Out of Step: Substance Use Recovery outside the 12 Steps

I practice sobriety. And I haven’t done any of the 12 Steps.

Let me be clear: Alcoholics Anonymous, Narcotics Anonymous, and other 12 Step programs have helped thousands (millions?) of people to come into sobriety. Some of these people include mentors of mine, close friends, and teachers. Many of my clients have benefitted from this paradigm. And as a peer-based movement with free meetings, I have to respect it.

And, 12 Step recovery doesn’t work for everyone.

In fact, according to a recent book by Lance and Zachary Dodes , a number of controlled studies put the overall success rate of AA at between 5 and 10%. Statistically speaking, this means that rather than people who enjoy success through AA as being the “norm,” they are in fact exceptions. The real tragedy is that the remaining 85 – 90% are often told (and end up believing) that their lack of success through 12 Steps is a personal failing of some kind. A character defect. A reflection of their stubbornness or how deeply imbedded the “disease” has become.

The topic of substance use tends to be emotionally loaded because of the real effects that substances can have on people’s health, relationships, career, and life path. This makes it all the more important for us to match our “interventions” to individual contexts and needs, rather than a “one size fits all” solution.

For some, the structure, teachings, and community built around 12 Step Recovery are clearly a fit. But they aren’t for many others. The concept of submitting to a God or higher power in particular is problematic for many people. Some find ways around that, and others cannot.  And so, 12 Step models of recovery should not be the only game in town. Colin Sanders’ work in  Narrative therapy and Noah Levine’s recent Refuge Recovery model are great examples of alternatives, as is Valerie Mason-John’s Eight-Step Recovery.  Having an array of choices for people to engage with makes recovery all the more possible.

If you’d be interested in working with me to revise your relationship with substances, contact me.  I’m planning to set up a Refuge Recovery group this Fall, and I have had a lot of success doing individual substance use counselling as well.

With gratitude:


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