A recent article entitled, “The efficacy of spiritual/religious interventions for substance use problems: A systematic review and meta-analysis of randomized controlled trials” has concluded that addiction recovery programs with a spiritual/religious focus are more effective than those that are not. To this we say, “Hallelujah!”
A New Study Confirms What Recovering People Have Known For Decades
The article was written by Audrey Hang Haia, Cynthia Franklina, Sunyoung Parkb, Diana M. DiNittoa, and Norielle Aurelioa. It was published in Drug and Alcohol Dependence, an international journal on biomedical and psychosocial approaches. This article finally gives credibility to what recovering people have known for decades.
The study is the first systematic review and meta-analysis looking at the effectiveness of spiritual and religious based interventions for substance use problems. Since the inception of the 12 Steps in 1953, millions of addicts and pepple with the disease of alcoholism have gotten sober by implementing a spiritual program in their daily lives. Many say this article has been a long time coming.
Check out the complete study.
The Scarcity of Research Available to Confirm the Success of 12 Step Programs
There is always a need for academic studies about 12-Step recovery. Those who oppose this method of substance use disorder treatment always argue there is not enough research available to prove the effectiveness of programs like Alcoholics Anonymous and Narcotics Anonymous.
It is true, there is very little research available on the success rate of 12-Step programs. There are a number of reasons for this.
The first reason is that a lot of people come and go in and out of what has been called the revolving door of “the rooms.” It is almost impossible for researchers to determine how many people attend and never return compared to how many stay and get sober.
Also, these are anonymous programs. From an ethical standpoint, academics have a first rule they follow when conducting research: do no harm. Many believe their presence in AA meetings or the interviewing of recovering people could potentially cause harm and impede the recovery process.
Because there is so little out there about 12 Step recovery, this published article is a welcome deviation from the norm. It has been embraced by those in the field of addiction treatment. It confirms that spirituality is integral to treating addicted people – something most of us have known all along.
Background of the Study
This study was fairly straightforward. Researchers pulled from 10 electronic databases to identify eligible studies (like randomized controlled trials) that were published between January 1990 and February 2018. The criteria was that the studies examined spiritual/religious “interventions” and their effectiveness for substance abuse treatment.
Twenty studies comprising 3,700 participants met inclusion criteria. Only 12-step-oriented interventions were compared with other interventions. These “other interventions” included Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy, Community Reinforcement Approach and other forms of treatment that were non-spiritual.
The spiritual/religious interventions in 16 studies (80 percent) were 12-step oriented. Four studies (20 percent) investigated the efficacy of non-12-step-oriented methods. This review has valuable implications for future research. The authored noted that more high-quality studies on the effectiveness of spiritual/religious interventions for substance use problems are desperately needed.
It is also important to recognize that the study identifies several spiritual practices: meditation, prayer, fasting, self-care, attentive awareness, solitude, acceptance, service, reconciliation, worship, gratitude, guidance, and celebration.
Defining Spirituality and Religion for the Purpose of the Study
Spirituality means different things to different people. The study defines spirituality “as the universal and fundamental human quality of searching for meaning, well-being, and profundity through connections with oneself, others, and the universe.”
It defined religion as “as an institutionalized system of beliefs, values, and practices oriented towards spiritual concerns and transmitted over time by a community.” Also, the study concluded that “religiosity refers to membership and participation in an organized religion.”
The study overlapped spirituality with religion. According to the authors, “spirituality and religiosity are both multidimensional constructs that can include behavioral, cognitive, existential, ritualistic and social component.”
Keeping Spirituality Simple and Staying Away from Religion
Whew! That was quite a definition to explain spirituality and religion.
Most 12-Step programs involve reading literature at the beginning of every meeting. This literature says “this is a simple, spiritual, not religious program.” While spirituality and religion are absolutely deep and very personal subjects for everyone, 12-Step programs pride themselves on keeping things simple.
In fact, everyone in a program like AA is encouraged to develop a relationship with a “God of their own understanding.” The 12 Steps are intended to celebrate each individual’s own understanding of spirituality.
