Search Results for: cognitive behavioral therapy

What Is Cognitive Behavioral Therapy?

CBT Triangle

What Is CBT?

What CBT is NOT

Cognitive behavioral therapy should not be confused with the following:

  • Psychoanalysis – This Freudian approach aims to get at the bottom of subconscious determinants of your actions/behavior.
  • Person-centered/ humanistic therapy – This approach involves a mostly-passive therapist that says little during sessions in an attempt to have you resolve your issues independently.

If you have recently started therapy or have been considering treatment for drug abuse, you’re likely to hear about cognitive behavioral therapy (CBT).

CBT is an approach to treatment that was originally developed to treat depression but has been expanded to improve symptoms of various mental health illnesses and issues including:

  • Addiction.
  • Anxiety.
  • Psychosis.
  • Trauma.

A major component of CBT is that thoughts, feelings and behaviors are connected in a way that one influences and is influenced by the others. For example, feelings are impacted by your thoughts and behaviors, and your feelings impact your thoughts and behaviors. This notion gives some level of power to the client to improve the unwanted facet by addressing the other two.

So, if you have feelings that you do not like, you can modify them by changing your thoughts and behaviors.



How Does CBT Aid in Addiction Recovery?

The goal of CBT is to increase your awareness of your thoughts, actions and the consequences of each. Through this process, you gain a better understanding of your motivations and the role of drug abuse in your life.

To learn more about your options for treatment that includes cognitive behavioral therapy, call 1-888-744-0069 and get on your way to a happy, healthy life today.

Cognitive Distortions

Many times, cognitive behavioral therapy will focus on studying your thought patterns to look for negative views of yourself, the world around you and your future. Chances are good that there will be flawed perceptions called cognitive distortions. These distortions are like a dark lens that changes the way you view the world. Some cognitive distortions include:

  • All-or-nothing thinking: Perceiving situations in absolute, black-and-white categories.
  • Overgeneralization: Viewing a recent, negative event as a never-ending pattern of defeat.
  • Mental filter: Dwelling only on the negatives.
  • Disqualifying the positive: Insisting that your positives don’t count because of some other force.
  • Jumping to conclusions: Assuming your thoughts, feelings or beliefs are true without any supporting evidence.

By changing your thoughts to become more positive, you can improve your feelings and behaviors.

Co-occurring Disorders

CBT will also prove helpful in identifying and treating comorbid mental health issues that often accompany addiction. Many people engage in addictive behaviors to escape or avoid emotional pain.

CBT can address those psychological issues directly to:

  • Reduce the underlying reasons for addiction.
  • Prevent future relapse.

What Should I Expect in CBT?

CBT helps clients learn skills that can be used in the present and interventions that can be applied to the future to reduce stress, improve behaviors and increase overall well-being.

CBT Works

Simply, CBT is a frequently used therapeutic style for addiction and mental illness because it works. In fact, CBT has been studied and tested over the years to prove its efficacy and value in a number of settings and for a number of presenting problems.

CBT will look very different depending on the therapist and the setting. A strong benefit of CBT is that it allows for incredible flexibility and freedom. Generally, your therapist will serve several functions during the course of your treatment:

  • Teacher. She will provide education regarding your symptoms, diagnosis and treatment. (Homework may be given to gather more information away from session.)
  • Teammate. As you work through the process, she will assist with your follow-through on planned interventions to achieve your goals.

A typical CBT session will last 45 minutes to an hour and will involve discussing irrational thoughts, negative behaviors, and stress of the last week. From there, your therapist will challenge your negative thinking and faulty beliefs while offering positive coping skills to employ when faced with challenges.

CBT helps clients learn skills that can be used in the present and interventions that can be applied to the future to reduce stress, improve behaviors and increase overall well-being.

Other CBT Techniques

Other interventions in CBT include:

  • Relaxation training for anxiety.
  • Assertiveness training to improve relationships.
  • Self-monitoring education to improve insight.
  • Cognitive restructuring to modify thinking patterns.

Finding Addiction Treatment that Includes CBT

If you are interested in starting cognitive behavioral therapy, you are in luck. Because of its strong reputation for being effective across a range of issues, mental health professionals trained in CBT are widely available. Chances are high that any outpatient individual, outpatient group, inpatient, residential treatment or rehabilitation program you would attend will be staffed with competent CBT therapists.

The best news is that CBT is very low-risk. The odds of something negative or harmful happening from attending a CBT session is minimal. The reward is a different matter.

If you are not convinced that addiction, depression, anxiety or other issues are negatively impacting your life, a CBT therapist can assess your situation and symptoms to see if you meet criteria for a mental health diagnosis. CBT therapists work with people looking to achieve more from life, as well as people with serious mental health and substance use issues.


Other Supplemental Therapies

Another major benefit of CBT is that it integrates aspects of other styles well while allowing clients to benefit from other services. Many CBT therapists utilize aspects of the following orientations into their sessions:

  • Motivational Interviewing – This style of therapy involves a certain method of questioning that is particularly helpful in addiction, and it fits easily with CBT.
  • Holistic Approach – A holistic approach will look at your overall well-being to find ways to improve your physical, emotional and spiritual health.
  • 12-Step Programs – Some differences of opinion exist between programs like AA and NA, but the similarities are enough to make these two interventions work well together. Many clients will attend regular meetings in conjunction with their CBT sessions.
  • Medication Management – When you work with a CBT therapist, they might recommend a psychiatric evaluation. You may be prescribed medication to help improve your symptoms. Many studies show that CBT and medication work better together than either alone.

The best type of treatment for your or a loved one will be tailored to your personal needs. Call 1-888-744-0069 to find a program that incorporates the types of care that you are looking for. Don’t put your physical and emotional health for another day.


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Group Therapy: Substance Abuse Treatment

Group Therapy
Along with individual therapy, family therapy, and medication management, group therapy is an indispensable element of effective substance abuse and mental health treatment. Group therapy is a broad term for any type of therapy aimed at creating symptom reduction and recovery in two or more people 1,2.

 

Group therapy is an option that can be as effective as individual sessions.

Group therapy will have a trained leader conducting the session 3. Unlike family therapy, the members in group therapy will not usually have a pre-existing relationship outside of sessions.

Group therapy sessions can be conducted in varied therapeutic settings and levels of care, including 1:

For someone committed to ending their drug use and beginning a period of recovery, group therapy is an option that can be as effective as individual sessions 3.


Advantages of Group Therapy

Group therapy has a number of advantageous elements that equal or surpass individual therapy, such as the ability to 3:

  • Offer members education about the recovery process.
  • Provide support and motivation from peers to maintain recovery goals.
  • Give members the opportunity to observe issues encountered by others in recovery and observe their methods of problem-solving.
  • Empower group members by encouraging them to offer assistance and feedback to other members.
  • Teach healthy coping skills to manage daily stressors without resorting to substance use.
  • Boost structure and routine in the lives of group members.
  • Build a sense of optimism, self-worth, and belief in the group members.
  • Develop relationships between group members that can be used outside of sessions for support and encouragement.
  • Effectively treat many individuals simultaneously with one therapist, allowing those clients quicker access to therapy.
  • Utilize therapeutic tools (such as challenging irrational beliefs and confronting poor decision-making) to modify behaviors.

Is Group Therapy Right for Me?

People interested in attending a therapy group will need to be matched up with a group that suits their individual needs. Before placing a recovering individual in a group, a provider will consider the individual’s 3:

  • Treatment preferences.
  • Unique needs.
  • Emotional stability.
  • Stage in recovery.

Some people will not be a fit for group therapy based on their current status. This therapeutic method may be inappropriate for those who 3:

  • Refuse group therapy as a viable treatment option.
  • Cannot maintain confidentiality and are at risk for breaking group rules.
  • Are currently in crisis with severe, unmanageable symptoms.
  • Struggle to build suitable relationships.
  • Experience extreme stress around other people and new situations.

Other groups, like women and adolescents, require special considerations when it comes to placement in a therapy group. Some evidence shows that women who participate in women-only groups may have better outcomes than those in groups with men 3. Also, there is some risk that adolescents in group therapy may actually encourage/reinforce substance use with each other 4. Leaders of adolescent groups must be aware of this risk and actively manage it 4.


Models of Group Therapy

If group therapy is recommended for you, there are 5 separate models of group sessions that you may encounter:

Various models of group therapy
  • Psychoeducational groups.
  • Skill development groups.
  • Cognitive behavioral therapy groups.
  • Support groups.
  • Interpersonal process groups.

With a knowledgeable and proficient treatment professional, any model can offer strong benefits; however, certain models may better fit your individual needs. Additionally, some therapy groups may take advantage of several models during the course of the meetings, meaning that they shift from one model to another.

Psychoeducational Groups

The primary focus of a psychoeducational group is to offer education and information regarding general themes of substance use, mental health, related behaviors, and the consequences of these behaviors. These groups might resemble a classroom setting, as the material will be presented through audio, video, or a lecture format 3.

Psychoeducational groups can be helpful for many situations as it teaches members 3:

  • To recognize the impact of substance use.
  • About their condition, the barriers to recovery, and how to live a drug-free life.
  • Beneficial skills like relaxation, meditation, healthy eating, and anger management.

Skill Development Groups

In skill development groups, the group leader will have a similar position as a teacher, but here, the material provided will be more specific to the group members and their individual needs. Skill development groups will depend more on the group interacting with each other rather than only the leader speaking to them 3.

The group sessions will focus on a skill that contributes to the members’ ability to remain abstinent from drugs. Potential group topics include 3:

  • Handling triggers to engage in substance use or related behaviors.
  • Positively interacting and communicating with others.
  • Identifying and modifying responses to anger.
  • Improving parenting skills.
  • Managing financial responsibilities.

Cognitive-Behavioral Therapy Groups

Cognitive-behavioral therapy (CBT) is a widely used evidence-based style of therapy that operates on the idea that negative behaviors are learned and reinforced over time. To change these behaviors, the individual must work to modify the thoughts, feelings, and behaviors that contribute to substance use 2. One example of a thought that may contribute to continued substance use is “I’m a bad person; I don’t deserve to be sober.” By modifying damaging thoughts and beliefs, the individual can accomplish the changes needed to sustain recovery.

