Author: Hannah Friedman

Hannah is a writer with a focus on holistic wellness. Her work explores post-traumatic growth and mental health as an intersectional issue. In addition to writing for Recovery.com, she’s composed meditations for the NatureSpace app, articles for the Cardea app, and essays on the connection between physical and mental health. In her private practice as a massage therapist, she works primarily with LGBTQIA+ clients and survivors of assault.
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What Does the Bible Say About Addiction? Insights and Guidance

Healing from addiction can be a spiritual experience. For some people, the Bible is an important resource during this process. If Christian principles resonate with you, there are many ways to incorporate them into your recovery journey.

Biblical Concepts and Teachings Related to Addiction

Some scholars call addiction a “crisis of faith.”1 Drug or alcohol addiction changes your priorities. You might lose track of what you once cared about, putting your addiction before other parts of your life. Christian teachings can help you reframe your values. 

The Bible frequently refers to the duality of good and evil.2 Spiritual warfare is the ongoing battle between these forces. If you have an addiction, it might feel like that fight is taking place within your mind and body. 

Some Christians compare drug cravings to spiritual temptation.3 Whether or not you believe doing drugs is a sin, addiction can certainly cause harm. Treatment gives you coping strategies to manage your cravings, knowing they might never go away. If you see recovery as a battle against temptation, you can arm yourself for that battle with the skills you learn in therapy. 

Examples of Addiction in the Bible

Certain Biblical passages offer valuable insight into addiction. 

The Prodigal Son

In the parable of the prodigal son,4 a son leaves home and squanders his father’s wealth. Facing poverty and starvation, he returns home to ask for help. Despite his mistakes, his father welcomes him home with open arms. 

This passage teaches that asking for and offering forgiveness is essential to Christianity.5 To heal from addiction, you first need to admit that you need help. For many people, this means attending rehab or joining a support group. It can also mean learning how to heal yourself. Either way, setting an intention to recover is usually the first step.

Samson and Delilah

The story of Samson and Delilah also sheds light on the nuances of recovery. Some modern-day interpretations say Samson had a sex addiction.6 He put his love affairs before his well-being. Ultimately, he surrendered all his power to Delilah by telling her the source of his strength—symbolically giving in to his addiction. 

When Delilah cuts Samson’s hair, he becomes powerless. But the story doesn’t end there. While he’s in prison, his hair continues to grow. Even when it seems like all hope is lost, he naturally makes progress toward freedom. 

In the same way, the process of addiction recovery can surprise you. Healing is nonlinear, and it requires great courage. For some people, spiritual teachings are a source of strength.

Encouragement and Hope for Those Struggling With Addiction 

According to one study, “religion and spirituality can play a powerful role in the prevention and treatment of substance abuse7 and the maintenance of sobriety.” There are several factors at play here. 

The Value of Prayer

No matter where you are or what you’re doing, you can express your faith through prayer. That could mean anything from speaking aloud to a higher power to silently focusing your energy. You can pray alone, with a religious mentor, or in a larger spiritual community. This practice is constantly accessible. 

Prayer has more than spiritual value. It also affects your brain chemistry.8 Data shows that silent prayer activates your reward system. Because addiction damages your reward system,9 the act of praying can make it easier to heal.

Healing Through Fellowship

Community is a vital part of addiction recovery. One study found that people in faith-based communities are less likely to abuse substances.10 These communities offer fellowship, emotional support, and accountability. 

Many Christian communities are open to members. You can easily find a church or a Bible study group in your area. You might also consider joining a 12-Step group like Alcoholics Anonymous (A.A.). While this fellowship draws inspiration from Christianity, 12-Step groups welcome people of every faith.

Biblical Principles for Recovery and Healing 

Dr. Harry Schaumburg, a Christian counselor, writes that “recovery is not repentance,11 and repentance is not recovery.” However, these ideas are deeply connected. 

Repentance occurs when you admit you have an addiction, turn to God, and sincerely ask for help. This might also be the moment when you quit drinking or using drugs. But healing isn’t always that simple. It could take you longer to act on your newfound faith. 

As Schaumburg says, “Heart change brings high motivation for behavior change.” In other words, repentance paves the way for recovery. At this point, you might go to rehab, seek spiritual guidance, attend therapy, or more. These practices can help you reconnect with your higher spiritual purpose.

Addressing Common Misconceptions and Criticisms

Spirituality can guide you toward a better life, but it’s just one aspect of recovery. For example, physical dependence on a drug sometimes requires medical intervention. Faith-based approaches can’t replace other types of care. 

Faith-based recovery isn’t for everyone. If spiritual ideals don’t resonate with you, this approach might not be a good fit. But if you take comfort in religion, Christian rehab can be highly effective.12 Data shows this type of treatment helps people maintain both their ongoing sobriety and a long-term connection to faith. Learn more about faith-based rehab to decide if it’s right for you.

Resources and Tools for Integrating Faith and Recovery

There are several ways to integrate Christian principles into your recovery journey.

Support Groups

  • 12-Step groups offer spiritual fellowship to people of all religious backgrounds.
  • Celebrate Recovery is a group for Christians recovering from addiction, mental health issues, loss, and more.
  • Life Recovery follows a 12-Step program like that of Alcoholics Anonymous. Unlike other 12-Step groups, these meetings have a strong focus on Christianity. 

Books

You can also incorporate religious ideals into residential treatment. Connect with a Christian rehab program to learn how. 

Frequently Asked Questions About What the Bible Says About Addiction

What biblical teachings can help people struggling with addiction?

The Bible offers insights into addiction, emphasizing the importance of faith, repentance, and forgiveness. It addresses the duality of good and evil and provides guidance on spiritual warfare. By reframing values and viewing recovery as a battle against temptation, Christians in recovery can find strength and healing in biblical teachings.

How can prayer and fellowship contribute to addiction recovery?

Prayer not only provides a constant practice that allows people to connect with their higher power, but also positively impacts the brain’s natural healing processes. Fellowship within faith-based communities provides emotional support, accountability, and a sense of belonging. Prayer and fellowship, as emphasized in the Bible, can play a powerful role in maintaining sobriety.

Is faith-based recovery suitable for everyone?

While faith-based approaches can be highly effective for those who resonate with spiritual ideals, they can’t replace other types of care, such as medical interventions for physical dependence. Faith-based recovery aligns with Christian principles and can help patients maintain long-term sobriety and a connection to faith. Consider your personal beliefs and preferences to see if this approach is right for your recovery journey.

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What Is Cross-Addiction?

What does cross-addiction mean? In short, it means that you have multiple addictions. But there’s a lot more to it than that.

Usually, people with cross-addiction switch out one behavior for another. Sometimes, it’s even called “addiction transfer.” For example, imagine you go to rehab for alcohol addiction, and successfully avoid drinking after the program. But once you return home, you develop a new addiction to cocaine. If something like this happens to you, you might need additional treatment.

Cross-addiction is a unique experience, and recovery can be complex. When you’re ready to plan your recovery, you can start by learning more about what it means to be cross-addicted.

How Does Cross-Addiction Happen?

Researchers are still studying the risk factors for cross-addiction.1 We need more information to fully understand its causes. But data suggests that genetics and stress can make you more vulnerable. Experts also believe that cross-addiction follows 1 of 2 patterns:

  1. Substituting a past addiction with similar behavior (e.g., quitting gambling and developing a sex addiction)
  2. Switching between addictions based on their availability, with equally severe symptoms for each one (e.g., recovering from daily heroin use and starting to do cocaine every day)

There are a few reasons this could happen during recovery. For one thing, any kind of addiction hijacks your reward system.2 It can get to the point where addictive behaviors are the only thing that makes you feel a sense of achievement. So developing a new addiction might make you briefly feel that reward again. But we need more data to know how big a role the reward system plays in this process.

How Common Is Cross-Addiction?

Because there are so many possible types of cross-addiction, it’s hard to collect broad data about this condition. But a few specific combinations are especially common:

Some experts compare cross-addiction to relapse.6 While not identical, these issues can have a similar effect on your journey. And data shows that 40-60% of people relapse at least once during recovery.7 

Common Cross-Addiction Examples

Cross-addiction can occur with any type of addiction, including substance abuse and compulsive behaviors. Learning about some common cross-addictions can help you protect against them in recovery.

Gambling

Gambling addiction is a behavioral issue. Unlike drug or alcohol addictions, it rarely includes physical symptoms. But it can still get very serious. Compulsive gambling interferes with your financial security, career, and relationships. One study found that gambling addiction often co-occurs with video game addiction.8 

Sex Addiction

In moderation, sex can be an important part of your life. But when you start prioritizing sex over all else—including committed relationships, work, sleep, and your physical health—you might have a sex addiction. 

While sex addiction isn’t in the DSM-5, it is diagnosed in ICD-11 as compulsive sexual behavior disorder (CSBD).9 This falls under the category of behavioral addiction, or impulse control issues. Data also shows that people with sex addiction often have additional behavioral issues. In one study, nearly 40% of people with sex addiction also had a work addiction.10

Compulsive Shopping

Shopping addiction, also called compulsive buying disorder, is another behavioral addiction. Compulsive shopping increases your risk of drug addiction,11 eating disorders, and depression. Up to 1 in 20 people may have a shopping addiction. 

