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Can You Do 12-Step Therapy & Suboxone Treatment Together?

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Sep 15, 2023 • 7 cited sources

Suboxone and 12-step therapy can theoretically be combined, although some 12-step programs have a stigma about using medication for addiction treatment (MAT). This can sometimes be an obstacle for patients on MAT who are also interested in group therapy. 

What Are 12-Step Programs? Do They Work?

12 step programs, also called “Alcoholics Anonymous” or “Narcotics Anonymous”, are a group of programs that follow a 12 step process designed to help people overcome substance dependence.

Evidence supporting the efficacy of 12-step programs is actually much more limited than even many experts realize.[2] Despite the widespread popularity of these programs, many are highly religious in nature and make many unscientific claims about their processes.

The success rate of Alcoholics Anonymous (AA) is around 5 to 10 percent when NOT combined with concurrent medication for addiction treatment (MAT). [2] In general, it is believed that the combination of behavioral support (one form of which is a 12 step program) and MAT together provides the strongest success rates for recovery for OUD. 

Why Have 12-Step Programs Traditionally Excluded Patients on MAT?

One of the tenets of 12 step programs is that individuals must be completely abstinent from substances. Historically, this has also included MAT (including Suboxone or Methadone medication). The belief at the time was that using MAT was simply “substituting one addiction for another”. [3]

As we learn more about the science of addiction, we have come to understand the inaccuracy of this belief. The scientific community now generally accepts that SUD is a chronic disease that often requires medication – MAT – for treatment. Patients should be encouraged to use MAT, and certainly not shamed or disincluded from support programs for doing so. [1]

Many 12 step programs have come around to this philosophy, and are including patients on MAT in their groups. However, some programs may still disallow patients from participating if they are on MAT. 

Can I be in a 12-Step Program while on MAT?

These days, often the answer is yes. However, if you find resistance among your local 12 step programs in allowing you to be on MAT while participating, there are a number of other very well established group programs that do not have any historical insistence on total abstinence. One example is SMART recovery. 

Understanding & Overcoming the MAT Stigma

While progress is being made, significant stigma still exists around MAT.

The evidence is very clear that MAT – including Suboxone (buprenorphine/naloxone) and Methadone – is a safe and effective way to treat OUD. [6]

Overcoming the stigma associated with MAT isn’t easy, especially when dealing with organizations that may be using practices and claims not backed by evidence that shame or discourage individuals from getting the help that they need for their medical condition. [7]

If you or someone you love is on MAT and is interested in concurrent group therapy either with 12 step programs or another group program, reach out to your treatment team to help connect you with a program that is right for your specific beliefs and needs.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

  1. Medication-Assisted Treatment Improves Outcomes for Patients With Opioid Use Disorder. PEW. November 2016. Accessed August 2022.
  2. With Sobering Science, Doctor Debunks 12-Step Recovery. NPR. March 2014. Accessed August 2022.
  3. By Shunning Medication-Assisted Therapy, 12-Step Meetings Are Making the Opioid Crisis Worse. STAT. October 2017. Accessed August 2022.
  4. The Surprising Failures of 12 Steps. The Atlantic. Accessed August 2022.
  5. Adoption and Implementation of Medications in Addiction Treatment Programs. Journal of Addiction Medicine. March 2011. Accessed August 2022.
  6. Stigma, Misunderstanding Among Barriers to MAT Treatment. American Psychiatric Association. September 2019. Accessed August 2022.
  7. Buprenorphine Treatment for Opioid Use Disorder: An Overview. CNS Drugs. June 2020. Accessed August 2022.

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