By Tom Horvath, PhD In the US many individuals who might benefit from addiction treatment never attend. Although there are probably many reasons for this non-attendance, surely one of the primary reasons is the typical rigidity of US treatment programs. In a commentary published in the Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine (ASAM), the committee overseeing the development of ASAM’s Engagement and Retention of Nonabstinent Patients in Substance Use Treatment presents a summary of the document. The California Department of Health Care Services funded this project, and it offers a path forward to get more people to seek addiction treatment. As this commentary states in its abstract: To improve population outcomes, it is im...

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...

by Tom Horvath, PhD Do you consider the food manufacturing companies to be “drug dealers?” Back to that question in a moment. What’s a food manufacturer? A company that creates ultra-processed foods (also known as “hyper-palatable foods”). Ultra-processed foods are manufactured first by taking genuine foods and breaking them into specific components (such as starches, sugars, flavors, and fats). Then those components are combined (depending on the food) with salt, artificial sugar, hydrogenated fats, artificial colors, stabilizers, etc. The result is a food that is highly tasty (and preferably has a long shelf life). This food might be hard to pass up, but your body will typically appreciate it if you do. How to spot a manufactured food? Two basic clues are the length of the in...

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 ...

By Tom Horvath, PhD SMART’s 3rd edition Handbook lasted about 12 years. Because SMART is committed to staying current with scientific advances, it was time for an update. The first update is the title: SMART Recovery 4-Point Program Handbook.  SMART now considers itself to offer three programs (or services): 4-Point Program meetings (for individuals with addictive problems), Family and Friends meetings (for their loved ones), and the Multiple Pathways Partnership (for organizations that want to support SMART and the concept of “multiple pathways for change”). The Handbook simplifies the language of the 3rd edition, removes some acronyms by renaming some tools (also in service of simplifying the language), adds some tools (particularly ones that reflect third wave CBT), emphasiz...