Prescription Medication

Data shows that people with health problems are more likely to abuse prescription drugs.12 This may be an issue of access. If you already have opioid medication in your home, for instance, it’s far easier to abuse. And what’s more, experiencing chronic pain increases your risk of cross-addiction.13 People with chronic pain may have easier access to prescription medication, especially opioids. 

Data shows that opioids, marijuana, and alcohol all have similar effects on the brain.14 Addiction to any of these substances can make you vulnerable to abusing the other two. 

How to Avoid Cross-Addiction?

Certain coping strategies can help you avoid cross-addiction before it becomes a problem. 

Self-Awareness

Until your triggers become intuitive, you can use tools to track your feelings and behaviors. For example, some mood tracker apps let you associate emotions with activities. If you notice that the mood “anxious” usually appears just before an activity like shopping or gambling, you can bring that information to your care team. This self-awareness can help you make changes before developing a new addiction.

Educate Yourself on Cross-Addiction

Learning more about any condition can help you stay safe. If there’s a specific substance or behavior you’re concerned about, start there. Once you understand the risk factors for a type of addiction, you can get the support you need before it becomes a problem. 

Group Support

A wealth of data shows that social support is essential during addiction treatment.15 That means something a little different for everyone. You might have a close relationship with friends and family, attend support groups, or live in a sober living environment. In any setting, strong relationships can help you stay grounded throughout your recovery.

Speak With a Professional

There’s no one-size-fits-all solution for cross-addiction. The right provider can help you navigate the complexities of treatment, offering advice tailored to your needs. With personalized support, you can stay on track to reach your unique goals for recovery.

How to Treat Cross-Addiction

There are nearly infinite types of cross-addiction. You could become cross-addicted to cocaine and gambling, marijuana and alcohol, or sex and video gaming. As a result, there are countless ways to heal from this condition. However, a few treatments stand out:

  • Cognitive behavioral therapy (CBT)16 is one of the most popular and effective treatments for any kind of addiction. In this behavioral therapy, you’ll learn to identify triggers and respond to them in new ways. Your therapist will also teach you practical coping skills for real-world situations. 
  • Contingency management (CM)17 is a treatment that offers patients tangible rewards. For example, if you pass a drug test, you might receive cash or movie tickets. Data shows that CM is highly effective for people with multiple simultaneous addictions. We still need more information about its impact on cross-addiction, specifically. 
  • Relapse prevention (RP) and mindfulness-based relapse prevention (MBRP)18 teach coping skills and build clients’ self-confidence. Evidence suggests that these treatments protect you against abusing any substance, even ones you haven’t used before.

Find a Treatment for Cross-Addiction

On the road to recovery, cross-addiction is a relatively common hurdle. You can get back on track in a rehab program that treats addiction.

Frequently Asked Questions About Cross-Addiction

How does cross-addiction happen?

The causes of cross-addiction are still being studied, but genetics and stress may make you more vulnerable to it. Cross-addiction occurs by substituting a past addiction with similar behavior, or by switching between substances based on availability. Addictive behaviors hijack the brain’s reward system, making the development of new addictions possible.

How common is cross-addiction?

Collecting broad data on cross-addiction is challenging due to the many possible combinations of addictive behaviors. However, some specific combinations are more common, such as alcohol addiction and prescription drug abuse. Studies suggest that approximately 1.1% of adult Americans had simultaneous alcohol and drug addictions. Cross-addiction shares similarities with relapse, and research shows that 40-60% of patients relapse during recovery.

What are some common examples of cross-addiction?

Cross-addiction can manifest in various forms, including substance abuse and compulsive behaviors. Some common examples of cross-addiction include gambling addiction, sex addiction, compulsive shopping, and addiction to prescription medication. Understanding these common cross-addictions can help individuals protect themselves during their recovery journey and seek appropriate treatment when needed.
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Addiction vs. Dependence: What’s the Difference and Why It Matters

The terms “addiction” and “dependence” may sound interchangeable, but they mean different things. Dependence is the physical reliance on a drug. Addiction, on the other hand, has primarily psychological symptoms. You can be dependent on a substance without having an addiction. Most types of addiction include physical dependence—but that’s not always true. When you understand the difference between these issues, you can find the type of treatment that best suits your needs.

Defining Addiction

Addiction means continuing to use a substance1 in spite of its negative consequences. This is a complex psychological condition. Addiction affects the way you think and how you behave. You might feel like your actions are out of your control. While everyone’s experience is different, there are some common signs of addiction:

  • Obsessively thinking about the substance or behavior
  • Feeling like you can’t stop acting on your cravings, no matter how hard you try
  • Developing withdrawal symptoms when you try to quit
  • Isolating yourself or hiding your behavior

People can be addicted to multiple substances at a time. This includes prescription drugs, alcohol, and illicit drugs. You can also develop addictions to behaviors like sex, watching porn, using the internet, and gambling. 

Understanding Dependence

With dependence, your body relies on a substance2 to feel normal. If you go into withdrawal when you stop drinking or taking drugs, you probably have a physical dependence on that substance. Withdrawal symptoms3 vary depending on your exact health history, but a few are especially common:

  • Sweating
  • Tremors
  • Insomnia
  • Nausea
  • Increased heart rate
  • Elevated blood pressure
  • Headaches
  • Seizures
  • Hallucinations 

Both illicit and prescription substances can cause physical dependence on drugs. But there’s a difference between dependence vs. addiction. For example, many people with diabetes depend on insulin but aren’t psychologically addicted to it. You can also come to depend on substances like alcohol, cocaine, marijuana, and nicotine. And some prescription drugs, like opioids, have high rates of both dependence and addiction.4

Even if you only take drugs as prescribed, it’s important to monitor your substance use. Notice when and why you start to physically depend on a drug. If that substance dependence has a negative impact on your life, you could be at risk of addiction.

Psychological vs. Physiological Aspects

It’s possible to have addiction without dependence,5 and vice versa. But if you have both, your physical and psychological symptoms might feed off each other. For example, you might start taking opioids to relieve pain after an injury. Then, as your body heals, lowering your dosage could make you feel anxious. What starts as a physical need can become an emotional one.

Without proper support, this can quickly lead to addiction. When you’re ready to recover, it may help to differentiate between the physiological and psychological aspects of what you’re going through. Doing this empowers you and your care team to choose the most effective types of treatment.

Psychological Aspects of Addiction

There’s a good reason addiction feels so out of your control. Addictive substances change the way your brain works.6 They flood your brain with dopamine, a feel-good chemical that activates your reward system. Over time, substances change the way your brain produces dopamine.7 Drug use might become the only thing that gives you a sense of reward. The National Institute on Drug Abuse explains:

The difference between normal rewards and drug rewards can be likened to the difference between someone whispering into your ear and someone shouting into a microphone. Just as we turn down the volume on a radio that is too loud, the brain of someone who misuses drugs adjusts by producing fewer neurotransmitters in the reward circuit, or by reducing the number of receptors that can receive signals. As a result, the person’s ability to experience pleasure from naturally rewarding (i.e., reinforcing) activities is also reduced.

Physiological Aspects of Dependence

Like your brain, your body can quickly get used to any drugs8 you take. If you use a drug often, you’ll need higher doses to feel the same effects. This is called tolerance. You can develop a tolerance to some drugs very quickly. For example, it takes just 2-3 doses of opioids9 for some people to develop a tolerance.

Once you have a tolerance, you might start taking higher doses to get the same effect. You might also become physically dependent on the drug, and feel withdrawal symptoms if you try to quit. Many people keep using drugs to avoid those withdrawal symptoms. If this pattern continues, it might lead to addiction. 

If your body depends on a substance, withdrawal can range from being uncomfortable to dangerous. Detoxing from certain substances—like alcohol, opioids, and benzodiazepines—can even be fatal. Formal addiction treatment can keep you safe during this phase of recovery.

Implications and Consequences

Addiction can impact every aspect of your life, starting with your mental health.10 Substances change your brain, and might contribute to co-occurring disorders like anxiety and depression. These symptoms, along with other aspects of addiction, can interfere with your relationships. If you prioritize drug use over your colleagues or loved ones, you might face serious consequences. 

Dependence also affects your physical health, whether or not you have an addiction. For example, alcohol dependence can lead to liver problems,11 heart disease, and even cancer. Opioids increase your risk for cardiac and respiratory problems.12 And illicit drug use has a high risk of overdose13 and death.

While addiction and dependence aren’t the same, they often overlap. So when you start recovery, both your body and mind will need time to heal.

Connect with a rehab program for alcohol and drug addiction to determine which treatments can best meet your unique needs.

FAQs

Q: What’s the difference between addiction and dependence?

A: Dependence is a physical reliance on a substance, while addiction is a psychological condition wherein people continue using substances despite negative consequences. While both are often present at the same time, they’re not always the same.

Q: Can someone be dependent on a substance without having addiction? 

A: Yes, you can be dependent on a substance without having an addiction. Dependence refers to the physical reliance on a substance to feel normal, while addiction involves psychological symptoms and compulsive behavior. While most types of addiction include physical dependence, not all cases of dependence indicate addiction.

Q: What are the common signs of addiction?

A: Common signs of addiction include obsessively thinking about the substance or behavior, being unable to stop acting on cravings, having withdrawals when you attempt to quit, and isolating yourself or hiding the behavior in question. Addiction affects the way you think and behave, and it may involve substances or behaviors such as drugs, alcohol, sex, internet use, and gambling.

