Author: Grace Ogren

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Addiction vs. Habit: What’s the Difference?

Do either of these sound like a true addiction, something that has the power to disrupt lives? Cause death, even?

“I’m addicted to these chocolates! I buy them without even thinking about it.” 

“I’m so addicted to watching my TV show at night! I love ending my day with TV!”

“I got so addicted to having a latte in the morning! I can’t imagine life without it now!”

These proclamations align more with habits, which are activities practiced regularly and usually without much thought. Think of brushing your teeth, wiping your shoes on the mat before stepping inside, or turning the lights off before you leave the house. 

Correctly identifying a habit versus an addiction can help you understand your potential need for treatment and empathetically communicate with others.

Addiction and Habits Defined

So a habit and an addiction aren’t the same thing—Why? What are they?

What Is a Habit?

The Merriam-Webster dictionary defines a habit1 as ”an acquired mode of behavior that has become nearly or completely involuntary.” In some contexts, the word habit can appear synonymous with addiction, but they differ quite drastically. Swapping one for the other can inadvertently cloud the truth of an addiction and the effects it can have.

Examples of habits include:

  • Having a cup of coffee in the morning
  • Talking evening walks
  • Reading before bed
  • Meditating
  • Making your bed 

If needed, you can choose to not do a habit. Though doing it may come instinctually, you could stop with some conscious effort. Even if it feels a bit weird or uncomfortable, it doesn’t cause physical withdrawal symptoms or consume your thoughts. 

What Is Addiction?

Addiction is a “chronic, relapsing disorder2 characterized by compulsive drug seeking and use despite adverse consequences.” The medical community defines addiction as a brain disorder, since it changes the brain circuits related to self-control, reward, and stress. Even after someone stops taking drugs (including alcohol), these brain changes persist.

At first, someone usually has control over their substance use and chooses to initiate it. But once the self-control aspects of their brain become impaired, so does their ability to control their compulsions and cravings. 

Some people are more at risk of developing an addiction2 than others. For example, one person can take or leave an alcoholic drink, while another may try a drink once and feel an immediate draw to the substance, until it becomes essential. Several risk factors, like genetic predispositions, childhood abuse, and influential environments, make repeated use and addiction more likely. 

Examples of addiction include:

Addiction primarily differs from a habit in that stopping has consequences. Many people who try to stop experience withdrawals, which are physical and mental reactions to not having the substance3. Someone with an alcohol addiction, for example, may experience tremors and sickness if they try to stop—even seizures and death. 

Characteristics of Habits and Addictions

Habits and addictions form differently and have distinct characteristics that set them apart. 

Formation and Development

You’ve probably heard the adage: “It takes 21 days to build a habit.” In reality, the timeline differs from person to person and depends on how much effort they put into solidifying their habit. All habits form through repetition4 and the positive reinforcement they bring. Habits become automatically followed formulas in your brain with triggers, actions, and results. For example, going to your bathroom sink after showering triggers the action of brushing your teeth. You get clean teeth and better dental health as a result, which reinforces the action.

Addictions form differently. They may start voluntarily2, like winding down for bed with a glass of wine. But as the circuits and functioning in your brain change, and your tolerance to the substance builds, your voluntary enjoyment becomes compulsive. Self-control fades. You need more and more of the substance to get the feelings you want. Your body can grow dependent on the substance too, leading to painful and potentially dangerous withdrawal symptoms when you try to stop or cut back.

Control and Consciousness

You can stop a habit at-will. Could you imagine going through painful withdrawals or intense emotional angst if you didn’t make your bed in the morning? You could stop any habit and, usually, suffer only mild inconveniences or discomfort. Conscious effort and practice are all you need to break a habit.

Addiction requires more than conscious effort plus a desire to stop. Even though you may know and feel the negative effects on your life, the urge to take substances overrides all reasoning. You could decide to stop and throw out all your substances but find yourself buying more a day later. Life without the substance seems scary and unmanageable—much different than a life without taking your shoes off before going inside.

Impact on Daily Life

Making your bed, brushing your teeth, and taking a shower all have positive impacts on your life. You give yourself a cleaner space, you improve your oral health, and you take care of your hygiene—all good things. Some habits may have no tangible effect on your life, like checking your phone in the morning. Habits also differ person-to-person, affecting their lives differently depending on their personalities and ways of living.

Addiction often has a devastating impact across the board. You may spend more time and money procuring and consuming substances, leading to job loss and financial crises. Your actions under influence could sever relationships, leading to divorce or being cut off from loved ones. In dire cases, substances and the actions people take when impaired can lead to legal consequences and death.

Psychological and Biological Factors

Both a habit and an addiction affect your brain, but addiction has a stronger impact.

Brain Chemistry

Both habits and addiction come from neurotransmitters traveling through certain pathways in the brain. The positive results of habits (like saving money by shutting off your lights) reinforces them, much like the positive feelings from substances can reinforce their use. Dopamine, a neurotransmitter, drives this feel-good sensation5 and encourages you to repeat the action.

With substance use, these pleasant feelings and the release of dopamine increase tenfold. That’s what most drugs are meant and designed to do—make people feel good and enforce repetition. They send a rush of dopamine through your brain’s reward system6, telling you to do it again because it has a positive result. As your brain adapts to the unnatural effects of the substance and overflow of dopamine, it learns to stop making its own. It becomes hard to feel pleasure any other way, causing cravings and urges to use the substance. 

Psychological Dependence

Once you become addicted to a substance, procuring and taking it can consume your thoughts and affect your mental state. You may feel emotionally reliant on it to relieve stress, discouragement, or boredom. A habit doesn’t consume your thoughts—even if you like doing it, it’s not an absolute necessity.

Physical Dependence

Taking less of a substance or stopping altogether can lead to withdrawals, which is why many people in treatment need professional detox services. Depending on the substance and how long you’ve been taking it, withdrawal can include symptoms like7:

  • Tremors
  • Headache
  • Irritability
  • Flu-like symptoms
  • Vomiting and diarrhea
  • Insomnia
  • Hallucinations
  • Seizures

If you don’t make your bed in the morning, you know it won’t make you throw up or have a seizure. That’s another way habits and addictions vary.

Behavioral and Social Implications

Seeing someone pull out their phone in a slow checkout line doesn’t come as a surprise; you probably wouldn’t even notice it. But what if they took out a liter of vodka, or shook pills into their hands? 

Social Acceptance

Habits are generally accepted and encouraged—online, you can find almost endless lists of suggested habits and books dedicated to building healthy habits. Addiction is met with stigma and seen negatively by the public. Those with addiction often hide their behaviors to avoid consequences and the stigma surrounding addiction.

Conversely, telling a friend you meditate with your morning cup of coffee would likely garner admiration and respect, casting you in a positive light. 

Behavioral Flexibility

Integrating new habits, or stopping one, usually just takes a bit of focus and effort. They can become part of your routine in just a few days or weeks. Stopping an addiction, however, isn’t nearly so simple. It often requires professional help and detox services to safely undergo withdrawals. It can take months or years to mentally, physically, and spiritually recover.

Recognition and Diagnosis

How do you know if something you do is an innocent habit or problematic behavior?

Identifying Habits

Perhaps the easiest way to identify a habit vs. an addiction is to stop doing it and see how it feels. Do you think about it all the time and feel distressed? Do you feel sick not doing it?

You can also ask yourself how your life changes, positively or negatively, if you cut out the activity. Are you happier, are your loved ones happier? Do your relationships improve? If you notice a positive change, that’s a good sign your habit may have been a problematic behavior or an addiction.

Diagnosing Addiction

A medical professional diagnoses addiction; the information provided here or anywhere else online isn’t a diagnosis. But you can use online resources to identify your concerns and acknowledge your need for professional help. An overview of the diagnostic criteria for an addiction8 is as follows: 

  1. Substance use becomes out of control, where you take more than intended and can’t cut back, despite wanting to.
  2. Craving the substance.
  3. Spending significant time getting the substance, taking it, and recovering from its effects (often in secret).
  4. Continuously taking the substance despite clear consequences at home, work, and socially.
  5. Substance use prevents you from fulfilling your obligations and responsibilities.

Treatment Approaches

Many treatment approaches can help you heal from addiction. Small behavioral changes and tips can help you break a habit, too.

Breaking a Habit

Several tricks and strategies can help you break habits like checking your phone when you feel bored, stressed, or need to pass the time. For example, you could leave sticky notes to remind you not to do something, limit your screen time, or sell/throw away the item to stop the habit.

Staying mindful of your behaviors and actions can also help you break a habit. You can modify habits with habit stacking4, which uses one habit (like brushing your teeth) as a launchpad for another (like checking your calendar afterward.)

Treating Addiction

Various treatment approaches for addiction offer healing to everyone. Generally, approaches include:

  1. Evidence-based
  2. Holistic
  3. Alternative

Personalized treatment plans usually blend these approaches to your specific needs so you can engage in evidence-based therapies, holistic services, and alternative treatments all together. 

