Learn About Addiction

Using evidence-based addiction treatment, individuals can learn a self-empowering approach to overcome addiction. Naltrexone vs Disulfiram Naltrexone and disulfiram are both used as deterrent agents in addiction treatment. Naltrexone is an opioid receptor agonist that reduces the euphoria associated with alcohol consumption and thus reduces the risk of relapse in alcohol-dependent individuals. Disulfiram blocks the metabolism of acetaldehyde, an intermediate product of alcohol metabolism. Upon consumption of alcohol, increased acetaldehyde levels cause a disulfiram-ethanol reaction, which includes flushing, nausea, vomiting, and a sense of uneasiness. Researchers in Mumbai, India, compared the efficacy of naltrexone and disulfiram in alcohol treatment for dependence in a one-year tria...

by A. Tom Horvath, PhD., ABPP It would be easy to misunderstand the title of this article. I’m not saying that AA (Alcoholics Anonymous) is harmful. On the contrary, many people attend AA and report it to be helpful. In the US there may be one million individuals or more active in AA at any one time.  A significant percentage may attend under court order, but the rest are free to quit anytime.  Although some individuals hate AA and speak their hatred loudly, it appears reasonable to believe that individuals who freely attend AA are not experiencing it as harmful. You may also be interested in: Debunking the Myth about AA In most other countries AA also has meetings, but does not dominate the recovery environment. In these countries there is a much greater opportunity to choose from...

Addiction, Recovery and Society How society should view addiction Ending recoveryism Let’s stop insisting addiction is a disease Will insurance cover addiction treatment if addiction is not a disease? AA’s dominance in the US is harmful Court-ordered 12-step attendance is illegal CRAFT: An alternative to addiction "intervention" Substance abuse evaluations in child custody cases Addiction and youth Teach teens drinking before it kills them Why do college students drink so much? Why does anyone? From adolescent substance experimentation to addiction Helping your troubled teen without making things worse Alcohol advertising targets youth Addiction impaired professionals On June 30, 2008, the state of California stopped its medical diversion program.  ...

In the news media, the typical expert describes addiction as a disease. Often these experts work at addiction treatment facilities. It would be easy to conclude that experts agree that addiction is hereditary, incurable, and lifelong. In the addiction field, this view is referred to as the “disease model.” There is significant disagreement about the disease model, but the scientists and professionals who view addiction in other ways do not receive the same media coverage. Why alternatives to the disease model (there are several) do not get more publicity is a story in itself. However, this article will focus on two reasons not to understand addiction as a disease. The first disadvantage of the disease model is that, for individuals with addiction problems, it is distracting. If I dri...

How Does Addiction Develop? Addiction develops when desire goes unchecked. Desire is a fundamental aspect of human life, and learning to manage desire is part of normal human development. Overcoming addiction is a special case of managing desire. Overcoming addiction is managing desire ‘writ large.’ You might also be interested in: Drugs Don't Cause Addiction Satisfying Desires I leave out of this discussion some Eastern approaches to living, in which the goal of proper living is the elimination of desire. In Western tradition, life is about satisfying desire. Some desires have their own names: hunger, thirst, greed, lust. Otherwise, we speak of desiring (seeking, wanting, wishing for) various objects and situations in our lives. We feel these desires with varying degrees of intensi...

How society should view addiction Ending recoveryism Let’s stop insisting addiction is a disease Will insurance cover addiction treatment if addiction is not a disease? AA’s dominance in the US is harmful Court-ordered 12-step attendance is illegal CRAFT: An alternative to addiction "intervention" Substance abuse evaluations in child custody cases Addiction and youth Teach teens drinking before it kills them Why do college students drink so much? Why does anyone? From adolescent substance experimentation to addiction Helping your troubled teen without making things worse Alcohol advertising targets youth Addiction impaired professionals On June 30, 2008, the state of California stopped its medical diversion program.  This program was designed to prot...

Antismoking campaigns and prevention programs in middle schools may be beneficial in teaching adolescents about the harms of smoking and drinking. Students who have been smoking and drinking in middle school may continue to smoke and drink throughout high school and even be at a higher risk for alcohol abuse in their lifetime. Thus, using evidence-based approaches to inform adolescents about addiction treatment and prevention in middle school may help reduce the number of students who try drinking and smoking. Parenting style is another key indicator of drinking and smoking by adolescents where subprime parenting may lead to an increased risk of tobacco use by middle school students. Individualized drug and alcohol treatment programs can help to reduce the risk of substance abuse in ...

Adolescent alcohol use and alcohol use disorders among adolescents constitute serious problems. By grade 12, nearly 60 percent of adolescents have been drunk, and studies suggest that approximately 6 percent of adolescents have an alcohol use disorder. In adulthood, males typically drink more frequently than females. However, during adolescence, females drink at rates equivalent to those of males. Among adults, alcohol-dependent women seem to be more susceptible to brain damage due to alcohol use. Animal studies suggest that the adolescent brain is more susceptible to brain damage due to alcohol use. Thus, alcohol use may affect male and female adolescent brains differently, and females may be more susceptible to brain damage from alcohol use in alcohol recovery. Researchers from the Un...

Self-regulation in the alcohol advertising industry is producing ads reminiscent of “Joe Camel” which targets impressionable youth, according to Australian addiction scientists who call for stricter regulation of the ads (Fielder, Donovan, & Ouschan, 2009). In the U.S., where alcohol advertising is also subject to self-regulation by the industry, more than 4,600 young people under the age of 21 died as a result of alcohol use each year. Past studies show that people who start drinking as adolescents have a higher risk of lifelong problematic drinking, ultimately perhaps necessitating a stay in alcohol rehab. Alcohol Advertising Targets Youth Other studies suggest that young people are more likely to drink when they’re exposed to more alcohol advertising. The Australian rese...

Through a non 12 step program, individualized treatment plans can be created for individuals who wish to completely abstain from all drugs and alcohol. AA alternative programs provide alcohol treatment plans that are self-empowering and by promoting abstinence or safe levels of alcohol consumption, individuals can lower their risk of certain types of cancer. It is important to note that heavy alcohol drinkers can also lower their risk for cancer by cutting down alcohol consumption to safe levels. You might also be interested in: Can Cannabis Cure Cancer? Several previous studies have reported a link between alcohol and cancer (especially cancer of the upper digestive tract and liver). However, many previous studies included males only, and many were general population studies. Few stu...

Individuals who drink heavily may find many benefits from either abstaining or dramatically reducing their alcohol consumption. Through a non 12 step approach to recovery, heavy drinkers can learn self-empowering tools to use in their daily life to assist them in coping with alcohol cravings, which in turn, may dramatically reduce their risk for developing various types of cancer in the future. Link Between Alcohol and Carcigonesis Previous studies show that chronic alcohol consumption is a risk factor for cancer of the mouth, pharynx, hypopharynx, larynx, and esophagus, and it is also a major factor in liver carcinogenesis (the creation of cancer). Studies also show that alcohol increases the risk for breast cancer and colorectal cancer. Alcohol treatment for heavy drinkers may preve...

Alcohol and Heart Disease Alcohol addiction has many negative side effects including higher risk for heart disease. Research has shown that heavy drinkers can lower their risk of heart disease by decreasing alcohol consumption. However, there are many people in alcohol treatment who struggle with decreasing their alcohol consumption and/or completely abstaining altogether. From a self-empowering perspective, individuals can learn and implement coping mechanisms when they feel the urge to drink that will enable them to decrease their alcohol consumption or completely abstain. Previous research shows a relationship between alcohol consumption and coronary heart disease. Low levels of drinking may reduce heart disease mortality. High levels of alcohol consumption increase heart disease...

The following study would be useful in a self-empowering addiction treatment program where individuals learn strategies to help them cope with cravings such as those experienced when viewing alcohol-related commercials and other media. Alcohol Commercials and Drinking Behavior - A Study Tobacco advertising has been minimized in many locations. Alcohol advertising, on the other hand, is generally accepted in Western societies. Alcohol advertisements on television and the portrayal of drinking in movies paint a positive picture of an addictive and potentially deadly substance. A number of past studies have found an association between alcohol advertising and drinking behavior, and some suggest that exposure to alcohol via television or cinema may lead to a relapse in alcohol recovery. A...

Among men who seek alcohol recovery, there are high rates of co-occurring alcohol dependence and intimate partner violence (IPV). IPV may include physical abuse, sexual abuse, threats, and emotional abuse directed toward current and former spouses and dating partners. A sensible approach for alcohol treatment for these men would need to include interventions that address both drinking and violence. Older Studies Show Drinking Increases Physical Abuse Previous studies show that drinking increases physical abuse. In 2003, for example, Fals-Stewart (2003) conducted a study of 137 men which found that men who drink alcohol and have a predisposition for IPV are more likely to be violent on days when they drink alcohol. The study found that the odds of any male-to-female aggression were eig...

Individuals who on a regular basis drink heavily may be at a higher risk for certain types of diseases than moderate drinkers. Although some people have been able to abstain from alcohol due to adverse health problems they are currently experiencing, some heavy drinkers cannot reduce their alcohol consumption regardless of the expected adverse effects. For those individuals, alcohol rehab may decrease risk of diabetes, heart disease, hypertension and other chronic health problems. In an alternative to the 12 step program, evidence-based addiction treatment is available to help individuals solve underlying issues that may have been the cause for their drug and alcohol abuse. Cognitive behavioral therapy is one of the approaches used where people use talk therapy to solve problems through...

Binge drinking, or excessive alcohol consumption, is a major cause of accidents and trauma. Previous research shows that among individuals with head trauma specifically, alcohol has been a major cause of morbidity and mortality. One previous study found that the consumption of five or more drinks on one occasion increases the risk of sustaining an injury by an odds ratio of 3.4. A team of researchers from Finland interviewed trauma patients to investigate any relationships between different patterns of alcohol consumption to different types of trauma (Savola, Niemela & Hillbom, 2005). The results suggest that alcohol rehab for alcohol dependent individuals and alcohol treatment for binge drinkers may decrease the risk of head trauma. Studying Alcohol Use and Head Trauma The study ...

Nausea, abdominal discomfort, and other gastrointestinal symptoms are commonly reported by individuals after drinking alcoholic beverages. The alcohol itself may cause gastrointestinal problems by affecting the gastric emptying process. Researchers at the University Hospital of Heidelberg at Mannheim in Germany conduced a systematic study of the effects of ethanol, alcoholic beverages, and the non-alcohol components of alcoholic beverages on the gastric emptying of solid meals in the human body, and the results suggest that alcohol rehab may improve gastrointestinal problems (Franke et. al., 2005). The researchers recruited 16 fasting, healthy, male participants who received once weekly 300 ml of pure ethanol, beer, red wine, glucose, and water in a random order. The solutions were g...

