When Do You Need More Than the 12 Steps to Beat Addiction?

AA and the many mutual-aid programs they’ve inspired have been helping people get sober since 1935. Working the 12 steps is a time-tested method for quitting alcohol and drugs, and millions of people are now staying sober one day at a time. The social support of mutual aid meetings like AA is especially important, which is why most people go to meetings even after completing professional treatment programs. However, it’s important to remember that 12-Step meetings are just one approach to recovery. Everyone has different needs when trying to overcome addiction. For many people, AA or NA will be all they need. Others may require more help. The following are some reasons you might need something more than your neighborhood 12-Step meeting.

When You’re Facing a Tough Detox

You don’t have to be sober to attend a 12-Step meeting; you only need to want to be sober. Unfortunately, beyond possibly offering some helpful advice, your 12-Step group won’t be able to help you detox. Sometimes, you will be able to tough it out at home, but other times that might be too difficult or too dangerous to attempt. For example, people trying to quit opioids often have a hard time making it all the way through detox because the withdrawal symptoms get too intense. It can be hard to take care of yourself when you’re experiencing what many have said feels like the worst flu you’ve ever had.

If you’re detoxing from a serious drinking problem or a benzodiazepine addiction, your life may even be at risk. Severe alcohol detox, DTs, can come on without warning and lead to death in a small percentage of cases.

It’s hard to know when you might need a medical detox and when you can do it at home. It’s always a good idea to consult with your doctor before deciding. If you have any medical conditions, especially cardiovascular issues or pregnancy, a medical detox is typically a good idea. If you’ve had a difficult time detoxing in the past, it’s likely the next time will be tough too. In general, the longer and more heavily you’ve been drinking and using drugs, the harder detox is likely to be.

When You Have Comorbid Health Issues

As noted above, if you have any medical conditions, it’s best to detox under medical supervision. However, medical issues can continue to be a challenge even after acute withdrawal symptoms have subsided. Many people starting in recovery have problems related to malnutrition, weak immune systems, and other issues related to substance use. Spending some time in a residential treatment program can help you avoid complications and restore your health more quickly. You get healthy meals, plenty of sleep, a bit of exercise, and easy access to medical care, should something go wrong.

When You Have a Co-occurring Mental Health Challenge

Perhaps the most common problem that mutual-aid groups aren’t well suited to deal with is mental health issues. According to the National Institute on Drug Abuse, at least half of people with substance use disorders have co-occurring mental health issues, such as major depression, anxiety disorders, PTSD, ADHD, personality disorders, schizophrenia, and others. Many of these conditions require specialized care and medication. That’s far beyond the support that a mutual-aid meeting can provide.

Trying to get sober without diagnosing and treating co-occurring mental health issues is extremely hard and probably won’t succeed for long. For most people with co-occurring disorders, the mental health issues are the main driver of their substance use. Mental health issues and substance use each tend to make the other worse, so only treating the addiction is not likely to solve the problem for long.

When You Have Trouble Sticking with a Program

Mutual-aid programs can be very effective in helping you to stay sober if you keep going. The problem is that most people don’t keep going. They may go to a few meetings but that’s all. One study¹ found that only about 10 percent of people who go to AA meetings keep going for three months. Some of the features that make AA attractive, such as free attendance, anonymity, and open doors, also make it easy to quietly disappear.

When you invest in a professional treatment program, you are far more likely to stick with it. For one thing, you may actually be in residence, perhaps far from home, so you’re less likely to just stop showing up. You can leave, of course, but your level of commitment is much higher, especially if you’re paying to be there. What’s more, the staff and other clients are more invested in your success. People will definitely notice if you don't show up for group therapy or other activities. You also form connections to others more quickly in treatment and that social bond creates an incentive to stay engaged.

When You Don’t Fit In

There are many effective approaches to addiction recovery, but unfortunately, some people who have succeeded through 12-Step meetings don’t always see it that way. Some groups are fairly rigid and dogmatic, which can put people off. Since 12-Step groups aren’t centrally organized, there is a lot of variation among meetings. However, if you’re in a place without many options, you might have trouble engaging with a group where you don’t feel welcome or comfortable. You may have to explore other options.

Twelve-Step meetings like AA and NA can be a great option for many people who want to get sober, but sometimes meetings alone are not enough. If you might face a hard detox, have co-occurring mental health issues, have had trouble sticking with the program, or you just don’t feel comfortable with the available groups, you might need something more. At The Foundry, we use the time-tested 12-Step principles combined with evidence-based modalities for treating co-occurring issues. To learn more, call us today at 1-844-955-1066 or explore our website.

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