To accomplish these changes, a CBT group will 3:

  • Identify the members’ distorted beliefs and problematic behaviors.
  • Teach and encourage the use of new thinking and behavior patterns.
  • Offer relapse prevention training.

Support Groups

As the name suggests, the principle focus of a support group is to offer care and understanding to all members of the group. This support will come from the group leader and from one member to the others. The leader will help members to improve their interpersonal skills as they engage in group discussion, share experiences, and help each other resolve their challenges 3.

The therapist will demonstrate the desired level of communication, model respectful interaction, and provide positive reinforcement for members 3.

Interpersonal Process Groups

Interpersonal process groups attempt to promote healing in members through an understanding of psychodynamics (the way individuals function psychologically). The group leader will note and process 3:

  • How each member is feeling and functioning in the group.
  • How the members are interacting with each other.
  • How the group is performing as a whole.

A focus will be on emotional development and childhood concerns that, when left unresolved, lead to poor decision-making, impulsivity, and unhealthy coping skills. By resolving these issues, the person can improve their judgment.

With interpersonal group therapy, the content covered in each group session is secondary. Rather, the leader looks to see how the group members are behaving and interacting in the present and how their present is being influenced by their past.

A Note on Self-Help Groups

12-step groups and other self-help groups are not considered group therapy. Although they occur in a group setting with people that did not have a preexisting relationship, they lack one key component of group therapy: a professional facilitator.

Group therapies employ various types of mental health professionals to lead the groups. Self-help groups may utilize peer leaders or have a collective approach. Self-help groups provide great assistance to people in recovery, but they are not a professional group therapy option 2.


Group Therapy Categories

Based on the way the group is conducted and who participates in it, different subtypes exist for each of the aforementioned group therapy models.

Fixed and Revolving Groups

Groups can either be fixed or revolving. A fixed membership group is one that begins and ends with the same members throughout. Once the group is initiated, new members are not usually added. These groups generally have less than 15 members and are appropriate for people that are at similar points in their recovery 3.

Revolving membership groups are named for their ability to change members at any time. When someone is appropriate for the group, they will join and then leave when the time is right. These groups will be run constantly with an ever-changing collection of members 3.

Time-Limited and Ongoing Groups

Fixed and revolving groups can be divided further into time-limited or ongoing groups 3:

  • Time-limited groups will ask members to attend for a specified length of time or number of sessions.
  • Ongoing groups will allow members to attend indefinitely based on their symptoms and overall progress.

Each type has strengths and weaknesses, and which one will be best will depend on the unique needs of the individual. All versions can be effective.


Stages of Group Therapy

Regardless of the model or category of the therapy group, it will progress through three general stages. They are 3:

Stages of group therapy
  • The beginning phasegetting started. In this phase, the members will become oriented to the process and learn the group rules and goals.
  • The middle phasewhere change is made. The middle phase should consume the majority of someone’s time in group therapy. Here, the therapist will use their skills to trigger changes in thought patterns and modify behaviors to move towards treatment goals. This is also where meaningful connections between members will be made.
  • The ending phasemoving to closure. Ideally, the relationships with leaders and members will not end abruptly. Any run of regular group therapy must come to an end at some point; however, this end point should be projected gradually to allow for adequate recognition of the accomplishments made over the course of therapy and for addressing any anxiety and/or sadness over the group coming to a close.

Group Leader Roles and Responsibilities

The qualifications and experience of those who lead therapy groups will vary somewhat. Examples of people that can lead groups include 5:

  • Social workers.
  • Psychologists.
  • Psychiatrists.
  • Licensed or certified substance abuse counselors.

Some terms like facilitator, therapist, or clinician are used generally and do not denote specific training or experience.

Leaders should have the following qualities to ensure an effective group 3:

  • The ability to maintain a consistent, safe, supportive environment to promote abstinence.
  • A strong sense of self to manage group members’ symptoms as well as the impact group sessions have on them personally.
  • The ability to listen actively and make the group members feel heard.
  • The use of empathy, the ability to understand what the client is experiencing.
  • The capacity for projecting self-assurance and expertise that provides a role model for members.
  • Creativity and flexibility to react to unexpected, unplanned situations as they present.
  • A strong sense of ethics that is maintained as challenging situations arise.
  • Trustworthiness that promotes openness between members and the therapist.
  • The ability to use humor and levity when appropriate to balance difficult moments.

Some groups will employ a team of therapists to better manage sessions. In substance abuse treatment, all leaders will work professionally to 3:

  • Link the connections between substance use and thoughts/feelings.
  • Limit conflict.
  • Boost motivation.
  • Build coping skills.

Group therapy is a preferred option in many situations for people in various stages of recovery. If you or someone you know could benefit from participating in a therapy group, call 1-888-744-0069 to begin the process and find treatment appropriate.


References:

  1. Substance Abuse and Mental Health Services Administration. (2016). Treatments for Substance Use Disorders.
  2. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.
  3. Substance Abuse and Mental Health Services Administration. (2015). Substance Abuse Treatment: Group Therapy – Quick Guide for Clinicians.
  4. National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide.
  5. Substance Abuse and Mental Health Services Administration. (2015). Behavioral Health Treatment and Services.

Eye Movement Desensitization and Reprocessing Therapy

EMDR-treatment-for-young-woman

What Is EMDR?

Eye movement desensitization and reprocessing (EMDR) is a therapeutic style originally developed to address stress, anxiety and depressive symptoms related to traumatic events and memories.

EMDR is used to treat posttraumatic stress disorder (PTSD) and has been shown to be effective in this area since its inception. In fact, depending on the level and complexity of trauma, EMDR is known to be effective in as little as one session. It is important to note, however, that there is still some debate among scholars and clinicians in regards to the validity EMDR research and its effectiveness.

There is hope in recovery. Call 1-888-744-0069 and find treatment now.

The world of psychotherapy is filled with talk therapies like cognitive-behavioral therapy (CBT), rational emotive behavior therapy (REBT), motivational interviewing (MI), person-centered therapy, reality therapy, acceptance and commitment therapy (ACT), and others. These all share the similarities of a having a dialogue between the therapist and the client, but EMDR differs from these. EMDR involves active physical participation on behalf of the patient, namely the purposeful direction of therapist-guided eye movements, in conjunction with therapist-patient dialogue.

EMDR believes that the problematic thoughts and behaviors occur because the traumatic life events were not appropriately processed when they occurred. This lack of processing leads to the events being stored as harmful memories that later disrupt cognitive, emotional, and social functioning.

The goal of EMDR is to reprocess these undesirable memories and experiences. A therapeutic style like CBT would be geared toward exposing the patient to the traumatic thoughts and feelings through imaginary scenes, or, perhaps, by re-confronting the traumatic situation (if possible). EMDR takes a different approach to working with these neurocognitive systems.

The idea behind EMDR is that reprocessing the memories allows them to be assimilated and accommodated in the brain. The act, called adaptive information processing, is at the core of EMDR. The eye movements are reported to aid in the way the information is accepted into the brain’s networks.


Video: EMDR

Credit: Michael Burns


Course of Treatment for EMDR

EMDR has a specific, formulaic approach to treatment based on an 8-phase approach. The therapist will lead the client through each of the phases at a pace that is appropriate for the client’s needs with some sessions accomplishing multiple phases and some phases requiring multiple sessions.

The 8 Phases of EMDR

Phase 1: History and planning. In this phase, the therapist will gather information related to the need for treatment. Current symptoms, past issues, triggers, and unwanted behaviors will be discussed to gain an understanding of the factors involved. An interesting facet of EMDR is that the information does not need to be exhaustive or detailed. At this point, the events can be vague and general as long as they yield targets for EMDR to address.

Phase 2: Preparation. Phase 1 may take a session or two, but phase 2 can take as many as four sessions. A major focus of this stage is building a trusting rapport between the client and the therapist. The relationship is needed so the client will have the comfort to express their feelings to the therapist later in treatment to ensure the best possible outcomes. Along with the trust building, the therapist will discuss the fundamentals of EMDR, the course of treatment, and needed relaxation techniques to use when emotional experiences arise.

Phase 3: Assessment. This phase involves looking at the established targets from phase one. The client will develop a mental picture of that traumatic event, a negative statement from the event, and a positive statement that is the goal belief. So, if the traumatic situation was a car accident, the picture might be broken glass in the car. The negative statement is “cars are dangerous.” The positive statement is “cars are safe most of the time.” Finally, in this phase, clients are asked to rate how strongly they hold these beliefs and their physical and emotional reactions to these ideas.

Phase 4: Desensitization. This phase marks the onset of the reprocessing. Here, the client is asked to become aware of disturbing images, thoughts, feelings, and physical sensations while the therapist utilizes stimulation in the form of instructing the client to shift their eye movements by following the therapist’s hand (though sounds and physical tapping can be used). The client reports the present elements in generalities, and the therapist continues to use the stimulation until the client reports lower ratings of distress.

Phase 5: Installation. Now that the negative image and statements are no longer provoking, the focus can turn towards the positive statement from phase 3. The new belief is given attention while the therapist continues to provide the stimulation in the form of the client’s eye movements, tapping, or sounds. The phase ends when the client reports having a full belief in the positive statement.

Phase 6: Body scan. This phase checks the efficacy of the previous two phases by asking the client to note any negative elements remaining from the target. If the target is unresolved, phase 4 will be restarted to yield the desired results.

Phase 7: Closure. The goal of EMDR is leaving the client feeling better than when she arrived. The therapist will lead the client through some of the relaxations and calming exercises previously learned. Additionally, the therapist will provide information on what the client may expect in between sessions regarding the continued processing of targets.

Phase 8: Reevaluation. The final phase actually occurs at the beginning of the next session. The therapist checks in to ensure that the results noted from the body scan continue. When all targets have been addressed and reevaluation shows no disturbing issues remaining, treatment will end.

The trauma-related use of EMDR can be applied to many situations including:

  • Sexual abuses like rape and molestation.
  • Physical injuries stemming from a range of accidents or intentional violence.
  • Emotional abuse in the form of conflictual relationships.
  • War-related trauma and post-traumatic stress.

