The Role of 12-Step Programs during and after Drug Rehab

12-Step or “self-help” programs consist of anonymous groups of people who get together to support each other in sobriety. The most popular of these programs, Alcoholics Anonymous (“AA”), is also the oldest and serves as a template for offshoots such as Narcotics Anonymous and Overeaters Anonymous. Underlying AA is the belief that 12 steps need to be taken in order for an individual to remain sober. Although not associated with any particular religion, there is a spiritual aspect of the program that has been modified over the years to accommodate those participants who are adverse to the religious connotations.

Studies show that participation in 12-step programs can be invaluable when recovering from addiction to drugs or alcohol; those who participate in the programs have higher rates of abstinence than those who do not. Patients are first introduced to the 12-step concept long before discharge from intensive drug rehab programs and often agree to have attendance at community-based meetings be part of their recovery plan.

Self-help programs like AA can help bridge the distance between active treatment in a clinical setting and what happens when clinical support is no longer readily available. What is important to understand, however, is that not all self-help programs are the same. In fact, 12-step meetings tend to have a personality all their own, which may require trial and error on the part of the patient to find a situation that he or she is comfortable with.

Variation among groups turns out to be a positive thing, as most people eventually find a perfect fit. Differences between groups reflect certain participant characteristics such as gender, sexual orientation, disabilities, language, age, or whether or not people smoke. There are even self-help groups for specific professions (like nurses, doctors or lawyers) and groups that require an invitation to join.

12-step meetings for drug addiction or alcoholism come in many shapes and sizes. Some meetings allow prolonged discussion among members; others focus on completing the 12 steps. Organizers of some meetings invite a speaker, often a member of the group, to discuss his or her addiction or recovery experience and allow members to pose questions or add their own thoughts. Drug rehab programs that teach patients, in advance, about the history and function of 12-step programs, as well as the existence of vast differences in group make-up and operation, help reduce the incidence of 12-step dropout due to ill fit, intimidation or frustration.

In order to effectively teach patients about 12-step meetings, clinical staff members need to be familiar with them, even if they are not in recovery themselves. Many clinicians find it helpful to attend open meetings, where those not in recovery are still welcome. Drug rehab programs typically train staff members how to handle patients who are resistant to the 12-step concept, especially patients who feel uncomfortable with the spiritual aspects. When helping someone find a local 12-step meeting that fits their particular circumstances, clinicians try to match similar backgrounds, cultures or experiences. In some drug rehab programs, participants are encouraged to form their own 12-step groups so that the same people can support each other even after formal treatment has ended.