There is an ongoing struggle between 12 step support groups like Alcoholics Anonymous, and psychiatrists when it comes to finding the most effective ways to treat alcoholism and addiction. Those who say that 12 step groups are the best approach believe that an alcoholic or addict should never use any prescribed drugs or even rely on psychotherapy when it comes to treatment. On the other side, psychiatrists say the spiritual aspects of groups like AA are not meant for everybody and simply don’t work for the majority of those seeking treatment.
Both of these views are quite extreme and following one or the other may actually do more harm than good. The truth is that the most effective addiction treatment combines methods from both, and takes each approach’s strongest and weakest aspects into consideration. In order to achieve a full and successful recovery, it is necessary for an addict or alcoholic to maintain sobriety as well as remain in a good state of mental health. This can normally be done with both commitment to a 12 step group and consistent psychotherapy treatment. For someone with a co occurring diagnosis, psychiatric medication can be a valuable tool for recovery.
Supporters of the 12 step approach and of psychiatry can both learn from each other’s methods, and also admit that their views aren’t without flaws. The following are some of the pros and cons of treating addiction the 12 steps and psychiatry.
Strengths of the 12 step approach
-Addiction and alcoholism have a profound effect on a person’s psychosocial abilities. Without acknowledging how a person’s life has been affected and addressing it during treatment, recovery just isn’t possible.
-Total abstinence from mind altering drugs and alcohol is necessary for any progress to be made during treatment.
-Treating any co occurring disorders is not possible if a person continues to drink or use any drugs.
-If someone refuses to stop drinking or using drugs, they can’t be helped, even by a psychiatrist.
Regular attendance of AA meetings provides a few things that psychiatry or psychotherapy alone can’t replicate. Some of these things include:
-Meetings and other social gatherings with other sober people that help provide support and guidance during recovery.
-Free, 24 hour support for an individual’s sobriety through a sponsor or others in the group.
-A spiritual approach to recovery that does work for many people.
On the other end of the spectrum, psychiatry has some benefits that can’t be replicated with treatment that only involves attendance at 12 step meetings. These include:
-A safe environment for medical detox from drugs and alcohol.
-The ability to diagnose other existing physical or mental health conditions.
-The ability to prescribe drugs that can make a difference during recovery. These usually include antidepressants that are prescribed about a month into recovery if a person still finds they are experiencing depression or anxiety.
-The ability to evaluate the mental health of family members that have been affected by addiction and treat them if necessary.
Psychotherapy is also a valuable tool for recovery when it comes to providing therapy where a person can question, challenge, criticize, and even confront their therapist or other patients in a group therapy setting. This is something that is forbidden at 12 step meetings, where there is a strict “no cross talk” rule. Abstinence from drugs and alcohol must always remain an individual’s highest priority. Even with the best therapy and psychiatric treatment, progress can’t be made in recovery if drugs or alcohol are affecting a patient’s mind and body.