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What to Do if You Have Debilitating Depression: Understanding Treatment Options and Finding Support

How do you know when you need treatment for depression? We all feel sad sometimes. There’s nothing wrong with sitting with your sadness and reflecting on your feelings as you work through it. But when sadness doesn’t go away, it can hint at a more serious condition. If it begins to interfere with your life, you can even attend a rehab program for depression. 

Sadness vs. Depression 

There are some key differences between sadness and depression. With either, you may feel tired or lost. When you have depression, those feelings persist for longer periods of time, accompanied by a sense of hopelessness or worthlessness. You might even feel numb. Everyday activities you once enjoyed can start to feel like chores. 

Severe depression1 can also take a toll on your physical health, causing restlessness, changes in appetite, and physical aches and pains. And depression often co-occurs with addiction.2 If you have either or both of these conditions, you can choose between several different treatment options.

Available Treatment Options for Severe Depression

When you’re dealing with debilitating depression, it can feel like there’s no way out. But with treatment that aligns with your values, you can build a life you love. The key is to make sure your unique recovery goals are at the forefront of any care plan. To accommodate each patient’s needs, most rehabs offer a combination of treatment approaches.3

Medication

Medication can be vital in reducing depressive symptoms. Mood stabilizers, antidepressants, or antipsychotic medication can help you regulate your brain chemistry. It’s normal to go through trial and error with antidepressant medications. Most people try different types and doses to find the best fit for them.

Psychotherapy

Having a therapist to confide in and talk through your feelings can help you heal from depression. Therapies like cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and family-focused therapy help you address any underlying issues contributing to depression. You—and sometimes your loved ones—will also develop new coping skills to help you move forward.

Inpatient Rehab

If you have severe depression, you can start recovery in an inpatient rehab. These centers offer a safe space to heal without the distractions and stressors of your typical environment. You can choose between a wide variety of programs, including trauma-informed care, rehabs that treat co-occurring disorders, and more.

Outpatient Treatment

With outpatient treatment programs, you can receive similar care to inpatient programs while living at home. Like most other approaches, outpatient treatment is tailored to your specific needs. Intensive outpatient programs (IOPs) let you attend treatment part time, while you continue to work, go to school, or spend time with friends. Partial hospitalization programs (PHPs) offer a higher level of care, but still give you some free time outside of therapy.

Alternative Therapies

If you attend a holistic rehab, you can participate in alternative therapies for depression. These treatments look a little different in every program. For example, you might connect with horses during equine therapy or practice mindfulness in a yoga class. These activities can be hugely beneficial, but they’re no substitute for more traditional treatments. A comprehensive care plan for severe depression could include these options as supplemental therapies.

Finding Support and Coping With Depression

When you’re recovering from depression, building a solid support system is essential. The details of that support system are different for everyone. Anything that keeps you engaged can help you work through difficult symptoms, reminding you that even strong feelings are temporary.

Spending time with family and loved ones you trust can help you feel supported. Opening up to a therapist might give you insight into your feelings. You can also join a depression support group to connect with people going through similar experiences. The opportunities are endless. But data shows that a few specific activities can be especially helpful.

Exercise 

Exercise has many powerful physical and emotional benefits. First and foremost, practicing physical self care is a meaningful way to cope with feelings of depression. Instead of working out so you can look a certain way, the activity itself can be your primary goal.

Exercise is shown to reduce depressive symptoms.4 When it’s hard to get out of bed, the last thing you might want to do is go for a run. But starting small, even for 10 minutes, helps you slowly build endurance and get stronger every day.

Changing Your Diet

Have you ever heard of the link between food and mood?5 Depression can make you skip meals, crave sweets, and indulge in junk food. Foods like refined sugars, processed foods, and fried foods can make depression worse. Adopting a balanced diet can help positively transform depressive symptoms.6

Eating whole foods that nurture your body can improve your mood along with your physical health. Complex carbs, protein, omega-3 fatty acids, and antioxidants are just a few vital nutrients that can help fight depression.

Getting Enough Sleep

Depressive symptoms can intensify when you don’t get enough sleep. Ironically, depression can trigger sleep problems7 like insomnia, making it hard to fall asleep or stay asleep. It can be frustrating to navigate this situation. But making your best effort to improve your sleeping habits is a start. 

You can consistently prioritize sleep with small habits like getting in bed earlier, removing distractions like TV or phones at night, and creating a comfortable sleep environment. These small changes can have a huge impact on the quality of your sleep. You can also ask your doctor or therapist for more specific advice, with your exact symptoms and health history in mind.

Mindfulness Activities

Depression often brings up a lot of dark thoughts. You can take a step back and reflect on your feelings by making time for mindfulness activities like meditation. Mindfulness helps you acknowledge those thoughts without blaming yourself. The act of noticing a thought, accepting it, and then letting it go can empower you to break out of negative cycles.

Creativity 

Many people use creativity as a form of therapy. Spending time on creative outlets like art, music, or web design helps you shift your focus as well. Putting your energy into something positive can help you grow and feel better.

For example, studies suggest journaling is good for mental health8 because it can help you get your thoughts out and clear your mind. Even if your writing is all negative or doesn’t make sense, putting it on the page can make you feel lighter.

Journaling can also help you make sense of your own thoughts and feelings. When you start to notice emotional patterns, you might discover ways to work through them. You’ll also have a written record of your progress, which might help you stay on track when you encounter future challenges. 

The Road to Recovery

The journey to recovery isn’t always straightforward. But with the right support, you can find the best way to improve. For many people, professional treatment is essential. With your care team’s help, you can learn the skills you need to get and stay well.

Healing from depression looks a little different for everyone. You might benefit from any combination of medication, therapy, or alternative treatments. Talk to your provider about which options might best suit your needs, and don’t be afraid to experiment. It can take time to find the most effective approach.

With an effective depression care plan, you can rediscover the things you love most. For example, if you’re a nature lover, your plan might incorporate hiking or time at the beach. Beyond being fun, data shows that spending time outdoors improves mental health.9

Stick to your treatment plan as best as you can. If it feels like it’s not working, get support from your care team. They may suggest changes, or they may encourage you to be patient as treatment takes effect. Healing can be a slow process, and you may experience setbacks. Recovery doesn’t mean that you’ll never feel depressed again. Instead, it means you’ll have the tools to live a rich, meaningful life, even when you’re experiencing mental health symptoms.

Planning Your Journey

As you start to plan your recovery from depression, you can choose from many treatment options. Make sure to put yourself first, and find the type of care that best meets your unique needs. When you’re on the right path, you can take things by day. Small changes in diet, exercise, and other routines can make a huge difference over time. 

Getting professional help for severe depression is a vital part of recovery. When you take this step, you regain power over your own life. Check out our list of depression rehab centers to start your recovery journey. 

Frequently Asked Questions About Severe Depression

What’s the difference between sadness and depression?

Sadness and depression share similar symptoms, but depression is characterized by persistent feelings of hopelessness or worthlessness that interfere with daily life. Depression can also cause physical symptoms such as changes in appetite, physical aches and pains, and restlessness.

What are the available treatment options for severe depression?

Treatment options for severe depression include medication, psychotherapy, inpatient rehab, outpatient treatment, and alternative therapies. These options can be tailored to your specific needs and often include a combination of approaches.

What are some ways to find support and cope with depression?

Building a solid support system is essential when recovering from depression. This can include spending time with family and loved ones, opening up to a therapist, joining a depression support group, exercising, changing your diet, getting enough sleep, and practicing mindfulness meditation. These activities help improve mood and overall well-being.

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What Is a Sponsor in Addiction Recovery? 

As a mentor and friend, a sponsor supports every part of your recovery progress, and plays a vital role in guiding your recovery journey. Whether by answering questions, holding you accountable, or just listening, they can help you commit to healing. Sponsors can help in any phase of recovery, especially when you’re newly sober.

Having a sponsor in addiction recovery isn’t mandatory. However, most 12-Step programs encourage you to find one. To do that, it’s important to understand the purpose of this relationship.

What Does a Sponsor Do?

A sponsor does a lot of different things, but their primary role is to offer guidance. In most 12-Step programs, a sponsor is a senior member1 who has been sober for at least a year. With personal experience in recovery, they can help you learn how to work the 12 Steps. 

Sponsorship is one of the key differences between 12-Step vs. non-12-Step programs. Studies show sponsorship leads to better recovery outcomes.2 Once you connect with your sponsor, you can come to them with any questions about addiction and the program itself. For example, say you have a few tough weeks and miss a couple of meetings. Expect a call from your sponsor to get you back on track. Your sponsor’s job is to hold you accountable, encouraging you to do the work to attain and maintain your sobriety.

Qualities of a Good Sponsor

A good sponsor is there for you but also knows when to let you figure things out for yourself. You should always feel comfortable reaching out to them for help. Here are some qualities to look for in a sponsor:3

  • They can guide you in the right direction: Your sponsor can answer your questions about membership, the 12 Steps, and addiction. They’ll also encourage your program attendance and participation. A good sponsor knows you’re responsible for yourself and capable of making your own decisions. Still, they’ll give you a nudge to keep you moving forward if you ever need it.
  • They set boundaries: It’s always okay to ask your sponsor for support. But a good sponsor lets you know when contacting them is appropriate. You can agree on times and ways to connect that work for both of you. 
  • They listen and offer support: Your sponsor is there to advise and support you—but they’re not your therapist. A good sponsor knows when a professional should step in. They may even connect you with outside resources.
  • They’re patient: Addiction recovery takes time. A good sponsor understands that you’ll face challenges as you adjust to sobriety. They’ll keep supporting you even when you’re having a hard time.
  • They understand you: With an understanding sponsor, it’s easier to ask for help. You might seek someone with a similar background to yours. Maybe you’re a mom of 4. A sponsor who has been through motherhood and addiction might understand you on a deeper level. But everyone’s needs are different. Sometimes it’s better to find a sponsor with a different history of addiction. You never know what you can learn from a new perspective. Considering your unique recovery goals can help you find the right fit.