Therapy is often the cornerstone of addiction treatment, including cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and eye movement desensitization and reprocessing (EMDR). Detox and medications also serve as important aspects of recovery, especially for more severe cases. In all stages of recovery, support groups can serve as an invaluable place to connect with others in recovery and build resilience.

Professional Help

Getting professional help for addiction is often vital to recovery. Many treatment professionals can help—your primary care physician may be the first step, who can then suggest next steps and refer you to other providers. This could mean you start inpatient treatment and detox, long-term residential treatment, outpatient levels of care, or therapy.

You’ll likely work with at least one therapist, along with medical professionals to manage withdrawal symptoms safely. You may also work with group therapists and providers specialized in trauma treatment, or another type of mental health condition.

Forming New Habits in Recovery

Addiction recovery often involves new habits, like dedicating time to attend support meetings, practicing self-care, and making time for your relationships. You may even add meditation, journaling, or exercise to your daily routine, too. New habits like these can strengthen your overall recovery and improve your quality of life.

Leverage the power of habits, now knowing how they come to be and how you can optimize your routines for your benefit.

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Discovering New Pathways to Eating Disorder Recovery

Dana Sedlak, LCSW, CEDS-C, was a wonderful guest on our recent Recovery.com Podcast episode. We were honored to learn more about her personal and professional experiences with eating disorder recovery, advancements in care, and how parents can navigate recovery with their children. Dana’s professional experience has centered around adolescents and their families, which she continues to this day. 

You can find Dana’s episode here and hear from our past guests.

A Passionate Eating Disorder Specialist

Dana Sedlak is a certified eating disorder specialist, licensed clinical social worker (LCSW), and a consultant with the International Association of Eating Disorder Professionals (IAEDP). She’s worked primarily with adolescents at several treatment providers for eating disorder recovery. She strives to help teens rediscover their personal identity, learn healthy coping skills, and feel empowered and hopeful in their recovery.

Dana’s own experience as an adolescent with an eating disorder, and her subsequent recovery, fuels the daily passion she brings to her work.

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Dana’s personal experience with an eating disorder began in 8th grade. Mono left her unable to participate in sports, which was a key aspect of her life. She also went through grief at that time, which, 

“I would describe it as a perfect storm, right? There were so many different things happening in my life at that time that really kind of set me up for the actual development.”

Mono led her to lose weight and nearly every form of socialization, like school and sports. The grief, sickness, life upheaval, and stress led to unhealthy and unpleasant coping behaviors. Dana says, 

“It was very clear that I didn’t want to be doing the behaviors that I was doing, but I had no idea how to stop them.” 

Dana bravely involved her family once she realized something was wrong. As someone who loves writing and how it let her voice what she really felt, Dana wrote her family a letter describing what she was dealing with and that she needed their help. They responded promptly and got her into treatment. But even with their quick and loving response, Dana still struggled with imposter syndrome and worrying she was just ‘being dramatic.’ She remembers wondering,

“Maybe it’s not a big deal. Maybe I’m just experiencing something that everybody else in the world or all the other adolescent females might also be experiencing. And so feeling, like, am I being dramatic? Am I making this to be something way more than it is?”

Telling her family about her struggles also meant giving up her coping tool, uncovering her deep secret, and committing to treatment. Dana recalls,

“There was a swift, also, panic, right? Of what did I just do? But then there was a moment of relief, of okay, this is no longer just mine. And someone is going to help me.” 

The Importance of Communication and Forming Personal Identity

Dana’s personal story and what she’s experienced as a treatment provider highlights the crucial aspect of communication—between parents and adolescents, treatment providers and patients, and even within ourselves. She suggests parents keep an open line of communication with their kids to catch issues before they arise, get prompt treatment when they do, and validate challenges along the way.

Identity also becomes a crucial issue to address in treatment for adolescents. Dana called out the tendency for teens (and adults) to tie their identity to the sport they play, their extracurricular activities, and their grade point average. While those aspects may be key parts of their personal identity, exploring who they are beyond that can help teens understand how and why eating disorders have become a coping mechanism. Dana says, 

“We have to be able to help somebody understand themselves enough to realize, how is this [the eating disorder] helping me? How is this serving me? What is this doing for me–positively, without the judgment around it–to then figure out. Okay, so what are my other options? But if we don’t know that to begin with, we’re never going to figure out other options.”

Social media has also affected how young adults view and form their identity. The positive reinforcement of likes and shares encourages them to develop “suitable” versions of themselves. Managing this can lead to the stress associated with eating disorders or encourage weight loss through unrealistic portrayals of bodies and body image online. Through treatment, Dana strives to make teens feel like they’re living an authentic life true to themselves and who they are. She says, 

“I want them to just feel like they’re living a life of purpose that’s true to them. And that’s going to be the biggest protective factor...”

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How Parents Can Help: Early Intervention

By the time a parent notices their child struggling with an eating disorder (unless they’re well-aware of the signs), it can have already progressed to needing intensive lifestyle changes and treatment. Regarding how parents often feel when discovering this, Dana empathetically says,

“There can feel like, there’s a lot of blame and shame in parenting, feeling like it’s a parent’s fault, or that they didn’t see something.” … “I think it needs to be everybody being more educated and knowing how we start to see these early onset signs.” 

The earlier intervention happens, the better treatment outcomes become (that’s true for eating disorders and addiction.) An honest and compassionate conversation can be the first step in initiating treatment. When these interventions happen, 

“And to me, if we’re doing that, we’re not just preventing eating disorders, we’re preventing a significant amount of mental health issues.” … “You have to be integrated into your own family unit, as best as you can and have the conversations as much as you can, just as a first step, as a preventative, as part of the family culture.”

Relating to this, our host Dr. Malasri Chaudhery-Malgeri adds,

“I think my message to parents who are doing that, is that you’re trying and that matters. And eventually, usually, that will get noticed. So don’t worry, you know, like as long as you’re making that effort and you’re trying and you’re keeping those lines of communication open, that’s great.”

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Advancements and Goals for Eating Disorder Treatment

More open communication and a team-oriented approach in the home is a preventative measure Dana sees having vast benefits. She says,

“…how do we eliminate that power struggle as much as possible of, we’re here to help you recover, but that also doesn’t look like me trying to take this thing away from you and getting into that back and forth with you, right? We can kind of both remove ourselves from that and figure out, how do we be a team? Against the eating disorder is what I always try to phrase it as, right?”

Family therapy and education on eating disorders also helps families heal as a collective unit. Many treatment centers, especially ones for adolescents, have started seeing the importance of family care and incorporating it as a vital component. 

Coaching has also become a vital tool in long-term eating disorder recovery. Therapists and/or  those with lived experience can become certified as eating disorder recovery coaches and walk beside people in their recovery. This keeps the patient connected to support without intensive care, or really the feeling of ‘being in treatment.’

As for what Dana would tell others struggling with an eating disorder, especially teens, she says, 

“But taking the chance, even if you don’t know that you want to get rid of the eating disorder, that’s okay. How can we still help you take a step towards feeling better right now? And like I was saying before, the rest will come. You deserve to feel better, you deserve a space to have less pain, regardless of your commitment level.”

Listen to Dana’s Episode Now

We’re grateful for Dana’s time and expertise, and for the illuminating conversations we had with our host Dr. Malasri Chaudhery-Malgeri and co-host Amanda Uphoff, Recovery.com’s Chief of Staff and a woman in recovery from an eating disorder and alcohol use disorder. 
You can find Dana’s episode here!

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Reshaping an Industry: Quality Care and Advocacy as Tools for Recovery

We were honored to have Marvin Ventrell, CEO of the National Association of Addiction Treatment Providers (NAATP) on our podcast this week. All three of our hosts gathered to lead an insightful, fun conversation on the treatment space and Marvin’s ideas for improvement. 

Listen to Marvin Ventrell’s episode to learn more about the improvements the NAATP has made in addiction treatment, how they plan to make a broader impact, and how Marvin’s career as an attorney and man in recovery led him to their leadership.

Beginnings of an Impactful Career

Marvin began his career in his early twenties as an attorney. Marvin has also worked as a teacher, director, and CEO of a previous organization. He spent 15 years working in the child and family welfare system, authoring influential books and building the practice of law for children, which became recognized as a specialization by the American Bar Association (ABA). 

Marvin recognized the need for the addiction treatment industry to have the same structure and ethical guidelines as children’s law. At the NAATP, Marvin immediately strived to expose the “bad stuff” in the industry as the first step to improvement, saying, 

“So we’re going to look in at our, we’re going to clean up our own house. And we’re going to create an ethics code. And if you can’t follow it and you don’t fit it, you’re out.”

This met immediate critique and pushback, but Marvin and the NAATP persisted. Much of Marvin’s passion for improving the treatment space and broadening people’s ability to access quality, ethical treatment comes from his own recovery story.

A Personal Passion for Ethical Treatment

“I’m working in this field largely because I am a person in long term-recovery.”

