Gender Differences in Substance Abuse

People of every gender experience addiction. But most of the available data focuses on men. Fortunately, scientists are starting to expand their research to include other genders. And a growing body of work shows gender differences in substance abuse and addiction.

Rehab can be very effective when the treatment plan puts you first. Gender-specific treatment programs make you the main priority while acknowledging the impact gender has on recovery.

Differences in Addiction Between Women and Men

Being male or female can affect the biological, psychological, and social aspects of addiction. For example, men have higher rates of alcohol and illicit drug use.1 However, both men and women are equally vulnerable to developing one of these conditions. 

As we learn more about gender and addiction, it’s important to note the gaps in scientific research. We need more information about people of every gender—not just cis men and cis women. The data we have points to stark differences between just these 2 groups of people. 

Understanding the impact of your gender on addiction can also help you approach recovery. With that in mind, some rehabs focus on gender differences in substance use disorders. These programs often treat people of different genders separately. 

Impacts of Gender on Substance Abuse

Drug and alcohol addiction goes beyond your emotional experience. It also reflects your relationships, social standing, and family dynamics. Many of these issues relate to gender. Anything from hormones to peer pressure can play a role in the onset and treatment of addiction.

For example, we now know that women’s biological characteristics— like fertility and menopause—can influence drug use. Addiction’s physical effects2 are often more profound in women, and they may develop addiction more quickly.

Because social pressures affect addiction, women and men often have different reasons for drug use. Many women report using drugs to control their weight, fight the exhaustion of providing childcare, or cope with domestic violence. 

Today’s gender roles aren’t as rigid as they once were, but these pressures still exist for many people. Western culture, for instance, pushes men to be providers and women to be caretakers. Understanding how gender roles affect your specific type of addiction can help you plan for recovery.

Alcohol

Men typically have higher rates of alcohol use.3 This might be because of peer pressure, or because they face a severe lack of emotional support. To work through these issues, you might consider a rehab for men. These programs help you connect with people who share both your gender and your experience of addiction. 

While men may be more vulnerable to alcohol use, its social impact on women is still severe. Data shows that alcohol addiction increases women’s risk of intimate partner violence.4 If you’re healing from this type of trauma, it might be easier to talk about your experience among people of your own gender.

Some rehabs for women offer trauma-informed care. These specialized programs can help you work through triggers while you recover from addiction and mental health issues. You can also connect with other women who have survived similar events. Building relationships with them can be empowering and validating.

Stimulants

Some effects of stimulant addiction are the same for both men and women. These drugs make it hard for anyone to concentrate and learn new things. Even short-term use can interfere with your academic achievement. But in some biological ways, men and women experience this addiction very differently.

Estrogen makes women more physically sensitive to stimulants. As a result, these drugs can put more stress on a woman’s blood vessels and heart. However, men are at a greater risk for resulting neurological issues. 

There are also differences between men’s and women’s social reasons for stimulant use. Many women report using stimulants to boost their energy levels so they can keep up with work and family commitments. Addressing those problems may help women recover. Men’s reasons for stimulant use5 are rarely so specific. As a result, it can be hard for men to define the root cause of their addiction.

Opioids

Opioids function as painkillers, and data shows that male and female bodies experience pain differently. This may explain some of the differences in how men and women develop opioid addiction.

Studies show women are more sensitive to pain than men, and more likely to have chronic pain. Perhaps as a result, doctors prescribe more opioid medications for women6 than men. This makes it easier for women to access these drugs. Women report using opioids to cope with both physical pain and emotional issues like anxiety. This behavior can quickly lead to addiction.

When it comes to illicit drugs, like heroin, men may be at a higher risk of addiction and overdose. Women who use these drugs tend to use smaller amounts for shorter periods of time. However, women are more likely to use heroin because of their partners.

In rehab for opioid addiction, men and women may have different recovery goals. For example, women might need to find new ways to manage chronic pain. And men who have been using drugs for a longer time may need to make lasting changes to their support networks.

Marijuana

Marijuana is a common way to self-medicate co-occurring disorders, like depression or anxiety. But like most substances, it comes with a risk of addiction. 

Men and women who use cannabis have similar rates of co-occurring disorders. However, men are more vulnerable to marijuana addiction than women. Men also report more severe symptoms of cannabis addiction and withdrawal.7 

On the other hand, data suggests that marijuana has a greater impact on women’s brains.8 It can even change the way teen girls’ brains develop—more than it does for boys of the same age. Both gender-specific and age-specific rehab programs can address the complexities of this addiction.

Gender Differences in Substance Abuse Treatment

Men and women tend to start addiction recovery for different reasons. For example, more men attend treatment than women.9 However, men might have a harder time admitting they need help. That can make early recovery an especially vulnerable time. Providers that understand the social roles associated with masculinity10 can support men as they begin treatment. 

Women typically face more barriers to addiction treatment11 than men. As a result, they may have more severe symptoms by the time they enter rehab. Women may benefit from seeking more specialized care, whether or not they attend a women-only program. 

Recovery can be more straightforward in a single-gender treatment environment. This is especially true for clients with a history of trauma. For example, in a group session, you can trust that all your peers share a certain amount of context. That saves time and energy for everyone. Instead of explaining your identity, you can immediately dig into your emotional experience. 

