12-Steps Addiction Treatment - Outdated or not?

While exploring online one evening, I came across an old book and eventually found a copy on eBay. It introduced me to Dr.Reid K Hester & William Miller’s Handbook of Alcoholism Treatment Approaches: Effective Alternatives1, including the intervention approach, community reinforcement and family training (CRAFT)2, which fascinated me.

I was surprised to discover that 12-step facilitation therapy (SFT) ranked 38th on the list of evidence-based models. As a health practitioner, counsellor, and coach in Cape Town, South Africa, I recently attended a CRAFT online course with Dr. Robert Myers. It revealed the flaws in the treatment system, which seemed more focused on profit than genuine care. I’ve always been a rebel and critical thinker, challenging traditional beliefs.

The current approach often feels limiting and retraumatizing, contradicting the principles of empathy, unconditional positive regard, and non-judgment that Carl Rogers proposes. While I acknowledge the value of sobriety for some individuals, I also believe in personal empowerment and the ability to quit without labelling oneself. Take smoking for example, 1000s of people quit smoking, the most addictive substance and most difficult to quit, and yet, people quit smoking without going to rehab all the time. Put that in your pipe and smoke it! The treatment landscape and the way people are being treated needs to change drastically. There will always be room for certain aspects of the 12-step program, but less rigid for sure.

Reading various literature over the years has opened my eyes and also exposed the bias and domination of certain organisations that stifled alternative research and capped certain treatment methods. This revelation has left me feeling mixed emotions. Having lost years to a system I once trusted. Labels and stigma associated with addiction have perpetuated a harmful narrative. The concept of abstinence itself is subjective and begs the question of where one draws the line, considering the prevalence of mind-altering substances in society and how the brain works, as the brain is a drug factory and releases ‘drugs’ involuntary. As the infamous, Terence Mckenna once mentioned, “..you are holding, and you can’t stop yourself.”

My previously narrow-minded thinking played a role in the death of a friend who sought support but was met with rejection. The reliance on physical Narcotics Anonymous (NA) meetings exacerbated his relapse when COVID-19 forced their closure. Ironically speaking, SFT and meetings merely replaced one drug with another, instead of equipping individuals with coping skills and tools for emotional regulation.

The stages of change theory (Prochaska and Clements) resonate with me, emphasising that relapse is part of the change process and not buying into the notion of being viewed as a permanent failure. I hope, dream and strive to change lives and to contribute to a happier, kinder society where individuals can find purpose and meaning, whether or not they use drugs.

I believe in being part of the solution and promoting evidence-based approaches that work differently for different people. In other words, tailor-made programming. While I sometimes see myself as a lone traveller, I also recognize the importance of a supportive community. However, communities are stigmatised and thus hide due to fear of judgement. I believe in finding alternative ways to treat individuals with respect and achieve successful outcomes, and question the idea of abstinence as the only path to recovery. I encourage others to conduct their own research, seek evidence-based information, remain open-minded, read more and cultivate empathy. Learn from my mistakes and embrace a more compassionate approach.

The focus should be on how individuals are treated and what methods yield the most positive results for them, not for us.

Reach out to me via this website.

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Is the 12-Steps Addiction Treatment outdated?

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