Crave: The Hidden Biology of Addiction and Cancer, by Raphael E. Cuomo, PhD A Book Review by Tom Horvath, PhD This compact and compelling book describes how our moment-to-moment actions regarding food, sleep and rest, physical activity level, electronic activities, relationships, and daily life in general contribute to increasing or decreasing our risk for developing cancer and other diseases. These actions often have the character of addictive behaviors, “the relentless cycle of stimulation and reward that defines ordinary life (pg. 1).” The impacts of these actions accumulate over time, altering “the internal landscape…the body’s terrain pg. 1).” This book could have been entitled The Body Keeps the Score, but that title was taken! “The term ‘addiction’ is reserved for beh...

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...

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 ...

Neuronal Plasticity, Mindfulness Meditation, and Addiction Recovery by Nicholas A. Nelson, Ph.D. Part 2 of 2 In Part 1, we visited the motivations for leveraging mindfulness as a tool for overcoming problematic addictive behaviors. We discussed the concept of neuroplasticity and took a theoretical look at how mindfulness meditation can aid in reshaping our brain and behavior during addiction recovery. In Part 2 we’ll take a look at a few specific scientific studies that have put these theories to the test, then wrap up with a discussion of what mindfulness meditation can feel like in practice. Let’s dive in. The Frontal Lobe Because the neuroscience of addiction and neuroscience of meditation are rather complex and relatively new topics, they are still undergoing rapid...

Neuronal Plasticity, Mindfulness Meditation, and Addiction Recovery by Nicholas A. Nelson, Ph.D. Part 1 of 2 It is not uncommon during active addiction or early in recovery for people to feel that their brain is working somehow differently than before, or to feel like it is going to be impossible to break out of harmful habits and thought patterns. It can feel like the mind is damaged, or operating out of our control. This lack of control, and feeling that something is broken, can lead to a sense of hopelessness. When we look at the brain there is some truth to this feeling - during engagement with problematic addictive behaviors and during early recovery, our brains are not wired in the same way as before these problems took root. Through months, years, or decades of repetiti...

by Lesley Wirth, MA I’m just going to say it: The self-help world needs to reconsider the phrase, “Take responsibility for your life.” Why? It rarely works. It is usually the wrong medicine, offered at the wrong time, to the wrong person. When someone has suffered from loss, injustice, or trauma, telling them to “Take personal responsibility for their reality,” is not helpful. It is damaging. Maybe you've been there: you lay your heart bare to a spiritual coach you believed you could trust, only to have them dismiss your experience by telling you to let go of your "victim consciousness." If you are really lucky, they will ask you what part of you attracted your situation so you could learn from it. I understand people mean well, but words like these can feel like...

by John de Miranda Early in my recovery from an alcohol use disorder I discovered that memoirs and first-person accounts of people struggling with addiction were a useful method to help me deal with the challenges of a life without alcohol. Many of these accounts were uplifting. Some were scary. I remember one in particular A Sensitive Passionate Man published in 1974 by Barbara Mahoney. Her account chronicles life with her husband Sean who died at the age of 45 from cirrhosis of the liver. Despite a life of material and personal success Sean rebutted all attempts from family and friends to intervene in his alcoholism and literally drank himself to death. In my pink cloud naivete I was taken by surprise that not all stories of addiction had a happy ending. I am an instructor in...

By Tom Horvath, PhD “We are disturbed not by events, but by our views about them.” - Epictetus, 60-138 CE Bad events happen to all of us. To some of us, they happen to a great extent. Whether we have first-world problems, third-world problems, or something else, our problems focus our attention. We want to solve them. In some cases, solving problems means changing or exiting a situation. In many cases, however, there are no obvious changes or exits to make. What now? These types of problems require a change of “view.” Psychologists and others who help people change their “views” have used many terms to describe what needs to be changed to address these types of problems: perspective perception context viewpoint beliefs point of view interpretation *gui...

By Tom Horvath, PhD I was recently contacted by a website putting together a list of 50 very brief accounts, including before and after pictures, about individuals resolving addictive problems. I was pleased that they included a few quotes from me, about the process of change. https://www.boredpanda.com/best-all-times-before-after-addicts-transformation/ Perhaps the most important fact to know about significant addictive problems is that most individuals fully or mostly resolve them. So often the stories we see are focused on problems, not success. The process of change often takes more effort and more time than we would like, but nevertheless it happens! The results of the change process are quite different from individual to individual. The lengthy time needed to change ca...