by Tom Horvath, Ph.D., ABPP How can the United States improve addiction treatment? The ultimate goal of support for overcoming problematic addictive behavior is to improve individual health and well-being while reducing societal costs associated with the behavior.  Several countries (e.g., Portugal, Switzerland, the Netherlands) are much more effective than the US in providing this support, which can include professional services (treatment) as well as a variety of non-professional and informal support. Calling for Change in US Addiction Treatment In the US a rational, medical and psychological approach would improve a system that has been overly influenced by the punitive aspects of drug prohibition and the diversity-suppressing dominance of the 12-step spiritual approach (which ha...

by Thaddeus Camlin, Psy.D. This week’s topic is the sixth and final installment in a series exploring lies that have permeated the recovery culture.  Thus far, lies about success, failure, everyone in recovery being the same, shaming, and labeling have been challenged.  While there are many more lies than six that have infiltrated the consciousness of recovery, I am forcing myself to stop here.  This final article may have saved the most controversial topic for last.  This article challenges the lie that we know “addiction” is a disease. There is no consensus amongst professionals or conclusive research that puts an end to the lively debate over whether or not “addiction” is a disease.  What research does show, however, is that believing “addiction” is a disease combined with a la...

by Thaddeus Camlin, Psy.D. Labels Can Actually Hurt the Recovery Process This week’s topic is the fifth installment in a series exploring lies that have permeated the recovery culture.  Thus far, lies about success, failure, everyone in recovery being the same, and shaming have been challenged.  This week’s article challenges the lie that people have to label themselves as an addict or alcoholic to successfully recover. There is no research that indicates people are more likely to recover from a substance use disorder if they label themselves as anything.  However, there is research that shows forcing people to identify as an addict or alcoholic can actually be detrimental to their efforts to change.  The latest diagnostic manual for professionals (DSM-5) recognized such research a...

by Thaddeus Camlin, Psy.D. This week’s topic is the fourth installment in a series exploring lies that have permeated the recovery culture.  Thus far, lies about success, failure, and everyone in recovery being the same have been challenged.  This week’s article challenges the lie that shaming people helps them change a problematic pattern of substance use. There is a fundamental logical fallacy to the concept that shaming people helps them change.  The reality is that people change all the time, not just when they feel down on themselves.  In fact, substances are an excellent way to achieve a temporary break from shame!  Helping people feel better about themselves is much more useful than making them feel worse. Beyond the logical fallacy of shaming people to help them change,...

by Tom Horvath, PhD, ABPP Why individual sessions in addiction treatment are important One of the most frequent complaints I hear from clients who have attended other treatment facilities is “I almost never had an individual session.” Why are frequent individual sessions unusual in US addiction treatment, and why are they important? Groups led by drug and alcohol counselors save money A business reason to provide treatment primarily in groups is to lower costs. All businesses want to save on labor costs. In many cases groups are oriented around a well-established curriculum, designed to help clients “get the program.” Getting the program typically involves accepting the perspective that “I have a disease, I need to go to meetings for the rest of my life, I can never drink again, my ...

by Thaddeus Camlin, Psy.D. This week’s topic is the third installment in a series exploring lies that have permeated the recovery culture.  The first article challenged the lie that perfect abstinence is the only way to succeed in recovery.  Last week’s article challenged the lie that most people in recovery fail.  This week’s article challenges the lie that all addicts are the same, which is often perpetuated by the phrase ‘terminal uniqueness.' Universal statements about any group of humans other than those who struggle with substance use are generally quickly dismissed.  Consider the absurdity of statements like, all mothers are the same, all children are the same, all men are the same, all politicians are the same, all criminals are the same, etc.  To dehumanize is to divest o...

by Thaddeus Camlin, Psy.D. The Biggest Lies in Recovery, pt. II This week’s topic is the second installment in a series exploring lies that have permeated the recovery culture.  Last week’s article challenged the lie that success in recovery is perfect abstinence.  This week’s article challenges the closely related lie that most people in recovery fail. I often hear people toss around arbitrary and unfounded statistics in recovery like, “only 10% of people succeed,” and that deviations from perfect abstinence inevitably lead to “jails, institutions, and death.”  The bad news is that “professionals” sometimes contribute to the spread of these unhelpful lies.  The good news is that the lie that most people in recovery fail is unequivocally false. People often say that numbers don’...

by Thaddeus Camlin, Psy.D. This week’s topic is the first installment in a series that will explore lies that have permeated the recovery culture.  Lies selected for critique will share a common theme of being detrimental to progress.  The first lie on the chopping block is the lie of perfection. How strange would it be if a therapist treating depression told a client to never be sad again?  It would not be at all helpful to tell someone with a phobia of spiders to never encounter a spider again.  Substance use is the only area of mental health in which those being treated are burdened with demands of perfection.  Lifelong abstinence, or perfection, is the unjust measure of success in substance use.  Not only is basing success on perfection unreasonable, it is unethical. Someon...

by Thaddeus Camlin, Psy.D. Depression and substance use often co-exist.  Substance use is a common method of coping with depression.  Thus, abruptly stopping the use of substances can result in the intensification of underlying depression.  It is important to have a specific understanding of what your personal experience of depression is in order to overcome it. Depression is often understood to be a result of a chemical imbalance in the brain.  While this understanding is certainly true, it is only part of the story.  The problem with understanding depression solely as a chemical imbalance in the brain is that it reinforces feelings of helplessness – a cornerstone of depression.  The truth is, the antidote to depression is indeed something that we have a tremendous amount of pers...

by Thaddeus Camlin, Psy.D. Much is being said about changing the nomenclature in the treatment of problematic substance use.  The latest diagnostic manual (DSM-5) no longer uses the term ‘addiction.’  Anne Fletcher wrote about the value of cleaning up the language of addiction using powerful comparisons to other avenues of treatment.  She astutely pointed out that no therapist would tell people trying to lose weight that no progress would be made until they labeled themselves in a pejorative way.  Can you imagine a therapist telling someone who is overweight that before work can begin she or he must identify as a fat pig?  To do so would be unconscionable.  Yet, it is all but universal in the treatment of problematic substance use that an individual is told that no progress will be m...