I worked at Cigna in the Alcohol and Drug Dependency Department in the 1980s. I also published two books on alcoholism which discussed the Twelve Step articles of faith and the lack of empirical support. At the time, most of the work force were people in AA. This has changed dramatically. Of course, Bill Miller and motivational interviewing had an impact. But, I think the biggest impact has been the opioid epidemic. I attend the SAMSHA supported Providers Clinical Support System which intends to provide guidance to those who are providing methadone and buprenorphine to those with opioid addictions. What is surprising is that none of these people are in recovery and they don’t even mention Twelve Step programs. SAMSHA also funds peer support. I have many social work students who are also peer supporters. Although these peer supporters often are in Twelve Step programs they don’t object to methadone or buprenorphine. What a change.