Cognitive behavioral therapy (CBT) is a type of mental health treatment founded in the 1960s, and it has shown great success in treating substance misuse disorders. In addition to substance misuse, CBT has been used to address co-occurring disorders like anxiety, bipolar disorder, OCD, eating disorders, and PTSD. If you or a loved one suffers from a substance misuse disorder, CBT might be helpful.
In short, the goal of CBT is to get at the root cause of why someone with a substance misuse problem feels the urge to keep misusing the substance. There are obvious biological factors behind any addiction, but there are psychological factors as well.
People with addictions often keep using based on impulse or habit, sometimes triggered by an emotionally charged memory or an environmental factor. But those reactions aren’t necessarily rational, and CBT can help dissociate the trigger from the reaction.
Cognitive behavioral therapists help those recovering from addiction to recognize their “automatic” thoughts — the thoughts that come up without prompting, set off by bad memories, past trauma, self-doubt, fear, and other negative inputs.
Often, the reaction of someone with a substance misuse problem is to self-medicate, using substances to drown out painful thoughts and feelings. With CBT, people recovering from addiction can learn to create new associations, replacing drug and alcohol use with more positive behaviors.
Destructive, negative thoughts are a common issue for individuals with substance misuse disorders, so changing these thought patterns is essential. For that reason, CBT is an effective treatment for substance misuse, eating disorders, and other mental health issues. CBT is focused on the present, sets clear goals, and focuses on specific problems, which helps patients to stay on track with their treatments.
Pharmaceutical treatments for substance misuse can be extremely helpful in treating the biological symptoms of addiction and withdrawal, but they fall short of exploring the underlying causes of continued substance misuse. CBT explores behavior and beliefs to identify and resolve patterns of self-destructive behavior.
CBT allows patients and therapists to work together in a therapeutic relationship, helping to identify harmful thoughts and seek out alternate ways of thinking, which allows patients to reshape the way they interact with their environments in the long term. CBT sessions are also usually augmented with homework outside of sessions to keep patients in the right frame of mind even when they encounter their old triggers.
Best of all, CBT skills are useful, practical strategies that can be incorporated into everyday life. One of the most difficult aspects of recovery for many who struggle with substance misuse disorders is seeing the same environmental cues over and over — locations where they used to obtain or use drugs, people who used the same substances, and so on. CBT can help remove the negative associations from those environmental factors, making it easier to recover without changing every aspect of your life.
If you or a loved one struggles with an addiction, and you think CBT might be able to help, contact TreatmentGuru today. We can help you find a treatment facility or program that’s right for you.
“If you light a lamp for someone else it will also brighten your path.” Buddha
I don’t know what’s more painful: being an addict or loving one.
To the mothers, fathers, spouses, partners, children, friends, siblings, colleagues, and loved ones of addicts: you are not alone.
To love an addict is to become consumed with trying to fix them, living in the delusion that we can somehow stop the insidious and all-consuming destruction caused by addiction.
To love an addict is to wonder each day whether your son/daughter/partner/sibling/friend is still breathing in and out. It is to grieve the loss of someone we once knew while watching their spirit diminish within the tumultuous shadow of addiction.
To love an addict is to grasp for the thinnest thread of hope when in the darkest of times. It is to deeply long for someone even when they are standing right next to us.
To love an addict is to hope and pray that he or she slept somewhere warm and safe last night as the temperatures dropped below freezing.
To love an addict is to show up to work every day with a forced smile plastered across your face unable to concentrate because you cannot stop asking yourself the question “What did I do wrong?”
To love an addict is to either embrace a life of growth and gratitude or succumb to a grim life without purpose. There is no middle path.
Drug addiction turns college funds into memorial funds. It causes parents to outlive their children. It leads to prison time, institutionalization, homelessness, fractured families, and a devastating absence in the lives of all who are impacted. It breaks our trust, our homes, and our hearts.
