As an addiction medicine doctor, I’ve found that many patients begin their recovery journey with a 12 step program. For some, this works wonders. For others, the 12 steps don’t feel like a good fit.
So, what happens if Alcoholics Anonymous isn’t effective for you?
What can you do now?
The answer is: plenty.
Here’s the truth: there is no one addiction treatment plan, method, or modality that is perfect for every single patient.
While AA’s 12-step program has helped many, it may not suit everyone. Alternatives like SMART Recovery or CBT (cognitive behavioral therapy) can offer different approaches to recovery. MAT, or Medication Assisted Treatment, is another good option that works well with many other healing modalities. There are many more routes to wellness that our patients have taken beyond these common paths, as well. Recovery is a highly personal process and there is no single “right answer” to the challenge of managing substance abuse disorder.
At Shanti Recovery & Wellness, we help patients discover the right path forward for them in reclaiming their lives from addiction. Each of our treatment plans is unique and tailored to the specific needs of the individual.
While we emphasize an evidence-based approach to addiction treatment, we work with patients walking all kinds of paths to recovery. For some, AA is an integral part of their healing. For others, AA doesn’t resonate.
Remember, there is no wrong answer. AA is not for everyone – and that’s OK.
Alcoholics Anonymous (AA) has been a beacon of hope for millions, offering a structured, community-driven approach to overcoming alcoholism. But what if AA doesn’t work for you? The concept of a “one-size-fits-all” recovery solution can feel restrictive, especially when the tried-and-true AA model doesn’t resonate with everyone.
The AA Model: A Quick Overview for Those Who May Have Never Spent Time in “The Rooms”
Before diving into alternatives, let’s quickly recap the AA method. Founded in 1935, Alcoholics Anonymous is a 12-step program built on the principles of mutual support, self-reflection, and spiritual growth. The program has been hugely successful for many, encouraging lifelong sobriety through fellowship, accountability, and a commitment to a non-specific, non-demoninational – and in some instances, non-religious – higher power.
Over the years, the 12 steps have been adapted to address many issues beyond alcoholism, including NA (Narcotics Anonymous), Al-Anon (Family and Friends of Alcoholics), GA (Gamblers Anonymous), and so on.
However, a 12 step based approach is not the ideal solution for every situation, and that’s perfectly okay.
There’s a lot of reasons why AA, Alcoholics Anonymous, or other 12-step programs might not be a good fit for some patients
- Spiritual Element Doesn’t Resonate
One of the pillars of AA is a belief in a “Higher Power,” which can be interpreted in many ways, whether as God, a universal force, or the collective power of the group. While this spiritual approach works for some, others may find it alienating, especially if they’re not religious or spiritual. Those with a history of religious trauma may find this approach especially counter-productive in some cases.
- The 12-Step Structure Can Feel Rigorous or Restrictive
The 12-step program is highly structured, and while it provides clear guidance for recovery, it may not align with everyone’s needs or pace. Some people may find the steps too rigid, or that they don’t address their particular struggles with alcohol addiction. The idea of “powerlessness” in Step One may feel demotivating to those who prefer to feel more in control of their recovery journey.
- Group Therapy Isn’t for Everyone
AA relies heavily on group therapy and sharing personal stories in front of others. For many, this sense of community is invaluable, but for others, it can be uncomfortable or even triggering. Public speaking and group sharing can be intimidating, especially for introverts or those with social anxiety. Neurodivergent people often do not feel comfortable with the socially-driven 12 step model, either. (And, yes, there is a connection between neurodiversity and addiction. We’ve written about it on this blog in an earlier post.)
- The “All or Nothing” Approach
AA often promotes the idea of complete abstinence from alcohol and other substances of abuse. This meets the recovery needs of some, but this approach simply does not work for others. Many people may feel overwhelmed by the pressure to be completely “sober,” especially if they rely on behavioral health or psychiatric medications to treat underlying dual diagnoses. Many 12-step programs take a very “black and white” approach to recovery. The highly structured nature of 12 step programs works very well for some, but others find the approach to be too draconian or unforgiving.
Alternatives to Alcoholics Anonymous
If AA doesn’t work for you, that doesn’t mean you’re out of options. There are a variety of alternative treatment methods, and what works best often depends on individual preferences, life experiences, and specific struggles with addiction. Some find that the 12 steps works well for a time but then they feel a need to branch out to other approaches. Others weave a 12 step approach into a more personalized plan, taking what resonates and leaving the rest.
