I acknowledge that Alcoholics Anonymous (AA), and Narcotics Anonymous (NA), which are based on the 12-steps, do help some people to obtain abstinence. However, the longer that I am in practice, I have been convinced that attending AA and NA meetings cause some people to relapse, or even overdose and die. The same holds true for outpatient and inpatient treatment centers that are strictly based on the 12-steps. However, it is not AA and NA per se that are harmful. The actual 12-steps do provide useful tools for achieving abstinence, improving oneself, and improving the quality of one’s life. It is the beliefs of some of the people and treatment centers who teach and are based on the 12-steps, along with the general culture of AA and NA, that I find to be harmful to some people suffering from the disease of addiction.
Why have I come to this opinion and conclusion? Well, official AA policy does not prohibit the use of medications for addiction and psychiatric illness. However, there are many in the AA community, as well in 12-step based treatment centers, who do not abide by this rule. They misinterpret the teachings of Alcoholics Anonymous, and they harm people. This is similar to some people that misinterpret the bible. They change it from something that can encourage love and tolerance, to something that encourages hate and intolerance.
When a referral is indicated, I have stopped recommending AA meetings as an option to the patients that I treat. Instead, I recommend SMART recovery meetings. These are free meetings, just like AA and NA, which are based on the principles of Cognitive Behavioral Therapy (CBT). I never refer to outpatient treatment centers or inpatient rehab centers whose treatment approach is based on the 12-steps of AA and NA. I refer to places that employ modern and current evidenced based addiction treatment. These facilities use CBT for the psychological treatment of addiction. They also use addiction psychopharmacology (medications) to treat the biological part (the”brain disease”) of addiction, as well as pharmacology for treatment of concurrent psychiatric illnesses.
To be continued in Part II…..