It is important to remember that the traumatic events can be experienced directly or to someone close to you. If someone you love was in a dangerous or life-threatening situation, you can develop posttraumatic stress disorder, as well.


EMDR for Addiction

When the model of treatment was created in the late 1980s and early 1990s, EMDR was used exclusively for trauma. How does this fit with addiction treatment? Many people dealing with substance abuse, addiction, and dependence have problems related to trauma.

For some, past trauma is a contributor to addiction, as substance abuse can be a means of self-medication to block out or escape from the harmful memories.

For others, they have experienced trauma during their use. For example, an addict may have been sexually assaulted while under the influence. In such case, the substance use is likely to continue unless the trauma feeding the addiction can be addressed.

Over the years, people have worked to expand and modify EMDR to treat other issues. One such example is called the feeling-state addiction protocol (FSAP). This therapy style is based on the foundations of EMDR but applied to issues related to addiction and compulsion. With EMDR, there is the focus on the negative experience that creates trauma. In FSAP, the focus is on the intense positive experiences associated with destructive, compulsive behaviors that create and maintain addiction. EMDR tries to replace the negatives with positives.

FSAP tries to:

  • Break the connection between the positive feeling and the destructive behavior.
  • Process the negative beliefs associated with the compulsion.
Fusce vitae

FSAP is believed to be effective in the treatment of:

  • Behavioral addictions including gambling, sex, addictive overeating, compulsive shopping, and shoplifting.
  • Substance use disorders including addictions to alcohol, legal drugs like tobacco, prescription drugs, and illicit drugs.
  • Anger.
  • Co-dependent and abusive relationships.

EMDR Therapists

Reports state that over 100,000 EMDR therapists are available around the world with available databases to find ones near you. Therapists are able to receive a certification in EMDR that signifies their ability to accurately utilize the skills.

To get help finding a program that utilizes EMDR, call 1-888-744-0069 today.


Integrating EMDR

In the world of counseling for mental health concerns, EMDR stands out for its unique view of treatment and the methods of improvement.

EMDR is used as a standalone treatment in many situations, but it can also be used in combination with other therapeutic interventions. For example, if a client has issues with depression, addiction, and trauma, the clinician may choose to begin treatment by using EMDR to address the trauma in hopes that reprocessing this information will reduce the other symptoms. If the symptoms do not alleviate completely, the therapist may shift focus by bringing in other treatment options including:

  • CBT, which is used with good results for a range of symptoms related to depression and anxiety.
  • Motivational interviewing, which helps reduce ambivalence related addiction while fostering a greater sense of control in the client.
  • Medication management, which will help limit the symptoms of mental health disorders and reduce cravings associated with the addiction. Medication may not be appropriate during the phases of EMDR, though.

In the world of counseling for mental health concerns, EMDR stands out for its unique view of treatment and the methods of improvement. EMDR is not without its detractors, though, that claim the eye movement portion of EMDR is not essential. Regardless, EMDR has a foundation of evidence to support its role as a helpful method of therapy.


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Dialectical Behavior Therapy

man-in-therapy-getting-treatment-DBT

What is DBT?

Dialectical behavioral therapy (DBT) is a branch of psychotherapy that is rooted in the principles of cognitive-behavioral therapy (CBT) with several modifications and additions. The treatment style was developed originally to aid those with borderline personality disorders (BPD) but has found success treating conditions that are related to or independent from BPD including:

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  • Depressive disorders.
  • Bipolar disorder.
  • Posttraumatic stress disorder.
  • Anxiety disorders.
  • Eating disorders.
  • Substance use disorders.

Like CBT, DBT is a type of treatment that is studied and researched to demonstrate its efficacy in these types of situations. It is shown to be more effective than other types of treatment or no treatment at all.

History and Development

DBT was created in the late 1980s and early 1990s by Dr. Marsha Linehan. While working with clients that engaged in self-injury and had suicidal thoughts, she found the standard CBT principles to be limiting, as they maintained a constant emphasis on changing these behaviors. Because of this, she developed DBT to add validation/acceptance and dialectics (explained below) into the CBT frame.

The validation is added to balance the desire for change with acceptance on behalf of the therapist and client. Validation is not used to permit or encourage unwanted behaviors, only to offer an understanding of why the client would act in these ways.

The addition of dialectics expands on the notion of validation. Dialectics is the idea that:

  • Everything is connected.
  • Change is constant.
  • Opposing forces can be brought together to find balance. This is illustrated in the view that acceptance and taking action to change are unified opposites.

Video: What Is Dialectical Behavior Therapy?

The following video will provide a short but comprehensive overview of DBT – what it means, its goals, and what to expect.

Credit: UC San Francisco (UCSF)


Views and Beliefs 

DBT shares many views and beliefs with CBT, noting that unwanted thoughts and behaviors are learned and reinforced. DBT believes that the interaction between two factors increases the chances of persistent mental health issues:

  • Emotional vulnerability.
  • Invalidating environments.

Someone that is emotionally vulnerable will feel like their life is turbulent and extreme, and they will be quick to respond with strong emotional reactions. This vulnerability can be caused by traumatic events or from the individual’s natural disposition (i.e., genetics).

An invalidating environment is where someone is consistently made felt as though that their feelings are wrong or “bad.” A lack of kindness, respect, and acceptance can produce an invalidating environment.

DBT includes a level of optimism that is not found usually in CBT. DBT conveys that:

  • People are doing the best they can in their current situation.
  • They want situations to improve.
  • People are capable of learning new behaviors to change their lives.
  • The problems are not always the person’s fault, but it is their duty to resolve it.

Goals of DBT 

DBT includes 4 main goals of treatment for the client that are divided into stages.

The Four Main Goals of Treatment

Stage 1: Transitioning from out of control to in control.

This stage is focused on reducing reckless and dangerous behaviors (e.g., self-harming) while building skills that include increasing attention, improving relationships, understanding emotions, and managing distress.

Stage 2: Transitioning from emotional unavailability to emotional engagement.

People will shut down emotions that are too overwhelming to manage. The goal in stage 2 is to fully and accurately experience feelings without relying on avoidance or escape.

Stage 3: Building an ordinary life and solving ordinary problems.

During this stage, the client will focus on problems that are more common and expected. Rather than targeting extreme symptoms like chronic suicidality, the treatment will focus on the relationship conflicts, problems at work, life goals, and more mild mental health symptoms that most people experience.

Stage 4: Transitioning from feeling incomplete to feeling complete/connected. 

The previous stages were focused on reducing the unwanted symptoms, but the goal of the final stage is to allow the client to move towards happiness in the future. DBT believes that finding a sense of connection to the world facilitates this goal.

 


Methods of Change

In DBT, the therapist controls all aspects of treatment planning and movement. The therapist will establish and organize the components listed below. Beyond that, the therapist will direct other care including medication management, substance use treatment, case management, and vocational rehabilitation when needed.

To successfully accomplish the goals of treatment, DBT uses a specialized treatment approach. The approach is comprised of 4 parts with three involving the client and one focusing on the therapist. They are:

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  • DBT group therapy. A major focus of DBT is the use of a skills group where a client will meet with a group of other people that exhibit similar self-destructive symptoms. The skills group will appear like a schoolroom where the therapist will teach a particular topic or skill during the session and assign follow-up homework for the client to practice between sessions. These weekly groups generally last for 2.5 hours over 24 weeks. At times, the groups are broken into four six-week sessions that focus on one skill only.
  • DBT individual therapy. This individual treatment will address past and present client issues as they occur. In some cases, the individual therapist will be the group therapist, but it could be a different therapist depending on the treatment center. Individual therapy sessions will last for about an hour and occur weekly.
  • DBT phone coaching. The therapists will make themselves available to the client to assist with issues as they present during time away from treatment. Like with other treatment styles, it will not be the job of the therapist to instruct the client on what to do. Rather, the therapist will guide the client through options and available resources to improve decision-making.
  • DBT therapist consultation. DBT is an intense course of treatment for the client. The same intensity is present for the therapist as well. To ensure the best treatment is being prescribed and followed through, therapists attend consultation in group or individual settings. These act as a support system to the therapist to discuss their clients, their progress, and the therapists’ reactions. When the therapist is well supported, he can better care for the client. Other theoretical orientations recommend supervision, but DBT is one of a few that demand this focus on the therapist.


DBT Skills

As mentioned, DBT is focused on creating an effective environment for the client to learn and practice skills. The primary skills addressed in DBT are:

  • Mindfulness. This is the act of being completely aware and engaged in one’s current setting. People with mental health or substance use issues often spend increased time distracting themselves, thinking about the past, or worrying about the future. Mindfulness is the practice of being fully immersed in the here and now, with kindness and curiosity towards one’s current experience.
  • Distress tolerance. When people experience distress, there is an urge to reduce or change it immediately. Using a substance during periods of stress is an example of an unhealthy way to manage distress. Distress tolerance teaches how to accept and tolerate distress rather than escape from it.
  • Interpersonal effectiveness. When communication and conflict resolution skills are lacking, problems increase. DBT teaches people to learn how to have happier, more fulfilling relationships through effective interactions with others.
  • Emotional regulation. This is another example of dialectics. Distress tolerance moves towards acceptance while emotional regulation works to identify unwanted feelings and find ways to change them.

These skills are so effective that other styles of therapy have borrowed them and currently use them in a number of settings. People that are interested in DBT but cannot commit to the full treatment plan (including group and individual sessions) can still benefit from these skills.


DBT Effectiveness

DBT has been shown to help clients invest and remain engaged in sessions.

Even though DBT is relatively young in the world of psychology, it has become the standard treatment for borderline personality disorder (BPD). Over the years, its efficacy has spread to include treatment of many self-destructive behaviors like self-injury and substance abuse.

The treatment works to improve the client’s well-being even when he does not meet the criteria for a mental health diagnosis. DBT has been shown to help clients invest and remain engaged in sessions.

Another positive about DBT is that all of the support for the style is backed by scientific evidence. It does not base its accomplishments on anecdotal information collected over the years. Many of the findings related to DBT are available here.


