By Tom Horvath, PhD This blog will publicize a recent blog post on syringe services from Nora Volkow, MD, the Director of the National Institute on Drug Abuse (NIDA). She states that: Nearly 30 years of research show that providing testing, counseling, and sterile injection supplies to people who inject opioids and other drugs helps prevent transmission of infectious diseases, without increasing drug-related or other crimes in the vicinity. Contrary to worries that syringe services programs (SSPs) will encourage or promote drug use, evidence shows that they more often do the opposite, linking people with addiction to effective treatment and even helping prevent overdose deaths. There is no scientist or professional who is more credible on this subject than Dr. Volkow. Her stanc...

By Tom Horvath, PhD, ABPP Although many of us have warm memories about Thanksgiving spent with family and friends, there may be some painful memories as well. If you're looking for tips on coping with Thanksgiving, and the problems that might arise, consider the following goals: If avoiding squabbles is your goal, can you sit on your own opinions for one day? Say nothing, or say “I don’t agree with these ideas, but this isn’t the time or place to discuss them.” Repeat “this isn’t the time or place” as needed. If your goal is not drinking, or drinking less, you might need some preparation. Will a family member or two be “in the know” and support you? If you are likely to be asked questions (“why are you not drinking?”) do you have an honest but not necessarily revealing ans...

By Tom Horvath, PhD “If we have our own why, we shall get along with almost any how.” -Friedrich Nietzsche, Twilight of the Idols, Maxims and Arrows, #12, translated (1954) by Walter Kaufman, originally published 1889. Our Own Why There is a range of “whys” that explain how we behave. We have in-the-moment behaviors like eating (why? “I’m hungry”). As we mature, we also have much longer-term timeframes, such as multi-year educational plans (why? “I want to be an X”), and multi-decade parenting plans (why? “I want to give my children opportunities and an upbringing that I did not get to have”). You can probably recall many examples of how you tolerated discomfort or pain for the sake of a longer-term outcome. I suggest that it is helpful to make a list of these experiences in you...

By Tom Horvath, PhD “We are disturbed not by events, but by our views about them.” - Epictetus, 60-138 CE Bad events happen to all of us. To some of us, they happen to a great extent. Whether we have first-world problems, third-world problems, or something else, our problems focus our attention. We want to solve them. In some cases, solving problems means changing or exiting a situation. In many cases, however, there are no obvious changes or exits to make. What now? These types of problems require a change of “view.” Psychologists and others who help people change their “views” have used many terms to describe what needs to be changed to address these types of problems: perspective perception context viewpoint beliefs point of view interpretation *gui...

By Tom Horvath, PhD Although occasionally we hear someone say “I’m addicted to everything,” it appears that most of us deeply enjoy only a few substances or activities. You would not have time for all of them! This fact means that there are many or at least some substances that you do not feel strongly drawn to, even though others may be. For instance, you might like gambling, but not be interested in any substances. Or you might very much like alcohol (or weed, or meth, or opiates, or coke, or ketamine, or various activities, etc.) but not especially be interested in MDMA (or alcohol, or weed, or meth, or opiates, or coke, or ketamine, or various activities, etc.). How do you do it? How do you NOT get carried away with substances or activities that others find so tempting? How...

What are your sources of pleasure? By Tom Horvath, PhD If you’ve had addictive problems, you may easily recall experiences (with substances or activities) that you found intensely pleasurable. Addictive behavior can provide that! However, regardless of how much you are still having that type of experience, you can understand and appreciate yourself much better by examining the other sources of pleasure in your life. A daily review of them is useful. That review could happen at any time, but doing so as you fall asleep is a good way to end the day with a sense of pride and gratitude. What experiences from your day stand out to you? You may be surprised at what you discover. Here are some questions to consider in that review. How much did you enjoy sensory experience today? S...

By Tom Horvath, PhD A recent scientific paper analyzed the responses from nearly 10K individuals who identify themselves as “in recovery” from substance problems. In recent years the addiction recovery field has been considering how to define “recovery.” Five major organizations have offered definitions or attempts at definitions. However, there is not much data on this issue. Two previous studies have looked at how individuals in recovery define it. The present study is an advance because it identified 30 sub-groups, based on socio-demographics, substance use problems, and help-seeking history. Each sub-group was analyzed for which components of a recovery definition might be common for that sub-group. The second study had averaged all subjects together, thus losing some of the diff...

By Tom Horvath, PhD, ABPP One of the simplest but most powerful ways to reduce stress is to focus on breathing. Although books have been written on this subject, the following ideas may be a sufficient guide for you. Because we breathe continuously, you will have lots of opportunity to practice! Less is More Perhaps the most important single step to reduce stress is to breathe less, while breathing regularly, through your nose. A deep breath or two can get you started on “breath work,” but after those initial breaths, focus on breathing regularly but more slowly, and with lower volume of air. You are not going to reduce your rate of breathing instantly. However, over the course of many breaths your rate will (probably not entirely smoothly) reduce. With practice you might breathe a...

By Tom Horvath, PhD In Part 1 I recommended that the term “addictive problems” replace several similar terms. In Part 2 I recommend that the term “recovery” be replaced with several better alternatives, depending on context. To summarize Part 1, there is a continuum of addictive problems (abstinence, moderation, misuse, mild substance use disorder, moderate substance use disorder, severe substance use disorder). Over time someone can move up or down that continuum. They are not stuck forever at one level. This possibility of movement is the most radical aspect of viewing addictive problems as lying on a continuum (vs. the view that you are an “alcoholic” or “addict” forever, or that you are not). The lower the level of problems, the less likely someone is to address them because t...

A collegiate recovery program can mean all the difference to a young person in recovery. Having a program like this available on campus means they do not have to choose between recovery and a higher education. It provides students with an avenue to stay committed to recovery, while focusing on school, and having a community of support in a setting where it’s stereotypically a place to overindulge in substances. We researched colleges across the country that understand this and have dedicated university resources to supporting students in recovery. This is far from all, but is a great showing of support for the recovery community in higher education. U.S. Universities with Recovery Programs for Students Alabama University of Alabama in Tuscaloosa, AL - The Collegiate Recovery and...