The 12 Steps: the Gold Standard for Recovery
People inquiring into substance abuse treatment are commonly advised to seek an “evidence-based” recovery program. Evidence-based means that it’s established by the latest scientific research. What works and what doesn’t is studied and published in reputable scientific journals. As a recovery provider, CORE’s interest is in providing the most reliable, evidence-based treatment available. That’s what we’re about.
The Cochrane Database of Systematic Reviews (CDSR) is the leading journal for systematic reviews in health care. CDSR is internationally recognized as the highest standard in evidence-based health care. Significantly, it recently weighed in on what works best in addiction treatment.
Its review, titled “Alcoholics Anonymous and Other 12-Step Programs for Alcohol Use Disorder,” shows that the 12 Steps are still the gold standard for recovery.
The lead researcher is a psychiatry professor at Harvard Medical School. The findings are unambiguous and conclusive: 12 Step programs not only help people get sober, but they also have much higher rates of continuous sobriety compared with other therapies (like cognitive behavioral therapy). The numbers are impressive, showing the 12 Steps are up to 60% more effective than all other evidence-based therapies.
Here at CORE, we see this study as confirming our decades of experience as a recovery provider. It also raises an important question, to wit, why is this so?
After all, the 12 Steps of Alcoholics Anonymous were published in 1939. Since that time, billions of dollars have been spent to advance the understanding and treatment of addiction. New pharmaceuticals have been developed, along with many different psychotherapies. Why then, after all this time, money, and scientific advancements, do the 12 Steps remain unparalleled in effectiveness for the treatment of addiction? What do they offer above and beyond other, more modern therapies?
To answer this question, we have to look at the key insights of AA founder and Big Book author Bill Wilson. Like so many interested persons of his day, Wilson well knew that the addict’s problem had both biological and psychological components. Notwithstanding, he saw that addiction is best understood and treated as a spiritual malady. While his approach was highly unorthodox in scientific circles, time after time Wilson’s fledgling AA groups got results even where the medical profession failed. Their successes continually showed that, once the spiritual illness is overcome, the sufferer straightens out mentally and physically, and recovers.
This spiritual malady, moreover, is the addict’s own egocentric nature. “Selfishness – self-centeredness!” the book observes, “That, we think, is the root of our troubles.”
In practical terms, the addict self-sabotages nearly every aspect of life by exerting self-centered expectations and demands upon everybody and everything around them. They feel hurt and anger, or are overcome with self-pity and indignation, when things don’t go to their exacting standards. They become restless, irritable, and discontent unless they can again experience the sense of ease and comfort that comes from drinking, or drugging, as the case may be. Even though the addict may recognize their drinking and drugging is harmful, a period of abstinence only highlights their malaise. Without fail, they will drink or drug again in order to experience that ease and comfort. They are helpless to do otherwise.
Modern researchers often speak of addiction as affecting free will, of stripping the addict of their capacity for decision-making. In the context of the 12 Step program, we say the addict is powerless over alcohol and drugs. Regardless of nomenclature, the addict is caught in a vicious cycle from which there is no apparent escape.
Now for the 12 Step solution. The addict’s troubles are very much of their own making. They arise out of self, and the various manifestations of self in the addict’s daily experience. Commonly prescribed treatments for addiction, by contrast, address matters such as the addict’s conduct, changing their drinking or drugging habits, or they teach methods to calm the mind, reduce anxiety, respond to environmental triggers, reform social networks, and the like. Such methods may well be appropriate for certain classes of problem drinkers and drug users, but for the addict and alcoholic, no.
For this latter group, the problem user “is an extreme example of self-will run riot,” as the Big Book observes. The addict at certain times has no effective mental defense against the first drink or drug. “Except in a few, rare cases, neither he nor any other human being can provide such a defense. His defense must come from a Higher Power.”
The primary objective of the 12 Steps is to rid the addict of selfishness. Both the problem and solution are spiritual:
“Above everything, we alcoholics must be rid of this selfishness. We must, or it kills us! God makes that possible. And there often seems no way of entirely getting rid of self without His aid. Many of us had moral and philosophical convictions galore, but we could not live up to them even though we would have liked to. Neither could we reduce our self-centeredness much by wishing or trying on our own power. We had to have God’s help.”
Does this really work? We can say, wholeheartedly, yes! The science backs it up. The program must be followed fearlessly and thoroughly but, as a rule, it absolutely works. In our experience at CORE, recovery happens for everybody who works the 12 Steps. The obsession to drink or to drug is lifted right out of the user, who returns to wholeness and health. For the one who recovers, moreover, the 12 Steps become a practical plan for living.
The Big Book offers two different lists, found on pages 52 and 83-84, which aptly contrast the experiences of the addict living in self (“the bedevilments”) with the blessings for those of us who recover (“the promises”). We set them forth below for consideration:
|The bedevilments of self||The promises of recovery|
|We were having trouble with personal relationships.||We will lose interest in selfish things and gain interest in our fellows. Self-seeking will slip away.|
|We couldn’t control our emotional natures.||We will comprehend the word serenity and we know peace.|
|We were a prey to misery and depression.||Our whole attitude and outlook upon life will change.|
|We couldn’t make a living.||Fear of people and of economic insecurity will leave us.|
|We had a feeling of uselessness.||That feeling of uselessness and self-pity will disappear.|
|We were full of fear.||We will intuitively know how to handle situations which used to baffle us.|
|We were unhappy.||We are going to know a new freedom and a new happiness.|
|We couldn’t seem to be of real help to other people.||No matter how far down the scale we have gone, we will see how our experience can benefit others. We will not regret the past nor wish to shut the door on it.|
The foregoing describes two very different, real experiences. The first is the addict who pursues a self-centered existence. The second is the addict who walks the path of a God-centered life. Interested readers will readily see themselves in one, or the other.
We know that some may feel hesitant about a recovery program based on spiritual principles. Some of us felt that way, too, upon first coming to the program. We hadn’t anticipated this. Could it really be that straightforward, we asked. We reacted like others who initially balked, but there was no denying the results for those who practiced the Steps:
“When we saw others solve their problems by a simple reliance upon the Spirit of the Universe, we had to stop doubting the power of God. Our ideas did not work. But the God idea did.”
The program works. If the Reader is seeking the highest quality, evidence-based treatment for substance abuse, we invite you to contact us at CORE. For more than a quarter century, thousands of our clients have gone on to lead happy, purposeful, and completely substance-free lives. The AA promises of recovery can be fulfilled in you, too. They will always materialize if you work for them. We’ll show you how to do it.
Additionally, we at CORE will continue to support progress in the sciences, medicine, and counseling therapies, as they pertain to the terrible problem of addiction. Used properly, they can be extremely beneficial in assisting a return to health. For an effective recovery program, we continue to approve the 12 Steps of Alcoholics Anonymous – the gold standard of recovery.