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 ...

The Value of Advocating for Safer (But Not Reduced) Substance Use By Tom Horvath, PhD In a study recently published online, researchers at Brown University (a major US addiction research site) compared an intervention to reduce the drinking of heavy drinking college students (without focusing on the consequences of drinking), with an intervention to reduce the negative consequences from drinking (without focusing on the amount of drinking). Both interventions worked as predicted. The first group (PNF; Personalized Normative Feedback) reduced drinking (without reducing consequences) and the second group (CAA; Counter-Attitudinal Advocacy) reduced consequences (without reducing drinking). The subjects were 585 students who by self-report engaged in episodes of heavy drinking and ...

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...

By Tom Horvath, PhD This article focuses on physicians with substance problems (and by extension all licensed professionals). However, the underlying idea, that those wanting to assist someone with substance problems should focus on ends not means, applies widely. In most US states there is a state-recognized Physician Health Plan (PHP) which often controls how physicians who have substance problems are dealt with. Similar plans exist for other licensed professionals. These organizations do much beneficial work. No one wants a licensed professional with substance problems. The national organization for PHPs is: https://www.fsphp.org, the Federation of State Physician Health Plans. In this article I focus on some major problems with PHPs (and the parallel organizations). The ide...

By Tom Horvath, PhD Mutual help groups for addictive problems have been in existence for centuries. No one knows exactly how they work. What follows is my best estimate of what happens in SMART Recovery meetings, and how they help. How SMART Recovery Works SMART offers an approach that will appeal to many (for either substance problems, activity problems, or both) because it is self-empowering, science based, progress-oriented, and holistic. Other mutual help approaches will appeal to other people. Some people may use multiple approaches. In 1994, when SMART Recovery began operating under that name, SMART elected to move beyond specific tools (which had been prominent in its pre-history) by identifying 4 common tasks for the process of addressing an addictive problem, the 4 Poin...

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 Tom Horvath, PhD With 2025 now over a week old, we may already be falling short of some of our New Year’s resolutions. Nevertheless, take heart! It is easy to fall into all-or-none thinking about positive change. Please consider the following ideas. Even if you did not make any New Year’s resolutions, you may have thought about self-improvement changes you want to make. The beginning of the year is an obvious time to do so. To the extent you did such thinking (or do it now!), you have acted on step one: identifying a desired change. What actions now make sense? This part is often complicated, but the principle of “small steps” can be very helpful. This may be a time to investigate, experiment, inquire, consult, and otherwise gather information. Keeping mental notes of what y...

By Tom Horvath, PhD This blog will publicize a recent blog post on syringe services from Nora Volkow, MD, the Director of the National Institute on Drug Abuse (NIDA). She states that: Nearly 30 years of research show that providing testing, counseling, and sterile injection supplies to people who inject opioids and other drugs helps prevent transmission of infectious diseases, without increasing drug-related or other crimes in the vicinity. Contrary to worries that syringe services programs (SSPs) will encourage or promote drug use, evidence shows that they more often do the opposite, linking people with addiction to effective treatment and even helping prevent overdose deaths. There is no scientist or professional who is more credible on this subject than Dr. Volkow. Her stanc...

By Tom Horvath, PhD “If we have our own why, we shall get along with almost any how.” -Friedrich Nietzsche, Twilight of the Idols, Maxims and Arrows, #12, translated (1954) by Walter Kaufman, originally published 1889. Our Own Why There is a range of “whys” that explain how we behave. We have in-the-moment behaviors like eating (why? “I’m hungry”). As we mature, we also have much longer-term timeframes, such as multi-year educational plans (why? “I want to be an X”), and multi-decade parenting plans (why? “I want to give my children opportunities and an upbringing that I did not get to have”). You can probably recall many examples of how you tolerated discomfort or pain for the sake of a longer-term outcome. I suggest that it is helpful to make a list of these experiences in you...