What Does a Sponsor Not Do?

There are some things your sponsor shouldn’t do.4 Even if you like them as a person, you should be wary if your sponsor shows any red flags: 

  • They impose their personal views on you: Your sponsor shouldn’t judge your recovery process. They might have similar experiences, but only you know what’s best for you. A sponsor should never urge you to make a decision based solely on their own beliefs. 
  • You’re already close with them: It’s not a good idea to have a loved one as your sponsor. You should be able to trust your sponsor and open up to them. Sometimes, personal relationships can lead to bias.
  • They exploit you: Your sponsor should never try to take advantage of you. Anyone in early recovery is in a vulnerable space. Your sponsor should understand that and do everything they can to empower you.
  • They’re not engaged in the program: If your sponsor regularly misses meetings, or you question their sobriety, they likely aren’t the best person to help you.
  • They believe they have every answer: A good sponsor isn’t afraid to say, “I don’t know.” If you feel like your sponsor always thinks they’re right or never considers another way, they might not be a good choice.

If you notice red flags like these, reach out to trusted members of your support network, both in and outside of AA. You can also talk to your therapist. And remember: you always have the right to change sponsors. AA’s literature on sponsorship5 specifies: 

We are always free to select another sponsor with whom we feel more comfortable, particularly if we believe this member will be more helpful to our growth in A.A.

How to Find a Sponsor

Typically, the process of finding a sponsor is informal. You might notice someone in the 12-Step program you admire. Maybe their outlook on sobriety inspires you, or they seem very open and honest. All you have to do is ask them to be your sponsor. Then, they can either accept or decline.

As a newcomer, you can also ask around the program. At some meetings, the leader may ask people who want to become sponsors to raise their hands. You can also ask people you meet if they know of anyone interested in taking on that role.

Your Responsibilities as a Sponsee

Just like your sponsor, you’ll have certain responsibilities in this relationship. Here are some tips to be a good sponsee:

  • Show up: Attending meetings regularly helps you stay on track. Try to let your sponsor know in advance if you have to miss a meeting.
  • Respect your sponsor’s boundaries: After you and your sponsor agree on boundaries, it’s important to honor them. Your sponsor has their own responsibilities outside of your recovery process. Of course, there may be times when you need to call them out of the blue. But this is an opportunity to practice building respectful relationships. Recognizing the other person’s needs is an important part of that process.
  • Work the 12 Steps: Show your sponsor that you’re just as committed to your recovery as they are. You can do this by working the 12 Steps of Alcoholics Anonymous or another 12-Step program. Sometimes you might leave meetings with assignments. Dedicate time to work on your sobriety outside of the program. Then, talk to your sponsor about your progress.
  • Don’t overshare: It’s easy to overshare as you become more comfortable with your sponsor. There’s nothing wrong with seeing your sponsor as a friend. But your sponsor isn’t your partner, your parent, or a clinician. They’re just one person in your wider support network. 

In most 12-Step programs, your sponsor plays an integral role. Still, many people reach sobriety without a sponsor at any point in addiction recovery. It all depends on what makes the most sense for your recovery process. 

Learn more about sponsorship and 12-Step rehab programs that might be a good fit for you.

Frequently Asked Questions About AA Sponsorship

What’s the role of a sponsor in my recovery?

A sponsor serves as a mentor and guide, providing crucial support throughout your recovery journey. They offer guidance, answer questions about addiction and the program, and help you work the 12 Steps. While having a sponsor isn’t mandatory, it’s highly encouraged in most 12-Step programs for better outcomes.

What qualities should I look for in a good sponsor?

A good sponsor should be knowledgeable and able to give guidance, while also maintaining healthy boundaries and encouraging your personal responsibility. A good sponsor listens, offers support, and understands the challenges of addiction recovery. Finding someone who understands your background and recovery goals can be beneficial.

What are red flags to watch out for in a sponsor?

While sponsors are meant to support your recovery, there are certain warning signs to be aware of. A sponsor should not impose their personal views, exploit you, or be disengaged from the program. It’s also important to avoid choosing a sponsor who is a close friend or family member to maintain objectivity. If you notice any red flags, seek support from other trusted people in your support network and consider changing sponsors.

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Alcohol vs. Marijuana: Is One Safer Than the Other?

Alcohol and marijuana use are both socially acceptable, and they can both be dangerous. But is one safer than the other? That’s a complicated question—partly because “safety” means something different for everyone. No matter how safe a substance seems, addiction is always possible.

Alcohol Use 

It may feel like almost everyone you know drinks alcohol. Around the world, this is one of the most socially acceptable substances. In 2021, more than 78% of Americans aged 12 and older reported using alcohol at least once in their lifetime.1 

How Addictive Is Alcohol?

Alcohol addiction is more common2 than other drug addictions in the U.S. There’s no fixed timeline for how quickly or easily this condition develops. Depending on your genetics, your drinking habits, and other factors, it could take several years or just a few months for you to need treatment.

Several factors can give you a greater risk of addiction. For one thing, it depends on how long alcohol stays in your system. Some people get drunk faster than others, or have a naturally low tolerance to alcohol. If you keep drinking regularly, your tolerance will go up. That means you’ll have to drink more and more to feel the same effects. This cycle can quickly lead to addiction.

Binge and heavy drinking also play a significant role in developing alcohol use disorder. For many people, it’s perfectly safe to have a drink or 2 with friends on occasion. But if you’re getting drunk every day, or blacking out every time you go to the bar, you may be more vulnerable to addiction.

Risk Factors of Alcohol Use Disorder 

It’s easy to overlook the short and long-term consequences of excessive drinking.3 Alcohol abuse impairs your judgment, and it can lead to impulsive decisions. Experts note a few common short-term risks of heavy drinking:

  • Injuries like car crashes, burns, and falls are common when you’ve been drinking. In the U.S., 1 person dies in an alcohol-related car accident4 every 45 minutes.
  • Alcohol poisoning is a medical emergency5 that can cause vomiting or seizures, and even be life-threatening. 
  • Risky sexual behavior may result in accidental pregnancy. It can also expose you to sexually transmitted infections (STIs), like herpes or HIV.

With ongoing alcohol abuse, you’ll also face certain long-term risks:6

  • Health conditions like heart disease, high blood pressure, digestive problems, stroke, and liver disease
  • Cancer, including breast, throat, esophageal, and colon cancer
  • Mental illness such as depression and anxiety
  • Weakening of the immune system, which increases your likelihood of getting sick and makes it harder to heal from any illness
  • Memory and learning problems, which can cause problems at school or work
  • Relationship problems with loved ones, colleagues, and your wider community

When to Seek Help for Excessive Drinking 

Alcohol affects everyone differently. It might be hard to notice when your drinking becomes a problem. So how do you know when you cross the line?

This question is very personal. Drinking might not cause any major problems in your life at first, or ever. But if you’re wondering whether you need help, you might be onto something. In a sober moment, you can take an inventory of your behavior by answering a few questions:

  • Do you usually drink more than you planned? 
  • Can you go a whole day without drinking alcohol?
  • Do you drink at inappropriate times (at work, first thing in the morning, etc.)? 
  • Does drinking interfere with important parts of your life? 
  • Do you hide your drinking from other people?
  • Do you often make poor decisions when you drink?  
  • Are your loved ones concerned about your drinking habits?
  • Do you think you have an alcohol addiction?

With a clearer sense of your own drinking habits, you can decide on next steps. However, only a professional can diagnose you with alcohol use disorder. If you think you need help, you can contact a rehab or share your thoughts with a specialist.

Marijuana Use 

Between alcohol and cannabis, many people see marijuana as the lesser evil. You might not even know that weed is addictive.7 As legalization becomes more widespread in the U.S., so do studies shedding light on cannabis use, weed’s potential risks and benefits,8 and addiction.

Medicinal Benefits of Marijuana

When you use it safely, marijuana has many medicinal benefits.9 It’s especially helpful for people with chronic pain. Some see cannabis as a safer alternative to prescription opioids and other narcotics. Natural chemicals like THC and CBD, which appear in most strains of marijuana, also have several other effects.

For example, CBD oil can help with anxiety10 and depression. It can also protect against neurological issues like Parkinson’s disease, Alzheimer’s disease, and multiple sclerosis. 

There’s no doubt marijuana can help people. But it’s up to you to decide if marijuana products will benefit you in the long run. Thinking about your relationship with substances is always a great place to start.

Is Marijuana More Addictive Than Alcohol? 

Whether marijuana is more addictive than alcohol is a complex question, and there’s no simple answer. On the surface, cannabis might seem like a medicine that does more good than harm. But just about any substance can be addictive11—even seemingly harmless ones like caffeine or ibuprofen. And marijuana is no exception. 

The health effects of marijuana use, however, are generally less risky than those of alcohol. Many studies suggest cannabis has a lower risk for health-related harms12 like cancer, death from severe withdrawal, and liver damage. And one study found that marijuana has a much lower risk of overdose than alcohol. Still, we need more data on weed and addiction.