Marvin began using substances like alcohol and marijuana in highschool, where partying was seen as a sign of ‘coolness’ as it still often is. His substance use continued throughout college and into law school, where a professor even urged students to not turn to substances to manage stress. Marvin recalls,

“My attitude was like, well, you don’t know me. I can. I can do it. I can do both…. Yeah, normal person can’t drink and get straight A’s, but I can.”

Marvin became a successful attorney, married, and found continued success in his career with leadership roles. Then finally, in his late thirties/early forties, a switch flipped and casual use turned into an addiction. 

“And I then needed the substances. I couldn’t not have them. And I, and I was breaking.”

Marvin’s previous company, which he was the CEO of, lovingly directed him to get treatment. He did, and Marvin has been sober since. His treatment experience taught him more about the treatment industry, as did his wife’s recovery journey. It also pointed out a dire need for change.

Leading The Charge in The NAATP

The NAATP lists vetted, accredited, and licensed treatment providers that abide by their ethics code and quality assurance manual. In short, they’ve taken as many liberties as possible to ensure any provider that’s part of the NAATP will be ethical and focused on providing high-quality care. The NAATP also offers a guide for selecting treatment.

Our co-host, Cliff McDonald (Chief Growth Officer), notes this about the beginnings of Recovery.com and the notable impact the NAATP has had on each facet of the treatment space:

“They [Recovery.com founders] have modeled the ethical standards that we have for our business after NAATP. They credit NAATP and you as the ones that turned around the space and cleaned it up. So that is wonderful.”

When Marvin and the NAATP voiced concerns about the ethics of the treatment space and exposed shady practices, they promptly received pushback and criticism for “talking crap” about the treatment industry. They were even sued, but won the case. Marvin responds to such critics with,

“And, you know, that’s not what I was doing at all. I was saying, look, we’re wonderful, but we’ve got to recognize where the poison is and get it out so that we can be successful.” … “And, because we thought, you know what we need, if we need to get smaller to get better, we’ll get smaller to get better.” … “And within a year of our, removing, if you will, certain members and not having others renew or allowing others to renew, we grew. Significantly beyond where we started, right? And so we made our footprint in ethics.” 

The NAATP also launched a recent initiative to measure outcomes in addiction treatment using their strong ethical and quality standards. This allows treatment providers to improve their programs with applicable, actionable data.

Goals in The Recovery Space

Marvin and the NAATP recognize stigma as a tall barrier to treatment. They’ve made progress in reducing stigma through addiction education, which is an ongoing goal for the NAATP.

Marvin also discusses emerging trends in substance use, like increased deaths from alcohol and stronger marijuana. The effects of these trends are another reason why he and the NAATP want to ensure people seeking treatment have a trustworthy place to find it.

Treatment Decided by Doctors and Scientists, Not Accountants

Marvin explained how insurance coverage works for behavioral health treatment and how insurance companies often dictate who gets treatment, and what level of care they receive; not doctors or scientists with education on the matter. Marvin says,

“In any universe that I can imagine, managed care means that the scientist doesn’t decide what health care you get. The accountant decides what health care you get.”

Ideally, insurance companies would respond better to a documented clinical need for a service and cover treatment. Reshaping how and what insurance covers improves access to care and has the power to reduce stigma as more conditions and needs are recognized as clinical conditions deserving compassionate care.
This episode dives into these subjects and more with humor, compassion, and intrigue. Listen to Marvin Ventrell’s episode now to explore these topics further and learn more about the addiction treatment industry.

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What Happens in Family Therapy?

Family therapy for addiction or mental health conditions may come as an unexpected aspect of treatment. If you’re not the one getting treatment, why are you getting involved? Many families initially wonder the same thing.

Many family members also want to, and would, do anything to help their loved one get better. If that means going to family therapy, they’ll do it in a heartbeat, even if it’s unexpected. Others may feel more skeptical and resistant, depending on the nature of their family dynamics and their mental health literacy. 

However, each group will likely have the same question: what’s family therapy like? What happens? 

We’ll help you learn more about it and what to expect in this article. You can also explore more about family therapy and group work by listening to our recent podcast episode with Dr. Claudia Black.

What Is Family Therapy?

Some family members first assume family therapy means hearing everything they did wrong and getting blamed for their loved ones predicament. That’s false. If behaviors from family did contribute to the patient’s condition, that will likely come up, but in a respectful, compassionate way. Family therapy isn’t a trick for the patient and their therapist to gang up on family members—it’s meant to restore loving relationships and heal their family dynamics.

The therapist, psychologist, or counselor who leads family therapy strives to help both the patient and their loved one verbalize and work through problems with respect and love, not judgment or blame. Through open communication, patients and their families can resolve issues, forgive, and learn how to modify potentially harmful behaviors. 

Many treatment centers strongly suggest and offer family therapy as part of their core treatment. That’s because family therapy has the power to heal relationships, improve the support system of the person in treatment, and give the whole family unit hope in recovery. You can also attend family therapy as a stand-alone service, without your loved one being in a residential or outpatient program.

Goals and Reasons for Family Therapy

The ultimate goal of family therapy is to help the person in treatment get better. Since family is often an extension of ourselves, their involvement in this healing is often crucial. 

And, after patients leave treatment, the closest and most impactful support system they return to is often their family. Discussing concerns, past issues, and resolving conflict in family therapy can create a stronger support system for when they get back. 

Another crucial reason for family therapy is to give loved ones the chance to heal. They often have their own recovery journeys to walk, even if they weren’t the one struggling with an addiction or a mental health concern. For example, some family members fall into codependency as a way to have some grasp at control over their loved one’s condition. Family therapy can help you recognize your own recovery needs and process the experience of your loved one’s condition without guilt, anger, or self-responsibility.

What Family Therapy Looks Like: First and Continuing Sessions

Family therapy typically begins once your loved one has stabilized, expressed approval for family therapy, and has shown initial progress in their treatment. This means your sessions could start anywhere from a couple weeks to 1+ months after they admit into treatment. It’ll depend on their preferences and progress. Once they’re ready and their treatment team determines it beneficial, you’ll come in for your first session.

Before that, you’ll likely meet with the family therapist to go over expectations, ask questions, and become more comfortable in the space. This might happen as soon as your loved one admits into treatment or just before your first official session.  

First Session

Your very first family therapy session will likely include these key parts:

  1. Setting expectations together.
  2. Agreeing (and even signing a written contract) on how you will conduct yourself and treat others in your session. For example, you may all sign a contract promising to listen without interrupting or to not raise your voices.
  3. Outlining what your goals are for family therapy and how the therapist will know if they’re being met.
  4. Defining a direction and plan for your future sessions.
  5. If time allows, diving into how everyone’s feeling and any conversations they’d like to have now, or something they’d like to understand about their loved one in treatment.

You’ll likely sit in a small, private room—probably the therapist’s office, or the designated family therapy room if the treatment center has one. Your sessions will stay confidential and what’s shared won’t leave the room. Before you leave, your therapist may check in with how you’re all feeling and how you think the session went.

Continuing Sessions

Treatment centers vary in how often they provide family therapy. Some will schedule it once a week or once every couple weeks; others will designate 3-5 consecutive days for loved ones to engage in education and family therapy. This format is called a family week, or family program. Family programs often split their focus between 1) education and multi-family support groups and 2) family therapy with the patient and their loved ones. 

If your loved one isn’t participating in a residential or outpatient treatment program and instead attending family therapy as a stand-alone treatment, your sessions may be more regular and adaptable to your schedules. For example, you could request weekly or bi-weekly appointments. 

In continuing sessions, you’ll build off the goals and outlines set in your first session. They may also flow more organically, addressing issues as they arise or as they come to mind. For example, you may talk about something that happened recently or, during your session, your discussions may remind you of a past event you want to go over.

You’ll check in continuously with others and the therapist to ensure you’re meeting the goals set in the beginning, and that you’re finding the therapy beneficial. If you have changes or suggestions in mind, you may discuss these at the very beginning or end of the session.

Who Can Go to Family Therapy?

You don’t need to share DNA to go to family therapy. Chosen family can come too—anyone who supports the patient and that they trust. When asking the patient about family therapy, the therapist will see who they’d like included or excluded. Here are just some of the people that can come to family therapy:

  • Parents
  • Siblings
  • Friends
  • Cousins
  • Step-siblings
  • Step-parents
  • Coworkers
  • Children
  • Foster parents
  • Foster children
  • Grandparents
  • Grandchildren
  • Honorary and/or chosen family members

Is Family Therapy Required?

No. The patient may not want to engage in family therapy, or family members may not want to participate. No one is forced to, though family therapy is often strongly recommended.

For example, patients who were abused and traumatized by their families would not find it appropriate to bring their family members into treatment. Their treatment providers would agree. In these cases, and any other time the patient doesn’t want their family involved, family therapy will not be required or pursued.

Family Therapy vs. Family Education

Therapy and education for families aren’t the same things. They may overlap in some ways, but they have different goals and purposes. 

Family Therapy

Family therapy aims to heal relationships and reconnect loved ones, strengthening their bond and support system. They learn how to communicate better and process disagreements with respect and love. 

