Twelve Step Recovery and Medication Assisted Therapies

by Louis E. Baxter, Sr., MD, FASAM | Jun 12, 2014

"You're not clean and sober if you keep taking that medication from your doctor!"

"You're just substituting one drug for another."

"You are depressed because you are not grateful enough."

These and other statements are often made to 12-step members who are legitimately prescribed and taking FDA approved medications to treat their addictions and other co-occurring illnesses. Unfortunately, this so- called “advice” from well-intended but misinformed members is not founded in scientific or 12-step philosophy and violates a long held 12- step policy of " AA members should not give medical advice to each other." (Read The AA Member - Medications & Other Drugs).

It is well known that AA supports and encourages its members to "follow doctor's orders." In an article published in AA News in 1999, author Dr. Jacqueline Chang wrote that research regarding short-term abstinence showed "other things besides and in conjunction with AA are helpful. These include therapy, counseling, and others like Valium, Antabuse, Naltrexone, and Acamprosate."

Dr. Ruth Fox, the Founder of ASAM, supported MAT. It is well known and documented that she regularly prescribed Antabuse to her family, friends, patients and colleagues to assist them in their recovery from alcoholism.

Further, Alcoholics Anonymous and Psychiatric Medication (September 7, 2010) says that "it became clear just as it is wrong to enable or support any alcoholic to become re-addicted to any drug, it equally wrong to deprive any alcoholic of medication which can alleviate or control other disabling physical and or emotional problems."

Although there is no dispute that abstinence from alcohol and other drugs with potential for addiction is the foundation for sustaining recovery in most instances, there are other cases where MAT, especially for persons with co-occurring illnesses, is essential to obtain and sustain term recovery. 

In the late 1980's it was discovered by NIH that addiction was a brain disease. Since that time, medications with FDA approval have been developed to target those areas of the brain. These medications have shown great efficacy in assisting patients into and sustaining recovery. Every other chronic medical disease employs and encourages the use of medications in concert with life-style changes. Addiction medicine should examine the benefit of following suit.

MAT in addiction treatment is not required for everyone, but used in conjunction with 12- step programs and other biopsychosocial interventions, for those that need it, has shown to be invaluable in appropriate cases.

Louis E. Baxter, Sr., MD, FASAM

Dr. Baxter is the Immediate Past President of ASAM and Executive Medical Director of the Professional Assistance Program of New Jersey, Inc, located in Princeton, New Jersey and Medical Director, of the Division of Addiction Services for the New Jersey Department of Health and Senior Services. He is also an Instructor in Medicine at the Thomas Jefferson School of Medicine in Philadelphia, Pennsylvania.