By Tom Horvath, PhD "An intimate look inside the billion-dollar addiction treatment industry where young people are bought and sold for their insurance policies and ushered into a system designed to keep them sick.” From www.StopTheShuffle.com Practical Recovery will host a free screening of this award-winning documentary on Thursday, 11/13/25, at 7:00PM, in the conference room of our building in La Jolla (just off I-5). Seating is limited. RSVPs are required, by emailing Susie.Lee@practicalrecovery.com. A brief discussion period with the producer and Dr. Horvath will occur at the conclusion of the 81-minute screening. In 2013 Practical Recovery organized a screening of The Business of Recovery. That film focused on how poorly addiction treatment can be provided, and how ...

By Tom Horvath, PhD Many of us are concerned about our weight. We might check the scale regularly, and not much else. I suggest that a food diary of everything you eat is a much more sensible approach. A simple version is a list of foods you eat at each meal, without listing how much you ate. There are apps, such as My Fitness Pal, which can streamline some aspects of this process. The apps also provide nutritional analysis of what you are eating. If you have food you tend to eat regularly (e.g., eggs at breakfast, bread at lunch), it is easy to copy them forward. There are free and paid versions, which means you have options when it comes to food diaries. This app was recommended to me by a registered dietitian (RD). I have found it useful. Be aware that there is no legal definit...

By Tom Horvath, PhD In the US many individuals who might benefit from addiction treatment never attend. Although there are probably many reasons for this non-attendance, surely one of the primary reasons is the typical rigidity of US treatment programs. In a commentary published in the Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine (ASAM), the committee overseeing the development of ASAM’s Engagement and Retention of Nonabstinent Patients in Substance Use Treatment presents a summary of the document. The California Department of Health Care Services funded this project, and it offers a path forward to get more people to seek addiction treatment. As this commentary states in its abstract: To improve population outcomes, it is im...

by Tom Horvath, PhD Do you consider the food manufacturing companies to be “drug dealers?” Back to that question in a moment. What’s a food manufacturer? A company that creates ultra-processed foods (also known as “hyper-palatable foods”). Ultra-processed foods are manufactured first by taking genuine foods and breaking them into specific components (such as starches, sugars, flavors, and fats). Then those components are combined (depending on the food) with salt, artificial sugar, hydrogenated fats, artificial colors, stabilizers, etc. The result is a food that is highly tasty (and preferably has a long shelf life). This food might be hard to pass up, but your body will typically appreciate it if you do. How to spot a manufactured food? Two basic clues are the length of the in...

By Tom Horvath, PhD Even if you do not have a specific partner this Valentine's Day, and especially if you do, it’s a great day to engage in relationship enhancing behaviors. You might do something special just for today. In addition to your partner, you could also reach out to someone who is not at all expecting to hear from you (a parent, relative, mentor, friend, etc.): “I know you may not be expecting to hear from me on Valentine’s Day, but when I thought about all the people who mean a lot to me, I realized that thanking you for being you was a great idea. So, I want you to know I appreciate you and am thankful for the role you have played in my life.” Too sappy? Keep in mind that a psychologist wrote it! Any variation that works for you can get the job done. Further, love...

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 “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...

by Kenneth Anderson, MA The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as drinking enough alcohol to reach a blood alcohol concentration (BAC) of 0.08% or higher, i.e., to become legally intoxicated. For men, this typically means drinking five or more US standard drinks in a two-hour period. For women, this is typically four or more standard drinks in a two-hour period. Extreme binge drinking, also known as high-intensity drinking, is defined as drinking enough alcohol to achieve a BAC of .16% or higher, in other words, drinking twice as much as the amount for regular binge drinking. Extreme binge drinking is associated with throwing up or passing out. In the United States, extreme binge drinking is a common occurrence at 21st birthday celebr...

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...

This week, Kenneth Anderson, MA, explores MRI and brain shrinkage research in part 2 of the series, "Does Alcohol Kill Braincells?" Part 1 can be found here. By Kenneth Anderson, MA A 2001 study by Kubota et al. performed MRIs on 1,432 employees and family members (1,061 men and 371 women) of a large Japanese corporation to investigate shrinkage of the frontal lobe of the brain. Subjects were each categorized by their drinking status (abstainers, light drinkers, moderate drinkers, heavy drinkers), age (30s, 40s, 50s, or 60s), and brain shrinkage (shrunken, not shrunken). Heavy drinkers were classified as those who drank 350 grams of ethanol (25 US standard drinks) or more per week. There were no significant differences between the abstainers, light drinkers, and moderate drinkers ...