Effects of Excessive Marijuana Use 

Abusing marijuana has both short and long-term impacts13 on your health. Some of its short-term effects might be enjoyable, but others are dangerous:

  • Enhanced sensory perception and euphoria: You may feel happy, and sights and sounds may become more profound.
  • Drowsiness and relaxation: Some strains of marijuana have more powerful sedative effects than others.
  • Slowed reaction times: Marijuana makes activities like driving more dangerous.
  • Problems with balance and coordination: Marijuana can make you feel dizzy or lightheaded.
  • Anxiety: Marijuana can increase anxiety levels over time—not just while you’re using it.

Continuing marijuana use over time also has long-term effects:

  • Chronic cough and frequent respiratory infections: The more you smoke marijuana, the more harmful toxins go into your lungs. Over time, this can lead to serious physical problems.
  • Learning and memory problems: Studies show regular marijuana use alters memory,14 learning, and impulse control. 
  • Mental health issues: Excessive ongoing marijuana use can lead to anxiety,15 depression, and psychosis.

When to Seek Help for Marijuana Abuse 

It can be even harder to recognize marijuana addiction than alcohol abuse. If you think you might need help, you can start by answering these questions:

  • Do you usually use high doses of marijuana?
  • Is it hard to go a day without using marijuana? 
  • Do you use marijuana at work or school?
  • Is marijuana use causing problems in your life? 
  • Are you detaching from the people closest to you or spending most of your time with other friends who use marijuana?
  • Have you ever had a relapse after trying to stop using marijuana? 
  • Do you drive while high?
  • Are your loved ones concerned about your marijuana use?
  • Do you think you have a marijuana addiction?

If you answered yes to some or all of these questions, you might want to share your responses with a clinical expert. They’ll be able to give you a proper diagnosis and help you plan for the future.

Treatment Options for Marijuana Abuse

Treatment for marijuana abuse16 normally includes a combination of therapies. Depending on where you go to rehab, you may have access to a variety of options: 

It’s important to find a program that can support your personal goals for recovery. If you need help with marijuana addiction, learn more about treatment at marijuana rehabs.

Treatment Options for Alcohol Abuse 

When you start treatment for alcohol addiction, you’ll probably need to attend detox first. Without proper medical care, alcohol withdrawal can be dangerous or even fatal. Healthcare professionals can help you safely begin recovery.

Once you complete detox, your rehab may provide a variety of alcohol addiction treatment options:17

  • Cognitive behavioral therapy 
  • Motivational enhancement therapy (MET)
  • Family counseling
  • Medications
  • Peer support groups

Browse alcohol rehabs that offer these therapies and more.

Frequently Asked Questions About Alcohol vs. Marijuana

Is alcohol or marijuana safer to use?

Both alcohol and marijuana can be dangerous substances, and addiction is a potential risk regardless of perceived safety. It’s important to exercise caution and make informed decisions about substance use to minimize potential risks and harms.

How addictive is alcohol compared to marijuana?

Alcohol addiction is more common than marijuana addiction. The development of alcohol use disorder (AUD) depends on various factors like genetics, drinking habits, and individual traits. Marijuana, though generally considered less risky, can still be addictive (as any substance can be). Further research is needed to better understand the relationship between marijuana use and addiction.

When should I seek help for alcohol or marijuana abuse?

Recognizing when to seek help for marijuana or alcohol abuse can be challenging. If you find either substance interfering with your life, or if you find yourself questioning your substance use, talking to a professional can be helpful.

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Why Is Alcohol Considered a Drug?

By definition, alcohol is a drug because it impacts the way your brain works. Not everyone sees it that way, partly because we no longer use alcohol for medical reasons. Today, people drink to celebrate, socialize, and relax. But like any other drug, alcohol can lead to addiction.

Alcohol: What Makes It a Drug?

Alcohol is a psychotropic central nervous system (CNS) depressant.1 Here’s what that means: 

  • Psychotropic drugs affect the way you think and feel. In other words, alcohol can change your mood, thoughts, and behavior. Other psychotropic drugs include cocaine, marijuana, and nicotine. 
  • Central nervous system depressants slow down your brain activity. This relaxes your muscles and makes you feel at ease. Other depressants include prescription drugs like Xanax, Valium, and Klonopin. 

How Alcohol Affects Your Brain and Body

When you drink, alcohol slows down communication between your brain cells.2 This makes you feel more relaxed as early as 15 minutes after you start drinking. Your unique metabolism determines how long alcohol stays in your system. 

For most people, the liver can only process about 1 drink an hour.3 If you drink more than that, you may feel more intense side effects. These can include lower inhibitions, intense emotions, and a loss of muscle coordination. You might even black out—which is when your brain stops recording memories due to binge drinking. If you drink beyond your body’s capacity, you can even get alcohol poisoning.

Alcohol also has long-term effects4 on your brain and body. For example, alcohol is a carcinogen, meaning it causes cancer. Long-term drinking wears down the immune system, which makes you more likely to get sick. According to the CDC, excessive drinking contributes to “high blood pressure, heart disease, stroke, liver disease, and digestive problems.” There’s also a link between alcohol and certain mental health issues, like anxiety and depression.

Alcohol Is Classified as a Depressant

The term “depressant” refers to slowing neural activity,5 not depression as a mental health issue. Certain prescription depressants can even treat anxiety and insomnia. Not every depressant makes you feel depressed. 

However, experts point out a link between alcohol and the feeling of sadness.6 According to one study, 1 out of 3 people with alcohol addiction have “experienced episodes of intense depression and/or severe anxiety.” This data suggests that alcohol addiction might indeed cause depression.

Is Alcohol Addictive?

Alcohol is highly addictive.7 However, not everyone with alcohol use disorder develops physical dependence. To find the right type of treatment, you can learn about the difference between physical and psychological addiction.

Physical Addiction

Drinking releases endorphins8—neurochemicals that make you feel euphoric. The more often and heavily you drink, the more your brain will associate good feelings with drinking. So any time you want to feel good, you’ll start craving alcohol. This cycle can quickly lead to addiction.9 

Because alcohol is a depressant, suddenly quitting drinking reactivates your central nervous system.10 This leads to physical withdrawal symptoms which can range from being uncomfortable to life-threatening. For some people, fear of these symptoms becomes a barrier to long-term treatment. 

Psychological Addiction

Many people abuse alcohol to self-medicate11 anxiety, trauma, and other mental health conditions. This doesn’t always lead to physical dependence. But if you keep drinking in spite of negative consequences, it can still constitute addiction.

According to the National Institute of Health,12 this strategy doesn’t work in the long term: 

“Drinking to cope with stress—while it may provide temporary relief from emotional discomfort—tends to enhance negative emotional states between bouts of alcohol consumption. These changes can motivate further drinking and cause an individual to become stuck in an unhealthy cycle of alcohol consumption.”

While alcohol is considered a drug, it still has cultural and economic value in the U.S. In fact, alcohol is a $363.33 billion industry.13 Alcohol was illegal in the U.S. during Prohibition, from 1920-1933.14 But the ban didn’t last long. Illegal alcohol was a public health threat, and creating a black market for drinking didn’t serve the economy. This is similar to the recent change in policy around marijuana legalization. When drugs are legal, the government can regulate them for safety and tax them to boost the economy. 

How Alcohol Abuse Affects Your Loved Ones

Alcohol addiction doesn’t only affect you. It can also impact your wider community:

  • Drinking takes up time. You might spend long nights away from home, or be too hungover to enjoy other activities with family.
  • Alcohol causes conflict. Because alcohol impairs judgment, you might act very differently when you’re drinking. On top of that, abusing alcohol can make you more aggressive.15
  • Drinking can damage trust. Many people try to hide their alcohol abuse.16 You might want to avoid consequences at work or protect your loved ones from the truth. If you have high-functioning alcohol addiction, this could go on for some time. But eventually, your loved ones will realize something’s wrong and feel betrayed as a result.
  • Alcohol addiction is expensive. Drinking can drain your finances, which puts stress on partnerships and families. 
  • Alcohol affects your work. Drugs, including alcohol, can make it hard to focus. Being drunk, hungover, or sleep deprived at work might damage your professional relationships. You might even risk losing your job, which could affect your family.
  • Drinking can cause legal problems. Alcohol abuse impairs your judgment. If you drive drunk, for example, you could get in an accident or get arrested. Even if no one gets hurt, that can damage your reputation and your closest relationships.

Signs and Symptoms of Alcohol Abuse

If you think you might be addicted to alcohol, it’s important to get a professional diagnosis. As you plan to speak to an expert, take stock of your drinking habits. The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines alcohol addiction17 by a few specific criteria:

  • Do you often drink more than you planned to?
  • Do you spend excessive amounts of time drinking or recovering from drinking?
  • Have you ever tried to quit drinking and failed? Has this happened more than once?
  • Have you ever wanted a drink so intensely you couldn’t think about anything else?
  • Does drinking or being hungover often interfere with your other responsibilities (family, friends, work, school, etc.)?
  • Have you ever given up activities you cared about in order to drink instead?
  • Does drinking make you feel depressed, anxious, or otherwise unwell? If so, do you continue to drink anyway?
  • Does alcohol have less of an effect on you than it used to? If so, does this make you drink more?
  • Do you ever feel shaky, nauseous, or have trouble sleeping when the effects of drinking start to wear off?

