was mixed and led to results that are confusing at best. The abstract boils the writers' conclusion down to the following sentences: "No experimental studies unequivocally demonstrated the effectiveness of AA or [Twelve Step Facillitation] approaches for reducing alcohol dependence or problems. One large study focused on the prognostic factors associated with interventions that were assumed to be successful rather than on the effectiveness of interventions themselves, so more efficacy studies are needed." They draw this conclusion from 8 studies, many of which, they admit, were somewhat inconclusive themselves.

The reality on the ground is that 12-step-programs are, and have been since their first appearance in 1935, an integral part of a solid recovery program. In my 20+ years of clinical experience I have consistently worked with my clients who struggle with addiction to make AA, NA or other 12-step-programs a part of their life. The community of AA is to be embraced as a substitute to the people, places and things that trigger urges to use. AA offers a ready alternative to all the old lifestyle debacles that plague the recovery process. More than this, however, AA is like a huge free database of distilled wisdom from millions of sober people who share their strength and hope to those who need it most. Therapy in an one-on-one setting, on the other hand, is a powerful tool for understanding the patterns of one's life that lead back to addiction. The family of origin issues are able to be explored and their grip on a persons soul can be loosened to permit fresh perspectives for the future. I firmly believe that the first year of recovery requires AA, individual therapy, small group therapy and online, structured therapeutic interactions for a successful resolution of an addiction. Each of these modalities in combination yield tremendous momentum to change and redifine one's life. Drugs and alcohol prevent people from exercising their innate courage to change, and recovery recaptures this ardor for life. The first year is a treacherous road that requires intensive work to unleash this powerful force for good that resides inside an addict's addiction. The most successful people I know are recovering addicts, so I know from experience that the above is true. I have had the pleasure of helping thousands of addicted people to recovery and I also know AA is indepensible.

Certainly, there is value in studying what about 12 step programs is successful and why they have remained a steady part of the recovery process for so long, but this review insinuates that these programs haven't been effective and for the millions of people whose lives have been saved, that is clearly wrong. As we move forward it will be important to assess how the internet and online meetings are effecting and changing the nature of the 12 step approach. More people in more areas will be empowered through the web to break their slavish needs and addictions, but the 12 steps will always have their part to play.


AA and 12 steps are not the only alternatives. Agnostics, atheists, and members of non-Christian may be turned off by the Christian religiosity imbedded in most 12 step groups. Secular Organizations for Sobriety (Save Our Selves)http://www.sossobriety.org/is one alternative for secular recoveryLifering is another.http://www.unhooked.com/index.htmRational Recovery is a third:http://www.rational.org/SMART (Self Management and Recovery Training) is a fourth:http://www.smartrecovery.org/JACS (Jewish Alcholics Chemically Dependent Persons and Significant Others)http://www.jacsweb.org/Buddhist Recoveryhttp://www.buddhistrecovery.com/Other Approaches:Health Recovery Center http://www.healthrecovery.com/
URL: http://lizditz.typepad.com
Posted by: Liz 7/25/2006 6:24:26 AM

Although there is no doubt a religious element to 12 step programs such as A.A. and the words "God" and "higher power" are frequently used in meetings and in the literature, it is in no way essential that a person be religious in order to engage in and benefit from 12 step programs. As a clinician of many years, I have seen many agnostics and atheists attend these programs with excellent results. One patient shared that in place of the word "God," he used "dog." Religious belief is not a prerequisite to 12 step programs. Committment to the program and acknowledgement that the individual has a problem that they cannot overcome and which is interfering with their lives is the only essential. While religious aspects of A.A. and other 12 step programs sometimes scare off individuals seeking help, one can certainly benefit from any 12 step program without religious beliefs.
Posted by: Ivan Spielberg L.C.S.W. 7/26/2006 2:28:01 AM

What do medical professionals think about the use of Campral in sober alcoholics?
Posted by: Vega 8/25/2006 2:45:49 AM

I have met a lot of people who underwent addiction intervention and in every aspect they are far better now. I don't know how exactly it worked for them but from their looks, I know they are happy to have made the decision. Thanks, anyway, for this article.Shiela
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Posted by: Nelson 2/18/2008 10:19:09 AM

12 Step programs are (usually) extremely flexible and very respectful of personal differences regarding spirituality. This goes so far as to engender a faith in "good things" that has no concept of God among some members (with no negative consequenses for "such athiest-faith" in most groups). There is the occassional local group that strays from this tolerance of diversity. One need merely leave that group and try other groups in order to find a more tolerant and loose approach to spirituality in most 12 Step programs.
Posted by: Phil 4/17/2008 7:13:52 AM

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