What Did the Research Conclude?
This study, like most academic findings, is filled with data that the average person would be completely incapable of reading. We want to share the conclusions with you in layman’s terms.
Ultimately, the authors concluded that spiritual and religious based interventions are more effective than comparison interventions for people with substance use problems. This means that the spiritual/religious based programs studied were more effective at reducing or eliminating substance use. Also, they are equally as effective as other programs on a broader measure of wellness and function.
It’s pretty black-and-white.
Why this Research is Important in Addiction Treatment
In the wake of the opioid epidemic – the deadliest drug crisis in American history – we need effective addiction treatment now more than ever. The more we learn about treating the addicted individual, the more we advance collectively in our pursuit to end addiction.
Substance use disorders are actually quite common in the United States. An estimated 21 million adults are currently battling an addiction to alcohol or drugs. Unfortunately, many people look down on these people and judge them harshly. Addiction is a disease, but many people still view it as a moral failing.
We simply must end the stigma associated with addiction if we ever hope to heal as a nation. One of the ways we do this is by publishing the most current research and data on the disease and the subsequent recovery process. Academic articles give legitimacy to the field of addiction science. And, it helps to further the evolution of substance use disorder treatment so it can be effective and transformative.
This research confirms that spirituality is more effective for treating addiction than non-spiritual approaches. This is HUGE news in the realm of recovery! Now, addiction treatment centers across the country and around the world are more likely to incorporate spiritual practices into their programs.
What This Study Means For Recovering People
In a moment, we will discuss the spiritual nature of 12-Step recovery and explain why it works. But first, let’s remember that the recovery community has relied on these steps since 1935 when Alcoholics Anonymous was founded by Bill Wilson and Dr. Robert Smith. They have been embraced for decades.
Sure, we have confirmation that spirituality is an integral part of the recovery process through this study. But, most people in recovery would tell you these findings don’t change anything for them. Millions of recovering people around the world have always had all the proof they ever needed.
They know what the 12 Steps have done in their lives and the lives of those around them. They are no longer shackled by the chains of their addiction. They enjoy freedom and live a sober lifestyle. This should be evidence enough that spirituality is vital to recovery. But, of course, this research lends credibility to 12-Step programs, perhaps elevating them in the eyes of the general public.
Now, let’s talk about the value of the 12 Steps as a spiritual approach to the recovery process. Why are they so effective?disease
The 12 Steps of Narcotics Anonymous – How They Are Different
Alcoholics Anonymous was the first program of its kind. All subsequent programs adapted the 12 Steps from AA. The steps are always the same, except the First Step varies from program to program.
We want to introduce you to the 12 Steps of Narcotics Anonymous and their accompanying spiritual principles. Keep in mind that NA is somewhat different from other 12 Step Programs.
In Step One of the NA program, the addict seeking recovery is asked to admit powerlessness over their addiction. All other programs admit powerlessness over a specific substance (like alcohol, heroin, marijuana, or crystal meth; for example).
NA teaches members in meetings that the disease of addiction is all-encompassing. Drug use is only a symptom of the disease. Addiction can also manifest with gambling, pornography, food, and sex. Also, many people relate to this program because they are polysubstance abusers. This means they used a variety of substances and weren’t just addicted to one type of drug in particular.
A Brief Overview of the 12 Steps of NA and Their Respective Principles
The 12 Steps represent a roadmap that orients people toward sobriety. This happens by “working” and living the steps and applying spiritual principles to daily life.
This involves surrendering to the care of a loving, caring Higher Power. Because addicted people are truly powerless over the disease of addiction, they desperately need some kind of divine intervention. This is where the Steps come in.
Here is an overview of the 12 Steps of Narcotics Anonymous and their accompanying principles:
STEP 1: HONESTY
“We admitted we were powerless over our addiction, that our lives had become unmanageable.”
An honest admission is necessary for the healing process to begin. Denial is a powerful driving force behind addiction. It convinces addicts and alcoholics that no problem exists or that it is “not that bad.” Denial says, “I can handle it, I am in control, and I can stop anytime I want to.”
