by Thaddeus Camlin, Psy.D. We know now through research, experience, and common sense that all so-called "addicts" are not the same, and that addiction is not an intractable, lifelong condition that cannot be overcome.  At the heart of addictive problems a compromised capacity for self-regulation is often found. Self-regulation is not a genetic trait that some inherit and some do not - it is a skill developed and nurtured largely by the environment.  An expertise in horticulture is not required to understand that lacking conditions are the most likely explanation for an underwhelming harvest. The good news is that self-regulation can be developed and refined at any stage of life, and there are concrete factors that help us improve our capacity for it. Underdeveloped self-regulatio...

by Thaddeus Camlin, Psy.D. Earlier this year I wrote a piece arguing that 12-step programs are wrong when they claim that drug use invariably leads to jails, institutions, or death.  The piece generated a decent amount of dissenting responses (even more than most of the stuff I write!). Impassioned retorts proclaimed that I built a “straw man” argument by referring to drug use leading to jails, institutions, and death, and insisted that the 12-step programs only make the ominous claim about people in “active addiction.”  Inherent in the dissenting opinions is an implied agreement that the original article was correct in claiming that most substance use does not lead to jails, institutions, and death, so at least we agree on something. Now, let us narrow the focus from the fact that m...

by Thaddeus Camlin, Psy.D. They said acid fries your brain and makes you jump off buildings.  They said shrooms make your brain bleed and that’s why they cause hallucinations.  They said pot makes people murder their families.  I don’t know exactly who ‘they’ are, but boy were they wrong.  The prestigious Johns Hopkins University just announced the opening of a nearly $20 million dollar research center to study psychedelic medicines.  The announcement from Johns Hopkins is arguably the single biggest acknowledgment that Western Society has been embarrassingly wrong about psychedelics all along.  Support for Psychedelic Therapy Research trials forthcoming from the new research center include the use of psychedelics to treat addiction, anorexia, Alzheimer’s related distress and cogni...

AA: Who it Helps, Who it Harms, Who it Kills, & Why, by Edward W. Wilson, PhD Kindle edition available on Amazon Print edition, 66 pages, available here. Preface by Tom Horvath, PhD (reprinted here by permission)   The psychological development of children is well studied. We know what children at different developmental levels can accomplish, and just as importantly, what they cannot accomplish.  The psychological development of adults has been studied much less, and the emerging knowledge that psychologists have on this subject has not become widely known. It doesn’t take a psychologist to know, for instance, that a situation that might lead to a temper tantrum in a two year old, should not lead to a tantrum in a teenager. However, because adults all loo...

by Tom Horvath, PhD., ABPP This blog is addressed to psychotherapists who do not view themselves as capable of providing addiction treatment. Many (if not most) therapists have this perspective. However, as I have suggested for many years, individual therapy (possibly supplemented by couple’s and family therapy) is the setting of choice for most individuals with addictive problems, and therapists should learn to address these problems. Unfortunately, many therapists lack the confidence even to learn about addiction treatment. Therapists already know most of what they need to know for basic addiction treatment. They also need some basic information about addiction and recovery. In an effort to boost the confidence of these therapists, below are the principles they would keep in min...

by Thaddeus Camlin, PsyD New England Journal of Medicine Article Says: Addiction is Learning, Not Disease One of the world’s most prestigious journals just published an article saying that addiction is not disease.  Not surprisingly, an uproar is underway.  Devotees to the disease model of addiction are not happy, but sometimes the truth hurts.  The article in the New England Journal of Medicine is a major step towards improving the standard of care in addiction treatment and deepening our understanding of the true nature of addictive behaviors. Including and Transcending the Disease Model of Addiction The article in the New England Journal of Medicine, written by Marc Lewis, Ph.D., does a masterful job of presenting the current state of the evidence about the etiology and maintenan...

The “tobacco settlement” was reached in 1998 after five years of litigation. Tobacco manufacturers agreed to change some business and marketing practices, and to pay over $200 billion spread over 25 years (with continued payments thereafter) to reimburse 46 states for their expenses in treating tobacco-related illnesses. Opiate Settlements There are now hundreds of opiate cases pending. The case against manufacturers is based on how opiates were marketed. Opiates can be more harmful than the marketing suggested. The case against drug distributors is based on the implausibly high numbers of pills that were made available to “patients” in specific localities, suggesting that massive amounts of medication were diverted from prescribed to other uses. Based on the tobacco settlement we cou...

by Tom Horvath, PhD, ABPP The US media often presents stories about substance problems. However, there are fewer stories about how individuals resolve these problems. The National Recovery Study (Kelly, Bergman, Hoeppner, Vilsaint, & White, 2017) was an effort to estimate how many in the US have resolved substance problems, and how they did so. This landmark study merits more attention. What We Already Knew 1) Many individuals who previously had substance problems resolved them on their own (“unassisted recovery”), without being involved in treatment, medication, mutual help or other recovery services (“assisted recovery”). Unassisted recovery is also termed natural recovery, or self-guided change (Bishop, 2018). 2) Many of the individuals in unassisted recovery do not consi...

by Tom Horvath, Ph.D., ABPP. Clients often attempt to choose addiction treatment carefully. Typically, they search for a “program” suitable to their problems, at least as they understand their problems. Unfortunately, most clients are uneducated about addiction. They are not professionals, and the addiction treatment industry and media often present inaccurate information. Consequently, clients can end up in facilities that harm them rather than help them, primarily because in these facilities substandard practices are common (U.S. Department of Health and Human Services, Office of the Surgeon General, 2016). Almost daily in our offices at Practical Recovery we hear about what goes wrong in addiction treatment. Here are some examples. Treatment sessions are not conducted by psychoth...

by Tom Horvath, Ph.D. According to a new ground-breaking study, individuals attending SMART, LifeRing and WFS now have scientific support for their choice to attend these groups. As with all new scientific findings, we have a reached a new vantage point from which to consider both next research efforts, and the clinical implications of what we now perceive more clearly. Before considering the clinical implications, let’s remind ourselves that any single finding is subject to re-interpretation in the light of new findings. However, this finding has many precedents, and therefore is not especially “single” or divergent. Although not a controlled trial, Atkins and Hawdon (2007) found individuals in multiple mutual help groups to obtain similar outcomes. In psychotherapy resear...