Finding a DBT Therapist

Depending on your location, finding a therapist trained in DBT should not be difficult. Because of its reputation for success, even therapists that were trained before DBT existed have attended trainings on the subject. The institute named for the creator of DBT offers a DBT therapist directory to locate a therapist that completed their training.

If you have questions or need help finding a therapist or a rehab program, call 1-888-744-0069 to speak to someone who can help you find the right care for you or your loved one today.

Resources:

Family Therapy: A Vital Part of Addiction Treatment

couple in therapy

The effects of addiction aren’t limited to the addicted person, and the causes of substance abuse can be varied and complex – family issues can contribute to and perpetuate the illness of addiction. In fact, addiction is sometimes referred to as a “family disease.” Successful treatment, therefore, often incorporates the family of the person struggling with addiction.

Family therapy refers to a group of treatment styles that target the group rather than the individual within the group. All of the styles are based on the notion that families share a connection, and by modifying one component of the system, you can affect the other components. This means the health of a family can play a major role in the success of recovery.

Historically, someone in recovery for addiction would receive treatment independently, often removed from their home, community, and family, but there has been a recent shift towards a more integrated approach to treatment that not only focuses on the individual but their family environment as well.

Family therapy is an example of this kind of treatment. This approach has been shown to provide high benefits with low costs, and organizations including the National Institute on Drug Abuse and U.S. Department of Health and Human Services recommend family therapy be incorporated into any substance abuse treatment program.

Is It Time for Family Therapy?

It might be time for family therapy if:

  • Your family member continues to use substances despite your objections.
  • Your mental and physical health have been negatively impacted by the family member’s use.
  • You want to learn methods to improve your ability to respond appropriately to your family members use.
  • Your family member has not found success from other treatment approaches.
  • You’ve experienced family issues that you (or your loved one) believe have contributed to the addiction.

Many family members of people struggling with addiction feel they don’t need therapy because the addict is the one with the easily identifiable problem. An important consideration is that family therapy can be completed in combination with other treatments like:

  • Individual therapy.
  • Group therapy.
  • Medication management.
  • Residential rehabilitation programs.

There does not have to be a choice between family therapy or others.

It’s also important to understand that therapy can provide support for family members but also boost their loved one’s health and chances of recovery as well.

Since there is no set definition for “family,” family therapy might be appropriate even if you are not technically family. Significant others, friends, and coworkers may choose to attend this form of treatment.


Benefits of Family Therapy

Studies show that treatment approaches that involve the family have better engagement, higher rates of success, and increased aftercare participation.

You can expect many positives to result from the treatment. Benefits of family therapy include:

  • Assisting the substance user to gain awareness of their needs and behaviors.
  • Improving the mental and physical state of the entire family unit.
  • Permitting family members to gain self-care interventions to improve their own well-being.
  • Improving communication styles and relationship quality.
  • Helping families understand and avoid enabling behaviors.
  • Address codependent behavior that may be preventing recovery.
  • Learning and understanding the systems in place that support and deter substance use.
  • Preventing the substance use from spreading throughout the family or down through future generations.

Family therapy will aim to accomplish the above by emphasizing the strengths of the complete family and diminishing the influence of substance use for all members.

Generally, a therapist will engage the family in dialogues focused on developing problem-solving skills, motivation for change, and assigning accountability for all in the family.

Are There Any Risks?

Family therapy, like most other forms of treatment, have some level of risk. The risks of family therapy are very low and include:

  • One member of the family feeling attacked.
  • An escalation of anger and violence in a family member.
  • The substance user being triggered to continue or increase use.

Fortunately, the potential benefits far outweigh the dangers. It will be the job of the therapist to thoroughly screen and assess each member of the family before treatment can begin to ensure safety for all involved.


Types of Family Therapy Available 

couple in therapy

Family therapy for addiction has roots in many established theoretical orientations including:

  • Marriage and family therapy.
  • Strategic family therapy.
  • Cognitive behavioral therapy.
  • Couples therapy.
  • Solution-focused family therapy.

Because of the range of sources, family therapies for substance abuse will look and feel different based on the specific model the therapist is utilizing. Regardless of the style, the therapist will work with the family unit as a complete group, smaller subgroups, and with members individually to create a plan based on the family dynamics in place. Each program will incorporate the family at different levels.

Many specific interventions are suited for family therapy for substance abuse like:

  • Multidimensional family therapy (MDFT). This style is most appropriate for adolescents and includes individual and family sessions occurring in an office, the home, or the community. Individual sessions will work to improve decision-making skills, communication, and problem-solving. The family sessions will explore the active parenting style and ways to positively impact the substance use.
  • Family behavior therapy (FBT). This style has value for both teens and adults. Its broad approach targets the substance use as well as mental health issues including depression and defiance, family problems, employment, and financial concerns. Treatment focuses on building skills to improve home life and developing goals to end substance use while providing rewards for accomplishing these objectives.
  • Community and family approach (CRA). This approach expands past the family to include the community as well. Sessions completed once or twice weekly involve learning ways to improve communication in the family and build a wider support system. The family is instrumental in identifying and modifying their role in the substance abuse.

Find Help

If substance use has been negatively impacting your life and the life of your family members, it may be time to seek family therapy. By engaging in treatment focused on the family, you can make a difference in the life of the addict while improving your own well being.

Call 1-888-744-0069 for more information and treatment appropriate for you.


Sources:

Principles of Drug Addiction Treatment: A Research-Based Guide. (n.d.). Retrieved October 30, 2015, from https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/podat_1.pdf

Substance Abuse Treatment and Family Therapy. (2004). Retrieved October 30, 2015, from http://adaiclearinghouse.org/downloads/TIP-39-Substance-Abuse-Treatment-and-Family-Therapy-55.pdf

Miller, S., & Saitz, R. (2014). Principles of Addiction Medicine (5th ed.) (R. Ries & D. Fiellin, Eds.). Philadelphia: Wolters Kluwer Health.

Rational Emotive Behavior Therapy

young-woman-telling-personal-beliefs-to-therapist

What is REBT?

Rational emotive behavior therapy (REBT) is a psychological orientation created by Albert Ellis in the mid-1950s that puts the focus on thoughts and beliefs. Ellis created this orientation in response to the prevalent therapeutic types of the time. In the 1950s, psychological theory and therapy were dominated by psychoanalysis and behaviorism. Ellis began as a trained psychoanalyst but began to view the style as something that only addressed the surface of the client’s needs and could even make symptoms worse.

It’s never too late to start your journey to recovery. Call 1-888-744-0069 and get help today.

Psychoanalytical thought is based on the idea that people are driven by unconscious motivation for sex and power. Behaviorism is based on the idea that people are a product of their environment and will continue engaging in behaviors that are rewarded and reinforced.

Ellis thought these theories were incomplete because they did not attend to the thoughts of the individual. He believed that it was the patterns of thought that lead to the development and perpetuation of psychological issues like depression and anxiety. This concept became the central focus of his theoretical orientation, REBT.


The Importance of Beliefs

Ellis wanted to give more attention to the thought processes of people, but he took it a step further to focus on their beliefs. He saw a belief having two components:

  • The first is the thought, which is how someone subjectively views a situation.
  • The second is the emotional component, which is how someone feels about that thing.

Ellis recognized that people have many beliefs that guide their lives. He separated these beliefs into the categories of positive beliefs and negative beliefs:

  • Positive beliefs are ones that are accurate, valid, and factual.
  • Negative beliefs are usually inaccurate, invalid, and false.

Having more negative beliefs will make someone feel worse, and more positive beliefs will lead to increased happiness and a greater sense of well-being. Ellis wanted to find ways for people to develop more rational, emotive beliefs. This is where the name rational emotive behavioral therapy came from.

The 3 Basic Musts of REBT

During his work on beliefs, Ellis found that people had endless versions of irrational beliefs. Despite the differences, he found that the majority could be placed into three major categories based on their theme. These themes are sometimes referred to the three basic musts of REBT. They include:

The irrationally high expectation of oneself to be exceptional and perform at outstanding levels.

I MUST do the best. I MUST show people how good I am. Of course, people cannot be the best in all situations, so anytime they do not meet or surpass their expectations, they will be let down and disappointed. They will feel like failures.

The irrationally high expectation of others.

Here, someone believes that others must always treat them with kindness and fairness. If others do not meet this expectation, they will be labeled as trouble, flawed or no good.

The irrationally high expectation to always get what you want.

In a very self-centered way, this belief marks the demand for only what you want, when you want it. It feels like a tragedy to not get what is desired.


The ABC Model

The focus on beliefs is the center of REBT. REBT works with the notion that situations and events in life do not lead to the unwanted feelings or symptoms; rather, it is the individual’s beliefs about the event that lead to the consequence. Instead of saying, “This person made me use drugs,” REBT would focus on the belief, making statements like “This person offered me drugs, and I believed that they would solve my problems, so I used.” In REBT, that faulty belief in the middle is the problem, even more so than being offered to use a substance.

To illustrate this point, REBT uses the ABC model (sometimes called the ABC Theory of Personality or the ABCDE Model of Emotional Disturbance). In this theory:

  • A represents the activating event. This is the situation that triggers the start of the cycle. The activating event can be a person, place, thing, event, or thought. It can be from the past, in the present, or in the future.
  • B is the belief that you hold about activating event.
  • C is the consequence of the belief. It can be a thought, feeling, or behavior.

The Power of Beliefs

Consider the following examples of the ABC model, noting how differing beliefs can lead to a range of consequences — even when the activating event remains the same.

A – Your spouse comes home late.

B – You believe your spouse is a lying, cheating jerk.

C – You feel angry and irritable. You yell at your spouse and demand that they leave.

A – Your spouse comes home late.

B – You believe your spouse is a loving and caring person, and maybe they got caught up at work.

C – You feel happy to see them and ask if they had a nice day.

A – Your spouse comes home late.

B – You believe your spouse is weak, fragile, and easily hurt.

C – You feel worried and scared. You considered calling the police and local hospitals to find them.

