12 Step Recovery vs Medically Assisted Treatment (Expert Round-Up)

As addiction rates continue to climb, we are seeing increased efforts to fight the epidemic.

While the Twelve Step method of has been a long standing staple in addiction recovery circles, New Medically Assisted Treatment options are becoming available.

We asked the experts how these Medically Assisted Treatment options compare to the classic Twelve Step method...

Dr. Sal Raichbach, PsyD.

"If you look at the numbers, Medically Assisted Treatment is the single most effective way to treat addiction available today."

When it comes to treating addiction, we have the same obligation to use evidence-based methods that we do with any other disease. It would be bad medicine to ignore the data. If you look at the numbers, Medically Assisted Treatment is the single most effective way to treat addiction available today.

12 step programs still have a place in helping people recover from addiction, though. The nature of these programs makes studying them almost impossible, as most of the evidence is anecdotal. But, that doesn't mean these programs don't help people and aren't worth exploring. Like many other diseases, addiction affects both the mind and body. We need to model addiction treatment methods with that in mind. 12 step groups give members purpose, a spiritual connection and peer-support. Those are vital aspects of recovery that MAT can't offer. 

We shouldn't rely on one method to treat substance abuse. Recovery from addiction is a lifelong process, and people get better in many different ways. As a treatment provider, it's our responsibility to give individuals every tool that's available. That means integrating MAT, therapy and peer support. This approach yields the best results across the board, and we have real data to back that up.

Dmitri Oster, LCSW, MAC, CASAC II

"There is no need to separate out both of these treatment modalities for patients that can, and do, benefit from both."

We live in an era where the abundance and oversupply of psychoactive substances and medications have spawned a Frankenstein-monster overtaking entire towns and cities across the contemporary United States of America. This nightmare creation has been partly due to our own tendencies to exploit readily available medicines and medical professionals forgetting the essence of their own Hippocratic Oath to primarily not do any harm to patient(s).

The 12-step approach to addiction recovery is incredibly powerful and healing for many individuals, but so are medication assisted-therapies. The problem lies in the belief that one approach over the other is inherently better and effective in treating substance addiction. In reality, both of these approaches have relevance and beneficial impact for individuals that are serious about addressing and containing their addictions.

The problem in the West is that we have forgotten about the integrated nature of our Being. More often than not, medical professionals and mental health practitioners uphold and reinforce the mind/body split that is a hallmark of our current schizophrenic state of psychological affairs.

The 12-step approach to recovery and medication-assisted therapies can work together, but only under the wisdom of the prescribing physician or informed clinician. There is no need to separate out both of these treatment modalities for patients that can, and do, benefit from both.

RJ Oenbrink, DO

"Why are these programs being considered exclusive, when in fact they are very complementary?"

There is controversy regarding the 12-Step Programs (AA, NA,etc.) for recovery vs. Medication-Assisted Treatment (MAT).

As a Board-Certified physician specializing in addiction medicine and an individual with decades of recovery, I believe this premise is faulty. Why are these programs being considered exclusive, when in fact they are very complementary?

Recovery, especially the initial time is difficult.  The brain is not working right.  It’s still trying to sort out reality from distortion.  This will take at least a year for most trying to get into recovery.  MAT serves to “ease” the brain,which has had up-regulated receptors for the multitude of neurotransmitters that drugs mimic, through this difficult transition period. 

Addiction is more than a chemical imbalance/illness.  There is a spiritual component.  Anybody with long-term recovery will recognize this.  The “program” helps the “whole person” to not only kick the addict, but to grow in multiple domains of their lives. 

“Recovery” is NOT about “white-knuckling” not using but craving badly.  Recovery is about not wanting to use, living a better life without these substances, that, with this disease, distort perceptions leading to poor decisions.  MAT keeps folks from craving, suffering from withdrawal symptoms and able to pay attention & work the program properly.  MAT is not detox.  MAT uses medications that are safe to use for as long as the patient needs them, promoting healthy recovery.

Sherrie Rager, Ph.D.

 "People no longer have to suffer to get sober."

At one point in time, the 12-step approach to recovery was the way to go. However, things have changed with advances in medication. People no longer have to suffer to get sober. In the midst of the opioid crisis, utilizing the old school approach to one's recovery is no longer working.

Aspects of 12-step programs can be helpful in MAT recovery. Social support is emphasized in 12-step, and should be emphasized as much in all types of recovery. It is now understood that there is not just one way to treat addiction, but addiction is a disease — it is reasonable to treat the disease with a medication.

Sadly, it is the belief by many “old timers” and those strongly influenced by the 12-step approach that their way is the only way. I have seen first hand how this approach is killing people.

We are losing some of our best and brightest simply because they have a disease that is not being treated by the advances that have been discovered to stop it. I do not think that there is any question that MAT should be utilized in treatment. The best option would be the approach that integrates the 12 steps with MAT.