The traditional Alcoholics Anonymous 12 step approach to alcohol treatment suggests that one must completely abstain from all drugs and alcohol to achieve recovery. However, in an alternative to AA, a self-empowering approach is implemented where individualized treatment plans outline recommendations for problem drinkers as well as those with less severe drinking problems. You might also be interested in: What is the Best Alcohol Treatment? Moderate drinking or controlled drinking refers to limiting alcohol consumption to the point of no (or few) negative consequences. Previous research suggests that controlled drinking strategies are successful for many problem drinkers. In the United Kingdom, Norway, and Australia, controlled drinking is commonly recommended by healthcare providers....

Social anxiety disorder (SAD) and alcohol use disorders (AUD) tend to co-occur at high rates. The National Epidemiologic Survey on Alcohol and Related Conditions (Grant et al., 2005) found that 48 percent of participants with a lifetime diagnosis of SAD also met criteria for a lifetime diagnosis of AUD. In instances of alcohol use and comorbid social anxiety disorder, the two disorders may lead to greater impairment than either condition alone. For example, research suggests that patients seeking alcohol treatment who have a lifetime diagnosis of SAD are more likely to have major depressive episodes, severe alcohol dependence, less peer social support, and lower occupational status when compared to AUD patients without SAD (Thevos, Thomas, & Randall, 1999; Thomas et al., 1999). Mot...

Many individuals continue to drink excessively in adulthood and into late adulthood. Excessive drinking alone is a significant problem among elderly adults. Moreover, this age group often faces additional risks from alcohol consumption because of comorbidities (such as gout or hepatitis) and/or use of certain medications (such as sedatives or antidepressants). Thus, the impact of increased alcohol-related risk for elderly adults should not be dismissed, and the need for intervention should be explored among at-risk elderly individuals. Indeed, researchers at UCLA’s David Geffen School of Medicine found that more than one-third of elderly individuals who consume alcohol are at-risk drinkers because of excessive drinking, comorbidities, or medication use (Barnes et. al., 2010). The res...

Alcohol treatment clinics commonly treat individuals with comorbid disorders. In fact, an individual with “pure” alcoholism is rare in alcohol treatment clinics. Comorbid anxiety disorders, including generalized anxiety as well as phobic disorders, are extremely common in alcohol treatment clinics. For instance, the 1994 National Comorbidity Study found social phobia in 19.3 percent of alcohol-dependent participants. According to the self-medication hypothesis, individuals with anxiety use alcohol to decrease anxiety symptoms, and this promotes excessive use. Researchers in Amsterdam and the Netherlands set out to answers three questions regarding comorbid phobic disorders: (1) What are the clinical characteristics of treatment-seeking alcohol-dependent patients with a comorbid phobic d...

Overall rates of driving under the influence (DUI) arrests have steadily decreased over the past two decades, but this decrease has not occurred uniformly for all groups of DUI offenders. The proportion of female DUI offenders, for instance, has significantly increased. Further, DUI arrest rates remain higher in rural areas. See also: Why You Should Get a Substance Abuse Assessment for a DUI Case A Center on Drug and Alcohol Research study examined indicators of problem severity for female DUI offenders across graduated levels of rurality and found that the problem severity of DUI offenders is greater in rural areas (Webster et. al., 2009). Practitioners who provide alcohol treatment for rural female DUI offenders may face unique challenges. The researchers examined 19,094 substanc...

When pursuing alcohol treatment, individuals have different options for detoxification, including a home detoxification program or inpatient rehab. However, once detox is completed, implementing a self-empowering approach to recovery will enable individuals to learn to coping mechanisms to deal with cravings. You might also be interested in: Detoxification from Addictive Substances Some alcohol dependent individuals elect for home-based detoxification. Some individuals are more comfortable at home, and inpatient alcohol rehab may be expensive. Evidence suggests that, with family support, home detoxification may be safe and effective. However, many individuals are still exposed to alcohol-related cues in the home. Researchers in the United Kingdom examined whether a brief alcohol t...

There may be an association between parenting style and alcohol consumption by adolescent children; however, it is important to note the availability of alcohol treatment programs for those individuals who have chosen to engage in drinking. In an alternative to AA, self-empowering addiction treatment programs are available to adolescents who may be seeking an individualized treatment plan. It is important to focus on the treatment of underlying issues and through the use of a self-empowering approach, adolescents can be offered a practical solution for their well-being. Individuals can learn problem-solving skills, good health habits, and self-control to aid them in learning how to live life with a purpose. It is important to have a treatment plan customized for a specific individual be...

Non 12 step addiction treatment programs provide individual treatment plans depending on a person’s age, personality, and addictive behavior. Alcohol-Related Media and Adolescent Alcohol Use - The Study Adolescents are more vulnerable to the effects of alcohol and generally consume it in a more risky fashion, compared to adults. Alcohol consumption during adolescence may cause permanent brain damage (at a time when the brain is still developing), injury or death (through automobile crashes and other accidents), suicide, depression, violence, date rape, spread of sexually transmitted diseases, and many other harms. Previous research shows that alcohol advertising is associated with more positive drinking expectancies. Because of ethical boundaries, it has been impossible to directly te...

Many studies present evidence that antisocial personality disorder (ASPD) is highly associated with substance use disorders (SUD). The DSM-IV defines ASPD as “a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.” Characteristics of individuals with ASPD may include persistent lying, superficial charm, lack of remorse, impulsivity, poor behavioral controls, and disregard for social norms and rules. Mariani et. al. examined the rates of different antisocial syndromes among cocaine-dependent and cannabis-dependent individuals seeking drug treatment (2008). Conduct Disorder A true diagnosis of ASPD must include the childhood component of antisocial behavior known as conduct disorder (CD). C...

There are many effective alternatives to the 12-step addiction recovery approach.  This article will describe the major treatments and support groups that one might choose if interested in and answer the question: are non-12-step recovery approaches effective?  These alternatives need to be widely known because individuals who might never attend an AA (Alcoholics Anonymous) meeting might attend treatment or a support group with a different approach.  What might not be possible for them in AA might be possible elsewhere.  It would benefit everyone if the alternative approaches were as widely known and as easily available as AA and other 12-step groups.  Even AA would benefit from the individuals who chose to go elsewhere.  Those remaining in AA would know that they were attending because...

Aripiprazole (Abilify) has been approved by the FDA for the treatment of schizophrenia and acute manic and mixed episodes of bipolar disorder and as an adjunct for the treatment of major depressive disorder. Although other FDA-approved atypical antipsychotics (clozapine, risperidone, olanzapine, quetiapine, and ziprasidone) antagonize the D2 dopamine receptor, aripiprazole acts as a dopamine receptor partial agonist. Might a dopamine receptor partial agonist have a useful role in alcohol recovery? Antagonist vs. Agonist An agonist binds to a specific receptor and triggers a response that often mimics the response of another drug or naturally occurring substance. For example, methadone is an opioid agonist that mimics the effects of opiates. Antagonists, on the other hand, bind to the ...

Evidence based addiction treatment can be used to help individuals in alcohol rehab to achieve sobriety. In a non 12 step approach to recovery, individualized treatments plans can be created to meet the needs of a specific person. An example of evidence based addiction treatment includes cognitive behavioral therapy in which this article describes in further detail. Depressed individuals and other clinical populations exhibit difficulty in recalling specific autobiographical memories, according to previous studies. (A “specific” memory refers to those about a single event lasting less than a day.) Typically this difficulty in recalling specific autobiographical memories is associated with poor psychological functioning, poor problem solving, and increased hopelessness. Researchers in...

A well-functioning family, community or society needs to have a balance between self-interested behavior, and altruistic or service behavior. If every member of a group pays attention only to his or her own immediate needs, life becomes very difficult quickly. For instance, a hunter-gatherer group that could effectively cooperate to hunt large animals would have more food, and be safer, than a group that had each member attempting to hunt alone. Solitary hunters are simply not as effective as a well-coordinated team of hunters. You might also be interested in: When Substance Use Affects the Family It is assumed in most Western societies that individuals will naturally “look out for number one.” In some non-Western societies there may be more emphasis on helping others over taking care...

German alcohol treatment survey shows that frequency of binge drinking predicts alcohol-related social problems better than volume of alcohol consumed. As an alternative to AA, a self-empowering addiction treatment program allows people to work on eliminating negative outcomes from binge drinking by looking as past drinking patterns. Binge Drinking and Social Problems - What is the Link? Medical, psychological, and social consequences of drinking are related not only to the volume of alcohol consumed but also to patterns of drinking. For example, binge drinking, sometimes referred to as irregular heavy drinking or heavy episodic drinking, has been linked to many negative outcomes. A team of researchers in Germany investigated the combined effect of volume and binge drinking in pred...

Science has revealed that addiction is far more complex than we formerly thought. As a result, professionals and individuals in recovery have changed their language about addiction and recovery. Addiction is now described as a complex problem, and recovery is described as having biological, psychological, social, and spiritual aspects.  This "biopsychosocial" model of recovery groups model includes physiology and genetics; behavior, beliefs and emotions; family, community and culture; and values, morality, and ultimate beliefs. If we accept that addiction and recovery are bio-psycho-social-spiritual, which addiction support groups support this broad and complex approach? Which groups include all four aspects in their program (based on a review of the primary publications)? Fortunately,...

Evidence based addiction treatment research suggests that alcohol-induced bladder dysfunction is not uncommon in alcohol rehab. However, the mechanisms are not clear. Researchers from The University of Tokushima Graduate School in Japan report on the case of symptomatic abdominal distension due to urinary retention after alcohol withdrawal (Iga et. al., 2005). You may also be interested in: Alcohol Treatment May Lower Risk of Multiple Cancers The patient was a 48-year-old Japanese woman, married with three children. She began drinking occasionally after college. At age 38 she experienced panic disorder and sought professional help. From age 42 to 48 she gradually increased the amount of alcohol she consumed until the alcohol abuse became severe at age 48, when she was admitted to the ...

In a non 12 step approach to recovery, a self-empowering addiction treatment plan can be created for an individual who would like specific needs met. A self-empowering approach to recovery, even if it is a brief alcohol treatment intervention, can be utilized by people in treatment and at-risk drinkers, alike. This approach incorporates focusing primarily on underlying issues and finding motivations that are deeper than the addiction. You might also be interested in: What is the Best Alcohol Treatment? It is important to identify at-risk drinking among individuals as early as possible. Serum gamma-glutamyl transpeptidase (GGT) levels may identify heavy alcohol consumption; brief screenings in general health settings may also be used to identify at-risk drinking. For example, at-ri...