Family Education

Family education focuses on teaching loved ones about addiction and mental health conditions. It covers how conditions develop, contributing factors, and the recovery process. Families learn the biological background of addiction and mental health conditions, helping them see behavioral health conditions don’t arise from a lack of willpower. 

If a treatment center offers a family program, they may include workshops and presentations from a variety of professionals or those with lived experience. These sessions are often more interactive between the educator and other family members. 

Family therapy will likely touch on these aspects as questions arise or to explain behaviors of the patient. But the main focus of family therapy isn’t education.

Resources for Family Healing and Education

Family members have many resources and support available, whether their loved one is in treatment or not. 

Online Resources and Groups

Here’s a few online resources to access support:

Call Lines

And here are some numbers you can call for support or crisis care:

Books

These books offer education and support for family members of someone with behavioral health concerns:

  • Undaunted Hope by Dr. Claudia Black, “Stories of Healing from Trauma, Depression, and Addictions”
  • Unspoken Legacy by Dr. Claudia Black, “A far-ranging examination of how the effects of addiction and trauma in the family can reverberate for generations”
  • Codependent No More by Melody Beattie, “How To Stop Controlling Others And Start Caring For Yourself”
  • Addict in The Family by Beverly Conyers, “Rather than providing simple solutions or definitive answers to every question, Conyers’ careful research and warm writing offer education and support from those who “have been where you are” and the healing, isolation-breaking power of shared experiences.”

Family members can also attend individual therapy to discuss their experiences, process trauma, and develop coping skills in a 1-1 setting. These private sessions offer greater personalization and may be helpful for family members who don’t feel comfortable sharing in a family setting.

Ultimately, family therapy in rehab benefits both the person in treatment and the ones who love them. It’s often a critical aspect of recovery, and one you can support simply by attending and participating in sessions. 
To learn more about family therapy and its importance in recovery, you can listen to our recent podcast episode with expert Dr. Claudia Black!

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Can You Be Addicted to Sugar?

Many of us relish having a ‘sweet treat’ after a meal or as a pick-me-up during the afternoon slump. You’ve likely experienced the little treat turning into a second slice of cake, another sliver, and just one more. Not having something sweet after a meal, or whenever the fancy strikes, can feel like a serious blow. 

The media has drawn more attention to the idea of sugar addiction, leading many to wonder, can you really be addicted to sugar? 

You can. But like other addictions, you can also recover and restore a healthy relationship with sugar and carbs. 

“A Spoonful of Sugar…!”

…Makes the medicine go down, makes a bad day better, and completes a celebration, as common cultural practices would have it. Sugar is a key part of how we socialize—no birthday party makes sense without a cake. No dinner with friends would feel whole without a nice dessert after. A first date with kale instead of ice cream wouldn’t spark the same excitement, date aside.

Overconsuming sugar has bitter consequences. Diabetes, inflammation, heart conditions, and an addiction to sugar can all stem from having one too many sweet treats. Even if you avoid sugar when you can, more and more ‘non-dessert’ products include exorbitant amounts of added sugars. This means the manufacturer adds corn syrup or an artificial sweetener to make the product more sweet. You’ll often find added sugars in canned drinks, processed foods, and even savory items like chips.

With sugar showing up in more and more products, it’s not surprising that more people feel concerned with their reliance on it. Sugar addiction has been tossed around, and that’s because sugar triggers the reward system in the brain1, releasing dopamine. This marks the sensation as good and causes reinforcement, meaning you’ll instinctually want to repeat the action. As you have more sugary foods, you’ll become more tolerant to its effects and need to consume more…thus leading to addiction.

Understanding Sugar Addiction

Definition of Sugar Addiction

A sugar addiction occurs when you keep consuming high amounts of sugary foods despite efforts to stop. If you do try to cut back, cravings can feel disruptive and challenging to cope with. You may find little pleasure in other activities besides eating sugary foods. 

A sugar addiction differs from a substance addiction in many ways. Substance addiction can lead to painful and potentially deadly withdrawals. The effects of substance use disorder can cause homelessness, financial ruin, lost relationships, and poor physical and mental health.

A sugar addiction can lead to health effects, too. But it’s rare for it to upend lives and relationships, as substance addictions can. You won’t need to undergo professional detox services or intensive residential treatment to stop eating sugar. Thankfully, new habits and determination, plus getting to the root cause of the addiction, can help you recover from a sugar addiction.

The Science Behind Sugar Addiction

Sugar addiction happens because sugar sends dopamine through your brain’s reward pathway and activates it2. You can become addicted to eating in the same way. Your taste buds tell your brain the food tastes good, which releases dopamine to reward the action. The dopamine then tells your brain to repeat the action, and it makes you more tolerant to the original trigger.

Hidden and Obvious Sugars

Sugar takes many names, including:

  1. Glucose
  2. Sucrose
  3. Fructose
  4. Maltose
  5. Lactose
  6. Dextrose
  7. Starch

Sugars are also a broken-down form of carbohydrates3, so eating bread puts sugar into your body—even though it doesn’t taste sweet. You’re likely to see the above names on a nutrition label; not every form of sugar is labeled simply as ‘sugar.’ Knowing its various forms and names can help you lower your consumption.

Symptoms of Sugar Addiction

You may recognize a sugar addiction in yourself or a loved one when you keep an eye out for these critical signs.

Physical Symptoms

Overeating sugary foods can lead to headaches4, cravings for more sugary foods, weight gain, and acne. It can also cause sugar crashes, where you feel pronouncedly fatigued after an initial jump in energy.

Behavioral Symptoms

Too much sugar can cause mood swings4 and contribute to conditions like anxiety and depression. As you consume more sugary foods, these mood swings can become more constant or severe. 

Signs regular consumption has shifted to an addiction include:

  • Inability to control how much sugar you eat.
  • Eating sugary foods even when they make you feel sick.
  • Overspending on sugary foods.
  • Eating sugary foods in secret. 
  • Hiding your supply of sugary foods so loved ones or friends don’t know how much you’re eating (and so they don’t eat it).
  • Constant cravings for sugary foods.
  • Using sugary foods to cope with negative emotions.

Emotional Symptoms

Eating too much sugar can make you irritable and tired4. You may feel like you have a short fuse, suddenly feel sad, or act grouchy for no apparent reason.

Causes of Sugar Addiction

A sugar addiction is ultimately caused by sugar’s effects on your reward system. Some people are more sensitive to its effects there; others can consume sugary food regularly without more than the occasional itch for something sweet.

Biological Factors

You can be genetically predisposed to sugar addiction5, meaning the way your body responds to sugar could make addiction more likely. Genetic predisposition passes through families and can alter how your brain and body perceive sugar. These variations can make the feel-good effects of sugar more pronounced, as is the risk for addiction. 

Psychological Factors

Food offers a unique comfort, so much so there’s a whole class of meals designated as comfort foods. Ice cream and sweets certainly make the list. Little indulgences are the norm, but regularly using sugary foods to cope with emotions and symptoms of mental health conditions can lead to a sugar addiction.

Conditions like depression and anxiety can fuel emotional overeating and make you crave sugary foods to activate your reward system. This provides momentary pleasure and relief from negative emotions, but it’s not a long-lasting solution. Conditions like binge eating and bulimia can develop from emotional overeating.

Environmental Factors

We use sugar to celebrate and offer comfort. In a world with much to celebrate and much to mourn, we can end up eating a lot of sugary foods. The vast availability of sugary foods leans into this ideology with bright packaging, fun advertisements, and marketing efforts meant to encourage more consumption.      

Think of how easy it is to get a candy bar pretty much anywhere with provisions—gas stations, grocery stores, pharmacies, smoke shops, auto parts stores, and hardware stores, just to name a few. You’re much more likely to run into sugar and sugar additives than whole foods like fruits and veggies. With sugary foods so readily available (and cheap), they’re often what we reach for first. And if no one’s telling you otherwise, this might not seem like a problem. 

The Impact of Sugar Addiction on Health

Physical Health Consequences

Too much sugary food can lead to health conditions6 like diabetes, cardiovascular disease, tooth decay, and obesity. These can occur over time, often beginning with more minor consequences like cavities and fatigue. Then, this overconsumption can overwhelm the body and cause long-lasting damage.

Weight gain can lead to musculoskeletal strain as your muscles and bones try to adapt to more weight. As weight increases, people can experience knee and back pain or even injuries.

Mental Health Consequences

Sugar causes an initial flush of energy but a crash soon after. It can make you irritable and prone to mood swings4, which can contribute to or worsen a mental health condition. 

Diagnosing Sugar Addiction

Having a sweet tooth isn’t the same thing as a sugar addiction. Assess your sugar-eating habits in yourself or a loved one to help tell the two apart.

Self-Assessment Tools

You can self-assess the possibility of a sugar addiction by answering a few key questions as honestly as possible.

