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Twelve-step program
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==Effectiveness== {{See also|Effectiveness of Alcoholics Anonymous|Effectiveness of Crystal Meth Anonymous|Effectiveness of Gamblers Anonymous|Effectiveness of Narcotics Anonymous|Effectiveness of Neurotics Anonymous|Effectiveness of Nicotine Anonymous|Effectiveness of self-help groups for mental health}} Alcoholics Anonymous is the largest of all of the twelve-step programs (from which all other twelve-step programs are derived), followed by Narcotics Anonymous; the majority of twelve-step members are recovering from addiction to alcohol or other drugs. The majority of twelve-step programs, however, address illnesses other than substance addiction. For example, the third-largest twelve-step program, [[Al-Anon/Alateen|Al-Anon]], assists family members and friends of people who have alcoholism and other addictions. About twenty percent of twelve-step programs are for substance addiction recovery, the other eighty percent address a variety of problems from [[debt]] to [[Clinical depression|depression]].<ref name="MAKELA1996">{{cite book |last=Makela |first=Klaus |title=Alcoholics Anonymous as a Mutual-help Movement: A Study in Eight Societies |url=https://archive.org/details/alcoholicsanonym00mkel |url-access=registration |year=1996 |publisher=[[University of Wisconsin Press]] |isbn=0-299-15004-6}}{{page needed|date=September 2017}}</ref> It would be an error to assume the effectiveness of twelve-step methods at treating problems in one domain translates to all or to another domain.<ref name="SAULNIER">{{cite journal |doi=10.1177/002204269602600107 |title=Images of the Twelve-Step Model, and Sex and Love Addiction in an Alcohol Intervention Group for Black Women |journal=Journal of Drug Issues |volume=26 |issue=1 |pages=95–123 |year=1996 |last1=Saulnier |first1=Christine Flynn |s2cid=147097398 }}</ref> A 2020 [[Cochrane Library#The Cochrane Database of Systematic Reviews|Cochrane review]] of Alcoholics Anonymous showed that participation in AA resulted in more alcoholics being abstinent from alcohol and for longer periods of time than [[cognitive behavioral therapy]] and [[motivational enhancement therapy]], and as effective as these in other measures.<ref name="Cochrane2020">{{cite journal|doi=10.1002/14651858.CD012880.pub2|pmid=32159228|title=Alcoholics Anonymous and other 12-step programs for alcohol use disorder|year=2020|last1=Kelly|first1=John F.|last2=Humphreys|first2=Keith|last3=Ferri|first3=Marica|journal=Cochrane Database of Systematic Reviews|volume=3|issue=3 |pages=CD012880|pmc=7065341}}</ref><ref name="NYTCochrane2020">{{cite news|url=https://www.nytimes.com/2020/03/11/upshot/alcoholics-anonymous-new-evidence.html|title=Alcoholics Anonymous vs. Other Approaches: The Evidence Is Now In| last1=Frakt | first1=Austin | last2=Carroll | first2=Aaron | newspaper=[[The New York Times]]|date=March 11, 2020 }}</ref> The 2020 review did not compare twelve step programs to the use of [[disulfiram]] or [[naltrexone]], though some patients did receive these medications.<ref name="Cochrane2020"/> These medications are considered the standard of care in alcohol use disorder treatment among medical experts and have demonstrated efficacy in randomized-controlled trials in promoting alcohol abstinence.<ref name="ChengMcGuinnessElbers2020">{{cite journal | last1 = Cheng | first1 = Hung-Yuan | last2 = McGuinness | first2 = Luke A | last3 = Elbers | first3 = Roy G | last4 = MacArthur | first4 = Georgina J | last5 = Taylor | first5 = Abigail | last6 = McAleenan | first6 = Alexandra | last7 = Dawson | first7 = Sarah | last8 = López-López | first8 = José A | last9 = Higgins | first9 = Julian P T | last10 = Cowlishaw | first10 = Sean | last11 = Lingford-Hughes | first11 = Anne | last12 = Hickman | first12 = Matthew | last13 = Kessler | first13 = David | title = Treatment interventions to maintain abstinence from alcohol in primary care: systematic review and network meta-analysis | journal = BMJ | date = 25 November 2020 | volume = 371 | page = m3934 | eissn = 1756-1833 | doi = 10.1136/bmj.m3934 | pmid = 33239318 | pmc = 7687021 | url = }}</ref><ref name="NICE_MCCMH2011">{{cite journal |title=Alcohol-Use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence |journal=National Collaborating Centre for Mental Health (UK) |date=2011 |pmid=22624177 |url=https://pubmed.ncbi.nlm.nih.gov/22624177/ |publisher=British Psychological Society (UK) |author1=National Collaborating Centre for Mental Health (UK) |series=National Institute for Health and Care Excellence: Guidelines |isbn=978-1-904671-26-8 }}</ref> A systematic review published in 2017 found that twelve-step programs for reducing illicit drug use are neither better nor worse than other interventions, though the researchers behind the review noted the weakness of most of the studies analyzed, which may lead to interpretations of their results that did not accurately reflect the actual picture.<ref>{{Cite journal |last1=Bøg |first1=Martin |last2=Filges |first2=Trine |last3=Brännström |first3=Lars |last4=Jørgensen |first4=Anne-Marie Klint |last5=Fredrikksson |first5=Maja Karrman |date=January 2017 |title=12-step programs for reducing illicit drug use |journal=Campbell Systematic Reviews |volume=13 |issue=1 |pages=1–149 |doi=10.4073/csr.2017.2 |issn=1891-1803|doi-access=free }}</ref>
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