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...

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 ...

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...

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...

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...

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,...

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...

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 ...

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...