Do 12-Step Programs Work?

Few things generate more controversy than the topic of 12-step programs and whether they do effectively work to help people who suffer from addiction to drugs and alcohol quit their dependence on these substances. People love to hate on Alcoholics Anonymous, the oldest 12-step program and to date the most effective solution to recovery. 12-step programs are under-researched and widely misunderstood, by the public, by haters who have tried it with little or no results and even by it’s own members.

Lack of Scientific Data

There is a lack of scientific data to support how and why this program works. Over 75 years of history, the widespread and worldwide fellowship, hundreds upon hundreds of cases where long-term sobriety has been realize. All this should be evidence enough that it works better than anything anyone has come up with so far. Still, the 12-step program is not scientific. It’s not that it doesn’t work, it’s that there is not sufficient evidence that it does. I find it funny when I hear different success rate statistics for various 12-step treatment centers and sober living homes, AA, NA, etc. As long as I’ve been attending Alcoholics Anonymous, there has been no role call. There are also no sign-in sheets or yearly census calculations.

When someone attends meetings for a year or so, leaves to carry on with his or her life and remains sober, there is no bean counter that keeps track of this person’s life. Isn’t this a success? Or is it a failure because they are choosing not to participate in AA any longer? When someone is sober for many, many years and relapses, this information is not included in a chart or a graph. Is achieving a measure of long-term sobriety then relapsing a failure? Isn’t it a success in and of itself given that most addicted people do not achieve such milestones.

Perhaps it’s necessary to take an in depth look first at a couple of popular reasons people say 12-step programs don’t work. This is in order to understand where all the passion is coming from. There is an ounce of truth in everything and for every reason someone gives as to why AA doesn’t work, there’s a probably a member who has gone rogue, took matters into his or her own hands and added fuel to the fire of misunderstanding. This is not new behavior, it happens everywhere. Including in all types of organizations, families and fellowships. Hopefully the person who needs to get sober will surround themselves with reputable members. Those who honor the sanctity of AA as it was intended.

Too Much Talk of God

12-step programs contain numerous references to God in the literature. Also in people’s shares and on the banners displayed in meeting halls…it’s everywhere. This makes some people feel they are being force fed the Judeo-Christian religion. No one wants to be pushed either to believe or to incorporate God in anything or everything they do. Whether they already believe or not, it’s personal. People like being “Master of Their Own Destiny”. They don’t resonate with the fact that the guiding principle in every 12-step program is dependence upon a higher power.

Bill and Bob didn’t create Alcoholics Anonymous as a vehicle for members to find their God. Rather they encouraged cultivating a relationship with God. They encouraged each individual to decide for themselves what exactly his or hers is. If a member was an agnostic, they were encouraged to find their own concept of a higher power. They knew that success was dependent upon belief in a higher power. But, the book is not an instruction manual in how to find this or where to find it. Some members as well as others who have tried AA and couldn’t get past the God concept have misunderstood this basic precept.

12-Step Programs Are Filled with Losers

Addiction is progressive illness, not a choice. As such, it takes a tremendous amount of courage to ask for help. Some people will be able to quit on their own but most people cannot. There is strength in numbers and together addicts help each other succeed in sobriety. The mind of an addict is constantly telling them they are different, that no one understands, that life will never work out for them. Just by the willingness to accept help from another human being, they have overcome a huge obstacle and have placed themselves in a better position to succeed. There is no shame in asking for and receiving help. The greatest leaders in the world depend on the sage advice of others to move them forward so that they can be more effective. Members who need and ask for help are not losers.

AA is just a microcosm of the macrocosm – what exists in the world is amplified in 12-step rooms. There is a saying, “AA is not a hotbed of mental health.” Unfortunately, there exists a chasm between the original intentions of the 12-step movement and the outside issues people are expecting AA to resolve for them. The intention of AA is to help people to stop drinking, not address trauma or mental illness. AA is not intended to be an organization where sponsors assume the role of therapist; it’s not a dating service or a place to solicit a job from another member. Unfortunately, some members are guilty of doing these things. AA’s primary purpose is to help another alcoholic achieve sobriety.

Regrettably, there are some members who have severe opinions that AA alone can handle mental health issues and they scorn medication. This puts an unfair pressure on those with dual diagnosis.   Members need to evolve and align themselves with mental illness professionals who are trained to handle these issues, not attempt to give people direction on how to handle it.

OK, But Do 12-Step Programs Work?

What constitutes 12-step programs working? Does it mean AA didn’t work because someone came for a couple of years and left? Even though they may still be sober? Does it mean it didn’t work if someone relapsed after long-term sobriety, even though that in and of itself is a tremendous success?   Life has its ups and downs, is it even a question of whether it works or not?

Are 12-step programs a perfect fit for everyone? Probably not, we are not robots. What constitutes 12-step programs not working or not working? Many people I speak with who hate on AA have not actually “worked the program.” There are 12 basic suggestions to follow: included is an admission of powerlessness over our disease, a declaration to allow a higher power to help us, a process for recognizing old behavior and harms done to others and ourselves, a practice for amending old behavior and replacing it with kindness and kinship for our brother and sister. Finally, we feel a sense of joy as we pass on what someone else gave to us without a fee. These are solid ideas that do not harm anyone – how can they be hated? How can they not work if sobriety is what someone is really after?

Do 12-step programs really work? My experience has shown me that they work when you work them.


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