PARTNER PERSPECTIVE

Twelve Step Programs Are Not a Legitimate Treatment for Nonreligious People

DARREL RAY, ED.D.
President, Recovering from Religion

Twelve step programs, such as Alcoholics Anonymous, are religion disguised as treatment. Eight of the twelve steps directly refer to religious concepts like Higher Power or God. What is worse, twelve step programs also preach and encourage practices that are demonstrably harmful, like convincing people that they are helpless and need supernatural help to overcome their addiction, rather than teaching valid and viable skills for coping with substance abuse. In another example, Alcoholics Anonymous materials promote the idea that addiction is a progressive disease that will eventually kill you, even though there is no evidence for this claim. Many twelve step programs also counsel against medically assisted treatment, which can be critical for individuals facing serious addictions who may suffer from severe withdrawal symptoms. In its 80+ year history, there has never been a large, peer-reviewed study that demonstrated the efficacy of Alcoholics Anonymous. At the same time, there have been many large and small, peer-reviewed studies showing that methods like harm reduction or cognitive behavioral therapy have measurable, positive effects on drug use and relapse. Organizations that use those methods, like SMART Recovery, Secular Organizations for Sobriety (SOS), and Moderation Management, have been around for many years, yet they are often ignored by court and prison officials in favor of only twelve step approaches.

Our legal system was captured by the twelve step religion of Alcoholics Anonymous decades ago, despite the fact that several courts have made clear that these programs are religious and cannot be imposed upon nonreligious people coercively. Twelve step programs have been presented to the legal system as a treatment for addictions of all kinds, when there is no actual scientific evidence for their efficacy. In other words, people have been forced by the courts to accept the care and treatment of these programs without being offered evidence-based options. Let me be clear, there is plenty of anecdotal testimony that twelve step programs help people with addictions, but anecdotes are not scientific evidence. There are plenty of anecdotal stories for demons, witches, and UFOs, but we don’t count that as evidence either. Too many courts and prison officials have swallowed the twelve step dogma for too long, to the detriment of hundreds of thousands of people, including many religious people, who would benefit from science-based help. Real treatment is not based on supernatural notions and unfounded claims of helplessness to resist addiction.

Although it is good that some courts have recognized that nonreligious people shouldn’t be subject to religious coercion in twelve step programs, it is not enough that there is sometimes accommodation for those who are secular. This implies that treatment for nonreligious folks is something that needs to be tailored to accommodate their lack of a god belief. Why are Alcoholics Anonymous and similar programs the default choice of the courts? These programs discourage self-efficacy and push irrational thinking. The default in our court systems should be treatment that is supported by the latest research and shown to be the most effective. Anything other than evidence-based treatment risks further harm. All people dealing with substance-use disorders, whether religious or not, would benefit from secular, evidence-based treatment. Instead of twelve step programs, this should be the courts’ default option.

Real treatment is based on the best scientific evidence. With the current state of psychology and psychotherapy, several well-developed and demonstrably useful treatments for addictions are available. There is no reason for our courts to impose a supernatural system of treatment on anyone—especially on nonreligious people.   

The leadership of The Secular Therapy Project and Recovering from Religion applaud the New York State Legislature for recently enacting legislation to ensure that nonreligious people are given secular treatment options when court-mandated treatment programs are considered. In the future we hope to see other states follow this example and require state courts to offer secular options to those dealing with substance abuse. Using scientifically proven methods will save lives and reduce relapses. Substance abuse is a serious problem in our society, and it should be treated with proven techniques that help people overcome addiction while dealing with the underlying issues that may have led to the substance abuse in the first place.