Yes, but…let’s discuss how drugs and alcohol can actually have a beneficial effect on your social life (or at least appear to). In the second section let’s discuss why drug and alcohol use can still be a bad idea for you. How Drinking and Drugging Can Help Your Social Life One of the most frequent reasons people use drugs, and especially alcohol, is to improve their social ability, either in social groups or on dates: "I didn't know how to enjoy myself with others unless I did this.  And I could go on a date more easily." Related to this benefit of using is the possibility of overcoming social awkwardness: "When I did this I didn't feel insecure, bashful, shy, ill at ease, inadequate, or left out." You may also be interested in: Self-Confidence vs. Self-Esteem Perhaps you don’t ...

Addiction recovery requires accomplishing several tasks, including: Build and maintain motivation Connect with others Identify and develop alternative coping methods Reduce resentment about changing Identify, understand and cope with craving Build a new, balanced life Lead a life that is purposeful, meaningful, and happy Stay alert for problems and follow through all the way Making Continued Progress To accomplish these tasks, you will need to make MANY decisions along the way. However, your judgment about your addictive behavior(s) has not been good. How could you trust yourself after addiction to make decisions about recovery? You could put yourself in the hands of others (AA, a therapist, your higher power, etc.).  However, many are not willing to...

What are the effects of cannabis on alcohol recovery? Many alcohol dependent individuals relapse after a period of abstinence in alcohol recovery. Researchers have used the reinstatement paradigm as an animal model of relapse. Animals are exposed to certain stimuli to test whether they reinstate previously extinguished responses, such as alcohol-seeking behavior. Lab rats, for example, will drink beer to the point of having withdrawal symptoms upon termination. Recent studies have found that synthetic cannabinoids (but not delta-9-THC, the main psychoactive constituent in marijuana) can reinstate previously extinguished drug-seeking behavior in lab rats (for cocaine, heroin, and methamphetamine). Since cannabis is often used with alcohol in social settings, a team of researchers in Aust...

Is media coverage of celebrity DUIs a missed opportunity for alcohol treatment and prevention efforts? A non 12 step alcohol treatment plan can provide people with strategies to prevent negative drinking behaviors that can lead to a DUI. Between 2005 and 2008, there were several high-profile celebrity DUI arrests, particularly among young female celebrities. Female celebrities arrested for DUI included Michelle Rodriguez, Paris Hilton, Nicole Richie, and Lindsay Lohan (who was arrested for DUI in May 2007 and again in July 2007). These celebrity DUIs received substantial media coverage. Did the media coverage create more problems by presenting problematic social modeling for young viewers to imitate? Did the media coverage miss an opportunity to provide alcohol treatment and prevent...

Should individuals who need help have choices when it comes to treatment and recovery from addiction?   Imagine talking to your child or partner, who is obviously drinking or drugging too much. “Why don’t you get it?  It’s SO obvious!  You are becoming addicted!  Look at the damage you are causing, to yourself, to me, and to everyone who cares about you.  YOU NEED TO STOP!  I’m arranging to send you to treatment.” And imagine an angry response, perhaps something like “This is my life, I’ll live it the way I want…You just don’t respect my lifestyle…You are blowing this way out of proportion…Just because you are a prohibitionist doesn’t mean I have to be one…You can take your treatment program and…” Looking in from the outside, we could say that this drinking/drugging indi...

Complete abstinence from all drugs and alcohol is promoted in a non 12 step approach to alcohol recovery. This article provides information regarding the importance of complete abstinence during alcohol rehab, and the possible benefits associated with greater lengths of alcohol recovery. Animal studies show that repeated alcohol withdrawals are correlated with impaired cognitive and learning abilities. The cessation of chronic alcohol consumption during withdrawal may lead to increased excitotoxicity in the brain, which can affect frontal lobe function. Researchers from the University of Heidelberg in Mannheim, Germany examined the effect of multiple alcohol rehab detoxifications on cognitive performance and decision making (Loeber et. al., 2009). Individuals with multiple rehab det...

When determining a self-empowering treatment plan for a person in recovery from cannabis, it is important to consider the motives for marijuana use. Some individuals may use marijuana recreationally and occasionally for years with relatively few negative consequences. Others become addicted to marijuana and continue to use it daily despite negative consequences. With increased use of marijuana, marijuana addiction is increasingly common, and drug rehab is often necessary to overcome the addiction. In the field of addiction research, relatively few studies have examined self-reports of motives for marijuana use. Self-reported motives for use are important for understanding addiction. Differences in motive for use may explain why one individual becomes addicted while another does not. ...

Non 12 step addiction treatment puts an emphasis on resolving underlying issues, including issues of anxiety. Family history with addiction and substance abuse can be a major factor in understanding the underlying issues behind one’s alcohol addiction. Previous research has shown that a family history of alcohol dependence is a risk factor for alcohol use disorders. Positive expectancies of alcohol use have been shown to moderate this association. Family history of anxiety disorders may also be a risk factor for alcohol use disorders; this is suggested by high rates of comorbidity between anxiety disorders and alcohol use disorders. Further, expectations of negative reinforcement (such as tension reduction) have been shown to moderate anxiety-related traits. With this in mind, resear...

If you have had strong cravings, you may not need a description of one!  Like hunger (which is what we call craving for food), craving is a complete (cognitive, emotional, and physical) experience.  Your mind is distracted.  You feel tense and/or frustrated.  You get physically uncomfortable.  Craving motivates us to engage with whatever we are craving.  Craving is specific, although we may gain some relief by using a substitute.  If you are craving red wine, beer would be a (poor) substitute!  If you are just craving alcohol, beer or wine will do. You might also be interested in: Drug & Alcohol Cravings - 10 Useful Methods to Cope We only crave what we have had experience with.  If you have never used heroin, you can’t crave it.  You might have a “craving” to try it, but that is ...

There are numerous individuals who use drugs and alcohol for coping with stress and their daily problems. Thus, to help those individuals disengage from constantly looking right to drugs for the answer to their problems, they need to be offered a way to find a solution. In a non 12 step approach to recovery, individuals can learn self-empowering tactics such as maintaining motivation, coping with cravings, managing thoughts, feelings and behaviors, and living a balance life. When individuals learn how to address stressful situations, they can use the tools they’ve learned to come up with a solution to their problems instead of looking to drugs and alcohol as their only solution. The Research: Coping with Stress Individuals who face and address stressful problems rather than avoiding t...

Within hours of Michael Jackson’s overdose, many asked, could an “intervention” have saved him, by persuading him to seek alcohol and drug rehab? Because it came out in the press that Jackson had actually experienced two interventions, the immediate answer to this question would appear to be that intervention was not helpful, at least to Jackson. But let us imagine what might have happened at these interventions, to understand more about intervention itself. What is an Addiction Intervention? The ‘Johnson Intervention’ is an organized confrontation in which the person with an addiction is misled into showing up somewhere (often by being told a lie), and then “ambushed” by as many significant others as can be recruited. Each person recites a prepared and rehearsed list of concerns and ...

A. Tom Horvath, Ph.D., ABPP Wondering if court ordered 12-step attendance is illegal? You're not the only one. This article is not intended to convey legal advice, which can only be provided by an attorney licensed in your state.  What follows is an addiction psychologist’s summary of a legal issue he has been following for over a decade. You might also be interested in: Mental Health Among Drug Court Participants in Drug Treatment The “establishment” and “free exercise” clauses of the US Constitution’s 1st Amendment state that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.”  In everyday speech we say that there is “separation of church and state” in the US.  Our religious or spiritual beliefs (or lack of them) are our p...

By: Tom Brown, Ph.D. CRAFT (Community Reinforcement and Family Training) is a non-confrontational approach to getting a loved one to enter addiction treatment. It is an approach designed for the concerned other (spouse, family member, friend), who is seeking assistance in getting their loved one help. CRAFT can also help the person you are concerned about reduce their substance use, even without their direct cooperation. CRAFT is successful in getting people into treatment by a three to one margin over traditional intervention strategies. CRAFT is motivational rather than confrontational. Concerned Significant Others (CSO) learn how to motivate loved ones to change, by rewarding sober activities and discouraging activities that include drugs or alcohol. The motivational approach to ...

The DSM-IV defines alcohol dependence as “a maladaptive pattern of alcohol use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period: (1) Tolerance, as defined by either of the following: (a) a need for markedly increased amounts of alcohol to achieve Intoxication or desired effect (b) markedly diminished effect with continued use of the same amount of alcohol (2) Withdrawal, as manifested by either of the following: (a) the characteristic withdrawal syndrome for alcohol (b) alcohol (or a closely related drug such as valium) is used to relieve or avoid withdrawal symptoms (3) alcohol is often used in larger amounts or over a longer period than was intended (4) there is a p...

The primary myth about AA is that “it is the only thing that works.” Of course, like other myths, there is some truth in this one. Many people assert that AA saved them or others they know well from alcohol problems. They may be correct. However, no one knows. From a scientific perspective, the effectiveness of AA is unknown. Furthermore, what is known to be effective alcohol treatment, from a scientific perspective, is not very similar to AA. Therefore, what should be said about AA is that “it might work—many people claim based on personal experience that it does—but other approaches are known to work, and they are rather different than AA.” An introduction to the complex scientific literature on AA can be found here: http://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_An...

A recent study suggests that depression, obesity, and alcohol use disorder are interrelated conditions among young adult women but not among men. A better understanding of the relationship between these interrelated conditions would help young women in alcohol recovery. A team of Washington University researchers collected data from young adults at the ages of 24, 27, and 30 (McCarty et. al., 2009). Nearly half of the 776 participants met the criteria for depression, obesity, or alcohol use disorder at each time point.   Alcohol Use Disorder Stats From The Study The study found that women with an alcohol use disorder (AUD) at age 24 were more than three times more likely to be obese at age 27. Women who were obese at age 27 were more than twice as likely to be depressed whe...

Detoxification from addictive substances A. Tom Horvath, Ph.D., ABPP Detoxification (“detox”), or withdrawal, is the period of time it takes your body to adjust to being without a substance which it is used to having regularly.  During this time period, a previous bodily “homeostasis” is restored, one based on not using the substance or substances.  This restored homeostasis is similar to the one you had before you started using the substances regularly. You might also be interested in: Medication-Assisted Treatment What is Homeostasis? Homeostasis refers to the body’s maintenance, by an ongoing balancing act, of a stable internal condition.  If you go scuba diving to a depth of 100 feet, your body adjusts to having that much additional weight pressing upon it.  We could say that...

A non 12 step approach to recovery promotes individuals to continue on to a sober living home after completing inpatient drug or alcohol rehab. While living in sober living homes, individuals can participate in outpatient services where there are opportunities for individuals to receive evidence-based addiction treatment. But do sober living houses help, and just how effective are they? One group of researchers put together a study to answer this question. You might also be interested in: What Will Drug Rehab be Like in 100 Years? Do Sober Living Houses Help? One Study Says Yes. The VH1 television show “Sober House” with Dr. Drew has popularized the concept of sober living houses. However, sober living houses are not just reality TV constructs. California in particular offers a wid...

