Across Utah — from court-diversion programs to residential rehab centers — our default response to substance use disorder remains frozen in 1935: “Go to a meeting.”
While Alcoholics Anonymous offered community when medicine had little to offer 90 years ago, modern public health cannot rely on prescientific dogma. Internal surveys and clinical trials show that 80% to 90% of newcomers leave within their first year, with long-term retention matching baseline rates of spontaneous recovery.
Worse, the twelve-step framework treats a biological, trauma-influenced condition as a moral shortcoming, requiring participants to profess “powerlessness” over “defects of character.” This rhetoric induces shame, while rigid “Day 1” chip resets trigger severe binge relapses. Grassroots meeting culture also routinely stigmatizes lifesaving, FDA-approved Medication-Assisted Treatment (MAT).
Addiction is a health condition, not a spiritual defect. Modern medicine offers targeted pharmacotherapies (such as Naltrexone), cognitive therapies (such as SMART Recovery), and harm-reduction strategies that build self-efficacy rather than demanding surrender.
Federal appellate courts have repeatedly ruled that court-mandated 12-step attendance violates the First Amendment. It is time for Utah’s judicial and healthcare systems to stop deferring to 1930s revivalism and embrace 21st-century science.
Cassandra Leyda, Logan