If you’re interested in other ideas beyond the 12 steps, here are a few approaches worth exploring:
1. SMART Recovery
SMART (Self-Management and Recovery Training) is a scientifically backed recovery program that focuses on building self-reliance through cognitive-behavioral techniques (CBT). Unlike AA, which emphasizes spiritual surrender, SMART encourages individuals to take an active role in their recovery. It emphasizes personal responsibility, goal setting, and managing cravings through self-empowerment rather than external control. SMART Recovery can be a great option for those who prefer a practical, evidence-based approach without a spiritual or religious component.
(And yes, there are many awesome SMART recovery meetings in Portland, Oregon!)
2. Therapy and Counseling
If the group dynamic of AA doesn’t appeal to you, individual therapy might be the right avenue for you. Cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and motivational interviewing (MI) are just a few therapeutic methods that can help address the root causes of addiction, including trauma, mental health disorders, or chronic stress. One-on-one counseling can also provide a more personalized, less stigmatized space to explore your relationship with alcohol and develop coping strategies. Many people combine 12 step programs or other peer support groups with individual therapy.
At Shanti Wellness and Recovery, we offer in-house counseling and psychiatric services to all patients as part of our all-in-one behavioral health clinic for busy patients with full lives.
3. Medication Assisted Treatment (MAT)
Medication assisted treatment can help those struggling with alcohol addiction by reducing cravings and withdrawal symptoms. Drugs like Suboxone and Vivtrol are used to support recovery and are often prescribed alongside therapy or other support services. MAT can help bridge the gap between physical dependence and psychological healing.
At Shanti Wellness and Recovery, MAT medications are one of our favorite tools for patients who are seeking evidence-based treatment for SUD.
4. Sober Living Communities
For individuals who need more support than can be provided by outpatient therapy alone, sober living communities offer a more immersive, structured environment. These residences typically offer housing for people in recovery, along with programs for community involvement, education, and peer support. While these communities aren’t always strictly clinical, they provide a solid foundation for those who need a supportive, sober environment to get back on their feet.
Oxford homes are a very popular option for some of our patients at Shanti Recovery and Wellness because they are resident-run non-profits, which means that they are run by and for the people living there.
5. TMS or Transcranial Magnetic Therapy can help with underlying mental health concerns
TMS or transcranial magnetic therapy is a recent FDA approved treatment for depression that offers improvements up to 4 times more effective than a placebo. For many patients, depression and anxiety play a large role in the presentation of Substance Use Disorder. We have seen remarkable results with TMS at our clinic and we are very pleased to offer this treatment to our patients in Portland.
At Shanti Wellness and Recovery, we offer TMS therapy for patients who can benefit from this evidence-based treatment for depression.
When to Seek Professional Help
If AA (or any self-help program) doesn’t seem to be working, it’s essential to recognize the problem and make adjustments to your plan.
Many of our patients at Shanti Wellness and Recovery begin with 12-step meetings and end up needing a little more support to achieve the recovery lifestyle they desire. For many, a medical evaluation to determine if there are underlying conditions contributing to addiction (such as co-occurring mental health disorders) is nothing less than revelatory. Sometimes, combining a variety of approaches works best, and a tailored treatment plan can offer more effective, lasting results.
Final Thoughts: Recovery is Not One-Size-Fits-All
Recovery from alcohol addiction is deeply personal, and what works for one person might not work for another. It’s important to keep an open mind and explore different treatment options until you find what feels right for you. Whether you end up sticking with AA, trying something entirely different, or developing your own unique path, the key is to stay committed to your health and well-being.
Remember: It’s okay to ask for help, and it’s okay if AA isn’t the answer. The most important step is to keep moving forward, no matter what path you choose.
We’d love to see you in person or via telehealth at our addiction treatment clinic in Portland
Portland residents tend to gravitate towards our programs because we offer a warm, family-style environment with knowledgeable clinicians in a comfortable, discrete setting.
Our building is a converted craftsman that looks and feels more like a chiropractor’s office or a naturopathic family medicine clinic than it does an addiction treatment center. We tailor our patient-centered treatment plans around your preferences and goals, taking the whole patient into consideration, rather than treating addiction in isolation.
Plus, we’ve recently added TMS – Transcranial Magnetic Stimulation – and Ketamine therapy to our existing patient services. We’re also pleased to announce that we now offer psychiatric services for pediatric and adolescent patients, as well.
Interested to learn more about how we can help? Give us a call today to begin your journey to freedom from addiction!