A. Tom Horvath, Ph.D., ABPP There are several significant differences between men and women concerning alcohol problems.  For instance, the same amount of alcohol (adjusted for weight) will have a bigger effect on a woman (because her stomach does not detoxify alcohol as effectively as a man’s stomach does), women may experience more medical complications (and these complications may be difficult to diagnose and therefore ignored longer), alcohol problems appear to develop (progress) faster in women, the effects of alcohol problems may be greater and more complex for women who have substantial responsibilities both at work and with their families, and the changing roles of women in society may create complications for women receiving adequate support for recovery (e.g., women seek tr...

DIY Moderate Drinking Are you interested in moderating your drinking? Many individuals are! Here are two books which provide everything you need to know about DIY moderate drinking. Responsible Drinking: A Moderation Management Approach for Problem Drinkers This book, by Rotgers, F., Kern, M. & Hoeltzel, R. (CA: New Harbinger Publications, 2002) is the basic text of Moderation Management (MM), a support group which helps individuals moderate drinking, or abstain. The first two authors are addiction experts who also volunteer on MM’s Board of Directors. The final author was successful in the MM program. MM offers a summary of its program on its website, and you might wish to start there: www.moderation.org. This book, which provides in-depth coverage of MM’s rationale, the sci...

Music television is popular among teens in Belgium as well as adolescents in the U.S. A great deal of recent research has examined how the portrayal of alcohol use on television impacts adolescent alcohol use. Previous research shows that adolescent alcohol use is associated with higher rates of television viewing in general. Music television often glamorizes alcohol use and contains more alcohol advertisements. Might MTV predict alcohol consumption and the need for alcohol treatment for adolescents? A team of researchers from Belgium examined whether television viewing and music video viewing specifically could predict alcohol consumption among adolescents (Ven den Bulck & Beullens, 2005). See also: Craft - An Alternative to Addiction Intervention The researchers recruited a rand...

Many studies have shown that alcohol and drugs are transferred to breast milk and ultimately to infants. Thus, drugs and alcohol should be avoided while breast feeding. Mothers who struggle with reducing drug and alcohol consumption should consider entering a drug or alcohol rehab. In an alternative to AA, a self-empowering approach can be used to help mothers learn how to abstain from all drugs and alcohol and learn tactics to cope with cravings so mothers can continue to breast feed without possible harm to the infant. Individualized treatment plans can be created for mothers who are breast feeding which can emphasize on specific thoughts, feelings and behaviors that may have been the cause for their drug and alcohol consumption, and learn how to manage them. You might also be intere...

Pharmacogenetics looks at genetic variation to predict individual differences in response to medications. Individuals may metabolize the same medication in different ways, and their genotype may indicate some of these differences in drug metabolism. Proponents of pharmacogenetics hope that this relatively new field of study will lead to increased efficacy and safety for a wide array of drugs, including those used for addiction treatment. The addiction medicine aspects of drug rehab may be substantially improved if pharmacogenetics lives up to its promise. Haile, Kosten, and Kosten researched how genetic variation might affect responses to cocaine, amphetamine, and methamphetamine and how genetic differences might guide pharmacotherapy. They performed a cross-referenced literature sea...

Research shows that substance abuse is a significant problem for individuals with physical, mental, or psychological disabilities. In fact, as a whole, individuals with disabilities use alcohol and other drugs as much or more than the general population, and they are at greater risk for problems associated with substance abuse (Moore, 1991). However, little research has examined substance abuse, drug treatment, and drug rehab for individuals with disabilities. When treating a primary disability, healthcare practitioners may fail to recognize secondary substance abuse. Substance abuse disorders often reduce the already-scant resources of a disabled individual. For example, many disabled people have limited social resources and low socioeconomic status; these problems are often exacerb...

Because alcohol use disorders are common among driving-while-intoxicated (DWI) offenders, a DWI arrest may serve as an opportunity for psychological screening and subsequent alcohol treatment. Holt et. al. examined the Beck Depression Inventory (BDI) as a tool for predicting intervention outcomes in first-time DWI offenders. The BDI is a multiple-choice self survey consisting of 21 questions. It is the most widely used questionnaire for measuring the severity of depression. Survey questions are related to affective depressive symptoms such as pessimism, guilt, self-dislike, suicidal thoughts, and feelings of worthlessness, as well as physical symptoms such as anhedonia (loss of pleasure), crying, agitation, loss of energy, change in sleep patterns, change in appetite, difficulty conc...

In an alternative to AA, a self-empowering approach can be used to create individualized treatment plans which incorporate greater or fewer relapse prevention approaches to recovery. A self-empowering approach to alcohol recovery emphasizes four main points including: maintaining motivation, coping with urges, managing thoughts, feelings and behaviors, and living a balanced life. By incorporating these four aspects into your daily life, one may have a greater chance for success in alcohol recovery. EEG Maps of Alcohol-dependent Individuals Although definitions of relapse vary, it generally refers to a return to former drinking habits after a period of alcohol recovery. Electroencephalography (EEG) measures electrical activity in the brain, and beta wave activity in EEG mapping has bee...

Racism, dogmatism, and sexism are the judgments that one race, set of beliefs, or sex are superior. I am introducing the term “recoveryism,” defined as the judgment that one approach to recovery is superior. Recoveryism often gets even more extreme: there is only ONE approach to recovery. Any other “approach” is just pseudo-recovery. Individuals who try these pseudo-recoveries will not recover until they finally seek the one true way. A Recent Example of Recoveryism One clear-cut example of recoveryism can be found in James Frey’s book, A Million Little Pieces.  Although aspects of Frey’s book have come under intense criticism, I suspect the recoveryism aspect of his writing is accurate.  He describes his two-month stay in residential treatment, and the intense hours just before and...

In an alternative to AA, a self- empowering addiction treatment program allows each unique individual to target specific risk factors that led them to drink or use. Here, we explore research that suggests a link between ethnicity and adolescent alcohol use. According to the deviance proneness model, alcohol use develops in adolescence as a pattern of deviant behavior. This deviant behavior may be influenced by parental history of substance abuse, social relationship with deviant peers, personality variables, alcohol expectancies, and other variables. Studies suggest that ethnic differences may also affect the development of alcohol abuse and the outcome of alcohol treatment. Researchers from the University of Connecticut evaluated a deviance proneness model for ethnic differences in ...

In an alternative to AA, alcohol recovery can be attained through a self-empowering approach. The Role of AA Sponsors Several previous studies suggest that participation in Alcoholics Anonymous (AA) is associated with less alcohol consumption, more sobriety, and improved quality of life. Few studies have focused on the role of AA sponsors. An AA booklet defines a sponsor as “an alcoholic who has made some progress in the recovery program and shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety through AA.” The booklet states that the sponsor’s role is to help the newcomer get sober and stay sober, answer questions about AA, and provide an understanding, sympathetic friend. In a primarily qualitative study, res...

Through a self-empowering approach to recovery, those in alcohol treatment can learn about alcohol addiction and how to cope with cravings. It is important to implement a client-friendly approach to recovery because this will maintain the clients’ interest in treatment. Understanding what the client hopes to gain from treatment may be a key indicator of what to emphasize on during treatment. The interests of men and women during treatment may be different where women like to focus on self-esteem issues and men find that a less important aspect of their recovery. Through the use of a self-empowering approach to alcohol treatment, individualized treatment plans can be created for men and women that emphasize on specific areas of interest they would like to enhance. Tools and techniques wi...

In Spain, alcohol dependence affects up to 10 percent of the population and a major public health problem. Previous studies have suggested that personality disorders affect from 2.8 and 11 percent of the population, and studies of personality disorders among alcoholics suggest that the prevalence of personality disorders ranges from 24 to 78 percent among alcohol-dependent individuals. There have been discrepancies in studies of personality disorders among alcohol-dependent individuals, but the literature nevertheless suggests that personality disorders are more prevalent in this group than in the general population. Thus, the possibility of personality disorders should be explored in alcohol treatment and alcohol recovery. A team of researchers in Spain set out to discover the most fre...

External rewards in drug recovery was not as effective as learning solid coping skills. Researchers at the University of Connecticut Health Center found that, for regular (dependent) users of marijuana, long-term abstinence was more likely to occur for patients who actively used recovery coping skills. Abstaining patients developed more confidence in the effectiveness of the coping skills and their ability to use these skills. Rewarding abstinence by paying the patients (an approach called “contingency management”) was successful in the early days and weeks of drug recovery. However, unless the patients also developed new insights and actively changed recovery-related behaviors (including actively taking steps to prevent relapse), the initial benefits of rewards wore off over time. ...

Addressing unresolved childhood issues can be an integral aspect to successful addiction recovery and through a non 12 step approach, a focus on underlying issues can be maintained. Facing Childhood Trauma Previous research has found a relationship between posttraumatic stress disorder and addiction disorders. Trauma usually occurs in a life-threatening situation or when an individual experiences a significant loss. Unless the trauma is resolved, it may lead to posttraumatic stress disorder and/or alcohol and drug misuse. Some authors have suggested that the conflicts underlying trauma — parental rejection, overprotection, or imposing too much responsibility — contribute to alcoholism. Previous research also shows that traumatic childhood experience increases the prevalence of psychia...

A. Tom Horvath, Ph.D., ABPP 1)  Stay focused on the desired outcome, not the process.  You may be hoping to find the “right” treatment for a loved one.  Rather than insisting that your loved one do this or that (some treatment program you think will be helpful), focus on what you want: no more (or at least fewer) addiction problems.  Don’t get so caught up in the process of treatment that you lose sight of the goal.  Let your loved one determine what might be helpful.  Any program the user chooses is better than one forced on him or her. Starting with local outpatient treatment often makes more sense than going off for 28 days to residential treatment.  In many cases simply entering individual psychotherapy will be sufficient.  Don’t hold your loved one accountable for going throu...

Although adolescence has always been a time of great transition, many older adults today may have trouble appreciating just how different adolescence has become. High school students today have extensive substance use experiences. For instance, based on federal studies, about 75% have tried alcohol (with 50% drinking regularly), 38% have tried marijuana, 20% have tried cocaine, 50% have had sexual intercourse and 50% have tried cigarettes (with 20% smoking regularly).  These numbers show us that most adolescents today face a range of choices that their parents may not have realized even existed. Despite the large numbers of adolescents who are exposed to substances and other addictive behaviors, most adolescents do not develop addiction problems. For most adolescents, substance use i...

