I think that we, as addictions professionals, may be inadvertently pushing patients away from 12-step recovery while filling seats at Smart Recovery meetings and causing sales of Rational Recovery to soar.

There are over 50,000 12-step meetings nationally and more than 300 weekly just in Palm Beach County. Estimates are that there are more than 23 million people in long-term recovery. Twelve-step recovery seems to be doing very well on its own. We don’t have to sell it.

Not only do we sell it, we over-sell. Many treatment centers have 12-step literature readily available. The twelve steps are often prominently displayed. We offer to take patients to 12-step meetings.

Patients seem to find out about Rational Recovery and Smart Recovery by themselves. They often feel like we’re keeping something from them; maybe we are. When patients feel pushed, they push back.When patients feel pushed, they push back. They react. They often react as a group. Maybe they feel like they need to support each other against the “Big Book Thumpers,” “the AA Nazis,” or whatever they’re being called that week.

When the newcomers find fault, we react. Instead of reasonably responding to legitimate concerns we fall back onto tired old arguments that just don’t work. People deserve legitimate responses to real concerns. So what is it about 12-step recovery that either turns people of?

Religiosity: It’s Not for Everyone

It is unreasonable to tell a person that a meeting that starts with “God” and ends with “Our Father” is not religious. It defies logic. 12-step recovery is religious. So is spending money. “In God We Trust” surely makes more sense than trusting that our money is in fact backed by gold in Fort Knox. We just do it. We’ve all sung “God Bless America” and believe that we have been “endowed by our Creator with certain unalienable right.” No question!

So why do we take our stand when it comes to 12-step recovery? Maybe it’s because “Our Creator” never told us not to drink a day at a time. So accepting 12-step recovery’s religiosity doesn’t need to be that big of a deal. We just make it a big deal. Maybe we don’t have to tell people silly things like God stands for Good Orderly Direction. Maybe we should just say “deal with it.” Being straight with people is a better way to go.

The Stigma Associated with “Alcoholic/Addict”

After religiosity, this comes next. On one hand, it may be said that using the label helps to develop humility; maybe it does. However, there’s a fine line between humility and shame.

I’ve heard a few people introduce themselves by saying: “My name is ­______ and I choose not to drink today,” or “my name is ­______ and I’m in recovery.” There are other options as well. They may be difficult for the newcomer. The Phrase: “I’m an alcoholic” is all encompassing. It feels like it’s describing the person in his/her entirety. “I’m in recovery” doesn’t weigh as much. No matter what, newcomers need to be helped through this and supported.

12-Step Meetings are Cliquish

Of course they are. How can it not be? When people hang out together for a long time they form cliques. Bars are cliquish. Country clubs are cliquish. Hang around long enough and pretty soon you will be part of the clique. Then newcomers can complain about you.

12-Step Meetings are Boring

Sometimes they are. There have been several boring Super Bowls, but most people watch it again the next year. The point is that even though some meetings are boring, some are not.

I was at an Alcoholics Anonymous (AA) meeting recently where topic of social drinking was raised. The chair responded: “I was a social drinker, when anyone said ‘I’ll have a drink, I said so-shall-I.” That’s an old joke, but the point is that there is a lot of humor in 12-step recovery.

Sometimes you can hear a truly inspirational story. On most occasions you will learn something about recovery. A lot depends on what someone wants to see. Take a meeting where there were about 100 people. One guy watched as 5 or 6 people got drunk after the meeting. Another guy saw 94 to 95 sober people.

12-Step Meetings Make Me Think about Drinking/Using

I suppose that’s possible. A person qualifying may spend too much time on the “experience” as opposed to the “strength and hope” (too much time on a drunk-a-log). Hopefully this will not occur too often, but let’s not deny that it happens. The point is that all of the above, and others, are legitimate and need to be dealt with openly, honestly, and not defensively.

Do Smart Recovery and Rational Recovery raise concerns? Sometimes I wonder just how well trained the people who facilitate Smart Recovery meetings are. What is the difference between having a member chair a meeting as opposed to a selected facilitator? Does Rational Recovery provide enough support? When people are reacting, questions aren’t raised.

Should All Paths to Recovery Get Equal Time?

Maybe. We know that when people stick to a plan for recovery the chances of getting and staying well are very good. We don’t really know if one path is better than another. My guess is that it’s not.

I do believe that we’ve reached a point where all reputable paths to recovery deserve equal time. There’s no reason that patients cannot be exposed to Rational Recovery, Smart Recovery, and 12-step Recovery. Allow people to make decisions and stick to them. People need to make informed decisions, not reactive decisions.

We need to either have literature from all paths displayed or none at all – none at all may be better.

12-step recovery may be the easiest plan to follow. Personally, I’m most likely to attend a meeting in my community that begins at 3:30 PM. If I get backed up, there’s another one at 5:30 PM. There are also meetings at 7:00 PM and at 8:30 PM. If I was to miss a Smart Recovery meeting the next one may be a week later. At least 12-step meetings need to be part of a default plan.

Can they be combined? Of course. We’re not having a contest; we’re helping people to get well.