• Undoing Drugs - a Review by Tom Horvath, Ph.D.

    Posted on December 2, 2021
    Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction, by Maia Szalavitz Review by A. Tom Horvath, PhD The harm reduction approach to addressing addictive problems has until recently been highly controversial, at least in the US. Treatment and other change efforts in the US have been primarily guided by the views that addiction is a disease and that the 12 steps are the primary (or only) method for change. Harm reduction accepts and encourages small steps toward change. The US approach has typically required an immediate and large change, often involving a completely new perspective: “I’m an addict, I have a disease, I will abstain from everything forever.” The small steps approach of harm reduction, even though it describes how most human change occurs, has ...
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  • Ending Stigma

    Posted on November 16, 2021
    By Tom Horvath, PhD Addiction professionals say they're working toward ending stigma surrounding addiction, but they also tend to promote addiction as a disease. These activities are contradictory. By promoting addiction as a disease they play into the general tendency to perceive in-groups (“normies”) and out-groups (those with the disease). Instead of emphasizing that “addiction is a chronic brain disease” or “treatment works,” the following ideas, depending on the context, would make much more helpful and less stigmatizing messages: You might also be interested in: The Stigma of Addiction and the Inadvertent Contribution of the Recovery Community 1. Addictive problems range from very mild to very severe. 2. Most addictive problems are not in the severe or very severe range. ...
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  • The Self-Empowering Approach

    Posted on October 22, 2021
    by Tom Horvath, PhD Practical Recovery and SMART Recovery both use the self-empowering approach for resolving addictive problems. This approach contrasts with the powerlessness-based approach of AA and other 12-step groups, at least on the surface. Both approaches begin with the person considering change, and then deciding to change (at least to some degree). Both approaches can be effective, but one may work better for specific individuals. The powerlessness-based approach is described in AA’s 12 steps. In the first step you admit you are “powerless over alcohol.” In the third step there is “a decision to turn our will and our lives over to the care of God as we understood Him.” This approach can be described as serenity (as used in the Serenity Prayer, and also as “letting go” o...
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  • Stanton Peele Book Review by Dr. Tom Horvath

    Posted on October 14, 2021
    A Scientific Life on the Edge: My Lonely Quest to Change How We See Addiction, by Stanton Peele, reviewed by Tom Horvath, PhD Peele’s latest book (#14) is a personal autobiography, an intellectual autobiography, and a detailed comparison of his work with that of many other authors and scientists, including Maia Szalavitz, Carl Hart, Marc Lewis, and Johann Hari. For those unfamiliar with Peele’s work, this book would be an excellent introduction. If you already appreciate him, the historical and comprehensive nature of this book (379 pages, plus 52 pages of online references) will likely be appealing. The references online are helpful, and save the reader from flipping pages back and forth. Peele revolutionized our understanding of addiction. Love and Addiction, published in 1975 (...
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  • America Celebrates the Drug War's 50th Anniversary

    Posted on July 2, 2021
    by Thaddeus Camlin, PsyD Let’s call a spade a spade.  The war on drugs is a euphemism for a war on personal freedom.  The hypocrisy inherent in a war on personal freedom in the self-proclaimed land of the free is more than a tad embarrassing (insert cringe emoji here).  The number of lives ruined with criminal scarlet letters and families torn apart because someone dared possess psychoactive compounds is beyond measure.  Even on the very day of writing this article a U.S. Olympian was kicked off the track and field team because she tested positive, not for a performance-enhancing drug, but for cannabis detected in her bodily fluids after she inhaled the plant’s smoke to ease the pain of the death of her mother.  This Independence Day, as America celebrates the passing of the drug war...
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  • Managing Interpersonal Boundaries, pt. II

    Posted on April 23, 2021
    by Tom Horvath, PhD, ABPP Interpersonal boundaries are part of the rules we establish about how we interact with other people. In this blog we focus on protecting ourselves from the outside. In a parallel blog we focused on keeping inside what needs to stay there. In both cases we can compare interpersonal boundaries to a house, which protects us from the outside, and keeps inside what needs to be there. We prevent violations to ourselves by establishing and managing boundaries. For instance, who can touch us and how, who can enter our living space and how far, whom we respond to online and whom we do not, whom we will accept advice from and whom we won’t, and so forth. The challenge often is that these boundaries need to be communicated and enforced, and communication and enforce...
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  • New Year's Resolutions & The Abstinence Violation Effect

    Posted on January 1, 2021
    by Thaddeus Camlin, PsyD The ‘us & them,’ ‘normies and addicts’ mentality continues to lose its stronghold in addiction theory.  The more addictive behaviors are recognized as a manifestation of normal human learning rather than diseased character defects and spiritual maladies, the better.  New Year’s resolutions, and their reputation for failure that often precedes them, offer yet another opportunity to highlight the universality of addictive behaviors.  New Year’s resolutions often fail because of a phenomenon of all-or-nothing thinking frequently referred to in the world of addiction as the ‘abstinence violation effect,’ where a single breach of a vow to change is viewed as failure and justifies absconding from the entire change attempt. Old habits die hard, new habits for...
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  • Sparks of Hope for the Holidays

    Posted on December 18, 2020
    by Thaddeus Camlin, PsyD Sparks do not burst from a vacuum, they are incandescent blasts from intense heat and friction.  The famous Christmas Carol ‘Feliz Navidad’ was back in the headlines recently celebrating its 50th anniversary.  Most stories talked about the song-writing process of its creator, José Feliciano, as one of magical ease, a spark of hope and inspiration.  The magical spark storyline fits, given that 'Feliz Navidad' contains only 19 words, was written in ten minutes, and recorded in one take.  What is missed in the magical story of Feliz Navidad’s inception is the backdrop of toil, perseverance, sacrifice, and hardship in the life of the songwriter that constituted the rich soil from which the Christmas Carol gem burst forth. Feliciano was born in Puerto Rico in 1...
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  • Questioning the 'Substance Abuse' Label

    Posted on November 13, 2020
    by Thaddeus Camlin, PsyD Abuse conjures amongst the most abhorrent of associations.  People who are abused often turn to substances because they provide reliable and effective short-term relief from intrusive and disruptive trauma symptoms like nightmares, flashbacks, and panic attacks.  From that perspective, referring to people who were abused as ‘substances abusers’ doesn’t make much sense.  Thus, some leaders in the field of addiction medicine and treatment are calling on national drug institutions like NIDA and NIAAA to remove the ‘substance abuse’ label from the addiction lexicon.  We shall see if the call for change is answered. Addiction language doublethink is familiar territory for us at Practical Recovery.  Examples of hypocrisy abound when the common vernacular of ...
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  • Oregon Decriminalizes Drugs & Legalizes Psilocybin Treatment

    Posted on November 6, 2020
    by Thaddeus Camlin, PsyD The glare cast from the hot spotlight on the Presidential Election drowned out what is arguably the single best day for drug policy reform in U.S. history.  Oregon became the first state to both decriminalize drugs and legalize psilocybin treatment. Four additional U.S. states legalized recreational cannabis.  All drug policy reform propositions up for vote in 2020 passed.  Even in South Dakota, where many believed recreational cannabis would not be legalized, voters chose to put an end to charging people with pot felonies that strip voting rights and rob employment opportunities.  Hope for meaningful drug policy reform is abundant and calls for federal reform are gaining steam. The legalization of psilocybin treatment in Oregon will take about two yea...
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