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Twelve-step programs as a treatment for heroin addiction

"Twelve-step" programs are so known because they name twelve steps a person must go through in order to cure their drug problem. The first and best known of these programs is Alcoholics Anonymous.

The twelve steps vary somewhat from program to program but they follow this pattern:

  1. They admit that they are powerless over drugs or alcohol and that their lives have become unmanageable.
  2. They come to believe that a power greater than themselves can restore them to sanity. 
  3. They make a decision to turn their will and their lives over to the care of God as they understand Him. 
  4. They make a searching and fearless moral inventory of themselves. 
  5. They admit to God, to themselves, and to another human being the exact nature of their wrongs. 
  6. They are entirely ready to have God remove all these defects of character. 
  7. They humbly ask Him to remove their shortcomings. 
  8. They make a list of all persons they have harmed, and became willing to make amends to them all. 
  9. They make direct amends to such people wherever possible, except when to do so would injure them or others. 
  10. They continue to take personal inventory and when they are wrong promptly admit it. 
  11. They seek through prayer and meditation to improve their conscious contact with God, as they understand Him, praying only for knowledge of His will for us and the power to carry that out. 
  12. They have a spiritual awakening as the result of these steps, and try to carry the message to others with similar problems, and to practice these principles in all of their affairs.


What's Good About It?

Like most other rehabilitation programs, there are some people who swear it is the thing that saved their lives and thus, by necessity, is the answer for others. No doubt that is certainly true for some people. You might be especially inclined to like it you also like religion. As you may have noticed, references to God are a big part of the Twelve Steps.

What's bad about it?

Lots of people don't like the devotion to religion. Supporters of twelve-step programs will say that there programs are non-denominational -- which is certainly true for many of them -- but it is still religion.

Other critics of twelve step programs argue that admitting you are powerless is the exact wrong thing to do. In essence, it attempts to excuse your bad behavior by saying it wasn't really your fault -- it was the fault of the drug you were taking. Such critics argue that what you really want to do is to emphasize your own power over your life -- because that is what you are really doing when you put down a drug addiction.

It should also be noted that proponents of twelve step programs often claim extraordinarily high success rates. The truth is that they tend to count only the people who stayed in the program (dropouts are ignored in the stats) and they don't even keep very accurate records on those -- nor do they typically allow others to do the kind of research that would allow a definitive answer.

If you encounter anyone claiming 80 or 90 percent success rates for ANY drug rehabilitation program, you may safely assume they are exaggerating.


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