In order to get sober and stay sober, someone must first make a commitment to stop using or drinking one day at a time. This usually only happens once someone has stepped out of denial and gotten honest about their addiction. Honesty is the key to recovery.
STEP 2: HOPE
“We came to believe that a power greater than ourselves could restore us to sanity.”
Addiction is insane. The unmanageability caused by prolonged drug or alcohol use is pure madness. Usually, by the time someone enters a 12-Step program, they have become painfully aware that they have lost touch with reality. Addiction ruins your life in a hundred ways. The first part of this step is acknowledging the self-induced insanity.
The second part of the step ignites the spiritual healing that happens by working the remainder of the Steps. Most people try to stop drinking or using drugs many times before they seek help. They find that they cannot quit on their own. Their addiction has become a power greater than themselves. They become lost to the Dark Night of the Soul.
Now, in Step Two, people seeking recovery are invited into a process of coming to believe. They are asked to accept that a power greater than themselves can restore them to sanity. They are no longer run ragged by the power of addiction. They are granted peace by a God of their own understanding.
STEP 3: FAITH
“We Made a decision to turn our will and our lives over to the care of God as we understood Him.”
This step is about turning over one’s will to the care of a loving, caring God as we understood Him. This can mean anything to the individual. Many members choose their 12-Step group as their Higher Power.
The idea behind this step is that when self-will runs riot, people become enveloped in their addiction. They become powerless. Their lives become unmanageable. They go insane. By turning their will over to the care of God, they surrender to a Higher Power who helps them stay clean.
STEP 4: COURAGE
“We made a searching and fearless moral inventory of ourselves.”
AH, yes, the dreaded searching and fearless inventory. This step requires a great deal of soul-searching, self-examination, courage, and honesty. It involves looking at past behavior.
This includes recognizing cycles of abuse and toxic relationships, as well as being accountable instead of placing blame. The NA Step Working Guide involves about 100 very personal questions. Many people are unnecessarily terrified of this step and avoid it for months or even years. It requires a strong, hard look in the mirror. Many people are scared to face themselves.
This step is important because most addicted people who arrive at a 12-Step program have no real sense of identity. They have numbed themselves for so long, they have forgotten why they started drinking or taking drugs in the first place. A Fourth Step is vital to smashing denial, experiencing ongoing healing, and getting real. It is also an identification of character defects.
STEP 5: INTEGRITY
“We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.”
This step involves going over the Fourth Step with a sponsor. A sponsor is kind of like a mentor in recovery; a person who takes someone through the steps.
It is important to get Fourth Step work out in the open by sharing it with another human being. Most people lose all sense of morality when they are trapped in the cycle of addiction. This step allows someone to reclaim their integrity. It is about accountability.
As the saying goes, “We are only as sick as our secrets.” Step Four shines light on the dark places and allows people to make peace with the past.
STEP 6: WILLINGNESS
“We were entirely ready to have God remove all these defects of character.”
Step Six is a continuation of Steps Four and Five. This is a process of becoming entirely ready to God remove the character defects identified in the previous steps. This can be an incredibly freeing process for people in recovery. It is also a necessary one.
The 12 Steps show addicted people a new way to live. This means old patterns and unhealthy behaviors must stop in order for the recovering person to stay sober and enjoy a life without drugs and alcohol.
STEP 7: HUMILITY
“We humbly asked Him to remove our shortcomings.”
After identifying character defects and becoming entirely ready to have them removed, the Sixth Step asks the recovering person to humbly ask God to remove them.
Things like impulsivity, selfishness, anger, fear, resentment, intolerance, shame, and guilt have to go. If not, a relapse is inevitable at some point. Recovery is about feeling comfortable in your own skin and enjoying life.
Character defects can be triggers that can cause someone to return to active addiction. By asking God to remove them, the recovering person experiences freedom from the bondage of self.
STEP 8: RESPONSIBILITY
“We made a list of all persons we had harmed and became willing to make amends to them all.”