This exercise could go on endlessly, which illustrates the power of beliefs. A range of consequences can stem from only one activating event since the belief filters the information and distorts it into something different. Looking at the examples above — it is easy to see which belief is the positive one and which are the negative ones.


Disputing Irrational Beliefs

In the ABC model, disputing irrational beliefs comprises the D. For there to be an improvement in symptoms and functioning, one must challenge his irrational beliefs. By doing this, the person will reduce the negative influence the thought pattern has on their life and, in turn, leave room for more rational thoughts to emerge.

Ellis understood that each person has some level of irrational beliefs, and that it was impossible to completely remove all irrational beliefs from the thought process. The goal of disputing beliefs is to reduce the major contributors to unwanted thoughts, feelings, and behaviors to result in lowered symptoms.

The process of disputing irrational beliefs is broken down into 3 steps. They are:

Fusce vitae

1. Detect. Before you can dispute an irrational belief, you have to recognize the presence of a belief. Along the way, you can gain an understanding of where it came from and the role it serves. The act is accomplished by being more aware of your thoughts and reactions to situations. Asking, “Why do I feel this way?” is a great starting point.

2. Debate. Once the belief has been identified, you can begin weighing the evidence for the belief being accurate or inaccurate. Defending both points of view can lead to a clarified perception of the situation.

3. Decide. The final step of the disputing process is to decide if your belief is rational or irrational. The best way to determine this will be to note the consequence of the belief. Many beliefs that lead to unwanted consequences are irrational.


What Should I Expect in REBT?

Many therapists integrate the focus on thoughts, feelings, and behaviors of cognitive therapy with the focus on irrational beliefs of REBT. This can result in a more thorough treatment that addresses more aspects of the individual.

Beginning treatment in REBT will be an easy process, but asking for REBT by name may lead to some confusion. During the same time Ellis was working on REBT, a person named Aaron Beck was creating his own brand of therapy called cognitive therapy. Over the years, the ideas of these two men began to merge because of their similar goals and views. Now, both of these therapeutic orientations exist under the umbrella term of cognitive-behavioral therapy (CBT).

Many therapists integrate the focus on thoughts, feelings, and behaviors of cognitive therapy with the focus on irrational beliefs of REBT. This can result in a more thorough treatment that addresses more aspects of the individual.

A session that involves REBT or CBT will last for about an hour with the therapist serving as an educator and a teammate interested in aiding your ability to accomplish your goals and lead a happier life. They will work with you to identify and dispute your irrational beliefs, since the process can be intimidating and overwhelming at times. Additionally, your therapist can suggest alternate ways of thinking that will aid in symptom relief.

The total course of treatment can be as short as a few sessions or as long as years depending on your needs. To find a treatment program that incorporates REBT or any other therapy type, call 1-888-744-0069 today.


How Does REBT Aid in Addiction Recovery?

If someone is facing recovery from addiction, REBT will inspect many of the beliefs that encouraged use in the beginning, maintained use through addiction, and are contributing to cravings or yearning for the substance in the present.

Also, REBT will impress the importance of acceptance in 3 forms:

  • Acceptance of self.
  • Acceptance of others.
  • Acceptance of the world.

REBT is a useful therapeutic tool because it works alongside other helpful interventions including:

  • Motivational interviewing.
  • Medication management.
  • 12-step programs.
  • Community treatment.

REBT is used to treat a host of physical and mental health issues as well as addictions. Best of all, REBT is a low-risk treatment style with a great deal of potential for positive gain. To find a program that incorporates REBT and/or other treatment types, call 1-888-744-0069 to speak to a treatment support specialist today.


Resources:

Naltrexone Effects

Woman sitting on bench thinking about taking Naltrexone for her addiction

Naltrexone is a drug used as part of medication-assisted treatment, or MAT, for those recovering from alcoholism or addiction to opioids (e.g., heroin, painkillers).

Naltrexone is an effective drug in addiction treatment, as its primary effect is blocking the euphoria associated with opioids and alcohol to discourage people from abusing these drugs for their pleasurable effects. Side effects of this drug may include nausea, vomiting, anxiety, and changes in mood.

Naltrexone is a prescription medication used to treat addiction to alcohol and opioids like heroin, morphine, oxycodone, and hydrocodone.1 Naltrexone is what’s known as an opioid antagonist and works by blocking the pleasurable effects of opioids and alcohol.3

Taking naltrexone can help reduce cravings for alcohol and opioids and will prevent a person from fully experiencing the pleasurable “high” should a relapse occur.2 Naltrexone is commonly taken as a tablet; however, a once-monthly injection (Vivitrol) is also available.2


How Is Naltrexone Used?

Medication-assisted treatment, or MAT, is a type of treatment for substance use disorders that combines prescription medications with counseling and behavioral therapy.3 Medications used in MAT are approved by the Food and Drug Administration (FDA) for the treatment of addiction. When used in conjunction with therapy, these medications can improve abstinence rates and reduce the chances of a relapse.

Will Naltrexone Cure Addiction?
Addiction is a complex illness that many struggle with their whole lives. Many addicted people require a comprehensive treatment approach that consists of prescription medications alongside counseling and therapy to help them maintain long-term abstinence from drugs and alcohol.

Naltrexone is one of several medications that can help opioid and alcohol addicts manage cravings and prevent relapse. It is most helpful when it is 1) combined with counseling, education, and support groups and 2) monitored closely by a trained medical professional.1 Naltrexone does not cure addiction but, when used as an adjunct to other approaches, it can help improve the chances of abstinence and long-term recovery.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the various medications used in MAT work by:3

  • Blocking the intoxicating effects of alcohol and opioids.
  • Restoring brain chemistry to normal levels.
  • Restoring the body’s normal functioning in absence of the abused drug.
  • Reducing cravings.

MAT has been shown to:3

The goal of naltrexone as part of MAT is to deter people in early recovery from relapsing on their drug of choice. Because naltrexone blocks the pleasurable effects associated with alcohol and opioids, it is an effective tool in reducing the compulsive drive of addicts in recovery to return to those drugs.

Naltrexone is administered as either a pill or an extended-release, injectable suspension:

  • The pill form of naltrexone may be prescribed for use at home or provided in a clinic. It may be prescribed as a 50 mg dose once daily, but when provided at a clinic or treatment center the regimen may vary somewhat.1,2
  • Vivitrol, an intramuscular injectable form of naltrexone, is given at a dose of 380 mg once per month. To help prevent an abruptly precipitated withdrawal, a person must abstain from opioids for 7-10 days before starting treatment with naltrexone.2

Medication like naltrexone should be offered in conjunction with behavioral therapies like cognitive behavioral therapy and contingency management.

Participation in peer-led recovery support groups like Alcoholics Anonymous and Narcotics Anonymous can be hepful. The ongoing support from similar peers can be key to long-term sobriety.


Who Should Take It?

Man looking down wondering if he should take Naltrexone for addiction

While naltrexone is recommended for the treatment of alcohol and opioid dependencies, it won’t be right for every recovering individual. Naltrexone is not recommended for anyone experiencing active liver failure or hepatitis.4 Naltrexone may also not be appropriate for people who are:4

  • Currently using illicit opioids.
  • Participating in methadone treatment.
  • Pregnant or breastfeeding.
  • Those with renal impairment.

Some prescription medications may negatively interact with naltrexone and may diminish its effects or cause additional side effects:3,4

  • Combining naltrexone with benzodiazepines like Valium and Xanax can have adverse effects and may even cause fatal reactions.
  • Taking high doses of naltrexone (200-250 mg per day) with nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen, can harm the liver.

It is important to discuss all medications you are taking with your doctor to prevent dangerous drug interactions. Naltrexone users should avoid drinking alcohol and using sedatives, tranquilizers, opioids, and all illicit drugs.2

Using opioids while taking naltrexone can be lethal. Here’s why: naltrexone blocks the euphoric effects of opioids, so when you take them while on naltrexone you won’t feel these effects (or you’ll feel them to a lesser degree). If you increase the dose to recreate the high you’re accustomed to, you can overdose and succumb to serious injury, coma, or death.

Naltrexone users are also likely to have lowered their tolerance to opioids during their course of treatment, which can increase the risk of an overdose should they take them again after stopping naltrexone.1

Medication-assisted treatments like naltrexone can have serious side effects so it is essential to speak openly with your medical provider about whether it’s the right option for you. Be honest about your medical and mental health history. This can include any:

  • Pre-existing medical conditions.
  • Current medications.
  • Past and current mental health issues.
  • Complete history of substance use.


Side Effects and Risks

Medication-assisted treatments can have short- and long-term side effects. Short-term side effects of naltrexone may include:1

In rare cases, naltrexone users may have serious side effects such as:1

  • Severe vomiting or diarrhea.
  • Blurry vision.
  • Extreme confusion.
  • Hallucinations.

  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Constipation.
  • Poor appetite.
  • Headache.
  • Dizziness.
  • Anxiety.
  • Agitation.
  • Depressed mood.
  • Changes in sleep.
  • Changing energy levels.
  • Muscle or joint pain.

For some users, naltrexone may cause:1,2

  • Liver damage. The risk of liver damage may increase with higher doses of naltrexone and for people with a history of hepatitis or liver disease.
  • Allergic pneumonia.
  • Infections or skin reactions. Users who take Vivitrol (the injectable form of the drug) may have reactions at the injection site that require medical evaluation.


Alternatives to Naltrexone for Opioid and Alcohol Addiction

Numerous treatment settings utilize medication-assisted treatment as part of their therapeutic approach.

Naltrexone is only one drug used in MAT. Other prescription drugs have also been shown to be effective in treating alcohol and opioid addiction.

Additional medications for opioid addiction include:3,5

  • Methadone—This full opioid agonist can lessen or prevent withdrawal symptoms and help opioid users manage cravings.6 It works by activating the opioid receptors in the brain but to a lesser extent than drugs like heroin and oxycodone. Methadone is only available in specially licensed clinics.
  • Buprenorphine—This partial opioid agonist can help manage acute withdrawal and decrease cravings for opioids.7 Suboxone combines buprenorphine with naloxone, an opioid antagonist that may cause a withdrawal reaction if the user attempts to abuse the drug by injecting it. Suboxone may be prescribed by physicians with a special certification.