When to Seek Professional Help for Alcohol Use

It’s never too early to ask for help. If you think you have alcohol use disorder, you very well might. An addiction expert can help you decide which type of treatment will best suit your needs. 

Treatment Options

Everyone’s experience with alcohol addiction is unique. What works for someone else might not be a good fit for you. However, there are a few common treatments for alcohol abuse:

  • Alcohol detox: Quitting drinking abruptly can cause potentially dangerous withdrawal symptoms.18 These can even be life-threatening. In a medical detox program, your care team will keep you safe throughout this process. Some rehabs require you to attend medical detox before you start longer-term treatment.
  • Residential rehab for alcohol addiction: In these programs, you’ll live on-site at a treatment center. Your length of stay in rehab could be anything from a few days to several weeks, or even longer. Most programs offer a combination of treatments, such as 1:1 therapy, support groups, and medical care.
  • Partial hospitalization program (PHP): Also known as day treatment, in a PHP, you’ll live at home but follow an intensive schedule of treatment. Most programs require you to be on-site for about 40 hours per week.
  • Intensive outpatient program (IOP): An IOP provides structured, intensive therapy and support services for people who don’t require all-day treatment. Outpatient care is often used as a step-down approach after residential treatment, and could be a good option if you need to keep working or going to school while attending intensive therapy. 
  • Sober living: Sober living environments help you transition out of residential addiction treatment. You’ll live with other people in recovery, but have plenty of access to the outside world. 

Alcohol addiction recovery is an ongoing process. With the right type of care you can detox safely, learn to recognize triggers, and start building a meaningful life without alcohol. To find the right program for you, explore rehabs for alcohol addiction.

Frequently Asked Questions About Alcohol Use

Is alcohol considered a drug?

Yes, alcohol is a drug because it affects the brain. It’s classified as a psychotropic central nervous system (CNS) depressant. While it’s commonly used for socializing and relaxation, it’s important to recognize its addictive properties and potential risks.

What are some long-term effects of alcohol?

Long-term alcohol use can have detrimental effects on both the brain and body. Prolonged drinking weakens the immune system, making you more susceptible to illness. Excessive alcohol consumption can also lead to high blood pressure, heart disease, cancer, stroke, liver disease, digestive problems, and mental health conditions like anxiety and depression. Getting professional help is crucial to address these long-term effects and mitigate their impact.

When should I seek professional help for alcohol use?

It’s important to seek professional help if you’re unable to quit drinking on your own. If you often drink more than intended, have intense cravings for alcohol, have mood swings as a result of drinking, or if drinking interferes with your responsibilities, it’s time to consult an addiction expert. Early intervention can lead to effective, long-term recovery.
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What Is the 13th Step in AA? 6 Ways to Protect Yourself and Your Recovery

Recovery should be a place where you feel safe, supported, and respected. Unfortunately, some people in recovery groups experience unwanted romantic or sexual advances from other members. This behavior is often called the “13th step,” and it’s important to know that it’s never okay.

If someone has made you uncomfortable in a recovery setting, you’re not alone. Many people have experienced this, and it’s not your fault. If you’re new to recovery, being aware of this unfortunately common pattern can help you recognize problematic behavior and take steps to protect yourself and your healing process.

Remember: You have the right to feel secure and respected in any recovery space—your safety and ability to continue healing matter most. Let’s take a closer look at what the 13th step is, why it happens, and how to stay safe while getting the support you deserve. 

What Is the 13th Step?

The “13th step” isn’t an official part of AA’s 12-Step program. It’s a term that describes when someone with more recovery time pursues a romantic or sexual relationship with a newcomer to the program. This typically involves someone who has been sober for months or years approaching someone in their first few weeks or months of recovery.

The key issue is the difference in recovery experience and the power that comes with it. Someone who has been in recovery longer often has more influence in the group and may be seen as a role model. This dynamic can make it very difficult for newcomers to say no to advances, even when they want to.

Understanding 13th-Stepping Behavior

Even when “13th stepping” isn’t intentionally predatory, it can still be harmful because of the power dynamics involved.

People who are new to recovery are in an especially vulnerable place. Early recovery is often marked by emotional instability,1 low self-esteem, and difficulty setting healthy boundaries. A lot of newcomers are also dealing with damaged relationships from their past and may be socially isolated.

People with seniority in recovery programs often hold informal authority within their groups. When someone in this position shows romantic interest, it can feel flattering at first. But it also creates pressure that someone newer to the group may not feel prepared to handle. Even with good intentions, pursuing someone in early recovery takes advantage of their vulnerable state and can seriously harm their healing process.

Thirteenth-stepping is woefully common. Investigative reporter and founder of the The 13th Step podcast Lauren Chooljian, who led a 3-year investigation into predatory conduct by the founder of one support group in New Hampshire, points how just how well-known this practice is: 

If you’ve never heard this phrase before, it’s likely that you’re not in recovery. Because people in recovery will tell you this is just the most common thing. I had someone tell me that they heard it first in the ’70s. In the history of addiction treatment, you’ll see it right there with the adoption of Alcoholics Anonymous. It’s a thing that has been around, but a lot of us haven’t been paying enough attention to see it.

The Risks and Dangers of 13th Stepping

Early recovery requires intense focus on healing and building new life skills. Romantic relationships, especially complicated ones, can pull attention and energy away from this critical work. The excitement or stress of a new relationship can become a distraction when your brain and emotions are already dealing with the challenges of early sobriety.2

Increased Stress and Relapse Risk 

Even good relationships involve work and can be consuming at times. But relationships with unhealthy dynamics can be downright draining. Romantic relationships have a way of triggering our most deeply held wounds. Dr. Sue Johnson, a clinical psychologist and developer of emotionally focused therapy (EFT) for couples, explains in her book Hold Me Tight:3 

Our past history with loved ones shapes our present relationships. In moments of disconnection when we cannot safely engage with our lover, we naturally turn to the way of coping that we adopted as a child, the way of coping that allowed us to hold on to our parent, at least in some minimal way.

This activation can often be a profound opportunity for healing. But in early recovery, it can all be too much. Heightened tensions and emotions can be relapse triggers, and breakups can truly disrupt your recovery process. 

Loss of Safe Spaces 

When someone in your recovery group pursues you romantically, it can make meetings uncomfortable or even unsafe. You might feel like you can’t say no without losing your place in the group. Some people end up leaving their support system entirely to avoid an uncomfortable situation, which cuts them off from crucial recovery resources.

Risk of Harm 

In some cases, 13th stepping involves more serious boundary violations or even assault. The informal structure of many recovery groups can make it difficult to report problems or hold people accountable for predatory behavior or sexual misconduct. 

Chooljian reports that while we often think of recovery as taking place in active drug addiction,

We don’t talk as often about, once substance abuse has ended, it doesn’t mean your brain is back to normal and everything’s fine, your life’s back in order. You’re basically finding out who you are all over again. And so to have an understanding of consent, when you’re still rebuilding your life and trying to figure out the next, healthier phase, is extremely difficult. While the 12 Steps of Alcoholics Anonymous have helped millions of people, I learned through my reporting that they can also be easily exploited because of the way the program is built.

Who Can Be a 13th Stepper?

Anyone can engage in 13th stepping behavior, regardless of their age, gender, or background. The key factor is the difference in recovery experience and group status, not personal characteristics. Someone who has been sober for 2 years has significantly more recovery experience than someone with 2 months.

Age, gender, and social status add more layers to these power imbalances. But 13th stepping can happen between people of any background when there’s a significant difference in recovery time and group standing. The problems occur when someone takes advantage of newcomers’ vulnerability to pursue romantic or sexual relationships with them.

Can Relationships Work in Recovery Communities?

Most experts strongly recommend avoiding romantic relationships during early recovery.4 The first year of sobriety is a time of major life changes when your emotions are heightened and your entire lifestyle is in flux. Your brain and emotions are still healing, and recovery requires all of your attention and energy.

Even relationships between people with similar recovery time can be problematic. When a romantic relationship in a recovery group ends, it affects the whole community. Fear of running into an ex-partner at meetings can drive someone away from a support system that has become a core piece of their sobriety.

Recovery communities work best when they focus on healing and mutual support, not romantic connections. If you’re interested in dating, consider meeting people who lead recovery-friendly lifestyles outside of your recovery circles to protect your safe space for healing.

How to Stay Safe in 12-Step Programs

Your safety and recovery always come first. These strategies can help you protect yourself while still getting the support you need:

1. Trust your instincts. 

    If someone makes you uncomfortable, that feeling is valid. You don’t need to prove that someone has bad intentions to remove yourself from an uncomfortable situation. If someone’s attention feels unwanted or inappropriate, it probably is.

    2. Consider taking a break from dating. 

      Many people in recovery find it helpful to focus solely on their sobriety during their first year. This gives you time to strengthen your recovery foundation and develop better boundary-setting skills before navigating romantic relationships.

      3. Build a strong support network. 

        Connect with multiple people in your recovery community, not just one person. Having several sources of support makes it harder for anyone to isolate you or make you feel dependent on them. Consider finding a sponsor whose gender or orientation doesn’t pose a risk of sexual tension if that feels safer.

        4. Understand healthy sponsorship. 

          A sponsor’s role is to guide you through the 12 Steps and share their experience. They should never pressure you to make specific decisions, ask for personal favors, or cross physical boundaries. If a sponsor behaves inappropriately, you have every right to find a new one.

