Science or Support? 12 Step vs. Non-12 Step Treatment
It’s almost impossible to miss the latest headlines regarding addiction. Every news outlet in the country reported on the fatal heroin overdose of actor Philip Seymour Hoffman. They also covered the Vermont Governor’s state of the state address dedicated to the crisis of heroin addiction in his state and beyond.
From policy makers to everyday citizens, the conversation about addiction is a hot topic. Many in the general public believe addiction is a moral weakness and that abusers can stop using any time they want on their own. Others, users and non-users alike, don’t quite understand the differences between medical treatment for addiction and after-care maintenance or recovery support groups. Treatment helps a person get sober while support groups help keep them that way.
Are Support Groups Treatment?
Since the founding of Alcoholics Anonymous (AA) some 80 years ago, many off-shoot 12 step groups have formed using similar principles. Examples include Narcotics Anonymous (NA) for those suffering from drug abuse or Overeaters Anonymous (OA) for victims of an eating disorder.
12 step groups offer no medical treatment for addiction or any underlying mental health conditions. What they do provide is a community where those seeking sobriety can attend meetings, listen to others who have experienced similar issues, and perhaps, share their own problems with the group.
Here are some some common aspects to 12 step support groups:
- Based in the belief that “working” the 12 steps will help addicts refrain from their particular addiction and stop their destructive behavior
- Provide regular meetings run by former drug or alcohol abusers, and encourage newcomers to attend 90 meetings in 90 days
- Suggest that newcomers find a “sponsor,” an addict who’s been in recovery longer than they have, to provide advice and guidance (generally, this is a person with no medical training or expertise in the field of addiction)
One long held controversy surrounding 12 step groups, like AA and NA, is how large a role religion plays. In fact, many of the 12 steps have to do with God or “a power greater than ourselves.” While the strict adherence to God has been loosened a bit since the original manuscript and replaced with “higher power” to be more inclusive, not everyone operates under the same belief system. This can be a serious impasse for many people seeking recovery from dependency issues.
In some of these communities, individuals on effective maintenance medications, such as Methadone or Suboxone, aren’t considered to be “sober” at all. This is unfortunate considering how many studies have shown these types of medications can reduce the death rate for recovering addicts by nearly 70 percent.
This is not to say that 12 step groups aren’t useful. On the contrary, they have helped many people by offering a sober, supportive community, and aid in the prevention of relapse. Most addiction specialists, though, consider this aftercare, and not a solely sufficient treatment for addiction.
Supporting The Science of Addiction Treatment
One fact that slices through the rhetoric is that addiction is a complex disease of the brain. This is supported by more than thirty years of research and endorsed by the National Institute on Drug Abuse, the American Medical Association and the American Psychiatric Association, among others in the medical community. It is simply not prudent to treat a medical disease with a series of religious, spiritual, or non-medical steps.
Non 12 step treatment for substance abuse issues begins with a physician certified in addiction medicine, which provides patients with an extensive physical and psychological evaluation. With that information, doctors can diagnose the stage that their disease is in, and if necessary, get patients through detox in a safe and comfortable way.
With the proper medical treatment, it’s possible the brain’s chemistry can come back into balance. Patients and physicians can then begin to address and treat any underlying mental health issues, like depression, anxiety or bipolar disorder.
While 12 step support groups play a significant role in relapse prevention and aftercare maintenance, they are not a substitute for proper medical attention when it comes to diagnosing and treating the disease of addiction. Similarly, there are also a variety of non-religious aftercare options that are available, such as SMART Recovery.