Do the 12 Steps Work?


Short answer? They do, but not for everyone. Alcoholics Anonymous, by far the longest lasting of the 12-step programs, currently has more than a million members in the United States and Canada, according to the organization itself. The total worldwide is more than 2 million. Arguably, it’s working for those folks or they wouldn’t be there.

A harder question is embodied in the phrase, “It works if you work it” – meaning members have to stick with their program to maintain sobriety. And that’s a real problem when evaluating any 12-step program. They are anonymous. No one tracks who joins and, more importantly, who leaves. Furthermore, there’s no testing requirement. Unlike typical rehab situations, members of AA and other 12-step programs aren’t providing urine samples to check their progress. You are as free from alcohol addiction and as clean and sober as you claim to be.

They aren’t cures

One mistake is thinking that “works” is the same as “cure.” It isn’t. None of the 12-step programs really offer cures – if they do, they are claiming rather more than they can reliably deliver. What they do offer is a guided recovery and ongoing treatment option.

This is largely why they are supported by the professional addiction treatment community. On the medical side, we do a pretty good job with detox and rehab. What is less satisfactory is long-term maintenance.

Life intrudes. Many of the same pressures and situations that first drove someone into addiction are still around. Without ongoing help, addicts and alcoholics are prone to slide right back into their previous behavior patterns. For this reason, having regular meetings and a stepwise plan is extremely helpful.

The human element

One of the most powerful tools 12-step groups use is support. There is nothing quite so compelling as the story of another addict or alcoholic that mirrors your own.

Every addiction is a personal struggle – self against self. But a group situation, and the ability to share with others who understand and who aren’t out to judge you, gives an element of support that’s hard to find anywhere else. There are things you can say at a meeting you would be too embarrassed to say anywhere else.

Advice is available from the group as well. While often we just want to talk, sometimes there’s a situation others have been through and their advice can be a critical helping hand to get through the crisis.

The steps themselves

There’s another catchphrase you hear: “If what you tried worked, you wouldn’t be here.”

If there’s a broad brush you can paint all addicts and alcoholics with, it’s that they have poor judgment. Not always and not for everything – but we wouldn’t be addicts if we’d made better choices, even if that better choice was to get help earlier.

The 12 steps give structure and a plan to people who are out of better ideas. They start slow and progress toward the goal we want – abstinence and a way to deal with life free from substance abuse. The mere fact that there’s a plan to follow, a plan we can believe in, makes a huge difference.

Even better, there will be members who have completed most or all of the steps. When we doubt, we have someone to look up to as both a model and a mentor. Sometimes, belief in the steps and sticking to them is all we have in the face of temptation and cravings.

Eventually, success starts to breed more success. As the days, months and then years of sobriety accumulate, that positive history gains a kind of momentum all its own. The idea of using feels like a betrayal to others and the progress made so far.

It works even when it doesn’t

I’ve never seen a meeting where there is drinking and drugging going on. Time and again, I’ve seen people get up and say it was their first day “clean,” though. And every try at sobriety starts with that first day.

Many don’t even work the steps. They aren’t participating fully and can’t be said to actually be in the program. But they still get some value out of attending. It works for them each day, and sometimes each hour they can remain drug and alcohol free. For these folks, long-term recovery isn’t yet on the table. But they keep at it and keep coming – and they get at least that, more than they would otherwise.

Which brings us to probably the most important thing 12-step programs offer: a chance. A chance to take positive action against a behavior that seems out of our control. A chance to throw off the chains of addiction, maybe not forever, but at least for awhile.

That’s a chance worth having.


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