Twelve Step programs like Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous are free, self-supporting, and do not advertise. That’s why many do not know about them and their success rate. Instituted in the 1930s, such programs promote no drugs and use no psychiatric or psychology experts, relying instead on peer-to-peer healing and often meeting in church basements.
In the last decade, drugmakers and insurance companies, distressed by all that non-prescription health care, have monetized recovery to the point that it is out of reach of the poor and uninsured. When people call some “free” drug hotlines, they can be connected with for-profit rehab operations.
Once drug-free programs based on spiritual principles, the $42 billion-a-year for-profit rehab industry, often hospital-based, amounts to a recovery U-turn with medication first in lucrative medication-assisted treatment programs. That’s why so many people who once called themselves alcoholics and drug addicts now say they are “dually diagnosed” with “major depressive disorder” and “bipolar disorder.”
Drugmakers got a lot of help for this seismic shift from industry-funded writers of the psychiatric “Bible” known as the Diagnostic and Statistical Manual of Mental Disorders over the years. They elevated “depression,” once a transient and self-limiting condition, to “major depressive disorder” and created the disease franchises of bipolar, ADHD, and “spectrum” disorders to sell drugs. Currently, “neurodivergence” is the craze: Anyone can declare the “disease,” and it can garner instant attention, sympathy, and excuses.
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Sadly, a quick look at non-pharma scientific papers suggests that the SSRI craze, affecting a quarter of some populations, might well sometimes cause the new lucrative “mental illnesses” now monetizing the monolithic pharmaceutical industry. “Our findings demonstrate a significant association between antidepressant therapy in patients with unipolar depression and an increased incidence of mania,” declared researchers writing in BMJ Open, for example.
“The chemical imbalance that causes my illness is very difficult to regulate,” wrote a “sufferer” on the website Medium. “One minute, I’m full of energy, euphoric, oblivious to the world around me, impulsive and reckless. Then next, I feel desolate, depressed, or apathetic.” Before industry invaded health care, such fluctuations would have been called “life.” Drugmakers pay legions of social media “influencers” to whom many relate to trump up conditions that lead to sales of their drugs.
Twelve Step programs criticized by government agency
A premise of Twelve Step recovery is that “cutting down” on use of an addictive substance is not possible; total abstinence is necessary, or the user will relapse and even die. Yet the National Institute on Drug Abuse (NIDA) actually says, “There is little scientific evidence to support the stereotype that people who return to use after a period of abstinence inevitably do so at the same intensity.” Stereotype?
“There is increasing scientific evidence to support the clinical benefits of reduced substance use and its viability as a path to recovery for some patients,” the NIDA leader Nora Volkow wrote in a newsletter. “The FDA has historically favored abstinence as the endpoint in trials to develop medications for substance use disorders,” she added. “But abstinence is a high bar.”
In 2024, the health news site STAT lamented that not enough recovering opioid addicts were taking drugs like methadone and buprenorphine and ridiculed the Twelve Step admonishment that recovering people should not seek an “easier, softer way” with drugs.
Twelve Step recovery programs are the commercial obverse of the uber-marketing drug industry. Is that why they are maligned?
Martha Rosenberg is an investigative reporter whose work has appeared in the British Medical Journal (BMJ), Consumer Reports, Public Citizen, the Center for Health Journalism at USC Annenberg, the Nieman Foundation for Journalism at Harvard University, and other outlets. She studied at Rush Medical School and writes on health care, food, medicine, and public policy.
Rosenberg’s reporting has been cited by Memorial Sloan Kettering Cancer Center, Mayo Clinic Proceedings, Public Library of Science Biology, ScienceDirect, the Journal of Pain & Palliative Care Pharmacotherapy, the Journal of Trauma & Dissociation, Britannica, National Geographic, Hastings Law Journal, and Wikipedia. She is the author of several books, including Multidisciplinary Management of Chronic Pain: A Practical Guide for Clinicians, Born With a Junk Food Deficiency, Big Food, Big Pharma, Big Lies, and Food, Clothes, Men, Gas and Other Problems. She publishes on Substack, OpEdNews, and her Amazon author page.
