As the 12-step program -- whose branches include Alcoholics and Narcotics Anonymous, among others -- continues to be a huge part of the worldwide recovery landscape, there rages the inevitable debate over whether this long-standing phenomenon is really the best avenue for people seeking help from substance addiction and other problems.
Benefits of 12-step
Whether a critic or a fan, it is hard not to appreciate AA’s merits on some level. First of all, it stepped into a void where basically nothing like it existed, giving alcoholics (beginning in the 1930’s) a program specifically designed for them, and by them (the founders were themselved hard-core alcoholics). Today, millions of people around the world participate in 12-steps groups, and while there is much debate as to its effectiveness with the average person, there is no doubt that it has helped countless numbers to manage a normally intractable problem. On top of that, it remains an egalitarian system (just one alcoholic helping another, on down the line) with no profit motive -- and it’s free. With all that in mind, Alcoholics Anonymous is really something of a miracle.
Criticism of 12-step
Nonetheless, criticism of AA flies all over the place. One controversial element is the program’s definition of alcoholism and other addictions as a “disease,” over which the afflicted person is, within their own means, powerless. Related to this line of thinking is the program’s rule that members identify themselves in meetings as alcoholics or addicts (“I’m Joe and I’m an alcoholic”). In this way, the program insists that people not only consistently acknowledge the existence of their addiction, but actually make it a core (and irrevocable) part of their identity.
These practices -- admitting powerlessness and identifying as an addict -- are meant (among other things) to encourage a robust commitment to the work of sobriety by reminding people of their vulnerability and, in turn, the need for perpetual vigilance. But critics say they can have the opposite effect, causing people to limit themselves or falter because they are made to feel weak or dependent, rather than self-empowered.
Over the years, a large number of institutions -- including the court system and many rehabs -- have adopted 12-step meetings as a central or even (in the case of the legal system) mandatory part of their framework. In doing so, such organizations have often veered away from AA’s original intention to be independent and non-proselytizing, sometimes presenting 12-step programs as the absolute best or perhaps only viable means of recovery. This posture can be a disservice to those who end up dissuaded against exploring new alternatives.
Alternative treatments for addiction
In today’s world, there are a lot of options for people seeking recovery from addiction. For some people, private psychotherapy is the preferred method for addressing life and emotional problems that feed their addiction; for those who do attend 12-steps or similar programs (such as SMART Recovery or Refuge Recovery, or the online recovery coaching program Being True To You) a healthy way to view such avenues of self-help are as foundational pieces and not as some all-consuming endeavor. In the end, a good recovery plan should incorporate diverse tracks aimed at physical health, emotional growth, self-awareness, healthy social engagements, a professional roadmap and spiritual exploration.
Psychedelics for addiction treatment
One addiction treatment tool of rapidly growing interest is the use of entheogenic substances such as Ibogaine, psilocybin, ayahuasca and marijuana -- particularly in ceremonial circles, or in the presence of a therapist or other guide. New research on psychedelics is revealing that many of these substances -- used carefully and in the right context -- have the capacity to actually heal the mind and body on some level, as opposed to damaging them. While the use of any non-prescribed psychoactive substance is generally considered out of keeping with the 12-step model, increasingly there are those who navigate both channels. Interestingly, the founder of Alcoholics Anonymous himself began to advocate the use of such substances back in the 1950’s, after his own transcendental experience with LSD.
So the bottom line is that, while the 12-step program has a lot to recommend it, one need not limit him or herself to any single avenue when it comes to substance recovery or personal growth. Indeed, one of the coolest things about recovery is it gives us the perfect excuse, in place of mindlessly banging our head on the wall, to direct our curiosity toward new experiences. That means exploring what’s dogging us, along with seeking healthy new ways to develop consciousness, improve our well-being, and engage with the world.