Working Definition of Recovery: Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life. Guiding Principles of Recovery: There are many pathways to recovery:  Individuals are unique, with specific needs, strengths, goals, health attitudes, behaviors, and expectations for recovery.  Pathways to recovery are highly personal, and generally involve a redefinition of identity in the face of crisis or a process of progressive change.  Furthermore, pathways are often social, grounded in cultural beliefs or traditions, and involve informal community resources, which provide support for sobriety.  The pathway to recovery may include one or more episodes of psychosocial and/or pharmacologi...

It has been widely said that “AA is the only thing that works” when it comes to alcohol recovery. The 12-step model of Alcoholics Anonymous (AA) is now applied to other substance use disorders in drug rehab centers around the world. However, research shows that AA is not the only approach that works. In fact, many studies have shown that other drug treatment approaches are just as effective as 12-step programs. Banerjee et. al. found that a relatively new approach known as Health Realization offered comparable benefits for women in a residential drug rehab program as compared to a 12-step program (2007). You might also be interested in: What is the Best Alcohol Treatment? Health Realization (HR) is an approach to psychology first developed by Roger Mills and George Pransky in the 1980...

Recent revelations of scams and manipulations on Wall Street have opened our eyes as to just how greedy and dishonest some individuals can be. It should be no surprise that there are individuals who prey on the desperation of parents whose teens have become involved in alcohol and other drugs, gangs, crime, and violence. Considering the many forms of trouble that seem to attract teens, and our seemingly limitless willingness to sacrifice for our kids, parents of troubled teens are appallingly at risk for exploitation. This sad truth is grippingly revealed in Maia Szalavitz’s appropriately titled Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead Books, 2006). Even professionals in human services are often not aware of what can be done for teens th...

Traditional Chinese medicine revolves around herbal remedies and acupuncture for addiction recovery. Might these ancient therapies be successfully used in modern addiction treatment? Chinese and American researchers studied the existing evidence and concluded that, although more testing is need, some traditional remedies can compliment modern medicine for promoting addiction recovery (Lu et. al., 2009). What We Know The research team examined texts and computerized literature concerning treatment and neurobiology of herbal medicines as well as acupuncture for drug abuse and dependence. They found that acupuncture showed evidence for clinical efficacy in opiate withdrawal, but it showed poor efficacy for alcohol and nicotine withdrawal and relapse prevention. No large studies support...

The United States has the world’s highest incarceration rate. Approximately 10 million individuals are sent to prison each year, and more than half of them have a history of substance abuse. Further, more than 200,000 have a history of heroin addiction. A recent study suggests that the prison system could improve addiction treatment offered to inmates. Nunn et. al. found that opiate replacement therapy (ORT) with methadone or buprenorphine (Suboxone) is frequently neglected in prison, even though it has been proven to be an effective addiction treatment for opiate dependence that can reduce drug-related disease and rates of recidivism (2009).   What does the Survey Say about Heroin Addiction Treatment in Prison? The researchers surveyed medical directors from prisons across...

Oliver Ameisen, an associate professor of medicine and cardiologist at Weill Medical College of Cornell University, reported in Alcohol and Alcoholism that he successfully used high-dose baclofen for alcohol treatment and achieved complete and prolonged suppression of symptoms of his own alcohol dependence (2005). You may also be interested in: Medication Assisted Treatment Ameisen had been diagnosed with alcohol dependence and comorbid anxiety disorder. He reports that his anxiety disorder preceded his addiction to alcohol. He had tried other medications for alcohol dependence with no success. Ameisen decided to try baclofen, a gamma-amino butyric acid receptor agonist that is used to control spasticity. Previous research showed that baclofen had reduced alcohol craving in alcohol de...

Individualized interventions for alcohol treatment plans enable people in alcohol recovery to focus on their physical health as it relates to their alcohol consumption. Individuals who practice unhealthy drinking habits often end up as patients in hospitals – for drinking-related accidents and health problems, among other reasons. This time in the hospital may serve as an eye-opener or “teachable moment” for convincing patients to decrease unhealthy drinking behavior. However, studies of brief hospital-based interventions have shown that such interventions are not always successful. A team of researchers based at the VA Puget Sound Health Care System hypothesized that hospital-based interventions for alcohol treatment might be more successful if they were based on the associations be...

How do I choose: Individual or group sessions for addiction treatment?  A. Tom Horvath, Ph.D., ABPP Are you searching for the “right” treatment center for you or a loved one?  This article is written to suggest that pre-established “programs” (individual or group sessions for addiction treatment) of treatment are not the best approach.  Rather, there are as many roads to recovery as there are individuals.  Treatment centers need to support you on your own path to recovery, not push you into a generalized recovery path that may be slightly helpful to many people, but not exactly helpful to anyone. Things to Consider When Considering Individual or Group Sessions If you were looking for the “right” center, there are many factors you would need to consider.  Are all of the substan...

Previous research shows that different individuals have different motivations for seeking drug and alcohol treatment. In one study, for example, “weighing the pros and cons of drinking and drug use” and “warnings from spouse” were the most frequently cited reasons for seeking treatment. A great deal of attention has been devoted to the stages of change once an individual is in treatment, but comparatively little attention has been given to the processes that lead to treatment-seeking or willingness to change in alcohol treatment. Researchers at Goteborg University in Germany set out to examine answers to the following questions: “How do men and women with recent experience of seeking treatment describe their paths to treatment?” and “What promotes and what hinders treatment-seeking?” (J...

Cluster B personality disorders (e.g., borderline personality disorder) and substance use disorders (SUD) are both marked by impulsivity and poor behavioral control. Previous studies (e.g., Taylor, 2005) have found evidence that symptoms of cluster B personality disorder and SUD are significantly and positively correlated. Because of accumulating evidence which suggests that personality disorders are prevalent in opioid dependent populations, along with evidence linking cluster B personality disorder characteristics and SUD severity, Murray et. al. hypothesized that opioid dependent patients with cluster B personality characteristics would have elevated methadone dose prescriptions (2008). Such a finding would have immediate implications for the doses of methadone, and possibly other me...

Why We Cope: No one complains about feeling happy! But we don’t want to have other, painful feelings. When these feelings arise, one way to respond to them is to drink or drug. One set of painful feelings can be broadly labeled fear or anxiety: ”Drugs and/or alcohol helped me cope with feelings like anxiety, tension, fear, stress, agitation, nervousness, vulnerability, intimidation, embarrassment, and panic.” Other painful feelings center around sadness and depression: ”They helped me cope with feelings like depression, sadness, hurt, discouragement, grief, feeling defeated, feeling deprived or feeling abandoned.” There are many other painful feelings as well: a) frustration, resentment, anger, annoyance, irritability, and rage b) feeling remorseful, ashamed, guilty, responsible, ...

Individualized treatment plans can help young adults see how marijuana use impacts the outcome of their alcohol treatment. Rates of alcohol and marijuana use are highest among young adults, and high rates of marijuana and alcohol use are seen in young adult patients admitted to emergency departments. Hospital admission provides an opportunity for alcohol treatment through brief motivational interventions, and previous research suggests that such interventions demonstrate positive outcomes. Researchers at the Center for Alcohol and Addiction Studies at Brown University examined how reported marijuana use affected response to brief motivational interviewing for alcohol treatment among young adults treated in an emergency department (Magill et. al., 2009). Participants were 215 young...

Alcoholics Anonymous (AA) and other 12-step groups (e.g., Narcotics Anonymous, Cocaine Anonymous, Marijuana Anonymous, etc.) suggest that to recover from addiction you must accept that you are powerless to recover on your own.  Only with inspiration from a higher power, recognition of your character defects, and fellowship in the group, among other steps, will you be successful.  If this perspective makes sense to you, then 12-step groups may be just what you need.  But the higher power concept is not acceptable to many, and it probably isn’t the foundation of the limited success AA achieves. Let's discuss how and why social support can be more important than a higher power. AA was established in 1935.  Other groups have followed, with several hundred types of 12-step groups now in e...

Addiction treatment readiness has been shown to predict enrollment and success in drug treatment programs. Researchers at Johns Hopkins Bloomberg School of Public Health asked, “Does taking steps to control one’s drug use predict entry into treatment?” The researchers set out to examine the association between treatment readiness (defined as engaging in activities to control one’s drug use) and enrolling in a drug treatment program. They examined data collected in 585 face-to-face interviews between 2004 and 2007. They concluded that taking steps to control drug use was associated with entering treatment at follow-up interviews. Steps to control drug use might include setting limits on use, avoiding the purchase of drugs, and avoiding drug-related people and places. Further, the like...

Self-empowering addiction treatment support groups, including SMART Recovery, provide online recovery resources much like the one described in this article. Read on to find out more about internet self-assessments as alcohol treatment... are they a viable option? Article Updated 4/13/2022 Internet Self-Assessments as Alcohol Treatment Might a web-based self-assessment of risky drinking serve as an effective tool for alcohol treatment? Several previous studies suggest that it might. The self-assessment questionnaire at drinkerscheckup.com is one example of such a tool. In Finland, a similar self-assessment service known as the Drinking Habit Test (DHT) was launched in 2003. The site provides feedback and normative comparisons to raise awareness about hazardous and harmful alcohol use. ...

Practical Recovery aims to offer ideal addiction treatment for any substance or activity addiction. We describe our approach as “collaborative addiction care.” Because each client is unique, and we are fully collaborative, no two treatment plans are alike. Hence we do not offer a “program.” Our treatment intensity can be as high as alcohol and drug rehab or our treatment-in-residence program and can range downward to brief outpatient services. The treatment-in-residence program is a combination of day-long intensive outpatient services and residence either in our six-bed sober living facility or an adjacent hotel. Our services work best for local clients, who can begin with high-intensity treatment (if needed), then transition to gradually decreasing collaborative addiction care over wh...

Why consider a collaborative addiction treatment relationship with someone who, by definition, is making very bad decisions?  Addicts and alcoholics keep using and drinking and are often irresponsible in other ways.  How could they meaningfully contribute to treatment decisions?  Don’t they need to be told what to do, and be made to do it long enough for changes to last? Not necessarily.  At Practical Recovery we suggest that 1) supporting recovery is about engaging motivations that are more fundamental than the motivations to use or drink and 2) we best engage these motivations when we collaborate with (rather than confront, direct or “motivate”) our clients.  To support this suggestion these articles will 1) review scientific findings about treatment, 2) place treatment in the larg...

Unfortunately, Practical Recovery does not yet have any long-term follow-up data on our clients. The task of designing the data collection is daunting. No two clients do the same treatment! However, we are in the process of designing a basic data collection system. We expect it to reveal that our clients do about as well as clients in well-run studies. Our lack of data should not be surprising. We are a for-profit facility in a highly competitive market. We are also blazing a trail that few others seem to be following on (so far). Blazing this trail has kept us fully occupied. Raising fees to cover the cost of extensive research (because it would require additional staff) would make our approach even more expensive.  We are hopeful that as “collaborative addiction care” becomes more ...

