by Tom Horvath, PhD There is no more important person to the addiction treatment and recovery field than Nora D. Volkow, MD. Dr. Volkow is the Director of the National Institute on Drug Abuse (NIDA). In the US government’s fiscal year 2021 NIDA spent about $1.4 billion, primarily on research. By comparison, the budget for the National Institute on Alcohol Abuse and Alcoholism is only about $500 million. A substantial portion (if not the majority) of the world’s addiction research is funded under Volkow. The Statement from Dr. Volkow: Consequently, when Volkow speaks, people listen. Maybe more so than ever now: “Making Addiction Treatment More Realistic And Pragmatic: The Perfect Should Not Be The Enemy Of The Good” https://www.healthaffairs.org/do/10.1377/forefront.20211221.6918...

by Tom Horvath, PhD Practical Recovery and SMART Recovery both use the self-empowering approach for resolving addictive problems. This approach contrasts with the powerlessness-based approach of AA and other 12-step groups, at least on the surface. Both approaches begin with the person considering change, and then deciding to change (at least to some degree). Both approaches can be effective, but one may work better for specific individuals. The powerlessness-based approach is described in AA’s 12 steps. In the first step you admit you are “powerless over alcohol.” In the third step there is “a decision to turn our will and our lives over to the care of God as we understood Him.” This approach can be described as serenity (as used in the Serenity Prayer, and also as “letting go” o...

A Scientific Life on the Edge: My Lonely Quest to Change How We See Addiction, by Stanton Peele, reviewed by Tom Horvath, PhD Peele’s latest book (#14) is a personal autobiography, an intellectual autobiography, and a detailed comparison of his work with that of many other authors and scientists, including Maia Szalavitz, Carl Hart, Marc Lewis, and Johann Hari. For those unfamiliar with Peele’s work, this book would be an excellent introduction. If you already appreciate him, the historical and comprehensive nature of this book (379 pages, plus 52 pages of online references) will likely be appealing. The references online are helpful, and save the reader from flipping pages back and forth. Peele revolutionized our understanding of addiction. Love and Addiction, published in 1975 (...

by Tom Horvath, PhD, ABPP Dialectical Behavior Therapy (DBT) is an approach to psychotherapy designed for individuals who are highly emotionally sensitive, who struggle with depression and anxiety, and who may at times become suicidal. DBT tools, which focus on distress tolerance, interpersonal effectiveness, emotion regulation, and mindfulness, can be helpful to anyone. You can remember these 4 categories as DIEM, as in carpe diem (seize the day). DBT is part of the larger family of CBT (cognitive behavior therapy). Marsha Linehan, a psychology professor emeritus at the University of Washington, Seattle, developed DBT as a result of coping with her own emotional problems. Linehan, born in 1943, revealed in her late 60’s the personal connection to her professional work. Distres...

by Thaddeus Camlin, PsyD Saying drugs cause addiction is like saying clouds cause tornadoes.  Tornadoes are caused by a complex combination of factors including warm, moist air, changes in wind direction and speed, and an unstable atmosphere decreasing in temperature rapidly with height.  Similarly, addiction is caused by a complex combination of factors, not drugs themselves.  Let us not forget, drugs are not even a necessary component of addiction, as addictive behaviors manifest in the absence of drugs with process addictions like gambling, video games, sex, food, social media, work, etc.   Just like tornadoes require an unstable atmosphere, addictions invariably grow from unstable, often traumatic environmental conditions.  Clouds don’t cause tornadoes, drugs don’t cause addictio...

by Thaddeus Camlin, PsyD Labeling people who’ve been traumatized as sick, is sick. There’s nothing pathological about being severely affected by the worst of life’s horrors. There is something deeply pathological when natural reactions to unnatural situations are described as sickness and disease. There’s nothing sick or diseased about someone experiencing post-traumatic stress after catastrophic events then easing the aftershocks with substances that provide fast-acting relief. Substance use is an adaptive effort to cope with life problems, and until we figure out ways to effectively and reliably help people who suffer from post-traumatic stress people will continue to take matters into their own hands. The problem is not the people in addiction treatment, the problem is the woefull...

by Thaddeus Camlin, PsyD [caption id="attachment_12950" align="alignright" width="500"] HBO's Euphoria misses the mark when it comes to addiction, again[/caption] The latest installment of HBO’s Euphoria is chock-full of harmful addiction myths and contradicting information.  The show’s main character, Rue, is a young and intelligent woman with a history of severe trauma.  Her father died young from cancer, she was drugged and nearly raped, and she was cheated on and heartbroken by her first true love.  Like many who experience horrible trauma, Rue found solace in substances like MDMA and opiates.  Like many who find solace from trauma in substances, Rue got a bit carried away.  Like many who get a bit carried away with substances, Rue experienced some negative consequences becaus...

by Thaddeus Camlin, PsyD Villains certainly make prime scapegoats.  Because villains make great targets they are also susceptible to false allegations and wrongful convictions.  Despite its dominance in the retail sector, global mega-merchant Wal-Mart manages to retain a special sort of derision from many.  Recently, Wal-Mart’s been under fire for ignoring red flags as opioid sales boomed in the past decade.  Given Wal-Mart’s ubiquity, it would follow that one of the largest dispensers of prescription medicine ignoring red flags while opioid sales soared deserves a lion’s share of blame for the opioid epidemic, right?  Wrong.   What Role Does Walmart have in The Opioid Epidemic? Ignoring red flags while quarterly profit numbers tickle the fancies of board members and shareh...

by Thaddeus Camlin, PsyD The ‘us & them,’ ‘normies and addicts’ mentality continues to lose its stronghold in addiction theory.  The more addictive behaviors are recognized as a manifestation of normal human learning rather than diseased character defects and spiritual maladies, the better.  New Year’s resolutions, and their reputation for failure that often precedes them, offer yet another opportunity to highlight the universality of addictive behaviors.  New Year’s resolutions often fail because of a phenomenon of all-or-nothing thinking frequently referred to in the world of addiction as the ‘abstinence violation effect,’ where a single breach of a vow to change is viewed as failure and justifies absconding from the entire change attempt. Old habits die hard, new habits for...

by Thaddeus Camlin, PsyD Abuse conjures amongst the most abhorrent of associations.  People who are abused often turn to substances because they provide reliable and effective short-term relief from intrusive and disruptive trauma symptoms like nightmares, flashbacks, and panic attacks.  From that perspective, referring to people who were abused as ‘substances abusers’ doesn’t make much sense.  Thus, some leaders in the field of addiction medicine and treatment are calling on national drug institutions like NIDA and NIAAA to remove the ‘substance abuse’ label from the addiction lexicon.  We shall see if the call for change is answered. Addiction language doublethink is familiar territory for us at Practical Recovery.  Examples of hypocrisy abound when the common vernacular of ...