          5. Speak up about predatory behavior. 

            If someone makes you uncomfortable, talk to people you trust. You can also contact group leadership or look for a different meeting. Remember, you’re not responsible for managing someone else’s behavior, but you do have the right to protect yourself.

            6. Know you have options. 

              There are many different addiction recovery meetings and groups available. If one group doesn’t feel safe, you can find another. Online meetings have also expanded options for people who need alternative support systems.

              Protecting Your Recovery Journey

              Your healing journey deserves to unfold in a safe, supportive environment. You have the right to seek help without having to worry about unwanted advances. Trust your instincts, build strong support networks, and remember that your healing and safety are the most important priorities.

              If you’ve been traumatized by an experience in your recovery group and need support, see our resource guide for survivors of sexual assault to find the help that’s right for you.

              FAQs

              Q: What is the 13th step?

              A: The 13th step is an unofficial term that refers to when a more experienced member of the group pursues a romantic or sexual relationship with a newcomer to AA or other 12-Step programs. AA only has 12 official steps—this term describes a problematic dynamic that can harm people in early recovery.

              Q: What does “13th stepping” mean in recovery communities?

              A: “13th stepping” is the act of pursuing romantic or sexual relationships with newcomers to AA meetings. It involves more senior AA members using their recovery experience, group status, or informal authority to approach newer members who are in a vulnerable state. Even when intentions seem good, this behavior takes advantage of power imbalances and can seriously impact someone’s recovery journey.

              Q: What are the controversies surrounding the 13th step in recovery programs?

              A: The main controversy is that while some people engage in this behavior with seemingly good intentions, it still causes harm due to the innate power imbalance. There’s also debate about when relationships in recovery might be appropriate and how recovery communities should address concerning behavior. A lot of AA groups struggle to balance supporting members while protecting vulnerable newcomers.

              Q: What are the risks associated with 13th stepping in recovery groups?

              A: The risks include: 

              • Distracting newcomers from their recovery work
              • Increasing stress and relapse risk
              • Making support groups feel unsafe
              • Potentially leading to more serious boundary violations

              When these relationships end badly, people sometimes leave their recovery community entirely, meaning they lose vital support during a vulnerable time.

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              How Long Does it Take to Detox From Alcohol?

              When you’re ready to recover from alcohol addiction, detox is an important first step. Most people detox from alcohol in a week or less. During that process, you’ll likely experience withdrawal symptoms. These can be uncomfortable or even life-threatening—but they’re temporary. And in a medical detox program, your care team will keep you safe from any serious side effects. Proper treatment can set you up for success when you move on to the next phase of recovery.

              Symptoms of Alcohol Withdrawal

              Everyone’s alcohol withdrawal symptoms are a little different. Your experience will depend on a few factors, including how long and how much you’ve been drinking. About 50% of people with alcohol addiction1 have withdrawal symptoms when they start recovery. Within that group, 3-5% have severe symptoms that could be fatal. The first symptoms of withdrawal2 usually appear about 8 hours after your last drink:

              • Alcohol cravings
              • Irritability
              • Anxiety
              • Insomnia
              • Nightmares
              • Tremors
              • Headaches
              • Nausea and vomiting

              Even mild alcohol withdrawal symptoms can be uncomfortable. Perhaps as a result, withdrawal symptoms can lead to relapse.3 Medically assisted detox provides a more comfortable withdrawal experience. You may still have symptoms, but your care team will help you manage them. Most programs include non-addictive medications, talk therapy, and some complementary treatments. 

              Delirium Tremens

              Withdrawal from severe alcohol addiction sometimes leads to delirium tremens4 (DTs, also referred to as DT), also called alcohol withdrawal delirium. While it’s not very common, this tends to affect people with chronically excessive drinking habits. This condition presents with a few key symptoms:

              • Hallucinations
              • Confusion
              • Elevated blood pressure
              • Elevated body temperature
              • Agitation or aggressive behavior
              • Seizures 

              Without proper treatment, these symptoms can be fatal. Certain people are more at risk for DTs than others. If you have multiple addictions, abnormal liver function, a history of DTs, or a history of seizures, this condition is more likely. Certain short-term health issues can also increase your risk, like dehydration and low potassium levels.

              Medical detox is extremely important for anyone with a risk of DTs—even a low one. In these programs, you’ll work with a team of doctors, nurses, and other experts. They can manage your symptoms with medication and offer round-the-clock care in case of emergency.

              Post-Acute Withdrawal Syndrome (PAWS)

              For some people, withdrawal-like symptoms last for weeks or even months after detox. This is called post-acute withdrawal syndrome, or PAWS. People experience PAWS differently, but the symptoms are often more psychological5 and less physical than those of acute withdrawal:

              • Mood swings
              • Brain fog
              • Anxiety
              • Depression
              • Lack of motivation
              • Decreased sex drive
              • Memory or concentration issues

              PAWS is often triggered by stress. Because PAWS can cause relapse,6 it’s important to have a treatment plan in place. With the right approach, you can manage your symptoms and continue to focus on recovery. 

              Stages of Alcohol Withdrawal

              Most symptoms of alcohol withdrawal7 appear during the first few days after your last drink. However, the precise timeline for alcohol withdrawal is different for everyone. Depending on the severity of your addiction, your symptoms may be mild or more intense.

              6-12 Hours

              Withdrawal symptoms normally start within 6-8 hours after your last drink. You might have a headache or start sweating. You may also feel nauseous or nervous. For people with a long history of heavy drinking, it’s possible to have a seizure in the first 6-12 hours of withdrawal.

              12-24 Hours

              Mild symptoms continue to build in the first 24 hours of withdrawal. You might have tremors, particularly in your hands. Some people experience insomnia. For those with more severe withdrawal symptoms, hallucinations may start to occur in the first 24 hours. These can be visual, auditory, or tactile hallucinations.

              24-48 Hours

              If you have only mild withdrawal symptoms, they may peak 24-48 hours after you stop drinking. From then on, symptoms like headaches, tremors, rapid heart rate, and nausea could decrease. 

              People with more severe symptoms might have seizures 48 hours into the detox process. 

              48-96 Hours

              If your symptoms are more severe, they may also last longer. For some people, peak withdrawal occurs within 72 hours of quitting alcohol. After that point, you’ll probably start to feel better.

              Other people are at risk for developing delirium tremens on the 3rd day of withdrawal, starting around 72 hours into detox. You might not know in advance whether this is a risk for you. This is why it’s so important to get proper care during alcohol detox. Your team can stand by during this crucial time, ready to help you if new symptoms develop. 

              96 Hours and Beyond

              Most people start to feel completely better around day 4 or 5 of detox. At this point, your body stops compensating for the lack of alcohol in your system. You’ll reach a new equilibrium as tremors, nausea, anxiety, and other symptoms subside. Most people complete withdrawal sometime between days 5-7.

              If you experience delirium tremens, you may need more time to detox. Delirium tremens symptoms usually last 7 days, and sometimes longer.

              Treatments for Alcohol Withdrawal

              You’ve got a few options for alcohol withdrawal treatment, including hospitals, medical detox centers, and rehab. Most detox programs follow similar treatment plans, though some provide more therapeutic support than others. 

              Treatment typically begins with a thorough physical exam. Doctors will ask about any pre-existing conditions that might impact your withdrawal experience. From there, you’ll begin detox. 

              Over the first few days, your medical team will monitor you closely. They might provide medication if you need it. If you don’t show any signs of withdrawal symptoms after 48-72 hours, you might be released to outpatient care or residential rehab. If you’re detoxing in rehab, you might progress to the next stage of treatment. 

              Risk Factors for Detoxing From Alcohol at Home

              While it’s a vital part of recovery, detox is dangerous without medical care. In particular, withdrawal from alcohol8 can be fatal. 5-15%of people with delirium tremens die9 from their symptoms. 

              For some people, the fear of alcohol withdrawal symptoms10 is a barrier to treatment. Medical detox programs can keep you safe and as comfortable as possible while you detox.

              How Long Will It Take to Detox from Alcohol?

              How long alcohol stays in your system is unique for everyone. In most cases, acute withdrawal symptoms end after 5-7 days. You can go through this process in an onsite or offsite detox program. Most care plans include medical treatment, non-addictive prescriptions, and psychotherapy. 

              Onsite Detox

              Some inpatient rehabs offer onsite detox. This approach lets you move seamlessly from initial detox into longer-term treatment. You can get medical and therapeutic support in the same place, instead of moving to a new center in the middle of treatment. 

              For example, at Noosa Confidential in Australia, clients stay in a waterfront retreat with 24-hour access to staff. Here, you’ll work with the same clinicians throughout detox and residential treatment.11 This consistency makes it easier to build trust with your care team.

              Off-site Detox

              In a program with offsite detox, you’ll go through withdrawal in a separate facility before you start inpatient care. For people with more severe withdrawal symptoms, more complex medical treatment might be necessary. With offsite detox, you can still transition smoothly into rehab when you’re ready.

              The Beekeeper House in Thailand is an inpatient rehab with an offsite detox program. They work with their partner facility, The Warm, to determine the best plan of action for your detox.12 Many patients go through detox at The Warm before they start residential treatment. If you have more complex medical needs, you can transfer to their partner hospital in Chiang Mai before returning for rehab.

              New Jersey’s Enlightened Recovery also has offsite detox as part of their flexible detox options.13 You can detox in their inpatient rehab, at one of their partner facilities, or an independent detox center before you start longer-term treatment. 