Daidzin, a compound found in the kudzu vine, interferes with the metabolization of alcohol and produces effects similar to those of the anti-drinking drug Antabuse. Dr. Ting-Kai Li of Duke University and Dr. Ivan Diamond of the University of California in San Francisco believe that they have discovered a synthetic version of daidzin that reduces alcohol cravings by preventing alcohol from increasing dopamine levels in the brain. Daidzin and synthetic daidzin (known as CVT-1-216) may prove useful in alcohol treatment. You may also be interested in: Herbal Remedies and Acupuncture for Addiction Recovery Harvard researchers first discovered the anti-drinking effects of the kudzu extract in 2005. Previous studies had shown that kudzu extracts reduced alcohol drinking in rats and hamsters....

A psychotherapy team involves multiple therapists who meet successively with the same client for individual therapy. Leading edge psychotherapy teams have begun to emerge, in varying degrees, in a few state-of-the-art addiction treatment facilities. Their emergence may have occurred somewhat serendipitously but as Pasteur remarked “chance favors the prepared mind.” To my mind, the experience with the leading edge psychotherapy team format highlights the illusion of believing that a client exists as such and that the client’s problems or difficulties exist as such. By “as such” I am referring to the idea that the client and his or her difficulties can be apprehended or discovered as they “really” are, objectively, in pretty much the same way that a physician (with the help of lab test...

Let the buyer beware about addiction treatment A. Tom Horvath, Ph.D., ABPP The Latin phrase caveat emptor (“let the buyer beware”) suggests that sellers may not inform buyers of everything buyers might want to know about the purchase they are considering.  Caveat emptor certainly applies when considering services from the highly competitive addiction treatment industry.  This multi-billion dollar industry divides into two primary parts: government-funded treatment (about 75% of treatment) and private pay treatment.  Private insurance may pay a portion of private treatment, but typically only a small portion.  Government-funded treatment centers do not compete so much for clients as for contracts.  If you attend one of these centers you may simply feel fortunate that you have the o...

The disease perspective discourages many people from seeking help and implies that addiction is a disease. Suppose you have had a “few too many,” and you have done so a few too many times in recent weeks or months. You might also be interested in: Addiction is Learning, Not Disease Most people, under these circumstances, will realize that a problem could be emerging. The idea that someone has to “hit bottom” before thinking about their addictive behavior is ridiculous! 1) So You Decide to Cut Back (Why Entirely Give up a Good Thing?) But if you aren’t successful, you might seek outside help. Unfortunately, there is almost no help for you, unless you are willing to say you have a disease! At the early stages of addiction problems, almost everyone could honestly say they don’t have a ...

A. Tom Horvath, Ph.D., ABPP There are many places you might receive assistance for overcoming addiction.  These places are generally referred to as “levels of care.”  By understanding the levels available you can choose the level most suitable for you.  We start with the least complicated and expensive level and work up.  We leave out detoxification (withdrawal), which occurs across several levels depending on how severe it is.  A comprehensive list of US addiction treatment facilities, across all levels of care, is provided by the federal government: http://findtreatment.samhsa.gov/ Natural Recovery There is no professional or organized care involved at these levels of care in addiction treatment.  Natural recovery is the process of using your natural environment to help you chan...

A non 12 step approach to addiction treatment teaches people to distinguish the difference between positive and negative outcomes related to addictive behavior. Gambling Addiction and Reward Systems - The Study Pathological gambling, or gambling addiction, occurs when recreational activity becomes dysfunctional and detrimental, and many pathological gamblers need addiction treatment to overcome their addictive behavior. Pathological gamblers typically face a variety of cognitive distortions in which they overestimate their chances of winning. Some speculate that the excitement of “near-miss” outcomes in gambling games encourage such cognitive distortions. In a previous study with healthy participants, researchers found that near-miss outcomes in recreational gamblers shared overlappin...

Evidence based addiction treatment takes into consideration the trend between peer delinquency and juvenile drinking behavior. However, there may be underlying issues present with adolescents that correlate with their alcohol consumption and aggressive behavior. Thus, it is imperative that adolescents receive individualized treatment plans during alcohol treatment so that the individual is encouraged to find motivations that are deeper than the addiction. An individualized self- empowering treatment plan enables adolescents to focus primarily on underlying issues that may have been the cause of their drinking and/or engaging in aggressive behavior. You might also be interested in: From Adolescent Drug Experimentation to Addiction Peer Delinquency and Juvenile Drinking Behavior - The...

In an alternative to AA, self-empowering approaches to recovery incorporate living a sen life. This includes proper nutrition, exercise, and rest. Maintaining good mental health is an important aspect of long term abstinence and nutrition, exercise and adequate rest, play a significant role here. Good health in recovery is an important aspect to achieving a greater quality of life. Link Between Sweet Tooth and Alcohol Treatment - The Study Existing evidence suggests that response to sweet taste reflects the activity of the endogenous opioid system, which is also involved in the pleasure response to alcohol consumption. Response to sweet taste is heritable and can be measured; the phenotype is identified as either sweet-liking (SL) or sweet-disliking (SDL). Naltrexone is an opioid rece...

Binge Drinking, Daily Drinking and Liver Disease   If you are aiming to establish an alcohol recovery by moderating alcohol as opposed to abstaining from alcohol, you may be tempted to believe that as long as you do not binge drink you will not experience any major negative health consequences.  Although binge drinking is clearly risky, the study reported on in this article found that daily drinking that was heavy (but not at binge levels) also can lead to liver disease.  There are other risks to consider also.  Although some studies suggest that moderate consumption of alcohol may offer cardiovascular benefits, other studies have found that regular drinking increases the risk of diseases such as cancer and liver disease. Is binge drinking causing problems in your life? We c...

Major depressive disorder (MDD), or clinical depression, is characterized by low mood, low self-esteem, and loss of interest or pleasure. The DSM-IV recognizes five subtypes of MDD. Could different subtypes of MDD affect drug recovery for different substances? If so, drug rehab would need to consider these subtypes when treatment plans are formulated regarding melancholia and drug recovery.   The Five Types of Major Depressive Disorder To begin, let’s review the subtypes of MDD. The five subtypes are as follows: Seasonal affective disorder (SAD) typically occurs during the autumn or winter months and resolves in the spring. The diagnosis of SAD can be made if at least two depressive episodes have occurred in colder months with none at other times, over a time frame of at le...

Although drug courts successfully reduce rates of recidivism for participants, research indicates that there is a need to develop mental health screenings to detect co-occurring mental health issues during associated drug treatment.   What is a Drug Court? Drug courts are specialized court dockets that bring together judiciary, prosecution, defense, probation, law enforcement, mental health, social service, and drug treatment communities to provide drug treatment for non-violent drug offenders. Through judicial supervision, drug testing, sanctions, and drug treatment (typically lasting a year), drug courts aim to provide rehabilitation as an alternative to incarceration. The first drug court was formed in Miami-Dade County, Florida in 1989. There are currently more than 2,1...

Inpatient or residential drug rehab programs can be stressful for residents on several different levels. Residents may experience stress as a symptom of withdrawal. Some treatment sessions will likely activate emotions and trigger stress. For many patients, pre-existing stress played a major role in the development of their addiction. An effective approach to stress management would be expected to help many patients in their addiction recovery and increase retention in residential treatment facilities. Mindfulness-based stress reduction is a relatively new approach to stress management in the drug rehab environment. Marcus et. al. compared mindfulness-based stress reduction to treatment as usual for reducing stress and increasing retention in a residential facility for substance use ...

Methamphetamine use has been linked to increased risk of human immunodeficiency virus (HIV) among gay men. Methamphetamine is a highly addictive stimulant that may lower inhibitions, increase sexual arousal, and lead to risky sexual behavior such as unprotected sex. Further, methamphetamine may be injected, and needle-sharing is also a risk factor for HIV.  These two epidemics have spread concurrently among gay men. There is a need for specialized approaches for addiction treatment and drug rehab for gay men with HIV, if such approaches could be developed.   Research Regarding Modafinil in Addition to CBT Researchers from the New York State Psychiatric Institute and Columbia University evaluated the efficacy of modafinil plus cognitive behavioral therapy as a treatment for met...

Motivational interviewing is a method of alcohol treatment which has the goal of establishing intrinsic motivation to change within the client through examining discrepancies between goals and behavior, and ambivalence about these discrepancies. For example, an individual may know that he or she has drinking problems but may tend to ignore the extent to which these problems are interfering with a desirable life. Motivational interviewing helps the client to see the problem in a new light and to overcome ambivalence about change. Read on to learn more about the impact of motivational interviewing on underage college drinkers. You may also be interested in: Why Do College Students Drink so Much? Studying Motivational Interviewing and Underage College Drinkers Researchers from the Uni...

The use of Naltrexone and/or acamprosate can be helpful during alcohol treatment, however, to achieve the greatest success, individuals would benefit from incorporating psychological intervention. Evidence-based addiction treatment incorporates cognitive behavior therapy (CBT) which enables individuals to learn ways to cope with cravings and eventually have greater success for alcohol recovery. You might also be interested in: Medication Assisted Treatment Naltrexone is an opioid antagonist that blocks the reward effects of alcohol consumption. The mechanism of acamprosate is less well-defined, but it may reduce unpleasant feelings (such as anxiety and tension) during withdrawal by blocking NMDA receptors. Previous research shows that acamprosate increases the number of individuals wh...

Do you feel anxious when you’re in the spotlight or under scrutiny? According to a recent study from researchers at Yale University and Florida State University, social anxiety – and fear of scrutiny, specifically – appears to serve as a risk factor for alcohol use disorders (Buckner & Schmidt, 2009). Future research into how observation anxiety can lead to excessive alcohol use will likely provide useful guidance for alcohol recovery. For now, it appears that individuals with both observation anxiety and excessive alcohol use will likely need to learn to manage their observation anxiety in order to achieve a stable alcohol recovery. Social anxiety disorder (SAD) and alcohol use disorders (AUD) are highly comorbid. According to one study, 48 percent of individuals with a lifet...

What is the relationship between alcohol and sense of smell? Olfactory impairment is one of the many potential side effects of alcohol dependency. In a non 12 step approach to recovery, individuals have the opportunity to completely abstain from alcohol and possibly decrease any potential olfactory impairments. Olfaction — the sense of smell — not only allows individuals to stop and smell the roses but also saves lives. Olfaction, for instance, might alert one to an unsafe food product or smoke from a fire. Unfortunately, an individual in alcohol recovery might not be awakened by the odor of smoke. Several previous studies have suggested that chronic alcohol use may damage olfactory function, but little is known about how this occurs. Previous studies indicate that alcohol-dependent ...