Additional medications for alcohol addiction include:3,5

  • Acamprosate (Campral)—This drug can help reduce cravings for alcohol. The medication is available as a tablet that is taken 3 times a day.8
  • Disulfiram (Antabuse)—This once-a-day tablet causes unpleasant side effects if a person drinks even a small amount of alcohol. These effects may include nausea, vomiting, chest pains, headache, and difficulty breathing.9

Numerous treatment settings utilize medication-assisted treatment as part of their therapeutic approach. These include both inpatient and outpatient programs. If you’re interested in taking naltrexone, speak to a doctor or addiction treatment professional about whether the medication would be a good fit for you.


References:

  1. U.S. National Library of Medicine. (2009). MedlinePlus, Naltrexone.
  2. Substance Abuse and Mental Health Services Administration. (2016). Naltrexone.
  3. Substance Abuse and Mental Health Services Administration. (2015). Medication and counseling treatment.
  4. Center for Substance Abuse Treatment. (2009). Incorporating alcohol pharmacotherapies into medical practice. HHS Publication No. (SMA) 09-4380. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  5. National Institute on Drug Abuse. (2014). Principles of adolescent substance use disorder treatment: A research-based guide.
  6. U.S. National Library of Medicine. (2017). MedlinePlus, Methadone.
  7. U.S. National Library of Medicine. (2017). MedlinePlus, Buprenorphine sublingual and buccal (opioid dependence).
  8. U.S. National Library of Medicine. (2016). MedlinePlus, Acamprosate.
  9. U.S. National Library of Medicine. (2012). MedlinePlus, Disulfiram.

When Drinking Becomes Alcoholism

Man looking intently at bottle of alcohol, struggling with alcoholism

Worldwide alcohol use and abuse statistics are staggering. The single highest risk factor for premature death and disability for individuals between 15 and 49 years old across the world is alcohol abuse.1 In the United States, 1 in 10 children live with a parent who has a drinking problem, and over 15 million adults abuse alcohol or suffer from alcoholism.2,3

Binge and problem drinking can easily progress to an alcohol use disorder (AUD),4 commonly referred to as alcoholism. The fine line between casual alcohol consumption, problem drinking, alcohol dependence, and alcoholism can be hard to assess and, in many cases, one can worsen to the next without the drinker even noticing.

If you or someone you love are struggling to control drinking, or showing signs of alcoholism, contact us today at 1-888-744-0069 for expert support in selecting the best alcoholism treatment options available.


Casual Drinking or Problem Drinking?

Man sitting on floor holding alcohol bottle with other empty bottles

Data show that many Americans regularly drink alcohol. According to results from nationwide surveys of 70,000 randomly selected individuals (age 12+) in 2005 and 2012, in both years approximately 56% report drinking in the past month.5 Just as the overall number of people who drink has held steady in the last decade or so, there continues to be a significant percentage of people already experiencing problem drinking, alcohol abuse, and dependence.5

While many people consume alcohol in moderation, binge drinking is common and raises the risk that the drinker will eventually become dependent on alcohol.15

One definition of binge drinking is having 5 or more drinks on the same occasion (4 drinks for women) on at least 1 day in the past month. Binge drinking 5 or more times in a month constitutes heavy alcohol use.6

In 2015, of the approximately 138 million Americans (age 12+) who drink alcohol, over 66 million (24%) report binge drinking and more than 17 million (6%) report heavy alcohol use.5 The rates of women binge drinking over the past decade has escalated enormously, increasing more than 17% in contrast to less than 5% for men.7

How can you tell if you are drinking normally or if you have progressed to problem drinking?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines state that low-risk drinking is consuming a maximum of:

  • 3 drinks in a single day and 7 drinks in a week (for women).
  • 4 drinks in a single day and 14 drinks in a week (for men).

If your drinking habits easily fall within these limits, you are likely not a problem drinker; only about 2 in 100 people who drink within these limits will become alcoholics at some point.8 If you’re drinking beyond these limits, you may have progressed to problem drinking.

Getting Drunk on a Regular Basis? You May Need Help.

Alcohol takes a major toll on the body when consumed in excess. As the amount of alcohol in your blood stream increases, alcohol intoxication results, with higher levels of impairment related to higher blood alcohol concentration (BAC). If you’re drinking more than the amount defined by the NIAAA as ‘low-risk’ and experiencing the following signs of intoxication on a regular basis, you’re likely to experience a host of health problems and may have an issue with drinking:

  • Impaired judgment.
  • Risk taking.
  • Vision problems.
  • Reduced coordination and memory.
  • Slurred speech.
  • Inappropriate behavior.
  • Impaired sexual functioning.
  • Blackouts.
The CAGE Screening Tool

Identifying the signs of alcoholism can be difficult when drinking is so normalized in our society. An easy-to-use evidence-based screening tool that physicians access called CAGE is a good place to start.

Using CAGE—which is an acronym for Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers—is as simple as asking yourself 4 questions.

Have you ever:

  1. felt the need to cut down your drinking?
  2. felt annoyed by criticism of your drinking?
  3. had guilty feelings about drinking?
  4. taken a morning eye opener?

Used for over 25 years to help screen for alcoholism, the CAGE questionnaire is deceptively simple but accurate. If you answer yes to 2 to 3 of the 4 questions, there is a high likelihood you have a problem with alcohol; a score of 4 is “virtually diagnostic for alcoholism”.9

It is important to note, however, that the CAGE assessment serves as a screening tool rather than as a method to provide an official diagnosis—scores between 2 and 4 will indicate the need for further evaluation. If you suspect you have a problem, speak to your doctor or an addiction specialist with whom you can discuss in depth your drinking patterns and related behaviors.


Alcoholism Defined

Alcoholism, like other addictions, is a chronic, recurring condition that is “…characterized by an inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response”.10

The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-V) outlines a cluster of symptoms as the criteria used to diagnosis someone with an alcohol use disorder. These symptoms, while varying, all indicate a negative effect on:

  • Your health.
  • Your daily life/personal obligations.
  • Your capacity to function as normal.
  • Your ability to positively engage with friends, family and work colleagues.

Specific Signs of an Alcohol Use Disorder

The spectrum of AUD can range from mild to severe based largely on the number and severity of symptoms experienced. These include:11

  • Cravings for alcohol.
  • Consistently drinking more than intended.
  • Excess time spent drinking and obtaining alcohol.
  • Increased time recovering from alcohol use.
  • Continuing to drink alcohol despite interpersonal, physical, and work-related problems.
  • Drinking alcohol in risky situations such as driving or using dangerous machinery.
  • Drinking more alcohol to feel the same effect (developing tolerance).
  • Experiencing withdrawal symptoms when not drinking.


How Does Drinking Progress to Alcoholism?

The transition from alcohol use to alcoholism is a complex one that has a lot to do with changes that occur in the brain as the disease progresses. While these changes are complicated and continue to be studied, the main point to understand is that drinking produces reinforcing effects in the brain that contribute to abuse and eventually to alcohol dependence and addiction.12

Reinforcement refers to the strengthening of a behavior based on previous experience. So, if you drink alcohol and enjoy the feeling, you’re likely to want to repeat it.12 The more and longer you consume alcohol, the harder it is to make the choice not to drink.13

The more and longer you consume alcohol, the harder it is to make the choice not to drink.

When you repeatedly drink to excess, your brain and body begin to adapt in such a way that it needs alcohol to feel “normal.” This is referred to as dependence, 12 (a condition in which your body must have alcohol to function and goes into withdrawal when it doesn’t have it).

An alcohol-dependent person will tend to keep drinking based on both positive reinforcing effects (the pleasurable feeling of being drunk) and negative reinforcing effects (the avoidance of the discomfort that comes with withdrawal). Alcohol dependence and continued drinking to prevent or alleviate  the medically dangerous withdrawal syndrome are indications that an AUD is either present or developing.

The path to alcoholism also involves increasing tolerance, a situation in which the drinker needs a constantly increasing number of drinks to get drunk. The more you up your drinks, the more likely you are not only to develop a problem with alcohol but also to experience alcohol poisoning (which can be fatal).

Overall, the inability to stop or cut down your alcohol use despite negative consequences suggests you meet the criteria for alcoholism.14


How Do I Get Help for Alcoholism?

Doctor talking to patient about alcohol detoxification treatment

Help for alcoholism is available and treatment works. While various treatment options exist, the stages of alcoholism treatment often include some combination of the following:

  1. Detoxification—Medically managing the withdrawal process that occurs when your body reacts to no longer having a high blood alcohol concentration is extremely important. As outlined above, severe alcoholics can experience severe complications—such as seizures, agitation, and delirium tremens—in association with acute alcohol withdrawal and need expert medical oversight during this process.
  2. Use of medications—As part of the detoxification process, to help with unpleasant symptoms after detox and to further discourage relapse, a number of medications may be used, including select benzodiazepines (e.g., chlordiazepoxide, diazepam), acamprosate (Campral), naltrexone, and disulfiram (Antabuse). Which medication or combination of medications is used depends on the assessment of your addiction and factors such as physical health, risk of complicated withdrawal, strength of family and other sources of supports, and the potential for relapse.
  3. Inpatient treatment—There are numerous inpatient and residential treatment centers that provide structured 30-90 day programs with 24/7 supervision and access to medical and mental health care services (including medication management). Throughout, patients will participate in numerous behavioral therapy sessions and other recovery support services. These programs are great options if you are suffering from a severe addiction and lack support at home, or if your home environment is particularly triggering. When you’re getting help at an inpatient center, you can focus completely on your recovery in a substance-free environment.
  4. Outpatient treatment—This type of treatment takes many forms and provides more flexible scheduling options if your AUD has not become sufficiently severe to require 24-hour inpatient care. Like inpatient treatment, evidence-based addiction services are provided through outpatient treatment for 90 or more days, but on a daily or weekly basis instead of 24-hour care. This may be a good option for you if you are unable to leave work and/or family for an extended period of time to engage in an inpatient program.
  5. Behavioral therapy—A key component of alcohol addiction treatment is individual and group therapy. Once the physical dependence to alcohol is addressed, gaining an understanding of the underlying psychological causes of your alcohol addiction becomes paramount.  There are a number of different evidence-based therapeutic approaches that have been shown to help improve treatment outcome. Three successful, widely-used approaches are cognitive behavioral therapy (CBT), motivational interviewing (MI) and contingency management.
  6. 12-step groupsAlcoholics Anonymous (AA) is a mutual help and support group that provides fellowship and strategies for avoiding relapse, maintaining sobriety, and pursuing a fulfilling abstinence based life. AA meetings are held multiple times a day around the world and are free.  These groups are often incorporated into residential and outpatient treatment programs.
  7. Aftercare—Abruptly ending all treatment may lead you back into drinking, which is why sustaining your recovery efforts through aftercare is so important. Through sustained engagement in individual and group therapy, skills training, wellness programs (such as mindfulness training, yoga, and meditation), support group meetings, and relapse prevention training, long-term recovery can become a reality.

