By Tom Horvath, PhD For many individuals, particularly those in 12-step groups, recovery means abstinence (and maybe not much else). I am “in recovery” if I am abstaining. However, there are also other important aspects of the process of change. Several national organizations have devoted substantial effort to defining recovery more broadly. The following definitions are available on the internet: Faces and Voices of Recovery (undated): Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life. SAMHSA (2005): Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life. Bet...

The Differences Between Moderate Drinking Programs and Harm Reduction Programs Part 2: Harm Reduction Programs, and How and Why I Created HAMS By Kenneth Anderson, MA The Backstory I first attended an MM meeting in Minneapolis, Minnesota in June of 1998; this was immediately after the great storm of May 30, 1998, which had knocked out power lines and even traffic lights throughout the Twin Cities area and had hit the suburbs even worse. I was the only one to show up at this meeting, but I tried again the following week. The following week there were only two people at the Minneapolis MM meeting: me and Audrey Kishline. I actually did not realize that I was talking to the founder until the end of the meeting when she lent me a copy of the MM handbook and I saw her picture on the ...

The Differences Between Moderate Drinking Programs and Harm Reduction Programs Part 1: Moderation Drinking Programs and Moderation Management By Kenneth Anderson, MA Moderate drinking programs and harm reduction programs start from opposite assumptions and wind up in very different places. This doesn't necessarily make one type of program better than the other--different people will find different programs to be a good fit. A Brief Overview of Harm Reduction Programs Harm reduction programs start from the assumption that the more harm there is associated with behavior such as the use of a substance, the more the person who engages in that behavior can benefit from harm reduction services. Harm reduction services are low-threshold and are provided unconditionally. For example,...

By John de Miranda The sociology term moral panic is relatively new, arising in the 1970s. Examples of moral panic can be found throughout history, however. The anatomy of the concept is simple. A group with power and authority determines that another group or group practice is a threat. Misinformation about the group under attack is generated and spread through various media creating fear. As the public absorbs the information strategies are promulgated to attack the group or practice. From the witch hunts of Salem, Massachusetts in 1693 to the red scare (communism) of the McCarthy era in the 1950s we have ample examples. Recently, the Las Vegas Sun carried an opinion piece that considered the current issue with the social media platform TikTok to be a real-time social panic. ...

By Tom Horvath, PhD Whether we think about them or not, our lives are an ongoing answer to “big questions:” What is important to me? Who is important to me? How important is my health and longevity? What is fun? What is most satisfying? What contribution (if any) do I want to make to the world (or some part of it)? What would I like to be remembered for, and by whom? Identifying Big Life questions The list of questions just stated is not definitive. You get to choose your own questions! It is often helpful, however, to learn about the big questions (the “God, man, and the universe” questions) that others have. For many of us much of the time, it is very easy to get caught up in short-term answers to these questions. We can focus on what and who is important right now, what is fu...

By Kenneth Anderson, MA Alcohol and the Cerebellum Some drugs like opioids, benzodiazepines, and amphetamines have been called chemical scalpels because each affects only a single neurotransmitter system. Alcohol, on the other hand, is a dirty drug which affects large numbers of neurotransmitter systems, including GABA (gamma-aminobutyric acid), glutamate, and dopamine. Hence, alcohol has been referred to as a chemical hand grenade. In this post, we will be looking at alcohol's effects on the GABA system to see how it causes staggering (aka ataxic gait) and slurring of speech (dysarthrias), sedation, and memory loss. First, let's take a look at the GABA receptors. Although there is only one type of GABA, there are two types of GABA receptors: type A, which are known as GABA-A recep...

By Tom Horvath, PhD On 4/9/24 the Society of Addiction Psychology (Division 50 of the American Psychological Association) released an interview with me about SMART Recovery. The interviewers are Noah Emery and Sam Acuff, both psychology professors. This podcast about SMART Recovery runs one hour and 10-minutes, and is an interview with sections on: the early history of SMART the four foundations of SMART’s approach, which is self-empowering, science-informed, progress-oriented, and holistic the efficacy of SMART (which based on the evidence thus far is comparable to AA) the importance of staying open to new ideas how SMART’s language will evolve over time (and already has) how SMART’s tools ultimately help someone arrive at new interpretations of themselves, th...

By Kenneth Anderson, MA Normal and Retrograde Neurotransmission Delta-9 THC (delta-9-tetrahydrocannabinol) and CBD (cannabidiol) are the two most commonly found cannabinoids in the cannabis plant. The plant contains over 100 other cannabinoids as well. THC and CBD both affect the endocannabinoid system. "Endo-" is a Greek prefix meaning "inside." "Endocannabinoid system" refers to all the systems of the body which contain cannabinoid receptors and are affected by cannabinoids. We will be primarily focused on the effects of cannabinoids in the central nervous system, and on the CB1 receptor, which is the main cannabinoid receptor there. Drugs like THC can affect the central nervous system because there are also naturally occurring cannabinoids in the central nervous system, the endo...

By Tom Horvath, PhD This weekend SMART Recovery is celebrating (a few months early) its 30th anniversary by holding a conference in Salt Lake City. What has SMART achieved? How well is it functioning? What might its future hold? What follows is my personal perspective on some highlights of SMART’s first 30 years (from someone who has been part of that process), and my hopes for the years ahead. Growth and influence The good news is that in 2018 SMART Recovery expanded into SMART Recovery International, which has a world-wide presence. The US based organization is now an affiliate of the international organization, which operates approximately 2,500 weekly meetings in 38 countries and has printed materials in 18 languages. The less-than-good news is that SMART in many parts of t...

By Tom Horvath, PhD How can we explain the widespread expressed concern about US overdose deaths, coupled with our rather ineffective response to them? US overdose deaths may be the highest in the world. I will limit the following discussion to opiates, but alcohol, meth and multiple substance use are also of concern. I suggest that harsh and inaccurate beliefs about substance use and substance users have led many of the parts of our “system” for addressing substance problems into actions that increase overdose deaths rather than reduce them. In the remainder of this blog, I provide some details to support that idea. Buprenorphine and methadone: The medications most helpful for opiates are buprenorphine and methadone.  As it stands much less than half of the US individuals who cou...