12 Step vs. Non-12 Step Models of Treatment: A Comparison of the Successes and Failures

12 Step and Non-12 Step Programs for Addiction

The 12 Step Program

Alcoholics Anonymous (or AA) was created in 1935 with the intention of forming a brotherhood of recovering alcoholics who would help each other recover and stay clean and help others suffering from alcoholism to do the same. It has since become the unofficial standard in addiction recovery programs in the United States and around the world. Many addiction treatment and recovery support groups such as Narcotics Anonymous and many others have formed around the original core principles of AA.

Many doctors and medical care providers may only ever have been taught about AA as an option to recommend to those needing help with addiction and substance abuse. It has also become common practice for many courts to mandate participation in an AA program to people convicted of drug relate offensives.

The AA recovery program was developed as twelve steps which when applied to the addict’s life (“working the steps”) can help the individual stabilize their life and stay off of whatever substance they struggle with. The Twelve Steps are sometimes modified or changed somewhat to suit the needs of whatever group is using them, but they usually follow the original twelve steps fairly closely.

The Original 12 Steps for Alcoholics Anonymous are as follows:

(Other groups would change “Alcohol” to whatever substance they struggle with.)

• We admitted we were powerless over alcohol–that our lives had become unmanageable.
• Came to believe that a Power greater than ourselves could restore us to sanity.
• Made a decision to turn our will and our lives over to the care of God as we understood Him.
• Made a searching and fearless moral inventory of ourselves.
• Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
• Were entirely ready to have God remove all these defects of character
• Humbly asked Him to remove our shortcomings
• Made a list of persons we had harmed and became willing to make amends to them all.
• Made direct amends to such people wherever possible, except when to do so would injure them or others.
• Continued to take personal inventory and when we were wrong promptly admitted it.
• 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.
• 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.

These steps are meant to be applied to the individual’s life and reworked on as needed. As you can see there is a very strong religious element to the twelve step program and in the first step, addicts admit that they are powerless over their addiction. It can not be denied that the 12 Steps have worked for many people and helped them stay off addictive substances, however, it is also true that there are many people to whom these steps were not workable.

To read more about the history of the 12 Step program and how studies have shown how it’s success rate is about 30 percent at best and may even be as low as 5-10 percent, click to read this article from The Atlantic. So what other options are there?

Non-12 Step Drug Rehab Programs

As you can imagine, over the last 70 years and even more so recently, there have been many newer rehabilitation programs developed. There are a lot of different programs out there and it would take a very long article indeed to cover them all. Therefore we will just go over some of the positive differences you might see when compared to the AA program.

These programs tend to be less stiff and inflexible than the 12 Steps and are often tailor-made for each attendee. If something is not causing positive change, then it can be changed. This is opposed to the 12 Steps which are inflexible and are considered by many to be infallible. If someone fails on the 12 Steps it is their fault for not trying hard enough, or not working the steps properly.

Many of these more modern programs involve an intensive detoxification program to completely remove drugs and harmful chemicals from the body. This serves to help eliminate the physical aspect of addiction. Then, after the physical needs for the drug are handled, the underlying reasons for the person’s drug use are discovered and addressed.

This is because it has been discovered that addiction and substance abuse are very rarely a problem that comes about on its own. That is to say that while addiction is obviously a huge problem in itself, it is almost always also symptomatic of unresolved issues in a person’s life that lead to the substance abuse.

This is opposed to the Twelve Step program which treats addiction as the main issue. Unfortunately, if you get someone off of drugs or alcohol, then set them loose without handling the reasons they felt like they needed to use them in the first place they will be much more likely to relapse or at the least, they will spend a long time, possibly even the rest of their lives struggling not to go back to the substance.

This may explain why the 12 Step program considers addiction and alcoholism to be incurable and encourages members to continue to attend meetings for the rest of their lives to help suppress the urges to go back to using because the reasons that they used may not have ever been addressed and handled.

One the common drawbacks of these Non-12 Step programs is their cost. Because of the in-depth, personal nature of these programs and the fact that they very often involve a somewhat lengthy inpatient detox and recovery process, they are usually more expensive for an individual to attend than a state-sponsored or volunteer-run 12 Step program would be.