  1. Can you go a full day without eating sugar or bread?
  2. Do you feel anxious and irritable when you don’t have sugar for more than a few hours?
  3. Do you have something sweet with every meal?
  4. Have you ever bought candy or sweet foods and hidden them to eat later?
  5. Are you able to stop eating something sweet or not eat it at all if it’s available?
  6. Have you started gaining weight or noticing other health concerns, like fatigue, cavities, or generally feeling unwell?
  7. Do you notice yourself eating sweet foods more often and in higher quantities than your family and friends?

How you answer these questions can clue you into the potential of having a sugar addiction. For a more robust and accurate diagnosis, bring your concerns to a medical professional.

Professional Diagnosis

Your primary care physician can ask more clarifying questions and run tests to determine your reliance on sugar. They may test you for diabetes, heart conditions, and check your blood glucose levels. Depending on their results, they may officially diagnose you with a sugar addiction.

Strategies to Overcome Sugar Addiction

Dietary Changes

Dietary changes are one of the quickest and most effective ways to stop a sugar addiction or prevent sugar-eating habits from becoming an addiction. Cutting out sugar and carbs will likely offer the best benefits, but so can smaller changes.

For example, you could cut out pop and other sugary drinks. You can also start reading food labels at the store, looking for added sugars and the number of carbs in each item. See how healthier snacks compare and if you can swap products for ones with unrefined sugars or no sugar at all. Put more vegetables and protein in your cart and reserve items like ice cream and cake strictly for birthday parties.

Behavioral Strategies

Promising to quit sugar is often the easiest step—doing it, then sticking with it, proves much harder. That’s where behavioral strategies like these make their assist. 

  • Practice urge surfing to navigate cravings. Urge surfing uses mindfulness to help you understand what triggered the craving, then notice and accept it without acting on it.
  • Identify other stress-management strategies other than eating, like journaling, working out, reading, or talking with a friend. Use them for the big and small stresses.
  • Forgive yourself and set your sights on the future. Slip-ups and relapses may happen, but they don’t equate to personal failure.
  • Connect with others trying to cut out sugar or stop it completely. You can find groups online or maybe recruit a friend or family member to embark on the journey with you.

Seeking Professional Help

A professional can help you get to the bottom of a sugar addiction and develop strategies to overcome it. They can also begin treating physical symptoms like heart conditions and diabetes. 

Your first stop will likely be your primary doctor’s office. They’ll form a personalized treatment plan and identify where the recovery efforts start. You may focus first on becoming physically healthier and losing weight; then, they’ll address urgent health needs and refer you to a specialist if needed. A dietician, for example, could create a new diet for you to follow and suggest tips for removing sugar from your diet. Nutritionists can help you understand more about food and how it interacts with your body, illuminating myths and mysteries to help you truly fuel your body.

Your doctor can also refer you to a therapist. A mental health professional can help you heal the underlying causes of sugar addiction, like stress or anxiety, and develop new coping mechanisms. 

Long-Term Management and Prevention

Can you really avoid sugar…forever? Some people do; they commit to going sugar-free and adopt the diet changes as their new normal. Even if you don’t go completely sugar-free, you can still benefit from watching what you eat and managing stress, which can prevent a sugar addiction from resurfacing.

Maintaining a Balanced Diet

Staying satiated can help you overcome or not feel sugar cravings at all. Eat whole foods rich in protein to stay full longer, since hunger could trigger the desire for a quick sugary bite. Add plenty of vegetables and water to your daily diet, too.

Ongoing Support and Resources

Many people worldwide want to eat less sugar or recover from a sugar addiction. Online communities can connect you to their support and advice, providing both accountability and encouragement. You can also attend peer recovery groups for sugar addiction. Check out these sites to find the best fit for you:

You can connect to groups on social media, too. Search platforms like Facebook for sugar addiction groups, or learn more about sugar addiction on places like YouTube. Some platforms, like Instagram, also allow you to find posts by searching hashtags like #sugaraddictionrecovery. 

With peer and professional support, you can learn new coping tools and recover from an addiction to sugar. You may even find life becomes even sweeter.

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Finding Sobriety, Strength, and Hope as an “Alcoholic in Long-Term Recovery”

This week’s podcast episode features one of our Recovery.com cohosts, Cliff McDonald! Cliff is the Chief Growth Officer at Recovery.com and identifies as an alcoholic in long-term recovery. In this episode, Cliff shares his recovery story and details his path as a successful entrepreneur, Wall Street businessman, coach, father, and mentor. 

You can find Cliff’s episode and listen to our past guests here. 

“A Ticking Time Bomb”

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Cliff was raised in a robust Irish Catholic drinking culture. His father, a Boston police officer and professional boxer, along with his grandfather, a decorated World War II veteran, both drank heavily. Alcohol was a staple at family gatherings, where even as a child, Cliff had “sips of beer” and occasionally Jameson whiskey. By 13, Cliff had not gotten used to alcohol but to also anticipate opportunities to drink.

“I had this other life where I was getting severely intoxicated with my friends since I was 13 years old. And that was a secret. And that remained a secret for a long time, until it didn’t. So, I experienced wholeheartedly the progressive nature of this disease.”

Cliff played football in high school and at Dartmouth College, where he sank deeper into the party culture and drinking habits of fraternities. His once-stellar grades dropped. At this point, he started noticing how he drank more than everyone else and seemed more reliant on it, especially during the off-season.

Cliff followed most of his college peers to Wall Street and made a successful career. He married and moved to Madison, WI, where he opened and ran several Irish pubs. Then, his father passed away at just age of 55, which Cliff suspects was because of his drinking. 

The slow-burning fuse became a racing flame. 

Gradual Descent to a Public Rock Bottom

As Cliff navigated the challenges of losing his father, managing a business, and balancing the responsibilities of parenting and marriage, drinking shifted from a habit to a necessity. He expanded his career beyond owning Irish pubs by taking on the role of COO at a company. But during visits to check on the pubs, what started as a routine beer gradually escalated to a beer paired with a shot. About this, Cliff says, 

“So these little changes, right, over time, and then, the next phase, which ended up being this real, real chaos for about 18 months, two years, when I became severely alcoholic.”

After having one too many at a company party, Cliff was let go. In 2018, he went to rehab for the first time but checked himself out after 14 days. His counselor said he’d see him again. Cliff recalls, 

“So I went home here to Madison and I had 90 days of sobriety. Brutal sobriety. Not going to meetings, not having a sponsor, just white knuckling it.”

And then, 

“After 90 days, I decided that it would be okay to have a drink.”

Wading Through The Mire

Life darkened after that drink. Cliff’s wife didn’t want him living in their house if he drank again, and held firm to that. He ended up in his own apartment, unemployed, and drinking around the clock. 

“I think I was drinking to die. And, really, no will to live.”

Cliff also remembers, 

“People were reaching out to me for a while, like, checking in, and I remember I wouldn’t answer the phone a lot, because I didn’t want to talk to people, and I was hiding.” … “Then the phone stopped ringing, and I had never felt alone in my whole life, and I was alone in this apartment without, it’s crazy, with no one near me, no one checking in on me.”

After not hearing from him for a few days, Cliff’s wife made a welfare check and found Cliff needing dire help. He returned to treatment after detoxing in a hospital for 6 days. 

Rising to Recovery

Cliff’s second time at rehab had a much different effect. Remembering what his counselor told him this second time, Cliff quotes, 

“”Some people are alone. You’re not. You have people who still love you and still care for you.” And it hit me. Like it hit me and it hit me hard.”

A spiritual experience and working the 12 Steps of Alcoholics Anonymous set Cliff on the path of long-recovery. After rehab he went to sober living, and then got a sponsor. His therapist at the sober living home told him: 

“She referred to me as a ticking time bomb. She was like, it’s amazing. You held it together as long as you did, and you were just destined to explode. And you did. Now we can do the rebuilding, but let’s dive into why.”

As for what kept him on the path to recovery the second time, Cliff says, 

“So therapy was huge. Prayer and meditation is huge. Fellowship is huge.”

Now, Cliff sponsors other men in recovery and brings his lived experience with addiction and the treatment space to his work as our Chief Growth Officer. He’s also written a book, called Don’t Sell, Generate Revenue. You can buy that here. 


Cliff credits his recovery and his Higher Power with reinstating his creativity, leading him to entrepreneurship and business success again, and being the husband and father he wants to be. Listen to his episode on the Recovery.com Podcast to hear more!

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Healing in Numbers: The Power of Group and Family Therapy in Recovery

We have an exciting new podcast with guest Dr. Claudia Black! We had an insightful and educational time discussing Dr. Black’s professional and personal experiences. We also explored what drew her to focus on behavioral health, adolescent treatment, and healing dysfunctional families. Dr. Black has authored multiple books on addiction, children of addiction, how families heal, and much more.

Listen to this fascinating episode with Dr. Black here!

Past Experience and Background

Dr. Claudia Black is the clinical architect of the Claudia Black Young Adult Center with the Meadows. She’s a renowned author and speaker, and a trailblazer in the field of addiction and family systems therapy. Her work shaped the awareness and healing surrounding adult children of parents with substance use disorders, and children from dysfunctional and abusive families. Clinicians around the world use her frameworks to understand, and treat, addiction and dysfunction within family systems. 

