There are different methods utilized in substance abuse counseling to bring about positive moral change in an addict. Probably one of the most commonly used is the Twelve Step approach practiced by the Alcoholics Anonymous or Narcotics Anonymous groups.

In this method, steps 4 and 5 and steps 8 and 9 deal with life inventory of the wrong deeds done and who was affected by them. In addition to this, the addict then makes up the damage done as a result of these negative actions.

This method is effective in recovery so long as the person's addiction has not progressed to the point where the individual has lost his or her ability to confront and communicate or to identify and solve problems. If an addiction persists long enough, an addict will lose even the basic social skills needed to perform in group therapy and to admit their wrongdoing.

In cases where drug addiction began in the adolescent years, individuals have not had the opportunity to develop these life skills. As a result, they do not perform as well in a Twelve Step program or other traditional treatment settings. In these cases, the addict needs to be educated or re-educated in these basic life skills before there can be any real hope of success in raising moral standards and permanent sobriety.

When conventional approaches are not working with a drug-addicted person, there are effective alternatives to pursue in recovery before one gives up. What has not proven effective is substitute drug treatment, e.g. methadone, anti-depressants or other prescribed medications designed to mask the symptoms of addiction mentioned in this series of articles. This, in effect, just trades one addiction for another. It does not aid the addicted person in developing the life skills necessary to raise their moral values or their quality of life. Nor does it provide them with the necessary tools to remain sober. Thus relapse becomes inevitable.