Imagine trying to cure a loved one’s cancer by begging them to simply STOP having cancer; to bribe, protect, control, nag, or rescue our loved one back to health. It seems ridiculous, doesn’t it? Yet that is what addiction does to family members and loved ones: our lives become highjacked by the fear of loss as we helplessly watch the addict’s interior light dim.
Our efforts to cope and survive are often fueled by desperation, denial, and fruitless attempts to rationalize, control, and change the addict’s behavior. While these methods of coping and “helping” the addict typically stem from a genuine desire to support him or her and relieve suffering, they often create more chaos and harm within relationships and the family system.Enabling behaviors end up hurting ourselves and our loved ones, preventing us from achieving the connection and healing that we all long for.
Enabling takes on many forms, but essentially it can be defined as: standing between a person and his or her consequences, doing for someone something he or she can do for him or herself, and engaging in actions that ultimately perpetuate someone’s problematic behavior.
Lost in our own anguish, grief, and terror, we are naturally compelled to do anything and everything we can to save this person, when in fact we must do one of the most difficult things possible when a loved one is suffering: nothing. Do nothing. Stop rescuing. Turn your phone on silent. Refuse to enable.Accept. Surrender.To heal while still loving our addict is to do the seemingly impossible: let go.
In order to stop the exhausting and ineffective cycle of enabling, it is important for not only the addict to receive help, but for families and loved ones to get their own support. Learning how to set boundaries with someone who is active in addiction is painful and frightening but essential for the entire family system to heal. This is easier said than done and becomes a lifelong practice of self-care, compassion, and “detaching with love.”
To heal from the destruction that addiction causes in our lives is to courageously face the truth of the terminal and progressive nature of this disease while surrendering to our ultimate powerlessness to stop it.
To heal is to accept the person as they are now and not as they once were or who you hoped they might someday become. It is to let go of false dreams and unrealistic expectations while creating space for the unknown possibilities that lie ahead.
To heal is to continuously remind ourselves of the “3 C’s” of Al Anon: “you didn’t cause it, you can control it, and you can’t cure it.” It is to embrace these simple truths.
To heal is to learn to hate the disease and not the one afflicted.
To heal is to set boundaries. It is to stop enabling and to start caring for yourself.
To heal is to communicate honestly, directly and compassionately.
To heal is to candidly admit problems and seek help from others.
To heal is to develop a sense of gratitude and humility while living “life on life’s terms.”
To heal is to love courageously despite the risk of loss, heartache, and suffering.
To heal is to be a source of light and hope for others who are still suffering.
Remember, it is impossible to love deeply without also experiencing heartbreak, grief, anger, and vulnerability. To heal is to accept this unalterable truth. It is to choose to love boldly in the face of fear and pain. It is to reach out to others, knowing within the deepest parts of ourselves that we are not alone.
Marie Tueller, MEd, LPC
If you or a loved one is trying to recover from a substance misuse problem, whether drugs or alcohol, a sober living facility might be a good option for you. Sober living facilities are a helpful transition for many who struggle with substance misuse, enabling them to live independently again after treatment.
A sober living home, also sometimes known as a “halfway house,” is a group home facility for those recovering from substance misuse disorders. Most of these facilities are privately owned, though some are owned by businesses or charity organizations as well. Sober living homes are usually located in quiet areas, where a calming environment free of external stressors can help promote a quicker recovery.
Sober living homes are different from rehab facilities in that rehab facilities are generally much more intensive and offer residents less personal freedom. By contrast, sober living home residents are generally free to enter and leave as they please. Most sober living homes have some house rules, including curfews at night and periodic drug testing, but in general, residents are expected to be relatively self-sufficient.
The idea of a sober living facility is to ease residents back into a normal life, free from addiction. Residents pay rent, buy and cook their own food, clean up after themselves, and have regular jobs and hobbies just as they would if they lived in a regular home. The only difference is that sober living homes come with slightly more oversight to help residents stay sober until they can manage their triggers and cravings on their own.