According to the National Institute on Drug Abuse (NIDA), actively choosing treatment (more than which specific treatment type you choose) is a strong predictor of success in staying sober, but you need to understand your options to make an informed decision and move forward with confidence. Trying to figure out the best next step can be overwhelming. For support in selecting the best alcoholism treatment option for you or your loved one, contact one of our rehab placement specialists today at 1-888-744-0069.


Sources:

  1. Lim, S.S.,Vos, T., & Flaxman, A.D. et al. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859), 2224–2260.
  2. Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality (2015). National Survey on Drug Use and Health (NSDUH). Table 5.6A—Substance Use Disorder in Past Year among Persons Aged 18 or Older, by Demographic Characteristics: Numbers in Thousands, 2014 and 2015.
  3. Substance Abuse and Mental Health Services Administration (SAMHSA). (2012). Data Spotlight: More than 7 Million Children Live with a Parent with Alcohol Problems.
  4. National Institutes of Health (NIH) National Institute on Alcohol Abuse and Alcoholism. (2016). Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5NIH.
  5. Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). National Survey on Drug Use and Health (NSDUH).
  6. Center for Disease Control and Prevention (CDC). (2012) Vital signs: binge drinking prevalence, frequency, and intensity among adults – United States, 2010. MMWR More Mortal Wkly Rep. 61(1), 14-9.
  7. Dwyer-Lindgren, L., Flaxman, A., Ng, M.,Hansen, G., Murray, C, Mokdad, A, (2015). Drinking Patterns in US Counties From 2002 to 2012. American Journal of Public Health 105, no. 6,1120-1127.
  8. National Institutes of Health (NIH) National Institute on Alcohol Abuse and Alcoholism, Drinking Levels Defined (2017).
  9. O’Brien, C.P., (2008). The CAGE Questionnaire for Detection of Alcoholism. JAMA. 2008;300(17):2054-2056.
  10. American Society of Addiction Medicine (ASAM). (2011). Quality of Practice: Public Policy Statement: Definition of Addiction.
  11. American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  12. Gilpin, N., Koob, G., (2008). Neurobiology of Alcohol Dependence. Focus on Motivational Mechanisms. National Institute of Health (NIH) National Institute on Alcohol Abuse and Alcoholism, Volume 31 (no. 3).
  13. Wrase, J., Makris, N., & Braus, D.F. et al. (2008). Amygdala Volume Associated with Alcohol Abuse Relapse and Craving. American Journal of Psychiatry 165(9),1179–1184.
  14. National Institute of Health (NIH) National Institute on Alcohol Abuse and Alcoholism. (2005). Helping Patients Who Drink Too Much: A Clinician’s Guide, Updated 2005.
  15. Robin, R. W., Long, J. C., Rasmussen, J. K., Albaugh, B., & Goldman, D. (1998). Relationship of binge drinking to alcohol dependence, other psychiatric disorders, and behavioral problems in and American Indian tribe. Alcoholism: Clinical and Experimental Research, 22(2). 518-523.

How to Help a Desoxyn Addict

man holding pill bottle
Desoxyn is a drug prescribed to treat attention-deficit/hyperactivity disorder (ADHD) and, more rarely, as an emergent intervention for cases of intractable obesity. As a stimulant medication, it increases energy, alertness, and wakefulness 1,2.

You may be surprised to learn that Desoxyn is actually methamphetamine. It is the only remaining marketed pharmaceutical containing methamphetamine 1.

Stimulant abuse is a major problem in the U.S. More than 1.6 million people in the U.S. admitted to using stimulants, like methamphetamine, in the last month 4.


How Can I Get Someone I Love to Accept Help?

If you worry that someone close to you is one of the 1.6 million people abusing a stimulant, proceed compassionately but carefully. You are unlikely to help if you are overly confrontational or react strongly without a plan.

Learn About Stimulant Abuse

People abusing Desoxyn may refer to it in street terms like 1:

  • Meth.
  • Crank.
  • Speed.

You will fare better in attempting to positively approach a loved one if you do so from an educated standpoint.

You can explore information related to Desoxyn abuse and stimulant abuse, in general, to gain a better understanding of the larger issue and how your loved one is affected. First, note that your loved one may also be abusing methamphetamine that is illicitly manufactured, which may produce more intense and unpredictable effects than Desoxyn itself 4. They may also use other prescription stimulants, such as Adderall, or illicit drugs like cocaine in place of Desoxyn when it is not available, and thus give rise to additional symptoms. For more information on symptoms you might come across, see our Stimulants Abuse page.

You’ll also need to understand a general picture of substance abuse and addiction so that you have appropriate expectations. If you expect your loved one to quit immediately because you ask them to, you likely will be disappointed. Drug abuse can change the brain of the user over time, impair self-control, and make quitting without help an extremely challenging prospect 5.

Practice communication. Now is the time to approach your loved one. To do so, come from a position of love, support, and encouragement to increase your chances of success. Be aware that your loved one may not be honest with you because of the shame, fear, anger, and denial associated with their drug use.

During your communication 6:

  • Stay calm and patient. Being angry or judgmental will lead to defensiveness from your loved one.
  • Ask many questions to help elicit your loved one’s own feelings about their substance use.
  • Establish your role as an aid and teammate to encourage honesty.
  • Remind your loved one that you care about them a great deal and emphasize their strengths and positive traits.
  • Consistently state your view that professional treatment is needed to manage substance abuse.
  • Discuss what you want them to do, how you are willing to help, and what limits will be set if they choose not to get help.
Establish your role as an aid and teammate to encourage honesty.

If you need help communicating with your loved one in a positive way, there are avenues you can take to learn the skills to help motivate your loved one to find treatment while also getting support for yourself. These include:

  • Community reinforcement and family training—Specialized training that helps loved ones to identify issues that contribute to substance use, learn to communicate effectively, and learn to take care of themselves 7.
  • Family therapy—Therapy that involves close loved ones to heal the whole family unit and increase the chances of sustained recovery.
  • Support groups for loved ones of addicts (e.g., Al-Anon)—A supportive environment of people who have similar struggles in watching a loved one fight addiction.
Should I Try an Intervention?

People wanting to get their loved one into treatment often consider interventions as a way of doing so. A formal intervention is a planned meeting between the person engaging in substance use and the important people in their life. During this meeting, the loved ones will state how they have been negatively impacted by Desoxyn abuse and what they intend to do if use continues 5.

Strong emotions like anger and hostility may emerge due to the confrontational nature of the meeting 5. The National Institute on Drug Abuse (NIDA) advises avoiding confrontational interventions like those you see on TV, in favor of steps like incentivizing your loved one to see a doctor about treatment. However, when the stakes are high and serious injury or death is likely to result, an intervention may be your best option.

To lessen the possibility that these negative emotions will arise and deter the meeting, you may wish to utilize the services of a professional interventionist. They can help you plan the event and ensure that communication stays on track for the best possible outcome.


What Can I Expect in Desoxyn Abuse Treatment?

The most intense use of Desoxyn could require inpatient detoxification services to manage symptoms of withdrawal, which can include 8:

  • Extreme depression with potential for suicidality.
  • Anger and aggression with risk for violence.

When the drug has been cleared from the body, the focus moves from managing withdrawal to treating the issues behind the addiction. Therapeutic approaches may include one or more of the following 8,9,10:

  • Cognitive behavioral therapy (CBT)—A therapeutic style that links connections between thoughts, feelings, and behaviors to understand and prevent substance use.
  • Motivational interviewing (MI)—An approach that builds the addict’s desire to change and commit to actions that match their goals.
  • Contingency management (CM)—A treatment style that rewards and reinforces many behaviors related to recovery to build a strong association between abstaining from drugs and positive feelings.
people in group therapy session

The Matrix Model is a treatment designed exclusively for people abusing stimulants like methamphetamine, with encouraging rates of success. With the goal of building self-esteem and dignity, this model utilizes techniques from other treatments including elements of 10:

  • Relapse prevention.
  • Individual therapy.
  • Family therapy.
  • Education.
  • Drug tests.
  • Self-help groups.

Is Desoxyn Addictive?

Yes. Desoxyn is essentially methamphetamine, which is notoriously addictive. The drug’s abuse potential is well known, yet with its recognized, albeit limited therapeutic uses, the medication is classified as a Schedule II controlled substance.

Desoxyn is essentially methamphetamine, which is notoriously addictive.

Desoxyn’s addictive potential is linked to the drug’s effect on the brain. When consumed, Desoxyn and other stimulants trigger an increased release of neurotransmitters, including dopamine. The release of excess dopamine creates rewarding feelings that over time prompt the user to prioritize drug use over other activities, even as negative consequences mount 1,2,3.

What Are the Signs of Addiction?

According to the Substance Abuse and Mental Health Services Administration, in 2014, of the 1.6 million that admitted to previous month stimulant abuse, about 570,000 were abusing methamphetamine.

If you’re worried about someone you love, first check for signs of Desoxyn intoxication. These typically include 1,8:

  • Increased energy.
  • Increased alertness.
  • Decreased appetite.
  • Euphoria.
  • Higher body temperature.

As use increases due to tolerance, people may show additional signs of abuse like 1,8:

  • Irritability.
  • Aggression.
  • Anxiety and panic.
  • Paranoia.
  • Excessive weight loss.

