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  • Writer's pictureGreg Miller

Do the 12 Steps work?

Many of my drug and alcohol counseling clients who struggle with addictions have found 12-Step programs to be a helpful part of their recovery. In my work as an addiction counselor, I don’t take the position that everyone with an addiction – be it to substances or behaviors like sex addiction – must attend 12-Step meetings. I believe that everyone is different and that the path to sobriety isn’t the same for everyone.

There is some debate about this

And there has been some debate in the addiction treatment field about the so-called 12 Steps, which began with Alcoholics Anonymous and now are used for a wide range of addictions to both substances and behaviors. The program was started in the 1930s and for decades was simply accepted as the gold standard for the treatment and support of addictions. Any inpatient treatment program or rehab program for substance abuse integrated the 12 Steps into its curriculum. But in the last 20 years or so, there has been some debate about whether the 12 Steps really work. Many have tried to determine via research if this is the case. Some research indicates the 12 Steps do nothing to increase one’s chances or getting clean and sober or remaining clean and sober; some research indicates the opposite.

Alcoholic anonymous meeting

What the 12 Steps provide

As a drug and alcohol counselor, I’ve tried to follow this debate. The research, in my opinion, is inconclusive. I think it’s hard to get strong objective data about the efficacy of an anonymous program. And in a certain sense, the research doesn’t matter to me. I know of no other option or program that is free and has meetings anywhere in the United States and in many other countries at nearly any hour of the day. People with drug and alcohol problems or behavioral addictions desperately need to connect with other people who can relate to precisely what they’re struggling with. 12-Step meetings are without question the easiest place to find this. Even my clients who travel 200 days per year can find meetings nearly everywhere they go. Even in non-English-speaking countries, it’s possible to find a 12-Step meeting in English. People with addictions desperately need to spend time with people in sober environments, environments without drugs or alcohol. 12-Step meetings and the communities and friendships that form around them are the best and easiest place to find this.

What I am clear on is what I’ve seen after working with thousands of clients with addictions over the last 25 years: I have not found anything – no type of treatment and no sort of program – that provides what 12-Step meetings do. I often think of the 12 Steps as a kinder, gentler way for people to get clean and sober than trying to do it on their own. I have rarely seen people with legitimate addictions get clean and sober and stay clean and sober over time without a lot of support, and often this support needs to be more than just weekly meetings with a drug counselor like myself. I’ve had many clients over the last 25 years who initially get clean with the help of one of the 12-Step fellowships and then over time stop going to meetings. Often this is followed by relapse. Though this is not always the case, it’s common enough that anyone in the addiction field has heard it hundreds or thousands of times.

For more information, visit my Drug and Alcohol Counseling page.

Feel free to contact me with any questions.



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