Effectiveness of 12-Step Programs: The Science & Success Across Different Addictions

When it comes to recovering from substance abuse or compulsive behavioral issues, the 12-step program has been a widely known and trusted process since its origin in the 1930s when it was first created through Alcoholics Anonymous (AA). Below, we’ll dive into how it works, why it works and the pros and cons.

Overview of 12-Step Programs

The 12-step program was originally created by the founders of AA, Bill Wilson and Bob Smith. It’s a peer support group facilitation process where those struggling with addiction or substance use disorders can find support, resources and a way to effectively work through their addiction. The core principles of the 12-step philosophy include:

Following the 12 Steps

Although each specific 12-step program may vary, here is a general outline of the steps toward recovery:

1. Admit powerlessness over the addiction.

2. Believe in a higher power and adopt spiritual principles.

3. Surrender control to this higher power.

4. Take a personal inventory of your life; practicing self-reflection.

5. Admit to yourself, to God or another higher power and another person of your wrongdoings.

6. Prepare to have your higher power remove all defects of your character.

7. Ask the higher power to remove these shortcomings.

8. Make a list of wrongdoings to others while being willing to make amends for these wrongs.

9. Contact people who you have hurt, making amends. Do not do this if this will cause that person more harm.

10. Continue to take personal inventory and admit when you are wrong.

11. Seek a strong relationship with your higher power through prayer or meditation, seeking connection and a strong sense of will.

12. After having this spiritual realization or awakening, spread this message to others and help them learn the same.

How 12-Step Programs Work

Twelve-step facilitation programs are structured to build community, a support network and a sponsorship program to help individuals who need addiction treatment find their path to sobriety.

Meetings

The cornerstone of 12-step programs is the meetings. Members are encouraged to show up regularly to support and encourage themselves and one another, to share their experiences and to listen and learn from others’ valuable experiences as a way to grow and heal.

Sponsorship

Another important aspect of 12-step meetings is sponsorships. New members in 12-step programs are encouraged to find a sponsor — this is a more experienced member who can help guide you through the 12 steps, while offering advice, support and accountability through the process.

Community

Finding a sense of belonging, knowing you’re not alone and connecting with and learning from others who have been through similar paths can significantly help in the recovery process.

Helping one another, holding each other accountable and developing a spiritual connection to a higher power are all important principles in the 12-step recovery process, whether you’re looking to recover from alcohol use disorder, drug addiction or compulsory behavioral addictions.

Scientific Basis of 12-Step Programs

The 12-step program has been proven to be effective, especially for alcohol addiction. In a study published in the Cochrane Database of Systematic Reviews, it found AA was almost always more effective than psychotherapy alone. This may be in part because of the community aspect of 12 steps, where there is a power in numbers to conquer a specific goal. Another study found that those who incorporated a 12-step program with their treatment were more than twice as likely to achieve abstinent recovery than those who relied on formal treatment alone.

These programs are also effective because they are accessible. Since meetings are typically free, individuals can save a significant amount of money on healthcare costs.

Success Rates and Effectiveness

Success rates of 12-step programs have been most thoroughly examined from Alcoholics Anonymous, where a team of researchers at Stanford School of Medicine found that AA was the most effective path to sobriety. However, this only covers alcoholism.

The three most well-known 12-step programs include: Alcoholics Anonymous, Narcotics Anonymous and Cocaine Anonymous, where each program conducts periodic member surveys. These surveys found that the median length of abstinence reported by AA and NA members is greater than five years, but they also implied they attended at least 2-4 meetings weekly. It’s difficult to assess the true effectiveness of these programs compared to others, as most research is self-reported through surveys alone.

Compared to other treatment programs and looking at long-term recovery, 12-step programs can be extremely helpful due to their smart process. You can be a member for life and attend meetings daily if you want — without cost. You can also rely on a sponsor, self-efficacy and community to hold you accountable to remain abstinent. Although if relapse happens, you have a community of supporters who will help motivate you without judgement. For the best chance of becoming sober permanently, it’s best to pair 12-step programs with individualized cognitive behavioral therapy, motivational enhancement therapy or other individual professional treatment programs that target your specific addiction and history. Typically, pairing two or more treatment options is the best path toward long-term recovery.

The Pros and Cons of 12-Step Programs

Pros

There are many pros to the 12-step approach, including:

• Affordability: 12-step programs are free of charge to join and to attend meetings

• Sponsorship: As a new member, you get an experienced sponsor who can help guide you through the early stages of sobriety

• Accountability: Having a community of support helps you retain accountability throughout your sobriety

• Accessibility: There are many 12-step programs available and multiple meetings weekly

• A Focus on Personal Growth: 12-step programs focus on becoming a better person, wronging your rights and developing a strong spiritual connection — going far beyond solely looking to become sober.

Cons

12-step programs, although accessible, empowering and affordable, lack several important factors:

• Lack of a Clinical Focus: They don’t focus on clinical mental health drug abuse or drinking outcomes. Due to its community-oriented nature and affordability, it lacks individualized support with psychiatry supervision.

• Strong Spiritual Component: Those who are atheists or simply do not want to develop a relationship to a higher source may have a hard time with 12-step treatments, as this is a major component.

• Chance for Relapse: Unfortunately, 40% of individuals who become AA members drop out within a year, according to some studies. It takes a lot of discipline and willpower to show up for meetings in these self-help groups regularly and to commit to AA participation to achieve success.

An Alternative Treatment Method: Caron Treatment Centers

Rather than focusing on a 12-step program, Caron uses evidence-based treatments, such as:

• Doctor-directed medical assisted therapy with cognitive behavioral therapy (CBT)

• Group therapy sessions

• Detox services

• A customized care plan tailored to each person

• Education around skills, stress management, relapse prevention, mindfulness and more.

Our patients see a 95.5% success rate 30 days after treatment.

Getting Started With Caron

If you or a loved one are ready to seek treatment and get your life back on track guided by health professionals, do not hesitate to reach out to explore our treatment options. Our medical clinicians and mental health therapists are here to help you find your best 1-1 individualized treatment route toward recovery. Explore our beautiful facilities in Pennsylvania and Florida, and contact us today.