The person may show new or worsening signs of mental health disorders like manic symptoms associated with bipolar disorder, depression, and psychosis 8.

Am I Addicted to Desoxyn?

Acknowledging your addiction to Desoxyn can be much more complex than seeing a problem in another person, especially if you are prescribed the medication. However, certain signs can help you determine whether you have a problem.

You may be addicted to Desoxyn if you 5:

  • Take more of the substance than prescribed or in ways other than intended.
  • Have made unsuccessful attempts to end use.
  • Spend a lot of time, energy, and money trying to acquire and use Desoxyn.
  • Experience more conflict with people in your life because of your use.
  • Struggle to complete your responsibilities at home or work.
  • Do not feel well if you miss a dose or are without the drug.


Call Our Hotline Today

If you or someone you know needs help, it is time to take action. Addiction to methamphetamine can have severe and even fatal consequences. Call 1-888-744-0069 today.


References:

  1. Drug Enforcement Administration. (2013). Methamphetamine.
  2. National Institute on Drug Abuse. (2014). Research Report Series: Prescription Drug Abuse.
  3. National Institute on Drug Abuse for Teens. (2016). Prescription Stimulant Medications (Amphetamines).
  4. Substance Abuse and Mental Health Services Administration. (2015). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
  5. National Institute on Drug Abuse. (2016). What to Do If Your Adult Friend or Loved One Has a Problem with Drugs.
  6. National Institute on Drug Abuse. (2015). Family Checkup: Positive Parenting Prevents Drug Abuse.
  7. Scruggs, S.M., Meyer, R, Kayo, R. (2014). Community Reinforcement and Family Training Support and Prevention.
  8. Substance Abuse and Mental Health Services Administration. (1999). Treatment for Stimulant Use Disorders: Quick Guide for Clinicians.
  9. National Institute on Drug Abuse. (2016). Drug Facts: Treatment Approaches for Drug Addiction.
  10. National Institute on Drug Abuse. (2012). Principles of Drug AddictionTreatment: A Research-Based Guide.

Cocaine Relapse

silhouette of man tired with his hands on his knees

According to the 2014 National Survey on Drug Use and Health (NSDUH), approximately 913,000 Americans met the criteria for cocaine addiction as outlined by the Diagnostic and Statistical Manual of Mental Disorders within the 12 months prior to the survey 1. Cocaine is a psychostimulant with powerful effects on the brain’s limbic system, creating feelings of reward, pleasure, and motivation in users. Because cocaine is highly addictive, many people relapse due to strong cravings and uncomfortable withdrawal symptoms 2.


What Is a Relapse?

Relapse is defined in its broadest terms as suffering deterioration after experiencing improvement. In terms of drug addiction, a drug relapse refers to returning to drug use after a period of abstinence or sobriety. It is important to understand that relapsing does not mean that a person failed at recovery. On the contrary, many schools of thought consider relapse to be a part of the recovery process 3.

Relapse rates for cocaine addiction and other drugs are similar to those for chronic diseases such as asthma, diabetes, and hypertension. Like these diseases, addiction is chronic in nature and is often recurring. This means that relapse is not only possible but likely for most people completing drug addiction treatment. For this reason, substance abuse treatment is usually a continuous process. Relapsing doesn’t mean that treatment didn’t work; rather, it means that treatment may need to be reinstated 4.


Learn more about living a life in recovery. Discover how to find treatment.


Why Do People Relapse on Cocaine?

Cocaine relapse statistics indicate that relapsing on cocaine is relatively common. According to research, approximately 24% of people relapse back to weekly cocaine use within a year following treatment. Another 18% of people end up returning for treatment following a relapse. Cocaine relapse rates are typically higher among those with more severe addictive problems and those who attend addiction treatment for shorter periods of time 5.

Stress Risk
There are many reasons why a person may experience a cocaine relapse. Stress plays a large role in addiction relapse and may initiate cravings for the drug. As stress can increase the frequency with which cravings arise, a person may be more likely to give in to cravings, especially if they are not actively using other coping skills 6.

Terence T. Gorski doesn’t see relapse as a single event but rather a progressive process that is akin to knocking over one domino and experiencing the ripple effects that it creates until the last domino falls.

In this scenario, a person feels their only choice is to relapse and use drugs to cope. The first domino may be something as simple as a single stressful event or a mistake that leads to more stressors or poor choices, which ultimately leads to cocaine relapse 3.


Cocaine Relapse Warning Signs

Fortunately, there are many warning signs that typically occur during the relapse process. Those completing addiction treatment should be aware of the warning signs of cocaine relapse to help prevent one from occurring. Some of the most common warning signs include 3,5,7:

  • Not following up with aftercare programs (counseling, support groups, 12-step programs).
  • Feeling overly stressed and not dealing with it effectively (using healthy coping skills learned in treatment).
  • Experiencing an increase in drug cravings.
  • Engaging in other compulsive behaviors such as gambling, overeating, overworking, and over exercising.
  • Spending time with drug-using friends or going to places or events where you once used.
  • Feeling a lack of support from your family and friends in your desire to stay sober.
  • Return to addictive thinking and negative thoughts.
  • Bottling up emotions and isolating oneself from others.
  • Having a poor self-care routine (not eating healthy, sleeping well, or taking care of oneself).
  • Glamorizing past use and minimizing the reality of negative consequences.
  • Lying to others or engaging in secretive behavior.
  • Planning a relapse or looking for a relapse opportunity.

What to Do When You Relapse on Cocaine

Cocaine relapse is not the end of the line. Should a relapse occur, people shouldn’t react as if they’ve been given a green light for unbridled cocaine use. Rather, relapse is a stumbling block to longer-term recovery and should signal to the individual that some changes need to be made—renewed engagement with various treatment outlets can get someone immediately back on track. Diligent aftercare program participation following cocaine addiction treatment can make a big difference for someone struggling with fears of relapse, and can help that individual create a plan of action for what to do in the event of an actual relapse.

close up of a couple sitting and holding hands concerned after a relapse

If you have recently relapsed on cocaine, do not give up. Here are some steps you can take to get back on track toward long-term recovery 3,7:

  • Don’t beat yourself up. Practice forgiveness and compassion.
  • Monitor yourself for negative or extreme thinking. Remember the unhealthy thinking styles you likely learned about in cognitive behavioral therapy, and try to keep your thoughts realistic and positive.
  • Do not engage in all-or-nothing thinking that tells you because you relapsed once you have already failed and might as well keep using. Just because you had a relapse does not mean that you have to keep using.
  • Remind yourself of the reasons you quit using in the first place (the negative consequences of your drug use).
  • Reach out to a supportive person such as an addiction sponsor, a trusted friend, or a family member.
  • Attend a 12-step meeting or other related support group.
  • If you aren’t currently attending counseling, schedule an appointment with your counselor ASAP.
  • If you don’t already have one in place, create a relapse prevention plan to help prevent further relapses.

Going to Treatment After a Relapse

You are NOT a failure if treatment didn’t work the first time.

Sometimes after a relapse you or your support system (counselor, sponsor, psychiatrist, family, or friends) may agree that reentering treatment is the best course of action. This does not mean that you are a failure or that your treatment didn’t work the first time.

Cocaine relapse rates and statistics indicate that returning to treatment is a common occurrence. One research sample of more than 300 people who completed cocaine addiction treatment revealed that 44% of people were readmitted into a treatment program within 2.6 years after completing their initial treatment 8.

For more information on cocaine relapse, aftercare programs, and other addiction treatment options, contact our recovery support team for information and support at 1-888-744-0069.


How to Create an Effective Relapse Prevention Plan

To help create safeguards against relapse, it is crucial that people have an effective relapse prevention plan in place before completing treatment. Most rehabilitation centers and aftercare facilities assist patients in creating their relapse prevention plan before they discharge.

An effective relapse prevention plan typically includes some combination of the following elements 7:

  • Recognize and outline the early stages (warning signs) of a relapse.
  • Be aware of your obstacles to recovery and the tools and skills you have acquired to help you overcome them.
  • Know your triggers, and make a plan to avoid them when possible and to effectively cope with those you cannot avoid.
  • Have a specific plan in place to help you manage cravings (journaling, distraction method, urge surfing).
  • Expect setbacks, and be prepared to handle them appropriately.
  • Make a definitive plan to follow up with aftercare programs (12-step programs, cognitive behavioral therapy, group counseling, and learning mind-body relaxation and stress-management techniques).
  • Practice good self-care (adequate nutrition, sleep, exercise).
  • Write down a list of people, places, and situations you may need to avoid in order to prevent relapse.
  • Redefine fun. Have recreational activities and hobbies readily available for you to engage in to help prevent you from glorifying past drug use out of boredom.
  • Set healthy boundaries with others.
  • Have a list of people you can call upon for support and ask for help when needed.
  • Have a specific plan in place for how you will handle a relapse if it occurs.
To learn more about treatment options following a relapse, contact our recovery hotline by phone at 1-888-744-0069.


References:

  1. National Institute on Drug Abuse. (2016). What is the Scope of Cocaine Use in the United States?
  2. Nestler, E. (2005). The Neurobiology of Cocaine Addiction. Science and Practice Perspectives, 3(1): 4–10.
  3. Gorski, T. (2001). Understanding Relapse. GORSKI-CENAPS Web Publications.
  4. National Institute on Drug Abuse. (2012). How Effective is Drug Addiction Treatment?
  5. Simpson, D., Joe, G., et. al. (1999). A national evaluation of treatment outcomes for cocaine dependence. Archive of General Psychiatry, 56(6): 507–14.
  6. Sinha, R. (2007). The Role of Stress in Addiction Relapse. Current Psychiatry Reports, 9(5), 388–95.
  7. Melemis, S. (2015). Relapse Prevention and the Five Rules of Recovery. Yale Journal of Biology and Medicine, 88(3): 325–32.
  8. Grella, C., Hser, Y. & Hsieh, S. (2003). Predictors of Drug Treatment Re-entry Following Relapse to Cocaine Use in DATOS. Journal of Substance Abuse Treatment, 25(3): 145–54.

 

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