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Drug Rehabs and 12 Step Programs – Harmful or Helpful

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Say the words “addiction recovery,” and many people immediately conjure up an image of Alcoholics Anonymous or Narcotics Anonymous. These are called 12-step programs, named for a sequence of guiding principles or “steps” outlined by the founders of Alcoholics Anonymous. Despite their popularity, Drug Rehabs, which preach the necessity of suffering, are less safe and effective than medical interventions for detoxification. Learn about the flaws in traditional Drug Rehabs and the 12-step model. Furthermore, understand how these programs can even be harmful to those recovering from addiction.

What Is the Theory Behind 12-Step Programs?

The first 12-step program was Alcoholics Anonymous, founded in 1935 by two recovering alcoholics in Ohio. They wrote a book outlining 12 principles, including admitting to being powerless over alcohol, making a moral inventory, admitting faults to others, and making amends to those affected by your addiction. Members of 12-step groups meet and anonymously share their testimonies. These groups are facilitated by individuals in recovery who have maintained sobriety for an extended period. Proponents of 12-step programs maintain that they are an effective way for people to overcome the physical, mental, and spiritual aspects of addiction.

Problems with 12-Step Programs

Despite the popularity of 12-step programs, there is limited scientific evidence supporting their use. Part of this is due to the anonymous nature of the program, making it difficult to run controlled research studies. Some experts estimate that the long-term success rates of 12-step programs are as low as 5-10%, making them scarcely more effective than “going cold turkey” or no intervention at all. Some of the major limitations of 12-step programs include:

  • The assumption that addiction is a moral defect. One of the core principles of 12-step programs is that you are powerless to control your addiction and that you should “give it up” to a higher power. This assumes that addiction is a moral defect or character flaw, causing many people to feel stigmatized and hopeless. In reality, we know that addiction is a complex condition, caused by substance use, which affects brain function. Rather than a moral defect, addiction is a consequence of disrupted brain chemicals and maladaptive behaviors. Additionally, addiction is often perpetuated by untreated mental health problems.
  • Lack of awareness of the physiological science directly related to addiction effects. The first 12-step program was developed in 1935 when very little neuroscience about addiction or brain function was available. In the subsequent decades, scientists have studied how taking opioids and other substances affects and changes brain response. As an example, chronic opioid use actually compromises the brain’s structure and how it responds and functions. Medical interventions for Opioid Use Disorder, make use of this significant knowledge by combining medical detox with behavior therapy to reset the way your brain functions.
  • Leadership from lay people rather than medical experts. The 12-step program model relies on former patients to lead groups, rather than a trained professional in addiction medicine and mental health. This can lead to misinformation, missed critical emotions assessments and poor quality advice. All of these factors are often the reason for treatment failure and relapse.
  • No supervised detox. Rehabs and outpatient twelve-step programs, often do not offer the much needed medical detox. The high level of withdrawal distress, combined with the lack of physical and emotional stability can result in dangerous situations.

Of course, 12-step programs get some things right. For example, the peer support and emphasis on spirituality can be significant to many people. Fortunately, evidence-based medical interventions can also be followed by group and individual therapy, which can address these critical aspects of addiction.

Benefits of Non-12 Step Programs – Drug Rehabs 

So, if 12-step programs lack scientific evidence, where should individuals struggling with opioid addiction turn? The answer is to find evidence-based treatments such as inpatient medical detoxification. These programs combine medical detox with behavior therapy to support individuals through the recovery process. Benefits of medical management and professional, emotional care over 12-step programs alone include:

  • Less stigma. Medical detox correctly recognizes that addiction is a brain disease, not a moral failing. You can receive treatment in an accredited, full-service hospital, just like you would for any other type of illness.
  • Higher success rate. Medical detox programs such as the Waismann Method® have nearly a 100% detox success rate when withdrawal is medically managed in an inpatient setting.
  • Less disruptive to your everyday life. For adherents to rehabs and 12-step programs, the solution to addiction is a long-term inpatient stay, followed by continuous meetings for the rest of your life. In some cases, people in recovery go to meetings every day. This can be enormously disruptive to your everyday productive life, while it can also be a possible trigger for cravings.
  • In contrast, medical detox requires a short stay in the hospital, based on your specific health and dependence needs. You may also choose to participate in supportive aftercare activities, including behavior therapy to address the triggers and root causes of addiction. Once you have achieved sustained sobriety, therapy continues on an as-needed basis.
  • Reduced need for maintenance drugs. Many 12-step programs are offered in conjunction with maintenance drugs such as Suboxone or Methadone. These drugs replace one dependence with another, meaning that you continue to take an opioid drug forever. In contrast, medical detox clears opioids from your system and promotes sustained sobriety.

In conclusion, there is not one answer for all addiction issues and there is not one type of treatment that is right for everyone. People should receive a professional assessment before a drug treatment plan is chosen. It is important to realize, that science has greatly evolved, which allows for better, more comfortable and effective drug treatment. If you or someone you love is struggling with addiction, seek evidence-based medical treatment from qualified experts like those at the Waismann Method. Contact us today to learn more.


Reviewed by Clare Waismann, CATC, Founder of Domus Retreat

All topics for the blog are selected and written based on high standards of editorial quality and cited source material. Clare Waismann, CATC and founder of Domus Retreat and Waismann Method®, reviews all articles for accuracy, credibility and relevancy. Clare Waismann is an authority and expert on opioid dependence and related topics covered on the blog. Additionally, one of Domus Retreat’s specialists, also reviews some articles depending on their area of expertise. For additional information and disclaimers regarding third-party sources and content for informational purposes only, please see our Terms of Service.