Rules for sober living facilities are different from facility to facility, but there are some rules that most homes have in common. Residents agree to the rules when they move in, and violations of the rules come with consequences like paying a fine, making amends to other residents, or writing an apologetic essay about what they did wrong.
The main rule shared by all sober living houses is that residents must remain sober during their entire tenure there. This means no drugs or alcohol, regardless of which substance the resident is trying to recover from. In some cases, homes restrict the use of substances like mouthwash or vanilla extract, which contain alcohol and can be abused or produce false positives on drug tests.
Residents are also encouraged to keep themselves busy. Some houses require that residents have a job or attend classes during the day, and most require that residents do chores to contribute to the house. Some houses also enforce curfews to help residents learn responsibility for themselves and their behavior.
Although most sober living homes don’t restrict the people who can live there, the most common resident is someone who’s already completed a substance misuse rehabilitation program before moving in. The goal is to help recovering substance users transition back to a normal life free of substance misuse, so the house will be more useful for those who have already learned some tools to help them stay sober.
For a lot of people, substance misuse arises simply out of having nothing else to do — boredom leads to experimentation, which leads to overuse. Sober living homes help residents find healthy, productive ways to occupy their time, from household chores like cooking and cleaning to exercise to outdoor activities.
If you or a loved one is going through a substance misuse disorder and you think that a sober living home might be helpful, contact TreatmentGuru today. We’ll help you find a facility that fits your needs and gets you back on the right track toward health.
The drug crisis in the United States is getting worse — more than 20 million adults have some form of substance use disorder. Unfortunately, it’s made worse by pervasive myths and misconceptions around addiction and the people who suffer from it. If people with substance misuse disorder hope to recover, they need understanding and compassion. With that in mind, there are a few myths about addiction that we want to dispel.
While it’s true that men are more likely to become addicts, women are the fastest-growing segment for substance abuse in the country. According to the Federal Center For Substance Abuse Prevention, roughly 2.7 million women in the United States struggle with substance misuse disorder.
Women are especially susceptible to opioid misuse. Opioid misuse usually starts with prescription painkillers like oxycodone, hydrocodone, and morphine, and women are much more likely to be prescribed opioids for chronic pain. They’re also generally prescribed these medications in higher doses and for longer periods — women make up 65% of total opioid prescriptions and are 40% more likely to become persistent opioid users after surgery.
One of the most stubborn myths in the world of substance misuse is that addiction is easy to see from the outside. Depictions of addiction in movies and TV shows give people the impression that drug and alcohol misuse sufferers are disheveled, desperate, and unable to keep their lives together.
Why is this myth so damaging? Because it perpetuates the idea that unless someone is visibly struggling, they don’t need help. In fact, many people who suffer from addiction have full-time jobs, happy family lives, and display no outward signs. Nonetheless, these people need help and support.
In 2007, a study by the National Institute of Alcohol and Alcoholism (NIAAA) categorized approximately 19.5 percent of all alcoholics as “functional” — by their definition, these people are “middle-aged, well-educated, with stable jobs and families.”
Other studies have indicated that 8 percent of full-time workers and 10 percent of part-time workers use illicit drugs, with prevalence in some industries reaching as high as 19.2 percent.
Many people deny that they have a problem because they’re successful in their work lives or because they only drink at home, but the fact is that anyone can be susceptible to addiction. People in these situations often hide their addiction due to negative stigma, shame, or the misconception that they’re not “bad enough” to warrant seeking help, but this simply isn’t true. Anyone experiencing any kind of conflict between drugs or alcohol and their personal and professional life should seek help.
While it’s true that the initial choice to try alcohol or an illicit drug is often voluntary, many people are able to use alcohol and drugs responsibly. Many people are prescribed opioid painkillers and never develop a misuse problem, while some do — if willpower was all it took, addiction would be much easier to solve.
The truth is that the factors that lead people to misuse and become addicted to drugs or alcohol are incredibly complicated — even today, scientists and psychologists are still trying to understand how addictive behavior develops in some people and not others.
