More Than One Pathway to Recover: A Guide

Pathways of Recovery

Article originally featured on The Fix. 

Regardless of how we achieved recovery, it is our responsibility as members of the recovery community to better inform ourselves (and others) of the other options out there rather than suggesting that our way is the only way.

We live in a country where 45 million American families are affected by addiction. The statistics are frightening: over 20 million adults have substance use disorder and  people have alcohol use disorder. 64,000 Americans die from drug overdoses each year and over 88,000 die from alcohol related causes. Sadly, less than 10 percent of people suffering with substance use disorder, and less than  of those with alcohol use disorder, get the help that they need.

In spite of this public health crisis and the tragic and very preventable deaths, the recovery community is divided in its efforts. While on the one hand we are making great strides by publicly speaking up to put a face and a voice to recovery in order to fight stigma and boost efforts to gain greater resources and access to treatment, there is still some infighting within the community about the best way to recover. If we’re fighting to eliminate the stigma that marks us as “less than” to the general public, we should also be fighting the stigma within our more insular community. How can we effectively tackle this crisis if we’re not helping each other?

There are many people in 12-step recovery who bicker in online forums and sit in church basements purporting to know the only way to recover and anyone who disagrees must be wrong. I have lost count of the times I’ve heard of someone relapsing or expressing their discomfort with the 12-step program, only to be told that the problem is actually them and their lack of willingness. As evidenced in the Big Book:

“Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves.”

This passage simply isn’t true. According to Zachary Dodes, who co-wrote The Sober Truth: Debunking the Bad Science Behind 12 Step Programs and the Rehab Industry, the success rate of AA is actually somewhere between five and 10 percent, with only one in every 15 people entering the rooms achieving and maintaining sobriety. This is in stark contrast to AA’s self-reported figures in 2007 of 33 percent of members having 10 or more years of sobriety. A 2012 survey revealed 24 percent of members were between one and five years sober, 13 percent of members were sober between five and ten years, 14 percent between 10 and 20 years, and 22 percent beyond 20 years sober. 

In fact, of the people who are fortunate to recover—22.35 million—half of those do so in various mutual aid groups. A recent study was conducted to determine the difference in attendance, participation, and recovery outcomes of 12-step groups versus alternatives of SMART, Women for Sobriety, and LifeRing. The study concluded that the alternatives were just as effective, if not more so, than 12-step programs. Study author Dr Sara Zemore recommended that professionals refer patients to these 12-step alternatives—especially when patients are atheist, or when they are unsure of whether they wish to pursue complete abstinence or a method of harm reduction.

I’m not the first person to say that 12-step groups didn’t work for me. And I did throw myself into the program for four years, completing the steps in both AA and NA. I reached a point where I could no longer ignore my feelings: I did not believe in the program—I found it positively disempowering and I found it self-limiting to refer to myself as something I used to be, a person with alcohol use disorder. And I’m not alone, there are articles published every day that echo my point of view, offering experiences of people who have successfully found recovery through alternative pathways.

As the recovery community expands and gains traction in fighting stigma and making resources more accessible—although we still need significantly more if we’re to end the crisis—we are starting to see greater emphasis on alternative pathways. What’s more, we are seeing that these pathways are presented on an equal footing as more and more research becomes available to support their efficacy. Just this week, Facing Addiction brought out a comprehensive guide, Multiple Pathways of Recovery: A Guide for Individuals and Families. Facing Addiction’s view is that just as substance use disorders are unique, so too is recovery—it’s dynamic and evolving, utilizing a collection of resources, or recovery capital.

The different pathways of recovery are:

  1. Inpatient or outpatient treatment
  2. Therapy
  3. Holistic therapies
  4. Natural recovery
  5. Recovery housing
  6. Recovery mutual aid groups. These include:
    1. Refuge Recovery,
    2. Celebrate Recovery,
    3. Women for Sobriety,
    4. LifeRing,
    5. Phoenix Multisport,
    6. Moderation Management,
    7. SMART Recovery,
    8. 12 Step groups.
  7. Faith-based recovery services
  8. Medication-assisted recovery, including MAT groups
  9. Peer-based recovery supports
  10. Family recovery
  11. Technology based recovery
  12. Alternative recovery supports
  13. Harm reduction.

There are a wide variety of pathways and resources that can be used to recover in a way that suits the unique needs of the person recovering. Whether we subscribe to one or more of these methods or pathways, it is our responsibility as members of the recovery community to better inform ourselves (and others) of the other options out there rather than suggesting that our way is the only way. Just because something worked for us does not mean that it must work for everyone. If a person doesn't find success with the 12-steps, it doesn't mean that they are just not willing enough or "constitutionally incapable" of being honest with themselves. Perhaps if we stopped judging, became more informed, and met people where they are in their individual recovery journey, we might have a fighting chance at ending this epidemic.

For more information on all of these pathways, click here.

Articles, Pathways, The FixOlivia Pennelle