When Are 12-step Meetings Not Enough?
Alcoholics Anonymous has been around for more than 80 years now. In the time since it began, AA and many other groups based on the 12 steps have helped millions of people recover from drug and alcohol use disorders. Twelve-step groups have many attributes that make them popular and effective. One major advantage is that they’re free. Anyone who wants to get sober is welcome. Another major advantage is that there are meetings almost everywhere. AA alone has more than 100,000 groups around the world. If you want to quit drinking or using drugs, there’s probably a meeting not far away that you can attend today. Another major benefit is that you can join a community of people who share your goal of sobriety. Although 12-step programs have helped many people and are a great resource for recovery, sometimes going to meetings isn’t enough to keep you sober. Everyone has different needs in recovery and going to meetings might not be enough in the following situations.
When you’re facing a difficult detox
You don’t have to be sober to attend 12-step meetings but if you want to get sober, you eventually have to go through detox. For some people, detox is a matter of feeling achy and irritable for a few days or a week. For others, detox can be brutal and even dangerous. Opioid detox is often so severe that people give up after a few days and start using again just to make the withdrawal symptoms stop. Withdrawal from alcohol or benzodiazepines can cause seizures or psychosis. Severe alcohol withdrawal, the DTs, is fatal in between five and 25 percent of cases. Anyone who has had a difficult detox experience in the past or who has been drinking heavily every day should at the very least consult a doctor before trying to detox or look into detoxing in a facility where they can be monitored for warning signs.
Opioid detox is rarely fatal and when it is, it tends to be from dehydration. Vomiting and diarrhea are common withdrawal symptoms and can lead to dehydration. Medical supervision can minimize the risk of dehydration. Detoxing in a facility can also reduce the likelihood that you will give up halfway through. Many addiction treatment programs have integrated detox and treatment so you can start treatment immediately after finishing detox.
When you have a co-occurring mental health issue
According to the National Institute on Drug Abuse, about half of adults and 60 percent of teens with substance use issues also have a co-occurring mental health challenge. Common challenges include depressive disorders, anxiety disorders, ADHD, personality disorders, psychotic disorders, and autism spectrum disorders. The relationship between substance use and these mental health challenges is complicated. Often, substance use begins as a way of self-medicating. Unfortunately, substance use only makes mental health issues worse. The result can be a vicious cycle of substance use and escalating symptoms.
For anyone with a dual diagnosis of a substance use disorder and a co-occurring mental health issue, it’s critical to get mental health treatment that’s integrated with addiction treatment. It’s very difficult to recover from addiction without treating the underlying mental health issue. Proper mental health treatment requires a qualified therapist, who may prescribe medication as part of treatment. Twelve-step meetings are not set up to help treat mental health issues. Meetings are run by members with no special training in therapy or mental health and so you can’t get professional treatment for a mental health issue at a 12-step meeting. Anyone needing this kind of therapy will at the very least have to work with a therapist in addition to attending meetings.
When you can’t seem to stick with the program
Twelve-step meetings work well for people who keep attending; the problem is that most people go to one or two meetings and then never go back. It’s easy to drop in on an AA meeting but it’s just as easy to drop out. Most people who start going to 12-step meetings are not entirely sure they want to be there in the first place so it’s not hard to talk themselves out of going back. What’s more, since 12-step programs are decentralized, one meeting is very different from another. People can typically find a meeting that suits them if they keep trying but not everyone keeps trying. If the first meeting they go to feels unwelcoming or at odds with their values, they may not try another.
People with serious substance use issues often need to make more of a commitment to a treatment program. Unless you attend 12-step meetings as part of a drug court deal, there’s no real reason to keep going when you lose interest. Committing to a treatment program makes it harder to drop out when motivation wanes. What’s more, treatment programs often use evidence-based techniques to help clients discover their own internal motivation for getting sober.
People who have a history of relapse often need more serious intervention than a 12-step meeting can provide. One of the strengths of a 12-step program is that you can pretty much keep living a normal life while you attend meetings. You can live at home and keep going to work or school while you get your substance use under control. However, for some people, this is a liability. They need that break in continuity to separate them from the forces in their lives that are driving addiction. Entering an inpatient treatment program can get you away from those influences and give you some space to focus on recovery. Transitional services may help you readjust to daily life after treatment. A personal recovery assistant can help you apply the lessons you learned in treatment to the chaotic situations of normal life and sober monitoring can provide an extra layer of accountability.
If you have a loved one who is struggling with addiction, Hired Power and our team of dynamic, experienced recovery professionals are here to guide you every step of the way. We offer many services, including helping you choose the best treatment program and transitional services, including interventions, sober monitoring, and personal recovery assistants. Call us today for information on our recovery services: 800.910.9299.