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Dr. Black grew up in a dysfunctional home herself, a child of a father struggling with alcohol use disorder. She deeply understands the effects dysfunction and addiction have on families, especially adolescents. Dr. Black brings a unique blend of empathy and clinical expertise to her treatment, books, and our conversation in this episode with host Dr. Malasri Chaudhery-Malgeri (Editor-in-Chief) and co-host Cliff McDonald (Chief Growth Officer).

Group Work as a Pillar in Successful Treatment

Dr. Black primarily works with adolescents, developing a campus and program specifically for young adults after recognizing they learn and respond to treatment much differently than older peers. For this age group and others, Dr. Black has seen profound benefits with group therapy. She notes,

“And…the advantages of group work, I think the biggest advantage is what I’ve really already stated. It is a major shame reducer. There is so much healing that comes with the possibility of connecting with somebody else who, on a gut level, knows exactly what you’re talking about.” 

She adds another truth patients often realize through group work: 

“It’s okay for me to be vulnerable because there is nothing wrong with me. And I understand that because there’s nothing really wrong with you. This is what happened to you. And I like you. You’re really an okay person. Therefore I must be okay too.” 

Dr. Claudia Black eloquently highlights the transformative power of group therapy in recovery, and how it can significantly reduce shame by connecting patients with others who truly understand their struggles. She also highlights a vital realization created in group settings: the acceptance of vulnerability. Patients learn that being vulnerable is acceptable because their core selves are intact and unblemished by their experiences. This mutual recognition of inherent worth helps patients accept themselves and others, creating a supportive community where everyone can feel truly ‘okay’.

Healing Emotional Abandonment in Dysfunctional Families

Much of Dr. Black’s work focuses on healing emotional abandonment, which can take many forms and roles. Her books and speeches cover the realities of growing up with parents with substance use disorders, abusive parents, and emotionally unavailable parents. Dr. Black defines emotional abandonment, stating,

“Emotional abandonment is when you have to hide a part of who you are in order to be acceptable.”

Emotional abandonment can skew what children believe about themselves, especially as they grow into adults. For example, they may believe showing emotion is weak or being kind to others opens them up for attack. Dr. Black adds,

“So what are these parts of self that I’m having to hide? Was it okay to make a mistake in this family? Or did you learn that if you did anything less than perfect, there was something wrong with you? Was it okay for you to have feelings?” 

As a result of emotional abandonment from abuse, emotional detachment, or absent parenting, children can turn to substances and illicit practices to find comfort and community. 

This quote poignantly addresses the deep-seated fears and insecurities many people carry into adulthood, often stemming from their familial environments. It challenges us to reflect on the parts of ourselves we’ve felt compelled to hide, questioning whether our upbringing allowed room for mistakes or if perfection was the unattainable standard. This introspection helps us understand and heal the internalized beliefs that may hinder our personal growth and emotional well-being.

Substance Use to Numb Emotional Pain

One of Dr. Black’s books, It Will Never Happen to Me!, highlights the connection between children of addiction and becoming a substance user themselves, despite seeing the effects and damage of addiction first-hand.

She notes how children of addiction almost always experience emotional abandonment, which can lead to substance use as a way to cope with the pain and manage their emotions on their own. As they get older, children of addiction and/or abusive parents may also use substances to numb painful memories and the trauma of their experiences. Even if these children, who watch their parents suffer with addiction, vow to live differently, they can end up following the same pattern. Dr. Black says, 

“If becoming addicted was an issue of willpower, children of addiction would be the last ones to become addicted. But it has nothing to do with willpower. What happens is alcohol or drugs can do something for this child that it doesn’t have to do for somebody else. It can give them a greater sense of confidence. It can give them courage. It can give them a sense of empowerment against the powerlessness in their life.”

The Role of Family Therapy and How It Works

Family therapy is an important part of treatment for all age groups, but especially young adults. Dr. Black deftly explains the importance of family therapy, anxieties and misconceptions family members may have, and how the patient and their loved ones can optimize the experience for their collective healing. 

Dr. Black notes common fears loved ones have coming into treatment:

“Anybody who walks into the treatment setting is very scared. It’s very vulnerable, in a way that is foreign to them.” … “So they’re, they don’t want to be part of a treatment program because they feel so guilty or they feel like they’re going to be blamed.”

These anxieties and fears are some of the reasons why Dr. Black and many other treatment providers focus on creating a welcoming, non-judgemental space for families to learn more about the condition their loved one has and discuss their experiences. What this reaps is:

“…the patient, the identified patient, the client themselves who goes to treatment, probably has a better chance of recovery typically when family members participate in family programming and ultimately experience their own recovery process.”

Sessions with loved ones often center on education, helping them understand each aspect of the patient’s behavior and conditions. It also helps them understand their own needs and recovery process. Dr. Black says, 

“Most of the family members, when they leave, will walk away saying, I couldn’t believe that I’d have a recovery process. I didn’t even know that I had something that I needed to recover from.”

“People Are So Resilient”

Dr. Black describes the inspiring sense of resilience each person has, and how that contributes to their recovery journey. She also describes real stories of resilience in her book Undaunted Hope. On resilience, she says, 

“So being able to recognize that some of what was survivorship is where our resiliency is today, as well. You get to keep the strengths that you created. A lot of dysfunction or a lot of trauma in your life, you get to keep the strengths. You just want to take away the rigidity of those strengths.”

Dr. Black gives an example of someone used to taking control and taking care of others. They turn out to be a natural leader, which is an inner strength, but can be over controlling and micro-manage. Loosening the reins allows this person to still lead, but be a better listener, more receptive to feedback, and gentler in how they communicate. 

Promising Trends and Innovations in Addiction Treatment

Dr. Black pointed out new trends in addiction treatment and suggestions for how providers can offer better care. One, she suggests new providers read her book Undaunted Hope for the real-life experiences highlighted in the book and stories of resilience. She adds,

“You have to know addiction. You don’t have to specialize in the field of addictive disorders. But you can not, as a mental health professional, work in this field and not know addiction and be open to the fact that that could be what it is that’s going on.”

As far as emerging trends and needs, Dr. Black says, 

“I think that we need to pay more attention to long term, what supports long term recovery and that, from an inpatient treatment standpoint, 45 days is not enough. It’s a wonderful start, but I don’t think that we’ve given credence to those next handful of months into this first couple of years.”

Dr. Black sheds light on evolving trends in addiction treatment and offers critical guidance for care providers. She emphasizes the importance of a deep understanding of addiction, regardless of a provider’s specialization, highlighting that it is essential knowledge for any mental health professional. Dr. Black also advocates for a reassessment of treatment times, pointing out that while a 45-day inpatient program is a good start, it doesn’t always support long-term recovery. She stresses the need for extending care well beyond these initial stages, which can significantly bolster recovery outcomes.


This episode was rich in information and wisdom. To find out more about this episode and Dr. Claudia Black’s work, listen to her podcast here!

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Urge Surfing: A Mindful Technique to Navigate Through Cravings

Have you ever given in to a craving for sugar or salt? Coffee? A movie you’ve seen a dozen times, ignoring all the others on your roster?

These passing, innocent cravings happen to all of us. Indulging doesn’t usually cost your sobriety, relationships, or financial wellness. But the urge to take drugs, drink alcohol, or gamble can. Urges can arise at any point in your recovery journey and can derail even the straightest course. That’s where urge surfing comes in. 

Urge surfing, a specialized mindfulness technique, can help you “ride the wave” of an urge and experience them less and less. Urges typically last 30 minutes at most when they’re handled mindfully and calmly through urge surfing.

You can use urge surfing for more than addiction recovery, too. Use it to navigate any kind of urge, anytime, anywhere.

Introduction to Urge Surfing

Psychologist Alan Marlatt developed the mindfulness-based urge surfing technique1 as a quick and effective way for people to navigate cravings. Urge surfing is based on the mindfulness principle that urges, like waves, rise, peak, and eventually crash and dissipate. It sees addiction cravings as “rideable” and bearable with the right tools and practices.  

Compared to other interventions, like mindfulness-based cognitive behavioral therapy, urge surfing has a much faster impact. You may immediately notice benefits instead of the expected 2-4 weeks with traditional therapy and other interventions. You can also practice urge surfing almost anywhere, whereas traditional therapy often occurs in a specific setting (like an office you have to travel to). And, you can urge surf without the guidance of a professional, making it even more accessible.

With its ease and effectiveness, urge surfing has been used as a tool for addiction recovery1 and craving management. It teaches you to mindfully notice, sit with, and “ride” urges without self-judgment or fear.

Understanding Cravings and Impulses

Cravings are strong desires for something, like dessert after a meal or a cup of coffee on a groggy morning. People in recovery and active addiction often experience cravings for substances. Cravings can occur as your body adjusts to not having a substance, like alcohol. Certain places, situations, and emotions can also trigger cravings2, since your brain relates substance use to relieving stress and other unpleasant emotions. Even someone in long-term recovery can experience intense cravings. 