              Will Health Insurance Cover the Cost of Alcohol Detox?

              Many detox centers accept insurance, including Medicaid. The cost of detox varies depending on the facility and the level of care you receive. Check with your insurance provider in advance to see what you plan will cover. Your treatment program’s admissions team can also offer guidance. There are options for everyone, even if you don’t have insurance. If you’re interested, you can learn more about alcohol detox and inpatient rehab programs that accept insurance.

              Detox is an essential step in the healing process. Medical detox programs can help you start recovery as safely as possible. When you’re ready to start addiction treatment, you can find a rehab that offers alcohol detox. 

              Frequently Asked Questions About Alcohol Detox

              How long does alcohol detox last?

              The duration of alcohol detox varies for each person. In general, most people complete alcohol detox within a week or less.

              What are the symptoms of alcohol withdrawal?

              Alcohol withdrawal symptoms can vary depending on factors like the duration and amount of alcohol you consumed. About 50% of people with alcohol addiction experience withdrawal symptoms when starting recovery, with 3-5% facing severe symptoms that can be life-threatening. Common early withdrawal symptoms (which start about 8 hours after the last drink) include intense cravings, irritability, anxiety, insomnia, nightmares, tremors, headaches, and nausea/vomiting. Even mild symptoms can be uncomfortable and increase the risk of relapse. Medically assisted detox programs provide a safer and more comfortable experience.

              What are delirium tremens (DTs), and who is at risk?

              Delirium tremens (DTs) can happen during withdrawal from severe alcohol addiction, although it’s relatively uncommon and typically affects people with chronic excessive drinking habits. DT symptoms include hallucinations, confusion, elevated blood pressure, elevated body temperature, agitation or aggressive behavior, and seizures. Without proper treatment, DTs can be fatal. Certain factors increase the risk of developing DTs, including multiple addictions, abnormal liver function, a previous history of DTs or seizures, and short-term health issues like dehydration and low potassium levels.
              Posted on

              What Does OxyContin Look Like?

              If you’re worried about opioid addiction, it can be helpful to know what OxyContin looks like. This brand of prescription painkillers can be dangerous if you take them improperly. It’s easy to identify OxyContin tablets because they’re all imprinted with either “OC” or “OP.” However, the 7 doses of OxyContin all look a little different from each other. 

              The answer to what OxyContin pills look like will depend on how strong the dose is. 

              10 mg Pill

              • Color: White
              • Shape: Round
              • Imprint: OC or OP on one side; 10 on the other side

              15 mg Pill

              • Color: Gray
              • Shape: Round
              • Imprint: OC or OP; 15

              20 mg Pill

              • Color: Light pink
              • Shape: Round
              • Imprint: OC or OP; 20

              30 mg Pill

              • Color: Brown
              • Shape: Round
              • Imprint: OC or OP; 30

              40 mg Pill

              • Color: Yellow
              • Shape: Round
              • Imprint: OP or OC; 40

              60 mg Pill

              • Color: Red
              • Shape: Round
              • Imprint: OC or OP; 60

              80 mg Pill

              • Color: Green
              • Shape: Round
              • Imprint: OC or OP; 80

              What Is OxyContin?

              OxyContin is the brand name for oxycodone, a type of opioid. By definition, all opioids are narcotic painkillers.1 What sets OxyContin apart from similar drugs—like morphine, codeine, and hydrocodone—is its extended release.2 When you take OxyContin, the tablets dissolve slowly and release oxycodone at a steady rate for up to 12 hours. 

              What Is OxyContin Used For?

              Doctors prescribe OxyContin to treat moderate to severe pain. Because it lasts longer than other pain medications, most people take OxyContin for conditions that require consistent relief over a long period of time. This includes pain resulting from arthritis, serious injuries, cancer, and other conditions. 

              Is OxyContin Addictive?

              OxyContin has been a subject of concern due to its addictive potential. Initially introduced in 1996, it was marketed as an effective prescription painkiller with a low risk for misuse.3 However, within a few years, the landscape changed dramatically. By 2004, OxyContin had become one of the most widely misused drugs in the United States. 

              Despite its intended purpose for chronic pain relief, when people take OxyContin for chronic pain they can quickly become dependent on the drug. Physical dependence isn’t the same as addiction4—it just means your body now relies on certain doses to find relief. Addiction, on the other hand, occurs when you’re no longer able to control behaviors that negatively affect your life. If taking increased amounts of OxyContin is the only way you can get pain relief, your risk of addiction increases. 

              It’s important to recognize OxyContin’s addictive potential and use caution when taking this medication. If you have concerns about your OxyContin use or think you may be developing an addiction, consult a healthcare professional for appropriate guidance and support.

              OxyContin Prescription Use vs. Misuse

              OxyContin, like other prescription medications, has legitimate uses but also carries a risk of misuse. 

              Prescription use of OxyContin is when patients who have a legitimate medical need for pain management take the drug under the guidance of a healthcare professional. When used as prescribed, OxyContin can provide relief and improve the quality of life for people with chronic pain.

              However, misuse occurs when you use OxyContin in a way that doesn’t follow your doctor’s instructions.5 This can include taking higher doses than recommended, using the medication more frequently than prescribed, or using it without a valid medical reason. Misuse of OxyContin significantly increases the risk of adverse effects, dependency, and addiction.

              The line between prescription use and misuse can sometimes become blurred. Some people may initially receive OxyContin for a legitimate medical purpose but gradually veer into misuse because of increased tolerance, desperation for pain relief, or other factors. It’s essential to use OxyContin strictly as directed by a healthcare professional and to promptly communicate any concerns or changes in pain management needs so they can adjust your prescription safely and appropriately.

              What Are the Street Names for OxyContin?

              OxyContin goes by a variety of street names:6

              • O.C. 
              • Hillbilly Heroin
              • Oxy
              • Oxycet
              • Oxycotton

              How Is OxyContin Abused?

              People with opioid addiction may want to bypass OxyContin’s extended release7 by snorting or injecting it. This is extremely unsafe, because then you can’t predict how strong the dose will be, or how quickly it will take effect. 

              When you snort OxyContin, it’s absorbed by the membranes of your nostrils. It goes directly into your bloodstream instead of first traveling through your digestive tract. If you inject the drug, it bypasses even your nostrils, so your body absorbs OxyContin even faster.8 This brings on a more intense euphoria. Injecting drugs also puts you at risk of diseases9 like HIV and hepatitis. 

              Can You Overdose on Oxycontin?

              OxyContin is a potent opioid and can cause overdose if used improperly or in excessive amounts. The specific dosage required to overdose on OxyContin can vary depending on factors such as your tolerance, body weight, and overall health. That’s why it’s crucial to adhere to the prescribed dosage and consult a healthcare professional for guidance throughout the course of OxyContin use.

              Overdosing on OxyContin can have severe consequences and may even be life-threatening. Some common symptoms of an OxyContin overdose10 include:

              • Extreme drowsiness or sedation
              • Slow, shallow, or difficult breathing
              • Constricted pupils
              • Loss of consciousness
              • Cold, clammy skin
              • Weakness or limpness
              • Slurred speech
              • Bluish tint to lips or fingertips

              Overdosing can cause seizures,11 brain damage, heart attack, and respiratory depression—slowed breathing that can become fatal.

              If you or your loved one shows signs of an OxyContin overdose, seek medical attention immediately. Risks of overdose increase when you combine OxyContin with other substances like alcohol or other opioids.

              What Are the Risks of OxyContin Use?

              OxyContin is a powerful opioid. The U.S. opioid crisis12 started in the 1990s and is still a major problem. As doctors overprescribe opioids like OxyContin, more people are at risk of addiction, overdose, and turning to even more potent street drugs. 

              Physical Risks

              Like any opioid, OxyContin depresses your nervous system.13 In other words, it slows down communication between your brain and body. Your heart rate, breathing rate, and blood pressure all go down. This can cause you to stop breathing, go into shock, or even die. 

              Abusing OxyContin also puts you at risk of injuring yourself or someone else.14 That’s because opioids can make you dizzy, confused, or poorly coordinated. Data shows an alarming rise in elderly people injuring themselves15 from falls while using prescription opioids. 

              Psychological Risks

              Over time, opioid use alters your brain’s reward system.16 You might begin to feel normal when OxyContin is in your system, and abnormal when it’s not. OxyContin also impacts your mental health. People who use opioids have higher rates of anxiety,17 irritability, lack of motivation, and depression. 

              From Prescription to Street Drugs

              If you first start taking OxyContin to manage chronic pain, it can become hard to function without it. Over time, you might need higher doses of the drug to achieve the same effect.18 This is a dangerous pattern, and it can quickly lead to addiction. 

              If you can’t get a high enough dose of OxyContin from a prescription, you might look for other sources. When it’s sold illegally, OxyContin can be very expensive. But more affordable opioids, like heroin,19 are often impure and even more addictive. 

              Following your doctor’s instructions, and bringing up any challenges you’re experiencing with your prescription, can avoid escalating OxyContin use. You can also ask your doctor about non-opioid-based pain management.

              Find Treatment Options for OxyContin Addiction

              When you’re ready to heal from OxyContin addiction, it’s important to get professional support. OxyContin withdrawal symptoms can be dangerous—and even fatal. The only safe way to detox from opioids is with proper medical care.


              To start recovery from OxyContin, learn more about opioid addiction treatment programs here.