How Many Quit Attempts Are Needed to Be Successful? By Tom Horvath, PhD It is common knowledge that abstaining from a substance that has become problematic is difficult and may require multiple attempts to be successful. But how many attempts does it take to succeed in quitting addiction? One effort to answer this question, based on the International Quit & Recovery Registry, was recently published. Subjects were 344 individuals who have registered with this registry. The substances studied were pain meds, opioids, stimulants, alcohol, tranquilizers, inhaling, anesthetics, cocaine, cannabis, nicotine, and hallucinogens. They are listed here in the order of most attempts to fewest attempts. How many quit attempts is complicated not only by the specific substance, but also...

The CHIME Model for Addressing Addictive Problems (and Life) In many approaches to addressing addictive problems, eliminating or at least reducing the problematic substance or activity is the immediate priority. That priority makes sense, except when it does not. You might not be ready to make that level of change, even though you may recognize your addictive problem is indeed a problem. An alternative approach is to focus on what you could be adding into your life, rather than taking out of it. Various alternative approaches have been suggested. We covered some of them here and here. By adding positive aspects to your life, in time, you crowd out the need or desire for other (problematic) approaches to pleasure, satisfaction, and happiness. The CHIME framework arose from an im...

Early Research on LSD for Alcohol Problems: A Look at State Mental Hospitals and Elsewhere By Kenneth Anderson, MA In the 1950s, researchers such as Humphry Osmond and Abram Hoffer in Saskatchewan, Canada developed a unique therapy for alcoholism which entailed using a psychedelic experience to alter the beliefs and values of the alcoholic patients. Set and setting were essential variables in successfully inducing a psychedelic experience. The term "set" refers to the internal mindset of the person about to undergo the psychedelic experience. Patients were given weeks of psychological preparation by the researchers before they were given LSD, in order to ensure that they had the proper mindset for a positive and life-altering psychedelic experience. The term "setting" referred to th...

Negativity Bias: How Negative Are You? By Tom Horvath, PhD Almost 25 years ago two psychologists coined the term “negativity bias.” It refers to our tendency to focus on information, cues, or ideas that are negative, even when we have positive information around us. For instance, after a meeting in which our ideas are presented, we are more likely to remember and focus on the one criticism, rather than the five positive comments. Even animals have this bias, so it has a long history. The negativity bias has the advantage of promoting our survival, particularly in a hunter-gather environment. We were better off staying focused on the rustle in the bushes nearby (because it might be an animal seeking to eat us) than the good taste of what we ourselves were eating. We are descended ...

By Kenneth Anderson, MA Is Moderate Drinking Protective Against Alzheimer's Disease? Brain Changes with Alzheimer's Disease Amyloid Beta Plaques We have known for more than a century that the brains of people with Alzheimer's disease are filled with amyloid beta plaques and neurofibrillary tangles. Moreover, the brains of people with Alzheimer's disease are severely atrophied due to the death of brain cells. Most researchers believe that the brain atrophy and death of brain cells found in Alzheimer's disease is due to the effects of amyloid beta plaques and neurofibrillary tangles, although many details about this process remain unclear. It is also unclear whether amyloid beta plaques and neurofibrillary tangles contribute equally to the death of brain cells or if one of these is th...

Tom Horvath, Ph.D. The second National Conference on Addiction Recovery Science was held online 4/23-24, 2025. The closing panel presentation was “Recovery Science: What Do We Know, and What Do We Need to Know?” The panel consisted of internationally recognized experts on this topic: David Best, Andrew Finch, Christine Grella, Keith Humphreys, and Sarah Zemore. The panel was skillfully moderated by Amy Mericle and Lourah Kelly. Here are my takeaways from the Addiction Recovery Science Conference: There was general support from the panel for the following ideas: Severe addictive problems are chronic disorders, but with many variations. Services for these problems need to be enduring. There is overwhelming evidence that AA (Alcoholic Anonymous) works (for those who will ...

The Value of Advocating for Safer (But Not Reduced) Substance Use By Tom Horvath, PhD In a study recently published online, researchers at Brown University (a major US addiction research site) compared an intervention to reduce the drinking of heavy drinking college students (without focusing on the consequences of drinking), with an intervention to reduce the negative consequences from drinking (without focusing on the amount of drinking). Both interventions worked as predicted. The first group (PNF; Personalized Normative Feedback) reduced drinking (without reducing consequences) and the second group (CAA; Counter-Attitudinal Advocacy) reduced consequences (without reducing drinking). The subjects were 585 students who by self-report engaged in episodes of heavy drinking and ...

Neuronal Plasticity, Mindfulness Meditation, and Addiction Recovery by Nicholas A. Nelson, Ph.D. Part 2 of 2 In Part 1, we visited the motivations for leveraging mindfulness as a tool for overcoming problematic addictive behaviors. We discussed the concept of neuroplasticity and took a theoretical look at how mindfulness meditation can aid in reshaping our brain and behavior during addiction recovery. In Part 2 we’ll take a look at a few specific scientific studies that have put these theories to the test, then wrap up with a discussion of what mindfulness meditation can feel like in practice. Let’s dive in. The Frontal Lobe Because the neuroscience of addiction and neuroscience of meditation are rather complex and relatively new topics, they are still undergoing rapid...

By Tom Horvath, PhD This article focuses on physicians with substance problems (and by extension all licensed professionals). However, the underlying idea, that those wanting to assist someone with substance problems should focus on ends not means, applies widely. In most US states there is a state-recognized Physician Health Plan (PHP) which often controls how physicians who have substance problems are dealt with. Similar plans exist for other licensed professionals. These organizations do much beneficial work. No one wants a licensed professional with substance problems. The national organization for PHPs is: https://www.fsphp.org, the Federation of State Physician Health Plans. In this article I focus on some major problems with PHPs (and the parallel organizations). The ide...

By Tom Horvath, PhD Mutual help groups for addictive problems have been in existence for centuries. No one knows exactly how they work. What follows is my best estimate of what happens in SMART Recovery meetings, and how they help. How SMART Recovery Works SMART offers an approach that will appeal to many (for either substance problems, activity problems, or both) because it is self-empowering, science based, progress-oriented, and holistic. Other mutual help approaches will appeal to other people. Some people may use multiple approaches. In 1994, when SMART Recovery began operating under that name, SMART elected to move beyond specific tools (which had been prominent in its pre-history) by identifying 4 common tasks for the process of addressing an addictive problem, the 4 Poin...