12-Step Treatment Pros and Cons

Addiction is a persistent disease that can cause permanent structural damage to brain activity and function. Approximately 2.6 million people received addiction treatment at a specialty facility in 2009, according to the National Institute on Drug Abuse. In addition to specialized addiction treatment programs, 12-step groups help millions of recovering alcoholics and addicts around the world.

Popularized in 1939 when published in the book titled Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism, the 12-step program has paved the way for many variations to follow, but most professional facilities tend to stick with the original format. While Alcoholics Anonymous is the original 12-step group, many offshoots have been created, such as Narcotics Anonymous, Cocaine Anonymous, and Heroin Anonymous. In addition to these groups, many rehab facilities offer their own programs that are based on the 12-step model.

Executive woman working on tabletSuccess rates have varied among studies over the years and conclusive data has not been available, largely in part due to the AA organization forbidding any research on their treatment models. The core of the tiered-level treatment approach is rooted in putting the responsibility for sobriety on the shoulders of the addict and forcing them to accept accountability for their actions, make amends with those they have harmed, and find a way out of the downward spiral of addiction with the help of a higher power.

According to the National Center on Addiction and Substance Abuse at Columbia University, addiction is present when substance abuse is accompanied by some or all of the following symptoms:

  • Frequent use of a substance in greater amounts than planned
  • Wanting to quit using but continually being unable to
  • A lot of time spent trying to track down a supply of drugs or alcohol, using or drinking, or bouncing back from using or drinking
  • Ongoing use causes disruptions in performance at work, school, or home
  • Continued use of the substance even though it is wreaking havoc in one’s personal, academic, and professional life
  • Limiting or altogether ceasing to participate in things once enjoyed to accommodate drug or alcohol use
  • Using the substance in situations where it presents potential hazards to health or life
  • Negative health effects do not stop or slow down the substance use
  • Persistent cravings for the drug/drink
  • Having to use more of the substance now than previously
  • Feeling symptoms of withdrawal if the substance is not used regularly

12 steps to recovery

The 12-step program has a religious or spiritual component and is strongly focused on rehabilitating a substance abuser via making amends and committing to help from a higher power. Per 12step.org, it is inclusive of the following tasks, in order of how they should be completed:

  1. Admit that you are powerless in the face of your dependency and you can no longer manage your life because of it.
  2. Accept that a higher power can provide you with the sanity and balance you’ve lost.
  3. Decide to give your life and willpower up to that higher power.
  4. Take note of your morals without bias.
  5. Admit to yourself, to your higher power, and to someone else you trust the wrongdoings you’ve committed.
  6. Prepare yourself for the higher power to rid you of these character flaws.
  7. Ask your higher power to take away the sins of your past.
  8. Write a list of the people you’ve wronged and prepare to seek their forgiveness.
  9. Set out to make amends with these people unless it would harm them to do so.
  10. Remain vigilant of your shortcomings and take responsibility for wrongdoings as they occur.
  11. Pray and meditate to elevate the relationship you have with your higher power and ask to be fulfilled with the intentions your higher power has for you.
  12. Achieve spiritual enlightenment after the completion of these steps and walk through life with the intent of practicing and relaying the 12-step message to others dependent on drugs or alcohol.


There are obvious pros to utilizing the 12-step plan, such as the success of so many who’ve come before you. Support groups like Narcotics Anonymous (NA) are also widely known and facilitated across the globe now, making them the easiest meetings to seek out and attend. In addition, joining these groups comes at little to no cost to the addict; most collect small donations at meetings that are quite small in comparison to the cost of attending a lot of rehab institutions for other therapy formats.


On the flipside, there are negative aspects of the 12-step plan, including the fact that most structured and guided 12-step programs are administrated via support groups like NA and AA, which many addicts may not be interested in participating in. There continues to be a fair amount of critics of the 12-step method, especially where the lack of official and published success rates are concerned.

Of primary concern, however, is how little 12-step groups appear to be beneficial to people suffering from mental illness. This is worrisome because 37 percent of alcoholics and 53 percent of drug addicts struggle with at least one serious mental health disorder, per the National Center for Biotechnology Information. The best approach for those suffering from co-occurring conditions is to seek help from a program that addresses both conditions – the mental health issue and the substance abuse or addiction – simultaneously. Many of these programs may incorporate a 12-step approach to care.

Drug addiction recovery at The Recovery Village

At The Recovery Village, you’ll find compassionate staff and skilled medical professionals who can lead you to solid ground where you can once again stand on your own. From detox to alumni support groups, we can provide you with world-class care while you enjoy all the comforts of home. We incorporate both 12-step and non-12-step options into our care models. Call us to learn more.