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...

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...

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 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...

Neuronal Plasticity, Mindfulness Meditation, and Addiction Recovery by Nicholas A. Nelson, Ph.D. Part 1 of 2 It is not uncommon during active addiction or early in recovery for people to feel that their brain is working somehow differently than before, or to feel like it is going to be impossible to break out of harmful habits and thought patterns. It can feel like the mind is damaged, or operating out of our control. This lack of control, and feeling that something is broken, can lead to a sense of hopelessness. When we look at the brain there is some truth to this feeling - during engagement with problematic addictive behaviors and during early recovery, our brains are not wired in the same way as before these problems took root. Through months, years, or decades of repetiti...

By Tom Horvath, PhD Although the following information is very basic, I hope it is a useful reminder for you. You are breathing all the time. With a few minor adjustments breathing can become a powerful tool to support yourself. Start by closing your mouth and breathing through your nose. Probably this step can happen immediately. You can also if you wish focus on the sensation of the air coming in and out of your nose. That focus can also be a helpful distraction technique. Begin to slow down your breathing. It may take many breaths to achieve a significantly slower pace. However, if you can get down to 6 breaths per minute (one every 10 seconds) you have a strong likelihood of lowering your stress level. If you are not sure how to accomplish slowing down, start counting you...

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

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

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

Progressive Muscle Relaxation: Using My Muscles to Relax My Mind By Tom Horvath, PhD Have you had moments when you believed “I cannot relax” or “I cannot relax unless I use?” Have you then used or drank because it was your best method to relax? Sometimes we do need to relax! The good news is that progressive muscle relaxation is one effective method that can work as well (with some practice) and does not have side effects. Progressive muscle relaxation (PMR) is over100 years old! There is strong scientific evidence of its effectiveness. It has been applied to anxiety, stress, insomnia, depression, sports performance, and other areas. Edmund Jacobson, a physician, developed the technique and wrote several books about it. You can easily find YouTube videos and other sources (such a...