Are Twelve Step Programs Useful for Teenagers?

Some people do not like the idea of teenagers entering addiction treatment programs like Alcoholics Anonymous or Narcotics Anonymous. These programs are self-help groups in which addicts and alcoholics support one another in their mutual goal of addiction recovery. Members must undergo "twelve-steps" to recovery that include spiritual renewal, taking a moral inventory, and making amends for past mistakes.

When it comes to people under age twenty, controversy arises because these programs require that you to admit that you are powerless over your substance abuse and that you are a lifelong alcoholic or addict. You must "surrender" your will to a higher power that will help you overcome your addiction because you cannot do this yourself through your own will power.

Is it a good idea for a fourteen-year-old to stand up before a group and declare herself a chronic alcoholic who will never be able to take a drink, even socially? Are you pushing religion on teenagers - forcing them to accept God as the only means to get over their addiction?

The answers to these questions are not easy.

Most addiction treatment today, whether through a therapeutic boarding school, short-term residential center or outpatient counseling, involves joining a 12-Step Program. The reasons are that 12-Step programs are among the most effective and cheapest treatments for long-term addiction recovery, and no one has come up with anything better. In addition, many scientific studies of teenagers in addiction treatment indicate that 12-step programs are a useful component for attaining long-term freedom from drugs and alcohol (see the ones listed below).

Alcoholics Anonymous came about in 1934, at a time when doctors considered alcoholism a moral failing and had no medical treatment for it. People simply died of acute liver failure or other physical damage resulting from alcoholism. The founders of AA came up with the radical idea that alcoholism was not only a progressive physical disease like cancer that results in death, but it was also a form of mental obsession. These were very radical ideas for the period just following Prohibition and the Temperance Movement.

The only requirement for membership became a desire to quit drinking. As AA puts it in their literature, religion, race, sex and nationality don't matter, and you can't be too old or too young to join us. Today about 3% of the members of Narcotics Anonymous are under 20 years, and 12% are under 30.

The very first members of AA came up with the twelve steps through trial and error, keeping only those steps that worked toward recovery. The key to working through the twelve steps is being completely honest with yourself, especially when you are listing all the people and institutions that make you angry, and making amends to those you have hurt. Members are not allowed to drink or use drugs at all. As they say in AA, one drink is too many - twenty drinks is not enough.

Each local group runs on its own and sets up its own rules or agenda. Some groups have themes and guest speakers; some even throw parties on holidays; others are simply open discussions. New members align themselves with a "sponsor" who becomes a friend and mentor. Newcomers who need extra support can call sponsors at every hour of the day or night or attend meetings every day or even more than once a day, if necessary.

One advantage of 12-step programs is that you can easily find meetings everywhere. NA has over 33,500 meetings per week in 115 countries; AA is an even larger worldwide organization. Another advantage is that the program is volunteer, making it a very cost-effective way of providing services to alcoholics and addicts on a twenty-four hour basis.

Twelve-step programs have no real "competition" so it is hard to determine if some other addiction treatment could do a better job. In the meantime, there is no doubt from the conclusions of the studies below that the programs are an effective and long-term means of helping both teenagers and adults remain sober and drug-free.