Addiction, 12-Step Programs, and Evidentiary Standards for Ethically and Clinically Sound Treatment Recommendations: What Should Clinicians Do?

Annette Mendola; Richard L Gibson

doi:10.1001/journalofethics.2016.18.6.sect1-1606

Addiction, 12-Step Programs, and Evidentiary Standards for Ethically and Clinically Sound Treatment Recommendations: What Should Clinicians Do?

AMA J Ethics. 2016 Jun 1;18(6):646-55. doi: 10.1001/journalofethics.2016.18.6.sect1-1606.

Authors

Annette Mendola¹, Richard L Gibson²

Affiliations

¹ Director of clinical ethics and an assistant professor in the Department of Medicine at the University of Tennessee Medical Center in Knoxville.
² Associate professor of medicine at the University of Tennessee in Knoxville, and a clinical investigator at the New Orleans Center for Clinical Research, and board certified in internal medicine, nephrology, and psychiatry.

PMID: 27322999
DOI: 10.1001/journalofethics.2016.18.6.sect1-1606

Abstract

Addiction is a complex phenomenon characterized by a loss of control and compulsive, habitual behavior. Since there is no single, specific cause for addiction, there is no single, standard treatment for it. A variety of approaches are used, including counseling, psychotherapy, medications, and mutual help groups (MHG). The best known and most widely available approach to addiction is 12-step (TS) programs of recovery, a variety of MHG. These have been lauded as lifesaving by some and criticized by others. We argue that TS programs are an appropriate mode of help for those seeking to quit an addiction but should not be the only approach considered.

MeSH terms

Behavior, Addictive*
Counseling / methods*
Ethics, Medical*
Evidence-Based Medicine
Humans
Practice Patterns, Physicians' / ethics*
Self-Help Groups*
Substance-Related Disorders / therapy*