Impulses are sudden desires to do something. For example, you may see a soft blanket and feel a strong impulse to run your hand over it. You might reach out to touch it without even thinking about it. But, some impulses you first feel, notice, and then decide to act on it or not, like an impulse to touch a hot stove. While impulses are typically brief and fleeting, they can feel intense and usually lead to immediate action. This distinguishes them from cravings, which are persistent desires for something specific. 

An urge can feel more dire and discombobulating than a craving or an impulse. Negative emotions, like sadness and anxiety, can increase urges3 and make them harder to resist. But urge surfing can mitigate the urge and soothe the emotions flowing with it.

The Principles of Urge Surfing

The grounding principle of urge surfing is that you can navigate and alleviate urges without giving in. It hinges on mindfulness and experiencing emotions without self-judgment, fear, or worry. You may not experience a change in your urges, but rather in how you respond to them4. By staying present and focusing on the sensations in your body, you can ride out the urge without giving in to it.  

The “wave” you ride has 4 core parts: a trigger, rise, peak, and fall. As you continuously surf these waves, you’ll get better and better at understanding and alleviating urges. 

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Step-by-Step Guide to Urge Surfing

The process of urge surfing5, like cravings and urges themselves, varies from person to person. One person may quickly ride the wave of an urge, while someone else may need a half hour of peaceful solitude to reach the end of the wave. So–listen to your body and what works for you without expectations or judgment. If you don’t feel it helps right away, stick with it. Try it again and keep yourself open to the possibility of success.

Acknowledgment

Urge surfing starts by noticing and acknowledging what you’re feeling. This may look like:

“I want a drink right now. I feel my mouth watering and want the sensation of it in my stomach. I’m irritated and distracted because it’s hard to think of anything else.”

You can also notice your environment, mood, and other factors that may have triggered the urge. Did you see or feel something that triggered it? Make note of it if you can. 

Acceptance

Next, you accept the urge, rather than resist or condemn it. It’s happening, but you can choose how you respond to it. Now, if you want, you can also adjust your environment. Maybe sit in a private room, cross-legged with your eyes shut. Keep in mind you can urge surf anywhere, but have the option to pick your environment.

Stay Present, Curious, and Patient

Stay on the wave—notice and accept however intense the urge feels with curiosity and patience. Don’t force yourself to do anything about it, just experience it. Even if it feels bad or uncomfortable, you’re still in control. Picture a wave in your head, and that you’re on top of the crest as it moves towards the shore. 

Use your breathing as a grounding tool. Imagine it as the pulse of the water beneath you, moving within the wave. 

Reorient as You’re Ready

Check in on how intense the urge feels. Does it feel distant now? Do you feel more in control? If you do, you’re ready to come to shore. Reorient to your surroundings (what you can hear, feel, smell, and taste) and open your eyes if you shut them. 

Reflect on the experience and what you may have learned from it. Write it down or record a voice note. Keeping track like this can help you realize progress, learn what triggers your urges, and know yourself better.

Applications of Urge Surfing

You can use urge surfing for all sorts of cravings and urges, related to addiction or not. Less intense urges, like an urge to check social media or have a certain food, can pass quickly with urge surfing. The intense urges to use substances can take longer to “ride”, but it’s just as doable. 

You can also use urge surfing as a tool for emotional regulation, which works almost the same way. Instead of riding an urge, you move through an intense emotion like anger or panic. You’ll notice the emotion and accept it without judgment, then let it pass without acting on it.

Because you can urge surf almost anytime, anywhere, it’s a practical tool for the cravings, urges, impulses, and intense emotions encountered in daily life. You could surf the urge to respond angrily in a work email, or use urge surfing to cut down on or quit smoking.

Challenges and Support

Those who dislike or struggle with meditation may find urge surfing tedious. Practice and repetition can help, especially if you make your environment as comfortable as possible. Try playing instrumental music or binaural beats to help you focus.

The intensity and discomfort of urges can also pose a challenge, as urge surfing requires you to feel but not to act on the urge. Sitting with that discomfort can feel difficult at first. But as you keep doing it, you’ll get more used to the process and confident in your ability to “surf” safely to shore.

Build Hope as You Hang 10

Urge surfing serves as a powerful sobriety tool and resource for hope. Use it to manage urges to take substances, impulses, and reactive behaviors any time in your life. You can see just how capable you are of managing urges and navigating challenging moments.

As you become more adept at urge surfing, you’ll discover a growing confidence in your capacity to manage difficult situations and make empowered choices in your recovery. This skill doesn’t just apply to sobriety; it’s a life skill that enhances your overall self-efficacy and agency. Each successful experience of riding out an urge reinforces a hopeful outlook, showing you can overcome challenges and continue on your path to recovery and well-being.

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Ethical Care and Recovery: A Cornerstone for Healing

Ethics and quality treatment go hand-in-hand. One often doesn’t exist without the other and if they do, the impact of either lessens. In an industry shaped by unethical practices, some of which have just become the norm, a pursuit of ethics sets many organizations and providers apart.

We’ll explore what ethics are in the behavioral health industry and why they’re such an important part of recovery—regardless of the conditions present, the level of care, or patient preferences. Ethics remain the baseline of effective care.

Listen to our podcast episode with Marvin Ventrell, CEO of the National Association of Addiction Providers (NAATP), to learn more about ethics in treatment from the person who spearheaded the effort.

Ethics: What They Are and Why They Matter

At first thought, ‘being ethical’ may sound like feeding the homeless, treating others fairly, or being honest. People without ethics often star as villains in books and films, but in reality, a lack of ethics often shows in more subtle ways. Sometimes, that’s because we or another party don’t know the ethics of a certain industry, place, or demographic and act unethically by accident. Other times, acting unethically is an intentional choice to manipulate and mislead for personal gain. Usually, monetary.

Treatment that prioritizes ethics both improves the chances of success and helps patients feel respected and cared for, which maintains their dignity. Lacking ethics has consequences, from being hurtful to costing someone the recovery opportunity they deserved. In dire cases, unethical practices can directly or indirectly end someone’s life. 

Unethical Practices in Addiction Treatment

Ethics in the addiction treatment space have gotten more robust and structured, but that wasn’t always the case. Old practices still happen today and, unfortunately, can marr the otherwise respectable reputation of treatment providers. These are some of those practices.

Patient Brokering

Patient brokering is the practice of unethically attracting people to a certain treatment center through a broker that offers free flights, gifts, money, or even drugs. The ‘broker’ who refers them to treatment gets a compensation fee. Sometimes, brokers will help people relapse and then encourage them to go to the specific treatment center that gives them compensation. Brokers may share their fees to encourage patients to relapse and go to treatment.

The Affordable Care Act requires insurance companies to pay for addiction treatment, which means patients with good-paying insurance are often the targets of patient brokering, or body brokering. Once the patient’s insurance is charged, they’re run through treatment quickly, primed to relapse and return again to the center (so they can charge their insurance again). 

Thankfully, patient brokering has become illegal and therefore less common. But it still happens. States like Florida and California still battle shady providers and brokers, shutting them down as soon as they can. 

Misleading Marketing

Some treatment centers rely on misleading marketing to draw in patients—and their insurance. AI-generated images or generic stock photos make the center look nicer than it is, or advertise amenities and therapies that don’t actually exist (like private bedrooms, a pool, or equine therapy). The center could also claim they have more experienced or higher qualified staff than they actually do, like saying all their therapists are masters-level when they aren’t.

Thinking they’ve found an amazing center at an equally amazing price, patients or their loved ones may commit to treatment and pay upfront for their care without realizing they’ve been duped. 

Paying for Leads

Some treatment providers pay for ‘leads’ to their website, which are website clicks, phone calls, or messages indicating interest in treatment. For example, a treatment center may pay a directory or call center to send them a certain amount of leads. One way a call center can do this is by saying other treatment centers are full or closed, leaving the one paying them as ‘the only option.’ 

Lack of Transparency

Some treatment centers purposefully make it difficult to ascertain what they do and how they do it. They may also distort what the living conditions will look like, using vague statements like, “Patients are onsite.” (Living where? What are the rooms like? Is it actually residential? Will there be meals?)

The admissions staff are often just as vague, encouraging you to make your payments, get through the admissions process, and start treatment instead of answering questions. Once you get to the center, you may realize it’s not a good fit or not at all what you expected. 

Exposing Patient Identities

One of the last things many patients want is to see their face plastered over marketing materials or used on the website of the place they went to get treatment. Addiction and mental health treatment is deeply personal and often vulnerable; not something people often want disclosed (especially celebrities or high-ranking corporate employees/employers).

Unethical providers sometimes use pictures of patients to capture their treatment services and amenities. If treatment centers do use pictures of patients in their marketing materials or on social media, the patient must be fully aware and give their approval before the image can show anywhere on the internet or printed materials. 