Drug and alcohol addiction does not come without its consequences. During this step, addicts make a list of every person they have ever harmed as a result of their addiction. Shame and guilt are constant companions for recovering people. This step is a prelude to forgiveness, healing, and the restoration of broken relationships.
This step is about recognizing who was harmed and how. Then, a list is made. These are the only actions taken with this step.
STEP 9: DISCIPLINE
“We made direct amends to such people whenever possible, except when to do so would injure them or others.”
This step is not simply about saying, “I’m sorry.” It is about righting a wrong. This means if money was stolen, it should be repaid. If property was destroyed, it should be fixed. If abusive words were spoken, a heartfelt apology and a willingness to make it right are in order. Step Eight is a way to make peace with the past by making restitution.
Of course, this step specifically says that in some cases, there should be no contact with the harmed person. If reaching out to them would cause them harm, it is better to stay away. Also, when speaking of “others,” it is important to note that this includes the individual working the step. If the person in question is toxic or abusive, they should be left alone.
STEP 10: PERSEVERANCE
“We continued to take personal inventory and when we were wrong promptly admitted it.”
Steps Ten, Eleven, and Twelve are considered the maintenance steps. Once the first Nine Steps have been worked, the following steps are to be practiced daily. They are designed to keep the recovering person on track and engaged in their recovery.
Step Ten asks the individual to look back over their day at the end of every day and ask themselves where they went wrong and how they could do better. If a wrong is identified and an apology is needed, it should be made immediately.
STEP 11: AWARENESS
“We sought through prayer and meditation to improve our conscious contact with God, as we understood him, praying only for knowledge of His will for us and the power to carry that out.”
This step promotes the implementation of prayer and meditation as a daily spiritual practice. This keeps the recovering person aligned with God’s will and not their own. It deepens the experience of the faith that was ignited in the Third Step.
STEP 12: SERVICE
“Having had a spiritual awakening as the result of these steps, we tried to carry this message to addicts, and to practice these principles in all our affairs.”
There is a saying in 12-Step Programs: we can only keep what we have by giving it away. By helping those who are working to stay clean, every individual is also helping themselves stay clean. This is an act of goodwill and brotherly love. It is an opportunity to give away what was so freely given to them by others when they first got sober.
So… Why Do the 12-Steps Work for Addiction Treatment?
We have just given you a brief overview of the 12 Steps of Narcotics Anonymous and their corresponding spiritual principles. We did this to show you how and why spirituality works in treating an addiction to alcohol or drugs like cocaine, heroin, and prescription painkillers.
The finding of the study affirmed that a spiritual approach to recovery is more effective than non-spiritual approaches. We believe this has everything to do with the healing power of the 12 Steps.
The 12 Steps address powerlessness, unmanageability, and insanity – three cornerstones of addiction. They also provide a restoration to sanity, a connection to a Higher Power, a new identity, and sharing sick secrets with another human being.
Plus, they allow for the righting of wrongs, and the removal of character defects that could lead to a relapse. Also, they allow for a daily inventory and opportunity to make amends for wrongdoings. And, finally, they incorporate the spiritual practices of daily prayer and meditation.
Essentially, all the bases are covered. The 12 Steps provide a proven program of recovery from drug and alcohol addiction, which addresses all aspects of the recovering person.
Finding a 12-Step Meeting Near You
There is no doubt that the recovery community could greatly benefit from more studies like the one we have identified in this article. If you have a problem with addiction, you can find a spiritual solution at one of the following programs:
Of course, you may need to go to rehab to get clean. 12-Step programs are best when combined with an inpatient or outpatient program. Think you might need to go to rehab to get clean? Take this quiz and find out.
Not sure if you are addicted? This quiz will help clear things up.
We hope this article has helped you understand what a vital role spirituality plays in sobriety. Some might argue that the study published in the Drug and Alcohol Dependence journal is a game-changer. It confirms that addiction treatment is more effective when it includes some kind of spirituality.
For others, the study merely reveals to the world what they have been saying all along – “Keep coming back. It works if you work it!”