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For decades, 12 Step based programs like Alcoholics Anonymous have been the mainstay treatment for substance use disorders. People come together to share their experiences and support each other in getting and staying sober. Sobriety meetings are free and plentiful, with different niches to fit various groups of people. Starting a new one is easy, too. The only requirement for membership is a desire to stop using substances.
While 12 Step programs have helped millions of people, they are not loved by all. In fact, many people take issue with several of the programs’ core aspects. In response, multiple other organizations like LifeRing, SMART Recovery, Secular Organizations for Sobriety, Women For Sobriety, Moderation Management, and others have popped up to fill the gap. These extra options help attract more people to recovery.
Common complaints about 12 step
1. The religion issue
Walk into any 12 Step meeting and the presence of religion and spirituality become immediately apparent. The second and third of the 12 steps read:
[We] came to believe that a Power greater than ourselves could restore us to sanity.
[We] made a decision to turn our will and our lives over to the care of God
as we understood Him.
It doesn’t end there, either. Numbers 6 and 7 imply that connection with God will “remove our shortcomings.” Number 11 calls for “prayer and meditation.” Finally, number 12 proclaims that people will have “a spiritual awakening as a result of these steps.”
Members of AA point out that the phrase “as we understood him” follows the mentions of God. That notion is supposed to give flexibility to the spiritual component. That may have been fine in the 1930s when AA began and almost all Americans belonged to a religion. But now, when over 1 in 4 of us don’t subscribe to any faith at all, it’s just way too much religion for some people.
2. The control issue
Another irksome issue with 12 Step is the concept of “control.” The first step demands that people admit they are “powerless over alcohol.” The next steps turn this control over to the higher power, God. This causes two major problems.
First, if people don’t like the religion aspect of 12 Step, they surely won’t like the idea of turning over control to a faith they don’t have.
Second, admitting you are powerless can feel like your relationship with alcohol is a fundamental weakness. Step 6 even calls it a “defect of character.” Go to a meeting and you will hear members introduce themselves, always including the statement, “I’m an alcoholic.” It can make people feel like they have a defect, something about them and drugs that others don’t have. Though the 12 Step process has helped plenty of people, thinking like this can also perpetuate stigma and deter people from trying to get sober.
3. The flexibility issue
Twelve step groups hold a pretty black-and-white view of drug and alcohol use: You’re either sober or using, in control or powerless. The program encourages people to identify as “alcoholics” for life, even if they’ve been sober for decades. It seems there is little room for middle ground. Isn’t it possible that someone could have trouble using alcohol or drugs in moderation by themselves but learn to do so successfully with the help of a supportive program?
According to the classic 12 step philosophy, you either have a problem or you don’t. And if you do have a problem, you can’t use any substances. Other programs are a bit more flexible than this. They include ideas like harm reduction, switching the “drug of choice” to a less dangerous substance.
Alternative sobriety groups
Like 12 step programs, SMART meetings are mutual support groups facilitated by people who have found sobriety through the SMART system. But the tools and the narrative about personal power are different. The foundation of SMART Recovery rests on evidence-based therapies such as Cognitive Behavioral Therapy and Motivational Interviewing. SMART stands for “self-management and recovery training.” The program helps people learn practical skills for dealing with urges. People break out of negative cycles of thoughts, feelings, and behaviors and, with support, discover the motivation to stay sober.
LifeRing follows the “3-S” philosophy: sobriety, secularity, and self-help. It requires a desire to be sober from all substances and does not have a religious aspect. LifeRing doesn’t have any specific steps or program. The general goal is to diminish the power of the ‘addict self’ and support the ‘sober self,’ but beyond that, it is very free-form. Groups do not go through any specific doctrine but rather share with each other what has worked and what hasn’t. The members then develop their own individual paths to recovery.
Moderation Management offers a source of support for people who want to try temper their drinking habits. People keep diaries about their drinking to observe their own behavior patterns. They make honest assessments of how severe their situation is and consider, “Can I moderate or do I need to be totally sober?” As part of this, members commit to a 30 day period of sobriety. They use this time to learn about their triggers and practice tools for moderation. Some are able to return to drinking in moderation, while others decide that abstinence is best for them.
Secular Organizations for Sobriety (SOS)
This program focuses on individuals sharing and supporting each other in sobriety. There is no specific set of steps and no religious or spiritual basis. Members gather to offer their advice and experiences so that others may learn.
Women For Sobriety
This program was founded on the belief that a women’s only group would be more effective for some people. The group’s 13 “Acceptance Statements” and its “Levels of Recovery” form the basis of its philosophy. Members use tools similar to Cognitive Behavioral Therapy to address negative thought patterns surrounding drug and alcohol use. The Acceptance Statements provide positive points for people to integrate into their minds and daily lives to help them stay sober.