Ethical Practices in Addiction Treatment

Many treatment providers and industry leaders recognize and prioritize ethics in treatment, slowly but surely changing the entire industry and restoring its reputation. Here’s how.

Clear Advertising

This applies to the treatment center advertising themselves and 3rd-party sites advertising the center. For the center, it means any material or messaging about their center is clear and not misleading. They clearly state what they are, what they do, and what patients can expect. Not only is this ethical and kind, it reduces fear of the unknown (FUD), which can be a barrier to treatment.

Third parties prioritize ethics by clearly marking which listings on their website are paid advertisers. At Recovery.com, for example, you’ll see we mark each treatment provider that pays for an extended reach. This lets visitors and potential patients know what is and isn’t an ad. 

Accurate Language and Images

The way a center portrays themself makes a big difference. If they say they’re the best rehab ever and upload a dozen stock images of a luxury spa, that’d likely change the way a potential patient views them—and sway their treatment decision. 

Sticking to the facts of what they treat, how they treat it, and including pictures of their center only make for a more ethical portrayal. Clear content and pictures also help potential patients make quick, informed decisions at a difficult time.

Updated and Accessible Licensing Information

A good indicator of quality care comes from 1) clinical licensure from the center’s country and state and 2) accreditation from organizations like the NAATP, The Joint Commission, LegitScript, and CARF. 

Many providers make these accreditations and licenses easily viewable on their website. You can also search the accreditor’s website for the specific treatment center to see if they’ve been accredited by them.

While licensure and accreditations don’t guarantee successful treatment, they can help you decide on a center and feel more confident in the quality of care you or a loved one will receive. 

Cultural Competency

Cultural competency means the staff at a treatment center have a learned or lived experience that allows them to understand someone’s culture, and how their culture can affect treatment. Cultural competency can help LGBTQ+, non-white, religious, and disabled people feel more comfortable, safe, and understood in treatment.

Making Every Effort to Offer Effective Care

Imagine if you went to the doctor for a sprained ankle and the staff only tossed you an ice pack. Some treatment providers do close to the same thing for addiction and mental health treatment; bare minimum services that don’t address core issues. 

Ethical providers do the opposite: making every effort to give you the best, most effective care they can. They collaborate with each other to better understand your needs and check that they’re addressing them. Depending on their services and available resources, you’ll receive the therapies and practices best attuned to what you need to recover.

Though effort and best intentions don’t guarantee recovery, they go infinitely farther than lackluster care and band-aid solutions. 

Organizations Enforcing Ethics

How does the treatment space enforce the concept of ethics and ethical practices? It takes the bravery and efforts of many organizations determined to improve the space and save lives. One of those organizations is the NAATP, who’s CEO we were privileged to talk with in our recent podcast episode. You can listen to that to learn more about his story and how the NAATP put their stamp on ethics. 

The Joint Commission also offers accreditation for many types of treatment providers. To gain accreditation from the NAATP and The Joint Commission, treatment providers go through rigorous screenings and approvals similar to state licensing. These organizations focus more on ethical care, though, which differs them from a center meeting the state requirements to operate. 
With these organizations and the passion behind them, finding quality, ethical addiction treatment is more than possible. People care. Hope is for everyone.

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Addiction Education in Rehab: Empowering Recovery Through Knowledge

Understanding addiction and mental health provides crucial stepping stones to long-term recovery. That’s why many rehabs provide psychoeducation, which teaches patients about behavioral health conditions. In a psychoeducation class, you’ll learn more about particular substances, how they work, their long-term effects on your brain and body, and why cravings happen. It also explains the connection between addiction and mental health conditions.

Gaining this understanding of yourself and your recovery journey can better prepare you for the road ahead, helping you feel confident in your ability to identify triggers, coping mechanisms, and relapse risks. 

Introduction to Addiction Education

Addiction education1 teaches the biological, psychological, and social aspects of addiction. The goal is to demystify the process of addiction recovery and provide vital insights into treatment. Learning about addiction can help people feel more empowered in their recovery and in supporting loved ones.  

Psychoeducation raises awareness about the nature of addiction, including how drugs impact the brain, the progression of tolerance and dependence, and the addictive cycle. Understanding the scientific basis of addiction can help people acknowledge the chronicity of the disorder and why long-term management plays a crucial part in their recovery.

Addiction education in rehab also emphasizes and teaches coping skills for relapse prevention. Patients learn how to recognize triggers, handle cravings, and navigate high-risk situations (like acute stress) without resorting to substances as a coping mechanism. It prepares them for “real-world” settings to bolster confidence in their recovery.

What It Looks Like

Psychoeducation in rehab looks a lot like a regular classroom. You’ll sit in a circle, at tables, or in rows with a whiteboard or screen up front. A “teacher” leads the lessons; they may be therapists, counselors, psychologists, doctors, or someone with lived experience. You’ll commit an hour or so to learn, potentially watching videos and engaging in discussions with the teacher and your peers. Your teacher may also encourage you to take notes.

Core Topics Covered in Addiction Education

Addiction education typically covers the neurological effects of substances, the impact of mental health conditions, the health risks of addiction, and how to recognize and cope with triggers. These topics can go in-depth, like learning how addiction rewires the brain, or broadly address ideas and themes. Classes may also focus on a specific substance, like cocaine or fentanyl. 

Methods of Delivering Addiction Education

Peer interaction, group discussions, and lecture-style lessons provide addiction education. Videos and written projects also contribute. You may watch videos or animated depictions of how substances affect the brain, for example. The educator will likely ask questions or prompt group discussions each session. You and your peers are encouraged to voice questions throughout the lesson to help yourself and others learn.

Psychoeducation may also include interactive workshops, where you and your peers have a more hands-on experience by acting out scenarios or seeing creative depictions of them. For example, you might study a plastic brain to see where addictive substances impact the reward system. Cartoons and drawings help visual learners1 understand and relate to information.

Learning could take place individually, in a group, or in a family setting2. The exact setting will depend on your program and how they structure psychoeducation.

The Impact of Addiction Education on Recovery

Learning about addiction helps you become more self-aware1 and make better-informed choices on your recovery journey. Knowing what triggers cravings can help you avoid them. And, you’ll learn coping tools to manage cravings both long-term and in the moment. These tools, gained by psychoeducation, can strengthen your recovery and empower greater confidence in your journey.

Psychoeducation has been found to improve treatment outcomes1 by reducing relapses and promoting abstinence. It also improves treatment compliance, which can help people stay in treatment longer and get the healing they need.

Integrating Education with Other Treatment Modalities

Psychoeducation in addiction treatment flows in tandem with therapy, medical care, and holistic therapies. It complements each facet of treatment by helping patients better understand the process and how each component works towards recovery.

For example, psychoeducation can educate patients on the medications they’re taking. They’ll learn more about the medication and what it does, helping them understand its benefits, potential side effects, and commit to taking it as prescribed. 

Overcoming Challenges in Addiction Education

Participants can run into challenges in psychoeducation, despite its many benefits. Challenges won’t necessarily make addiction education ineffective, but they can limit how much patients engage in the lessons. Here are some examples of common challenges in addiction education:

  1. Unengaging teaching styles 
  2. Unenthusiastic facilitators
  3. Poorly designed and confusing lessons distracting from the content itself
  4. Mental health and/or learning conditions affecting learning abilities
  5. Peers not getting along
  6. Bias, prejudice, and lack of cultural competency from facilitators

To face these challenges, providers can ensure they assign competent, enthusiastic teachers with clearly defined lesson plans that patients can access beforehand to know what to expect. A syllabus, for example, would detail what patients can expect to learn and keep their lessons moving toward defined goals and milestones.

Teachers should also have access to a variety of learning materials, helping them adapt to various learning styles and meet the needs of their ever-evolving students. Additional training on inclusivity, diversity, and anti-bias can help facilitators create more welcoming environments students feel comfortable engaging in.

Continuing Education and Support Post-Rehab

Addiction education doesn’t end after rehab. You can keep learning every day, in big or small ways. 

Educational Courses and Training

Online training or college courses can deepen your knowledge of addiction and earn you a certification or degree. Your classes will mimic psychoeducation classes in rehab but with graded homework and assignments or other completion requirements. Colleges may offer these courses or platforms like Coursera. 

Support Groups

You can find local or online support groups by searching the internet or connecting with your local community. For example, you could check with your community center for guidance and see where local groups take place. Alcoholics Anonymous (AA) or other 12-Step groups likely exist in your area and actively welcome new members. Online groups connect you to others in your state, country, or worldwide to share and receive support.

Community Engagement

Your town or city may have activities and groups for those in recovery, like monthly dinners or sports clubs. Even if they’re not geared toward people in recovery, you can still join a group that seems fun to you and meet new people, learn about their experiences, and build your support system.

Learning to Hope

Addiction education in rehab serves as a powerful tool in recovery. It helps you understand how addiction works, what it does to your brain, and why certain triggers cause cravings. Psychoeducation helps you create relapse-prevention strategies centered on your new knowledge of your addiction and contributing factors, like mental health conditions, to empower your recovery.