The creation of addiction treatment programs was heavily influenced by two very different peer-based methodologies: Alcoholics Anonymous (AA; a support group format) and therapeutic communities (TCs; a long-term residential format). The original TC was named Synanon and was the brainchild of charismatic ex-addict Charles Dederich. Synanon flourished in the 1960s in California as a residential community for addicts who were seeking to become drug-free.

AA and TCs were models for the development of early treatment programs funded directly by the federal government. The National Institute on Alcohol Abuse and Alcoholism fostered the expansion of AA-derived treatment programs, and the National Institute on Drug Abuse funded many TC-based treatment programs. The success of these peer-based approaches contrasted sharply with the failures of physicians and psychiatrists who attempted ...