12-Step Programs Might Not Be the Best Way to Beat Addiction

Many of us have a friend or family member who just can't say enough good things about a 12-step program for beating addiction, such as Alcoholics Anonymous. Indeed, the 12-step concept has become a mainstay of commonsense "folk" psychology. But do these programs actually work? Newer research into the psychology of addiction suggests that the success of 12-step programs has been largely exaggerated and that, for most people, a different approach to treating addiction is required.

This statistic may surprise you, given all the positive talk about 12-step programs: studies show only about 5 to 10 percent of Alcoholics Anonymous (AA) participants achieve success in beating their alcoholism, reports addiction expert Dr. Lance Dodes. But because AA is so well-loved by its proponents, who are very vocal about it, those participants who don't succeed in AA and other 12-step programs (i.e. a vast majority) tend to feel that they personally must have failed, because the program is so obviously great. This makes things worse and keeps the "failures" from spending time and energy on other, more promising forms of treatment.

And, even regarding the 5 to 10 percent of AA participants who succeed in kicking their alcohol addiction to the curb: why think it's the12 steps themselves that did it? These programs primarily provide crucial socialization and camaraderie opportunities to addicts, who are often otherwise socially isolated. In general, addictions are horrible not merely due to resulting health problems, but also in the way they lead sufferers to throw away friends and family in the course of pursuing the objects of their addiction.

There is a dopamine-related, scientific explanation for why the socialization helps — addicts may be using their substances or activities of choice to compensate for unhealthy attachments, and need to form healthier ones now. But that doesn't mean that the 12-step programs are the answer; they're just one possible solution. Even those defending the programs are forced to concede that they don't work for many people, and that their methods are not empirically well-founded.

So, if 12-step programs are mostly a failure at best (and actively harmful to participants at worst), what can addiction sufferers try instead? Dr. Dodes recommends an approach focused on understanding the root cause of the addiction: people using their addiction(s) of choice to serve as a "displacement" (or substitute) for handling some recurring problem or emotion, rather than handling it directly. If you're suffering from an addiction, you might do well to skip the church basement 12-step meeting and proceed directly to a qualified psychotherapist, so that you don't waste any time in getting to the bottom of your troubles.