The fact is that addiction and addictive substances “re-wire” the brain on a very fundamental, unconscious level. People struggling with substance misuse aren’t deciding to keep using any more than they decide to be hungry or tired — the addiction becomes a biological urge that they can’t ignore any more than they can ignore the urge to breathe. Changing those urges and associations in someone’s brain is difficult and complicated, and blaming people with substance misuse disorders for causing their own problems isn’t helping.
While it’s true that dosages are more controlled when it comes to prescription drugs, prescription pills can be just as addictive and just as dangerous to misuse as “street” drugs. People are also more likely to take pills with alcohol or other drugs, which can cause adverse reactions that make the chances of overdosing much higher.
According to the CDC, almost 218,000 people have died of prescription drug overdoses between 1999 and 2017, with the rate of overdose death involving prescription opioids increasing by a factor of five in that time. Prescription drugs may carry the illusion of legitimacy, but they should be taken just as seriously.
The truth is that substance misuse disorders can affect anyone, no matter their current situation, history with substance use, upbringing, or environment. You can’t rely on your intuition to tell you whether someone you love is struggling or not — many people with substance misuse disorders hide it well. If you or someone you love is having trouble with substance misuse, there’s no sense in waiting until it gets worse. Contact us today.
According to the CDC, more than 130 people in the United States die from an opioid overdose every single day. It’s not just street drugs like heroin — prescription painkillers and synthetic opioids like fentanyl are just as responsible, if not moreso.
Opioid addiction and misuse has become a serious national health crisis with far-reaching effects that have an influence on not just public health, but also on the social and economic welfare of the communities affected.
In fact, the CDC estimates that the “economic burden” of prescription medication misuse alone is $78.5 billion per year, including healthcare, lost productivity, addiction treatment, and criminal justice expenditures. The opioid epidemic is a very real, very serious crisis — here’s what you need to know.
Opiates are substances derived from the opium plant, while the term opioids encompasses synthetic opioids like fentanyl. The body naturally creates opioids to help regulate stress, pain, and how your body processes them, so the receptors in the brain already exist.
Drugs like heroin and fentanyl mimic the body’s natural pain-killing processes but on a much higher level, masking pain signals with much greater strength and efficiency than the natural ability of the body to do so and creating intense feelings of pain relief and relaxation. That’s the reason that opioids like OxyContin and Vicodin are so commonly prescribed for major surgical pain and similar conditions.
The other feature of opioids is to prompt the brain to release dopamine. Dopamine is a naturally occurring chemical associated with the brain’s reward system — the brain releases dopamine in response to survival actions like eating and sleeping in order to create the urge to do those actions again.
The problem is that opioids raise the dopamine levels in the brain to much higher levels than any naturally occurring activity — sleep, eating, exercise, meditation, listening to music, sex, and many others — so natural activities no longer satisfy the brain’s cravings. Instead, the brain has been trained to seek out the sensation of opioids usage above all other priorities because the dopamine spike has convinced it that that behavior is the most rewarding.
As the body and brain become more tolerant of opioid use, the dosage required to create the same sensation continues to rise. Some users start to use higher amounts at a higher frequency, eventually becoming addicted when they can no longer control their need for opioid consumption.
The first thing to realize is that heroin is actually a relatively small piece of the puzzle. Of the 20.5 million Americans with a substance misuse disorder in 2015, only 590,000 — less than 3% — were heroin users.
By contrast, more than two million people had a substance use disorder involving some form of prescription pain reliever, and more than 11 million people misused prescription opioids. While it’s true that heroin still accounts for almost 60% of opioid overdose deaths, deaths from overdoses of prescription opioids are rising rapidly. More than 17,000 people died of an overdose from a prescription opioid in 2017 — more than five times as many as in 1999.
One of the most-blamed culprits in this crisis is the medical community. In 2016, health care providers issued more than 214 million prescriptions for opioids for the purpose of pain management — nearly 70 prescriptions per 100 people.
