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How the 12 Step Process Works in Addiction Recovery

The 12 step process, according to the NIDA, is a group therapy model that “draws on the social support offered by peer discussion to help promote and sustain drug-free lifestyles.” Usually, the 12 step process is best used as a supplemental treatment, either before, after, or during formal rehabilitation. However, some people also use the 12 step process as their main treatment for substance abuse disorders.

What is the 12 Step Process?

The 12 step process is based on a treatment program that was originally used as a treatment for alcohol addiction. According to the NCJRS, 12 step programs are “based on a model of total abstinence.” They usually involve individuals becoming members of a mutual-help group and “certified counselors (often recovering addicts) conduct most of the group and individual counseling, with program staff providing consulting and resource backup as needed.” Often they will take place in a church, outreach center, or another type of community facility.

Patients will go through detoxification and a health assessment as part of most 12 step programs. Most of the treatments are based on social interactions and therapy in order to help patients work through their addictions and change their destructive behaviors.

Who Benefits Most from the 12 Step Process?

This treatment is most often used by “middle-class or working-class males with a high school education who do not have co-occurring psychiatric disorders.” There are also other self-help groups which employ the use of the 12 step process that are specifically created for certain groups of individuals like

  • Women
  • Teens and adolescents
  • LGBTQ individuals

Generally, the individuals who benefit the most from the 12 step process are

  • Those who feel comfortable with the process and its teachings
  • Those who follow the rules and traditions to the best of their ability while being respectful of other individuals in the group
  • Those who are comfortable discussing their feelings with a group
  • Those who do not have polydrug or multiple substance addictions
  • Those who do not have other mental disorders that are co-occurring with their addictions including:
    • Generalized Anxiety Disorder
    • Depression
    • Bipolar disorder
    • Schizophrenia

What are the 12 Steps Based On?

12 steps

The 12-step program was created as a part of Alcoholics Anonymous.

The original 12 steps are based on those by the mutual-help group Alcoholics Anonymous. The steps begin with admitting that alcohol, or another substance, has come to create an extreme problem in your life and that you need help in order to become better. The steps also include admitting your mistakes, asking for forgiveness, making a list of those you’ve harmed, praying, and meditating. You can find all 12 steps as they are most commonly used at both the Alcoholics Anonymous and Narcotics Anonymous websites.

The 12 steps are meant to help individuals become totally abstinent from the substance to which they are addicted which, for some, is the only way that true recovery occurs. However, there are others who need to be maintained on medication in order to find their recoveries in the best way for them (including individuals on methadone maintenance who often stay on the treatment for a year or longer).

12 Step Programs Vs. Formal Addiction Rehab

In most cases, formal addiction rehab is necessary for the treatment of individuals with substance use disorders. Whether you attend rehab in an outpatient or an inpatient center, there are parts of formal treatment that are necessary for many people to recover. Medication is often very helpful to those who are addicted to substances like alcohol and opioids as it helps reduce cravings, curb withdrawal symptoms, and allow patients to focus on therapy.

Many patients also have co-occurring mental disorders that the 12 step process will not help with. These individuals need to attend formal addiction rehab, some in an inpatient facility where they can be monitored in a controlled environment. In these facilities, treatment for both addiction and other disorders can be done simultaneously which is much more beneficial to patients who suffer from both.

However, some people choose to only attend 12 step programs in order to treat their addictions to alcohol, drugs, and other substances. This type of treatment is not unheard of and can be favorable under certain circumstances. The NIAAA states, “Despite developments in medications and behavioral therapies, mutual-help groups remain the most commonly sought source of help for alcohol use disorders in the United States.”

Others may seek 12 step programs as a treatment for different substance abuse disorders as well, but using it as an exclusive treatment for addiction is not always the safest or best method as

  • People often find the best recoveries with formal treatment and the use of medication and therapy together. According to the NIDA, “Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process.”
  • 12 step programs are usually best for those who have less severe addictions and have made a strong decision to stop abusing drugs for themselves and their loved ones.
  • Addiction is a chronic disease, and relapse can occur after treatment, calling for the need for more treatment months or even years after their initial rehab session has finished. Even if someone uses the 12 step method successfully at first, there is always a possibility for relapse which may call for the use of formal addiction treatment.

The 12 Step Process as a Part of Addiction Recovery

12 step programs are best used as a supplement to formal treatment for most individuals. They help patients continue the lessons they learned in therapy and give them a social environment where they are able to surround themselves with others who want to see them recover and stay in treatment. If you need formal addiction treatment, it is important to attend it and often many individuals who do decide to attend a 12 step program afterwards.

However, this does not mean that all individuals follow this treatment model. Many do take on the 12 step process as their main treatment method. It all depends on knowing which treatment works best for you and being able to recognize what you need as an individual, a patient, and a recovering addict.

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