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...

By Tom Horvath, PhD Although occasionally we hear someone say “I’m addicted to everything,” it appears that most of us deeply enjoy only a few substances or activities. You would not have time for all of them! This fact means that there are many or at least some substances that you do not feel strongly drawn to, even though others may be. For instance, you might like gambling, but not be interested in any substances. Or you might very much like alcohol (or weed, or meth, or opiates, or coke, or ketamine, or various activities, etc.) but not especially be interested in MDMA (or alcohol, or weed, or meth, or opiates, or coke, or ketamine, or various activities, etc.). How do you do it? How do you NOT get carried away with substances or activities that others find so tempting? How...

What are your sources of pleasure? By Tom Horvath, PhD If you’ve had addictive problems, you may easily recall experiences (with substances or activities) that you found intensely pleasurable. Addictive behavior can provide that! However, regardless of how much you are still having that type of experience, you can understand and appreciate yourself much better by examining the other sources of pleasure in your life. A daily review of them is useful. That review could happen at any time, but doing so as you fall asleep is a good way to end the day with a sense of pride and gratitude. What experiences from your day stand out to you? You may be surprised at what you discover. Here are some questions to consider in that review. How much did you enjoy sensory experience today? S...

By Tom Horvath, PhD For many individuals, particularly those in 12-step groups, recovery means abstinence (and maybe not much else). I am “in recovery” if I am abstaining. However, there are also other important aspects of the process of change. Several national organizations have devoted substantial effort to defining recovery more broadly. The following definitions are available on the internet: Faces and Voices of Recovery (undated): Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life. SAMHSA (2005): Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life. Bet...

By Kenneth Anderson, MA Normal and Retrograde Neurotransmission Delta-9 THC (delta-9-tetrahydrocannabinol) and CBD (cannabidiol) are the two most commonly found cannabinoids in the cannabis plant. The plant contains over 100 other cannabinoids as well. THC and CBD both affect the endocannabinoid system. "Endo-" is a Greek prefix meaning "inside." "Endocannabinoid system" refers to all the systems of the body which contain cannabinoid receptors and are affected by cannabinoids. We will be primarily focused on the effects of cannabinoids in the central nervous system, and on the CB1 receptor, which is the main cannabinoid receptor there. Drugs like THC can affect the central nervous system because there are also naturally occurring cannabinoids in the central nervous system, the endo...

By Tom Horvath, PhD This weekend SMART Recovery is celebrating (a few months early) its 30th anniversary by holding a conference in Salt Lake City. What has SMART achieved? How well is it functioning? What might its future hold? What follows is my personal perspective on some highlights of SMART’s first 30 years (from someone who has been part of that process), and my hopes for the years ahead. Growth and influence The good news is that in 2018 SMART Recovery expanded into SMART Recovery International, which has a world-wide presence. The US based organization is now an affiliate of the international organization, which operates approximately 2,500 weekly meetings in 38 countries and has printed materials in 18 languages. The less-than-good news is that SMART in many parts of t...

By Tom Horvath, PhD How can we explain the widespread expressed concern about US overdose deaths, coupled with our rather ineffective response to them? US overdose deaths may be the highest in the world. I will limit the following discussion to opiates, but alcohol, meth and multiple substance use are also of concern. I suggest that harsh and inaccurate beliefs about substance use and substance users have led many of the parts of our “system” for addressing substance problems into actions that increase overdose deaths rather than reduce them. In the remainder of this blog, I provide some details to support that idea. Buprenorphine and methadone: The medications most helpful for opiates are buprenorphine and methadone.  As it stands much less than half of the US individuals who cou...

By John de Miranda Innovation does not come quickly or easily to the addiction treatment sector. For example, harm reduction strategies had been employed in the public health sector for decades before their recent adoption by the federal government as a latecomer to fighting our nation’s opioid epidemic. Similarly, the Minnesota Model of addiction treatment, which emerged in the 1950s, still accounts for the model preferred by the majority of treatment programs. At its core, this approach draws heavily from 12-step ideology and requires a commitment to abstinence as the key focus of treatment goals. “If you have had enough and are ready to quit, then we can help you,” is the metamessage sent to potential clients by most addiction treatment programs. The problem with this approa...

By Tom Horvath, PhD How well can I calm myself or energize myself using my own abilities? How much do I need to use a substance for help? Although at times a mild sedative (one drink) or mild stimulant (a cup of coffee) can be a helpful tool, the more we rely on such tools the more our internal abilities diminish (atrophy). Daily low doses of sedatives or stimulants can be helpful. As the doses get higher, problems can emerge. In cases of substantial addictive problems, it is common to see someone bouncing between “downers” and “uppers,” sometimes even multiple times per day. At that level of substance use we can lose all sense that self-regulation can be accomplished by ourselves. None of us may reach the ideal of regulating ourselves entirely from our own resources. However, ...