This trend has had an especially high impact on women. Women are more likely to report suffering from chronic pain, more likely to be prescribed pain medication, given higher doses, and more likely to use them for a longer time than men. There’s also some evidence that women can become dependent on prescription opioids more readily than men. As a result, while men are still more likely to die of prescription painkiller overdoses than women, the rate at which women overdose is rising much faster — between 1999 and 2016, the percentage increase in deaths among men was 265%, while in women it was 400%.
Unfortunately, this trend only appears to be accelerating. Between July 2016 and September 2017, opioid overdoses increased by 30% in 52 areas of 45 different states. The Midwest in particular saw an increase of 70% in opioid overdoses in that time, and large cities saw an increase of 54% across 16 states.
Fentanyl is the newest opioid to enter the US drug scene, and it’s rapidly becoming the most dangerous. Fentanyl is between 20 and 50 times stronger than heroin and is often cut with heroin to keep potency up. The result is that heroin users, unaware of how strong their drug supply is, overdose much more easily. Fentanyl overdose deaths have risen 540 percent in just three years, from 3,000 to almost 20,000 between 2013 and 2016.
In 2017, the president declared the opioid crisis as a public health emergency. As a result, the U.S. Department of Health and Human Services (HHS), the National Institutes of Health (NIH), and NIDA have combined their resources and announced that their strategy for combating the crisis would focus on five major priorities:
Wider access to addiction treatment and recovery programs
Alternatives to opioids for treating and managing pain
Support for research into pain management and addiction
Improved public health and addiction education
Wider access to overdose-reversing drugs
The first three goals fall under the purview of a program called the Helping to End Addiction Long-term (HEAL) Initiative. HEAL works with the pharmaceutical industry to find alternatives to opioids for pain management and better understand the most effective forms of treatment.
Overdose-reversing drugs are becoming much more widely available, and have already been able to save thousands of lives. The most common version is Narcan, which can completely reverse the effects of an overdose and is now carried by law enforcement, first responders, and other emergency services. It’s important to remember that Narcan is not a treatment for addiction, only for the short-term effects of an overdose. It will have no effect on the chemical desire to use opioids again in the future.
If you or someone you care about is struggling with a misuse disorder associated with opioids, whether prescription or illicit, you need to take action now. Keeping Narcan on hand is a good start, but it isn’t a substitute for proper care and treatment.
Treatment Guru can help you find the treatment program or facility you need to break free from substance misuse for good. Every patient is different, and our MatchMe program will take into account your personal history and needs to ensure that you have the best possible chances of fighting your substance misuse disorder. Don’t let yourself or your loved ones become another statistic in this growing crisis — contact us today.
The human brain is only three pounds of gray and white matter, but it’s the most complicated organ in your body. It’s the center of everything you do and think. It operates your whole body — your every function, voluntary and involuntary. In short, your brain is you.
You’d need a whole new degree to completely understand how the brain works, but there are a few basics that will help you understand how drugs affect the function of the brain. The brain is structured roughly like a computer chip, with billions of interconnected cells called neurons. Neurons act as switches, sending and receiving electrical signals to each other and to the rest of the body.
These signals are triggered by neurotransmitters, specific chemicals that travel between neurons through gaps called synapses. Those neurotransmitters are a specific shape and fit into their receptors like a key into a lock.
Drugs interfere with the natural function of the brain in a number of ways. Some drugs, like marijuana and heroin, mimic the natural neurotransmitters that the brain produces, allowing them to fit in the neurons. Although chemically, these compounds are similar to the body’s natural neurotransmitters, they don’t interact with neurons in the same way.
Other substances, like amphetamine and cocaine, can cause neurons to release abnormally large amounts of certain neurotransmitters, interfering with normal communications in the brain. They can also prevent the normal recycling process — the means by which neurotransmitters are sent back to the cells they started in so they can be used again.
Depending on the area most affected, drugs can have drastically different effects and long-term consequences for the brain, including a lasting effect on life-sustaining functions.
The basal ganglia is the part of the brain associated with developing habits and routines. It’s the part of the brain that causes the subjective experience of pleasure associated with eating, socializing, and sex, and is thus often referred to as the brain’s “reward circuit.”