Even if you have been away from your children because of reasons related to your addiction, your kids are probably not far from your mind. In early recovery, it is important to focus on yourself long enough to build a solid foundation for change (however long that takes will vary from person to person). Once a stable foundation is established, it is time to think about your relationships, especially those with your children as well as some of our tips for being a better parent. Most parents strive to be the best parents they can be. Given the hectic nature of our lives, this is not always an easy feat to accomplish. When we are under stress, our children may also exhibit signs of stress by becoming irritable, moody, clingy, or withdrawn. They may also show changes in their eating or ...

Evidence based addiction treatment takes into consideration the trend between peer delinquency and alcohol consumption. However, there may be underlying issues present with adolescents that correlate with their alcohol consumption and aggressive behavior. Thus, it is important to consider the relationship between peers and adolescent drinking behaviors. Peers and Adolescent Drinking Behaviors - The Study Previous research studies have found associations between impulsivity and alcohol consumption, between alcohol expectancies and drinking behavior, and between drinking and aggressive behavior. The Acquired Preparedness Model (APM) integrates genetic influences as well as social learning to describe impulsivity as a major disposition for delinquent behavior. The APM also suggests that ...

Curious about whether your peers impact your drinking behavior? For most individuals, alcohol consumption is a social phenomenon, at least at the outset of their drinking. Previous research suggests that most human behavior is learned through imitation or modeling. Studies also suggest that imitation plays a role in addictive behaviors. Previous wine-tasting studies have demonstrated that participants exposed to a heavy-drinking model consume more alcohol. However, in these studies the participants knew beforehand that they would be consuming alcohol. Researchers from Canada and The Netherlands examined the effect of exposure to a heavy-drinking model on imitation of drinking behavior in a more naturalistic setting (Larsen et. al., 2009). Spoiler alert: our peers' drinking behaviors im...

Past research suggests that (self-empowering addiction treatment) cognitive-behavioral therapy is effective in the treatment of alcohol dependence. In some cases, psychological treatment can be significantly improved by pharmacotherapy. Pharmacotherapies used in alcohol treatment include disulfiram, an aldehyde dehydrogenase inhibitor; naltrexone, an opioid antagonist; and acamprosate, a noncompetitive NMDA receptor blocker. Few studies have compared the effectiveness of these pharmacotherapies for alcohol treatment. A team of researchers from Finland set out to do just that (Laaksonen et. al., 2008). You might also be interested in: What is the Best Alcohol Treatment? Effectiveness of Pharmacotherapies for Alcohol Treatment: The Study The researchers conducted a randomized, open l...

Through the use of evidence-based addiction treatment, predictors of drug addiction treatment can be identified. Previous research shows that alcohol-dependent individuals have an increased risk of developing dependence on illicit drugs and prescription drugs. For instance, the National Longitudinal Alcohol Epidemiologic Survey of 42,862 households in the United States found that individuals with lifetime alcohol use disorders were 9 to 17 times more likely to meet the criteria for a lifetime substance abuse disorder. Studies suggest that approximately half of alcohol-dependent individuals also have substance use disorders. This tends to complicate alcohol rehab and recovery. Thus, it is important to identify predictors of drug addiction among individuals in alcohol rehab so that com...

Naltrexone is commonly prescribed in alcohol rehab. It is an opioid receptor antagonist that blocks opioid receptors and thus blocks the feeling of pleasure derived from alcohol consumption. Several double-blind clinical trials have shown that naltrexone is more effective than placebo in treatment for alcohol dependence. However, naltrexone may not work well for everyone. Its effectiveness varies among individuals. This has led some researchers to speculate that perhaps not all alcohol dependent individuals derive pleasure from an increase in endogenous opioids after alcohol consumption; perhaps there is a subtype of alcohol dependent individuals which may derive more benefit from naltrexone treatment. Certain clinical predictors might be able to identify individuals who would derive th...

Using drugs during pregnancy creates multiple risks for the mother as well as the baby. Drug use during pregnancy may lead to miscarriage or severe developmental abnormalities for the child. Yet little research has examined the motivation for drug treatment among pregnant women. Researchers at Johns Hopkins University hypothesized that pregnant drug-using women would be more likely than non-pregnant drug-using women to have higher motivation for addiction treatment (Mitchell, Severtson & Latimer, 2008). The researchers analyzed data collected from 149 drug-using women between 2000 and 2007; 49 of the drug-using women were pregnant and 100 were non-pregnant. The study found that pregnant women were more than four times as likely as non-pregnant women to express greater motivation ...

In addiction recovery, if your life is filled with non-pleasurable activities, you are more likely to relapse. The relapse will provide an intense, but only temporary, satisfaction. Let's explore what preventing relapse and the role that lifestyle balance plays in everyday life. Perhaps the greatest risk for imbalance comes when we are too focused on what we “should” do and not enough on what we want to do. Of course, we need to do what we should do. But in balance! One comparison for this is someone who places too large a portion of income into retirement funds. Daily life becomes constrained. There is also the risk that a “binge” of spending may undo the savings, to experience some more immediate well being. More balanced money management could prevent the desire for a binge. Li...

Parents want to have “a great time” with their kids. Realistically, however, how many “Kodak moments” are likely to occur? Wonderful moments or encounters don’t happen daily, and maybe not even weekly. More importantly, these moments can’t be scheduled. They happen when they happen. There is a simple guideline for increasing the number of wonderful moments you have with your children: Spend more time with them. Aim to have “quantity time” and the “quality time” with your kids will follow. What ways of spending time together are there? First, there are the basics. Have meals together. Engage the children in helping prepare the meal. Tuck your younger children into bed each night, preferably reading something out loud with them beforehand. In the car, turn off the radio and talk wit...

The relationship between negative affect and addiction is an important consideration when developing a customized treatment plan. Learn more about this relationship as we explore the study below. Previous research shows that children who have a parent with a substance abuse disorder have an elevated risk of developing alcohol and drug addiction problems. Children of alcoholics, for instance, are more likely to experiment with alcohol and drugs at a younger age, compared to children of non-alcoholics. Research shows that negative affect also plays a role in the development of drug and alcohol addiction and should be examined in addiction treatment. The negative affect regulation model posits that individuals use alcohol and drugs to cope with negative affect. The four fundamental comp...

Residential addiction treatment: Possibly helpful, probably not essential A. Tom Horvath, Ph.D., ABPP The reason almost all health insurance companies have stopped paying for residential addiction treatment is that the effectiveness of residential treatment and outpatient treatment has been compared many times, with no advantage being found for residential treatment.  The July 1986, issue of the American Psychologist contains the definitive article (by Miller & Hester) on this subject.  Their article “reviews findings from 26 controlled studies, which have consistently shown no overall advantage for residential over nonresidential settings.”   You might question whether a 1986 article would still be relevant this many years later.  However, more recent evidence has not led to ...

Resolving the core of drug abuse David Jacobs, Ph.D. When I see a “drug abuser” in addiction treatment my primary concern is to help the individual understand how the past remains in the present and to consider how that past and present might be changed, with the goal of ending the costs that arise when drugs are used to solve emotional problems. I put “drug abuser” in quotes to avoid making a caricature of a real person. Treatment needs to be founded on the observation that everyone does their best given their background.  But it avails the “drug abuser” naught to focus on this truism.  Consider nutritional diseases.  It does not matter how much your childhood caregivers wanted to provide more nutritious food.  If in ignorance they failed to provide it, or if it was not available,...

Although Alcoholics Anonymous (AA) and other 12-step groups are far more widely known, there are other addiction support groups worth knowing about.  They are listed here in approximate order of size and influence.  All of the self-empowering recovery groups support abstinence, with Moderation Management supporting both abstinence and moderation with alcohol. SMART Recovery:  Self-Management And Recovery Training (SMART) is a global community of mutual-support groups. At meetings, participants help one another resolve problems with any addiction (to drugs or alcohol or to activities such as gambling or over-eating). Participants find and develop the power within themselves to change and lead fulfilling and balanced lives guided by our science-based and sensible 4-Point Program®. http...

Debunking the myth about AA Should people who need addiction recovery have choices? Are non-12-step recovery approaches effective? Why choose a non-12-step recovery approach? In AA social support is more important than a higher power Treating psychiatric and addiction comorbidity with a cognitive-behavioral (non-12-step) approach  Leading edge psychotherapy: The psychotherapy team

Cigarette smoking is common among individuals with alcohol use disorder (AUD), and research suggests that smoking may interfere with alcohol recovery. Mon et. al. found that smoking slows the healing of brain damage during alcohol recovery (2009). Several studies have shown that AUD can damage the brain. AUD brain damage, commonly visible in the frontal cortex and parietal cortex, is at least partially reversible with sustained abstinence from drinking. What Can an MRI Reveal About Smoking and Alcohol Recovery? Magnetic resonance imaging (MRI) can show the extent of brain-damaging by illustrating blood flow. Cerebral perfusion is a measure of the blood flow to brain tissue. Blood not only carries nutrients to the brain but also carries away metabolic byproducts. Good blood flow ind...

Previous studies suggest the existence of a socially constructed “script” for alcohol problems that is widely known and learned through common social learning processes. The term “script” refers to a functional, learned social cognitive schema. Such a script might affect the results of questionnaires in alcohol treatment programs. Researchers at the University of Strathclyde and the University of Abertay in the United Kingdom examined the extent to which problems reported by alcohol users are derived from social scripts rather than from memory (Davies et. al., 2004). Social Learning and Alcohol Treatment Questionnaires: The Study The researchers recruited problem drinkers and non-problem drinkers to complete a questionnaire about drinking. Each group consisted of 30 male participants....

A. Tom Horvath, Ph.D., ABPP I make a number of assumptions when conducting a substance abuse evaluations as part of a litigation process: The individual’s use is usually not less than the individual reports, but it might often be more (or much more). Inaccurate accusations of substance abuse are common because there is usually little negative consequence for inaccurate accusations. The parties to the litigation, and those connected with them, may provide biased and inaccurate information. Therefore outside corroboration of their reports is essential for determining the extent and consequences of substance use. Getting Outside Corroboration: As a practical matter, getting outside corroboration (information from sources not connected with the litigation) is difficult becau...

Individualized treatment plans are extremely beneficial for adolescents in drug treatment because specific programs can be created to allow adolescents to work through problems of anxiety and depression. In an alternative to AA, individuals can use evidence based addiction treatment plans to reduce anxiety. Adolescent drug treatment and prevention programs tend to focus on illicit drugs and alcohol. However, the misuse of prescription medication is also a major problem among adolescents, especially those who have high levels of anxiety. Researchers at the University of Kentucky, University of North Carolina at Chapel Hill, and University of Michigan employed latent profile analysis to identify three distinct classes of adolescent sedative and anxiolytic misusers (Hall, Howard & M...

