Is Twelve-Step Recovery Relevant in 21st Century Addiction Medicine?

February 21, 2015


In a Feb 13 ASAM article, Michael Miller, MD questions the relevance of Twelve-Step recovery in the current treament of addiction. This is of particular importance in monitoring programs where a high reliance is placed on regular attendance at mutual self-help support groups through carefully crafted Relapse Prevention Agreements (RPAs).

 

In fact, attendance does not have to be limited to traditional twelve-step programs, but can include other self-help group meetings such as SMART or 16-Step. 

 

I believe in the power of the fellowship as a mechanism to maintain long-term sobriety. It has been said that the brain of someone in addiction is similar to a bad neighbourhood: You do not want to go there alone.

 

Miller states:

"Is Twelve-Step Recovery an antiquated concept or intervention? Many addiction specialist physicians contend that while the majority of continuing medical education in addiction, aimed at sharing novel breakthroughs and improving practice and outcomes, addresses pharmacotherapies, it is the psychosocial therapies which warrant at least equal attention. Some addiction medicine physicians are concerned that not only do biological interventions predominate in continuing education curriculums, but they dominate graduate medical education in addiction, and some of these physicians are concerned that fellowship training programs in addiction as well as residency programs in primary care, psychiatry, and other medical specialties should include training about and in Twelve Step Facilitation and on Twelve-Step Recovery in order for the physician to have an appropriately well-rounded educational experience and a full skill and knowledge base in the rapidly-growing specialty of addiction medicine."

 

Dr. Jenny Melamed

Addiction physician and MRO

 

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