Achieving a long-lasting recovery from a substance abuse problem means learning, and there are a lot of lessons to pick up in a short period of time. People need to understand how drugs and alcohol have changed the way their minds work, and they need to develop a sophisticated understanding of why substances seemed like the answer to problems they simply didn’t know they had. But knowledge alone can’t protect a person from a relapse to substance abuse. Life’s challenges come and go, and situations that once played a prominent role in a person’s life can quickly disappear from the scene altogether.
If knowledge alone isn’t sufficient to drive abstinence, what works? According to experts quoted in an article produced by National Geographic, the key involves a spiritual awakening or a profound psychic change.
When people amend their lives on a fundamental level, and they develop a new understanding about their place in the world, they develop the ability to stay sober. That change, these experts suggest, can come about through participation in the 12-Step movement.
It Starts with Community
The 12-Step movement began in the 1930s, and it developed out of the work of two people, known within the recovery circles as Bill and Bob. These two had attempted to recover from alcoholism using standard treatment models available at the time, but they still faced the ongoing temptation to lapse into drinking when times were tough. No matter how hard they tried, they just couldn’t seem to make changes that would stick.
The two started meeting on a regular basis, just talking about their challenges and trying to support one another, and soon other people joined their meetings. In time, many were involved in this movement, and they found that the meetings were remarkably helpful in keeping people away from the dangers of alcohol.
Steps to Recovery
In time, the founders of the 12-Step movement chose to codify the steps they found most helpful in the fight against an addiction to alcohol. These were the lessons that seemed to be the most profound for people who had dealt with addictions, and they seemed to be the sorts of actions most people should take in order to stay free of substance use and abuse. These are the 12 Steps to recovery that most people are encouraged to use when they join Alcoholics Anonymous, Narcotics Anonymous or any of the other support programs that are part of this movement.
These are the 12 Steps used by Alcoholics Anonymous, from A.A. World Services:
- We admitted we were powerless over alcohol — that our lives had become unmanageable.
- Came to believe that a power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked him to remove our shortcomings.
- Made a list of all persons we had harmed and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- Sought through prayer and meditation to improve our conscious contact with God, as we understood him, praying only for knowledge of his will for us and the power to carry that out.
- Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
Making the Steps Work
Let Us Assist
There are a lot of goals buried in the 12 Steps, and sometimes the language of the steps can be a little difficult for people to understand or take to heart. Meetings are designed to assist. In some meetings, people discuss steps in detail, explaining what is typically involved in the completion of a step and allowing members to explain how they applied a specific step in their own lives. Sometimes, too, meetings take a more generic format in which people share their own stories of working the steps and coming to a greater understanding. Someone who goes to these meetings may emerge with a more profound idea of what needs to happen right now in order to accomplish a particular part of the steps.
Meetings can also provide people with a sense of accomplishment. At the end of most meetings, people are provided with tiny token awards for the days of sobriety they’ve achieved. They’re also given a moment of applause for the steps they’ve completed in a journey to sobriety. For people who haven’t ever been praised for their hard work in fighting an addiction, this can be remarkably motivating.
Studies suggest that just going to meetings can help some people to recover from an addiction. For example, in a study discussed in an article in Scientific American, researchers suggest that of those who attended at least 27 weeks of meetings within the first year of alcoholism recovery, 67 percent were sober at the 16-year mark. Of those who didn’t go to meetings, only 34 percent were sober after 16 years. Studies like this demonstrate that just going to meetings can be remarkably transformative for some people.
However, there’s more to this process than simply participating in meetings. People who want to recover must also learn how to apply the lessons in their day-to-day life that takes place outside of a meeting. Members call this “working the steps,” and often, that involves working with someone who has extensive experience in the recovery process. These mentors can help people new to recovery to understand what true sobriety looks like and how it can be achieved, and they can provide understanding and support during moments of crisis when a relapse seems likely.
Working the steps also means giving back to the community in some way, and focusing on activities that connect an addict with something deeper and more profound. Volunteering, church work or activism could all fit the bill, and that’s another important part of the work involved in 12-Step recovery.
In a study of this issue in people who abuse cocaine, published in the journal Drug and Alcohol Dependence, researchers found that active participation in the steps was more important, in terms of sobriety, than simple meeting attendance. It’s the next phase of recovery, and people must complete it in order to take the lessons in the 12 Steps to heart.
Where the Steps Fit
The lessons people learn in therapy strengthen the lessons they learn in a support group, and the reverse is also true.
While attending meetings and working the program can help people to make a transformation they might be unable to make without the 12 Steps, this isn’t the only type of care a person with an addiction might need. In fact, a study in the Journal of Substance Abuse Treatment suggests that working in a 12-Step program and working in a drug treatment program produce an additive effect. As a result, people who do both might achieve a level of recovery they’d never see if they just completed one type of care and not the other. They really need both.
In addition to participating in a support group, a person with an addiction might also need:
- Medication management
- Drug addiction education
- Cognitive Behavioral Therapy
- Motivation Enhancement Therapy
- Drug monitoring
- Psychosocial support services
- Relapse prevention monitoring
- Sober coaching
Support group work is important, but clearly, it’s just a part of the kinds of services a person with an addiction might need in order to make a break with the past and pull together a future that’s both healthy and happy.
In general, 12-Step support group work is considered remarkably effective for almost anyone who has an addiction. In fact, a study in Medscape suggests that even adolescents who have addictions can benefit from a 12-Step support program, as those who participate tend to remain sober at rates not seen in those who do not participate. For many people, it’s remarkably helpful.
However, it isn’t the right model of care for everyone who has an addiction. For example, a study in the journal Substance Use and Misuse suggests that a lack of will to change, or a lack of motivation to make big decisions about the recovery process, could lead to lackluster participation in support group work. People need to want to make changes in order to achieve a real recovery, and a support group might not be the best place in which to develop that kind of motivation. People like this might benefit from many counseling sessions before even beginning support group work, so they’ll be more inclined to make changes that stick.
Using the Steps at Black Bear Lodge
As a Dual Diagnosis treatment facility, we incorporate the 12 Steps into our treatment model. We encourage our patients to participate in the meetings we hold in our facility, and we ask them to keep the steps in mind while they’re working in their counseling sessions and going through their addiction therapies. When our patients are ready to transition out of our treatment facility, we help them to find meetings in their communities, and we check in with them to ensure that they’re participating. We think the steps are vital to recovery, and we do all we can to help our patients take advantage of this powerful model of care. If you’d like to know more, please call.