Drugs activate this circuit to a much greater degree than natural stimuli, causing extreme senses of pleasure — the problem is that over repeated exposure, the “reward circuit” starts to adapt to the drug. Eventually, it loses its sensitivity so much that natural stimuli don’t trigger it anymore, leading to a dependence on the drug to replicate those sensations.
The extended amygdala is the part of the brain that contributes to stressful feelings like anxiety, irritability, and unease. Normally, these features are useful in getting us out of bad situations — they’re sort of a defense mechanism for the mind.
The problem is that the extended amygdala also contributes to withdrawal symptoms when drug usage fades, prompting the user to seek out the drug again. This mechanism gets more sensitive over time — the “lows” get “lower” and the “highs” don’t get any “higher.” Eventually, the person with the substance misuse disorder starts to use the drug just to avoid the discomfort, not to get high.
The prefrontal cortex is the portion of the brain that affects rational decision-making. It powers thinking, planning, problem-solving, and self-control. This is also the last portion of the brain to mature as people get older, making it especially vulnerable in teens and young adults.
As the balance between the circuits for reward and stress in the basal ganglia and extended amygdala become disrupted by drug use, it also disrupts the prefrontal cortex, reducing their impulse control and causing them to seek the substance compulsively. This mechanism is the root of addiction.
Of course, some drugs also have further physiological effects that start in the brain — pupil dilation, elevated heart rate, increased energy, and effects on breathing and sleeping all trace their roots to various parts of the brain, which is what allows drugs to do so much physical damage and even cause death.
The high from drugs is complex and not well understood, but seems to be tied to an increase in the brain’s production of endorphins and other neurotransmitters. These chemicals do occur naturally in the brain in response to eating, music, sex, creative pursuits, social interaction, and other stimuli, but drugs can produce far greater amounts of these compounds.
It was once thought that dopamine itself — a neurotransmitter in the brain — caused euphoria and the experience of a “high” by itself, but that’s no longer thought to be the case. Current research now indicates that dopamine has more to do with causing us to repeat the activities we find pleasurable, building habits and reinforcement, than with the sensation of pleasure itself.
When the reward circuit in the basal ganglia is activated by a source of pleasure, a release of dopamine tells is that the experience was positive and should be sought out again. The more often this happens, the less we have to focus on remembering to seek out that experience — it becomes habitual.
Just as drugs produce an intense euphoria, or “high,” they also produce an unnaturally large surge of dopamine. This reinforces the association between the pleasure and the drug in a powerful way, making it more likely that the user will seek out the drug again and again to reproduce that euphoria.
These peaks in dopamine, as with any other source of dopamine, also become associated with the environment in which drug use occurs. Certain locations, people, smells, sights, and other impulses can trigger cravings in people to use drugs again, making new habits a vital part of any substance recovery plan.
The brain mechanism for natural rewards versus those that come from drugs isn’t really different — the same chemicals are released, the same areas of the brain are triggered. So why is cocaine, for example, so much more addictive than riding a bike?
Think of the difference like the difference between loud and soft noises. If your speakers only produce loud noises, eventually you’ll turn them down. If a soft noise then comes out of the speakers, you won’t hear it.
The problem with drugs isn’t the type of chemical reaction it produces in the brain, it’s the magnitude. When the brain experiences the massive spikes in pleasure and dopamine that drugs produce, it becomes less sensitive — turning down the volume, as it were, on its response to those compounds.
This is why a person who develops a substance misuse disorder starts to feel flat, unmotivated, and lifeless — the natural sources of pleasure and dopamine in their lives can no longer compete with the huge spikes that drugs afford them.
Luckily, the brain can be “re-tuned.” With a good recovery program and medication, the brain will re-calibrate to more natural levels of dopamine and pleasure to the point that it no longer requires drugs to sustain its function. If you or a loved one has a problem with substance misuse, it’s never too early — or too late — to seek help.