Beyond the Twelve-User’s Guide: A Workbook for Navigating the Intersection of Addiction and Change (without the Twelve-Step programs), by Ryan Paul Carruthers A Review by Tom Horvath, PhD I stopped years ago attempting to keep up with new books about how to address addictive problems without using the 12 steps. There seemed to be so many! Unfortunately, it has taken more than books to sufficiently penetrate US awareness about the existence of the multiple pathways, “beyond the 12,” available to us. Much work remains to be done before “everyone seeking recovery from addictive behavior [is] informed about the full diversity of recovery options available and allowed to choose freely amongst them (p 5).” Nevertheless, progress is being made. Carruthers has made a worthy contributio...

How effective is ketamine for depression? By Tom Horvath Depression often coincides with addictive problems, as a cause or effect, or some combination thereof. Addressing depression, whatever its causal role, is often one of our main focuses at Practical Recovery. Fortunately, there are a wide range of methods for addressing depression, and we expect to be successful, in time, with nearly everyone. In recent years many clinicians have been interested in the possibility that ketamine is an effective antidepressant. (There is also interest in ketamine as a direct treatment for addictive problems, but for now we focus on depression). Any large urban area is now likely to have multiple ketamine clinics. A recently published study raises significant concern about whether, as with othe...

Substance use disorders slightly declined worldwide over the past 3 decades, but deaths increase 2.2 times. By Tom Horvath, PhD A recently published study (9/30/25) in the Frontiers in Psychiatry reported that although the presence of substance use disorders (both new cases—incidence, and existing cases--prevalence) has declined slightly around the world since 1990 (to 2021), substance-related deaths have increased 2.2 times. Increases in deaths were most prominent in North America, with an 11.2 times increase. The study was conducted with publicly available datasets from https://ghdx.healthdata.org. These datasets are collected and maintained by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle. [The IHME] provides rigorous and ...

A slight improvement in California law for addressing complaints about addiction treatment By Tom Horvath, PhD AB 424 was signed by the governor on 10/3/25. The bill is quite brief! It adds a section (11834.33) to the Health and Safety code about how the Department of Health Care Services (DHCS) is to address a complaint from the public about an alcohol or other drug recovery or treatment facility. The primary requirements of this 125-word bill are: (a) Within 10 days of the date of the complaint, provide notice to the person filing the complaint that the complaint has been received. (b) Upon closing the complaint, provide notice to the person filing the complaint that the complaint has been closed and whether the department found the facility to be in violation of this ch...

Practical Recovery’s Free Psychoeducation Group Every Wednesday at 9AM by Zoom, Practical Recovery offers a free one-hour psychoeducation group to all current and past clients. This group has existed for over 10 years. It has regular participants, some of long standing. If it were a SMART Recovery group, we’d call it a “check-in” meeting. We go around the room (I call on people one by one). Depending on the size of the group, you get one to a few minutes to tell us what is on your mind. If you are new to the group, I call on you near the end. However, you can “pass.” No one is required to participate. Because from time to time it is good to review and update our regular activities (e.g., clean out our drawers, closets, and cupboards, reorganize our hard drives), I have been review...

By Tom Horvath, PhD For many of us a good life is a happy or a meaningful one (or some combination). However, in recent years a group of psychologists has proposed a third guideline: “psychological richness.”  On their deathbeds the happy might say “I had fun.” Those with meaningful lives might say “I made a difference in the world.”  Those pursuing psychological richness might say, ”what a journey I had” or “that was an adventure!” These three approaches can be and probably often are combined. You can pursue happiness by creating or finding satisfaction, well-being, and even joy. You can pursue meaning by looking for connection with others, purpose, and making the world a better place. If you add the dimension of pursuing personal growth, you can keep working to expand your persp...

By Tom Horvath, PhD "An intimate look inside the billion-dollar addiction treatment industry where young people are bought and sold for their insurance policies and ushered into a system designed to keep them sick.” From www.StopTheShuffle.com Practical Recovery will host a free screening of this award-winning documentary on Thursday, 11/13/25, at 7:00PM, in the conference room of our building in La Jolla (just off I-5). Seating is limited. RSVPs are required, by emailing Susie.Lee@practicalrecovery.com. A brief discussion period with the producer and Dr. Horvath will occur at the conclusion of the 81-minute screening. In 2013 Practical Recovery organized a screening of The Business of Recovery. That film focused on how poorly addiction treatment can be provided, and how ...

Tom Horvath, PhD Part 1 suggested that tracking what you eat rather than what you weigh promotes better health and could also lead to slow but sustained weight loss over time. Part 2 adds further detail about what to eat. Even if there were only a minor reduction in some of the less-than-healthy foods you eat, the introduction of better foods is a significant improvement for your health. The food diary will remind you to keep it filled with good food. Part 1 emphasized consulting with your doctor if appropriate and the Mediterranean diet with its focus on fruits and vegetables. Part 2 adds eating 1) at least 30 different plant foods each week and 2) probiotic foods (not supplements). Both actions support increasing and maintaining the diversity of the gut microbiome. What is th...

Longterm: A Podcast on Recovery Interview with Tom Horvath, Ph.D. Episode: Understanding Recovery Beyond the Stereotype YouTube: https://youtu.be/c3wGl2If6o8?si=8HplQQxea6gMuG7c Spotify and all other podcast platforms: https://creators.spotify.com/pod/profile/tiking/ The host is Ti King. The podcast was described this way: Dr. Horvath explains that SMART Recovery is a free mutual-help group, similar to AA in its community-driven support. However, it stands apart with its self-empowering philosophy, contrasting with the "powerlessness" approach. SMART Recovery does not require belief in a higher power and supports individuals choosing to reduce harm, moderate, or abstain from substances, allowing for personalized goals. The program teaches a variety of coping and thin...

By Tom Horvath, PhD Many of us are concerned about our weight. We might check the scale regularly, and not much else. I suggest that a food diary of everything you eat is a much more sensible approach. A simple version is a list of foods you eat at each meal, without listing how much you ate. There are apps, such as My Fitness Pal, which can streamline some aspects of this process. The apps also provide nutritional analysis of what you are eating. If you have food you tend to eat regularly (e.g., eggs at breakfast, bread at lunch), it is easy to copy them forward. There are free and paid versions, which means you have options when it comes to food diaries. This app was recommended to me by a registered dietitian (RD). I have found it useful. Be aware that there is no legal definit...