A. Tom Horvath, Ph.D., ABPP Alcohol prohibition in the US lasted from 1919 to 1933. Prohibition continues for those under age 21. Prohibition was repealed because it was violated so often.  Given how much people like to drink, prohibition as a public policy was not realistic. In this article, I suggest that we are seeing similar violations of drinking laws by young people and that it is time to modify the prohibition on their drinking and to teach teens about alcohol. The actions I suggest are already in place in many families. Drinking actually seems to be decreasing among young people (according to the Monitoring the Future surveys the federal government funds).   However, despite the “zero tolerance” approach, some young people drink regularly or in large amounts. On occasion, so...

According to previous research, MDMA (3,4-Methylenedioxymethamphetamine), popularly known as Ecstasy, may negatively affect cognition among heavy users. Golding et. al. set out to investigate whether light users and ex-users of MDMA in drug recovery also exhibit deficits in cognitive performance (2007).   The History of MDMA MDMA has an interesting history. It was first synthesized by a Merck chemist in 1912 and largely forgotten for the next 60 years. MDMA appeared as a street drug in the 1970s after its analogue MDA (3,4-Methylenedioxyamphetamine), known as “the love drug” or “the hug drug” in the 1960s, was criminalized. Andrew Shulgin, a researcher at the University of California, become interested in MDMA after hearing about its unusual effects on students. Shulgin develo...

In an alternative to AA, a self-empowering approach can be used to help individuals cope with cravings upon completion of a drug or alcohol treatment program. With individualized treatment plans, the score from the Obsessive Compulsive Drinking Scale can be used to rate individuals, where those with higher OBCD scores may find increased relapse prevention approaches more useful. From a self-empowering perspective, coping with cravings is an integral aspect of relapse prevention. You might also be interested in: Drug and Alcohol Cravings - 10 Methods to Cope Many individuals relapse after alcohol treatment, often because of cravings for alcohol. The Obsessive Compulsive Drinking Scale (OCDS) is a self-rating measure that has been used to predict future alcohol consumption after alc...

What is Addiction? Let’s define addiction as repeated involvement with anything, despite excessive costs, because of craving.  That sounds similar to habit, which is also repeated involvement with something. What are the differences and similarities between addiction and habit? Let’s start with some examples of what appears to be an addiction. A college freshman ends up in the emergency room after his first binge but is not repeatedly involved with alcohol (although he may soon be). A medical patient on opiates for pain control does not crave the next injection for the "high," but simply wants pain relief. A low stakes poker player has minor losses, but the pleasure of gambling in this manner, for this individual, outweighs the cost. This last example illustrates how addiction is hi...

Article Updated 4/13/2022 Self-empowering addiction treatment utilizes cognitive-behavioral therapy and teaching mindfulness to help people cope with their cravings, be more aware of their thoughts, and increase self-regulation in alcohol recovery. But just how important is self-regulation in recovery from alcohol use? To better understand it in recovery, it helps to understand it in the context of addiction. Read on to learn more about the relationship between self-regulation and alcohol use. According to Hustad et. al., self-regulation refers to “the effortful ability to plan and achieve adaptive outcomes through goal-directed behavior, often by delaying gratification” (2009). It is important for individuals to develop self-regulation ability in alcohol recovery. Since lower lev...

Perception vs. Reality Generalities about people tend to be either trite or misleading.  To risk one anyway, I have acquired the impression that all the people I have worked with, in addiction treatment for severe and persistent drug use, regard the drug (or drugs) as their most dependable and effective source of soothing (calming, relaxing, good feeling, etc.). Let us call such individuals “drug abusers.”  I use the term “drug abuser” in quotes because I do not want to make a caricature of a real person.  In other words, for a “drug abuser,” other people are regarded and experienced as relatively useless for emotional survival in the world (even the person’s partner, if there is one). The “drug abuser” is not choosing the drug over the partner in the sense of a competition in which ei...

As more addiction treatment programs treat comorbidity it seems likely that client confusion about treatment approach will increase.  Comorbidity is here defined as having both a mental health disorder (such as anxiety or depression) as well as an addictive disorder.  Client confusion might arise because CBT (cognitive behavior therapy) has become the treatment of choice for many mental health disorders, but 12-step based treatment remains the most widely available treatment for addictive disorders.  Clients receiving CBT for their mental disorders can be confused when they compare the self-empowering strategies of CBT with the emphasis on powerlessness in a 12-step approach.  Although 12-step treatment now often incorporates relapse prevention and other CBT components, there remains a ...

Habitual drug users may find it beneficial to seek addiction treatment sooner rather than later because the long term effects of drugs can lead to long-term depression (LTD). LTD affects memory formation and learning and continued drug use over time will lead to a loss of control where drug users lose many defenses against drug-seeking behavior.   Understanding Synaptic Plasticity Why is it that some regular users of drugs or alcohol develop addictions while others don't? The beginning of addiction appears to be related to a loss of synaptic plasticity in the brain, according to research carried out by a team of researchers at the University of Bordeaux in France (Kasanetz et. al., 2010). Understanding synaptic plasticity may be the key to developing more effective methods of ...

The use of alcohol for pain management can easily become problematic and addictive, resulting in the need for alcohol treatment. Riley and King examined the use of alcohol for pain management among adults with tooth pain, jaw joint or face pain, and arthritis in a South Florida community (2009). The researchers examined race, sex, and age to determine their associations with alcohol use for pain management. After conducting structured telephone interviews, the researchers found that non-Hispanic whites and males were the most likely to use alcohol to cope with pain. Additionally, alcohol use for pain was highest among younger adults. Individuals who self-medicated with alcohol also tended to have greater pain frequency, depression, and higher levels of education, regardless of the pa...

What are the advantages of group sessions for addiction recovery?  A. Tom Horvath, Ph.D. There is no single correct or best way to recover from addiction.  No element of the recovery process must be completed by all individuals.  Although group sessions are often described as essential to recovery, they are not.  In fact, most people who recover do not attend groups of any kind!  However, these non-group-attending individuals are often ignored by treatment professionals, who are sometimes so focused on how they approach recovery that they fail to recognize other approaches. Nevertheless, group sessions can be valuable.  This article will describe some of the advantages of attending groups.  By groups we are referring to a) free, mutual-aid, self-help or support meetings (let’s ...

In scientific research, potentially fuzzy concepts are “operationalized” to make them measurable. For example, the fuzzy concept of “length” must be defined in terms of the measurement operations used to obtain length (contingency management in drug treatment).   Meanings of Contingency Management in Drug Treatment The term “contingency management” may have different meanings, depending on how this approach to drug treatment is operationalized in a particular study. This article aims to help the reader understand what subjects in a contingency management drug treatment program might experience. The reader may then have a better sense of whether contingency management would be useful in his or her own addiction treatment or drug rehab program. Although scientists will be intere...

Denial is one aspect of resistance to change. In regards to addiction, it involves denying or minimizing the existence or seriousness of addiction problems. Unfortunately, within the field of traditional (12-step) addiction treatment, the belief is that “addiction is a disease and denial is its symptom.” From the traditional perspective, it is also believed that “alcoholics and addicts” exhibit denial as a rather permanent “character trait.” It requires strong and direct confrontation, and sometimes other extreme measures, to blast through denial. Based on this traditional perspective individuals with addictions are sometimes treated in cruel or disrespectful ways, which would never be considered with any other clients or patients. Is Denial a Symptom of Addiction? However, denial as ...

There are three myths about alcohol treatment, according to some of the foremost researchers in the area, led by psychologist William R. Miller (Handbook of Alcoholism Treatment Approaches: Effective Alternatives, 3rd edition, edited by Hester & Miller, published in 2003 by Allyn & Bacon). The first myth, and possibly the worst, is that there is one and only one effective approach to addiction recovery. If you are seeking treatment and a facility tells you a version of this myth, it would be better to look elsewhere for help. Alcohol treatment research, and addiction treatment research generally, shows there is no single approach that is best for all individuals. Many Paths to Addiction Recovery The first principle of the 12 Guiding Principles adopted by SAMHSA’s Center for Su...

Some college students drink to excess. Such drinking is obvious to anyone who visits a college town on nights that “specials” are offered at the bars, and on other nights also. Why? Just a result of college culture? A self-fulfilling prophesy of the party crowd when they leave home? A youthful perception of invincibility? Perhaps. But how about a more mundane and controllable factor: the price of the alcohol? In her column, “Tara Parker-Pope on Health” (Sept. 2, 2009), Parker-Pope reports that alcohol researchers from the University of Florida and San Diego State University studied how drink specials influenced the alcohol consumption of about 800 men and women leaving seven near-campus bars. Patrons were studied at different times, with drink prices varying from time to time. Alcoho...

Research shows that substance use disorder (SUD) patients who attend 12-step mutual help groups such as Alcoholics Anonymous experience reduced healthcare costs and better outcomes. However, many individuals with SUD never attend 12-step meetings, while others who attend initially do not follow through. The reasons for non-attendance and dropout of 12-step meetings have not been thoroughly studied. Kelly, Kahler, and Humphreys asked, “Why do individuals stop attending 12-step groups (and why do others refuse to attend meetings in the first place)?” (2009). These researchers suggest that the questions are important because 12-step groups are almost universally recommended as a component of drug rehab, addiction treatment and long-term addiction recovery. The Research:Why Do Some Avoid...

A clinical trial supported by the National Institute on Drug Abuse (NIDA) marks the first successful, placebo-controlled demonstration of a vaccine against illicit drug addiction. The anti-cocaine vaccine causes the immune system to produces antibodies that attach to cocaine molecules, preventing them from entering the brain. Thus, the vaccine blocks the drug’s effect.   The Premise of The Anti-cocaine Vaccine Study The study followed 115 patients who received either the anti-cocaine vaccine or a placebo. Participants in both groups received 5 vaccinations over 12 weeks and were followed for an additional 12 weeks. All participants participated in drug treatment which consisted of weekly relapse prevention sessions with a trained substance abuse counselor. They also had their ...

Will insurance cover addiction if it's not a disease? Some highly vocal addiction recovery advocacy groups claim that addictions, or at least some addictions, are diseases. These groups argue that insurance coverage for addiction treatment is crucial for recovery, and that insurers will not pay for treatment if addiction is not understood as a disease. Therefore, they say, we need to keep insisting that addiction is a disease, and keep insisting that our insurers cover addiction treatment. Defining Diseases and Conditions However, insurers already pay for many conditions that are not diseases. For instance, broken bones, pregnancies, and the repair of congenital defects are not normally called diseases, but these conditions are covered by most insurance plans. The term that is relev...