Finding Gender-Specific Treatment Programs

Recognizing the impact of gender on your addiction can help you choose a rehab that feels right for you. Gender-specific programs acknowledge the differences in addiction for men and women—and sometimes, for people of other genders. As a result, they can offer treatment that caters to your specific needs. These programs aren’t right for everyone, and your gender doesn’t have to define you. But for some people, it can have a huge impact on recovery. 

Connect with a gender-specific rehab that meets your unique needs for recovery. 


Frequently Asked Questions About Gender and Addiction Recovery

How do gender roles affect addiction?

Social pressures related to gender roles can affect addiction. For example, many women report using drugs to cope with domestic violence or childcare exhaustion. Men may use drugs as a way to cope with a lack of emotional support.

How can rehab programs address gender differences in addiction?

Gender-specific treatment programs can help people feel better understood and prioritize their unique needs. For example, men’s rehab programs can help male clients connect with others who share their experience of addiction, while trauma-informed care can help women work through triggers.

Why are women more vulnerable to opioid addiction?

Women are more sensitive to pain than men and more likely to have chronic pain, leading doctors to prescribe more opioid medication for women than men. Women report using opioids to cope with both physical pain and emotional issues like anxiety.

How Does Addiction Affect Women?

Women healing from addiction and mental health conditions face distinct risks and challenges. Your sex and gender can impact the way your body responds to substances. While we need more data about people of many genders, we know that women often use drugs for different reasons than men. Women also face unique cultural pressures that can make addiction more likely. Women-only rehabs offer a safe space for women to work through these challenges. 

The Relationship Between Gender and Addiction

It’s important to note that most addiction research to date focuses on men and women. We need more data about the impacts of addiction on people of all genders. However, it can still be helpful to learn about how addiction affects different genders differently. 

Physiology and Addiction

Some physiological factors uniquely impact people assigned female at birth, whatever their gender. For example, many people with bodies assigned female at birth have a lower total percentage of body water1 than those assigned male at birth. This means it takes less alcohol for them to feel just as intoxicated. 

It’s also possible that men and women respond to substances differently. Experts report, “a number of studies have suggested that, relative to men, women may have an accelerated course of substance use,2 progressing more rapidly from initiation of substance use to problems with substances, and from problems with substances to treatment-seeking.”

Societal Challenges for Women

Women face certain social pressures, whether or not they were assigned female at birth. For example, data shows that both trans and cis women have higher rates of eating disorders3 than cis men. 

People of all genders feel shame about addiction.4 But these difficult emotions are stronger in women, especially those with children. Women are also more likely to feel a sense of stigma around addiction. And that, even more than the feeling of guilt, can be a barrier to treatment.

Women’s reasons for using drugs5 are also different from men’s. Men usually drink and use drugs for fun or to take risks. Women, on the other hand, use substances to regulate their mood, reduce stress, and find relief from difficult life experiences. If you’re using drugs to cope with your life, it’s easy to develop addiction. What’s more, data shows that women become addicted more quickly than men. 

What Types of Addiction Are Women Prone To?

While men are more likely to abuse substances6 in the first place, women are more prone to some types of  addiction. Women are also at a higher risk for certain mental health conditions. 

Alcohol

Because they typically weigh less than men, it takes less alcohol for women to become intoxicated.7 Most women also have lower levels of the digestive enzymes that break down alcohol. 

This means that drinking exposes women’s bodies to higher concentrations of alcohol. And that exposure lasts longer for women than it does for men. These factors make women more vulnerable to alcohol addiction. 

Prescription Drugs

Women are more likely to experience chronic pain8 than men. This may be part of the reason why women are more likely to misuse prescription opioids. And due to their brain chemistry, women develop opioid addiction much faster than men.

Gambling

Gambling addiction is commonly a way to cope with anxiety, loneliness, or boredom.9 While men are more likely to develop an addiction to gambling than women, that gender gap is closing. They may feel more shame about their behavior, or worry about whether it’s safe to get treatment in a mixed-gender setting.

Eating Disorders

The relationship between gender and eating disorders11 is a complicated one. Many women develop these conditions due to societal pressures about their appearance. According to one study, “girls or women are more likely than boys or men to report weight dissatisfaction, dieting for weight control, and use of purging.” 

Co-Occurring Disorders

When you have a mental health condition and addiction, you can look for a rehab that treats co-occurring disorders. Women are especially vulnerable to certain diagnoses. For example, almost twice as many women experience depression12 as men. People with depression are more likely to use substances,13 and people who use substances are more likely to be depressed. Without treatment, this can easily become a spiral.

Many women also use substances to cope with trauma. Data shows that as many as 59% of women with addiction also have PTSD.14 When drug use masks your mental health symptoms, it might feel like a coping strategy. But if you’re already vulnerable to addiction, that behavior can easily get out of control. 

Women and Relapse

It’s widely believed that women are more likely to relapse than men. However, there are studies with conflicting findings. Some say that women are more likely to relapse, while others have found the opposite to be true. In all, experts report “few gender differences in rates of post-treatment relapse15 to alcohol use, although the evidence is mixed in regard to relapse to drug use.”

Certain factors contribute to women’s relapse rates:

Supportive Treatment for Women With Addiction

Gender-specific treatment can make a huge difference in your healing journey. In women-only rehabs, your gender stops being a barrier to treatment. Instead, it can inform your specific goals for addiction recovery.

Women-Only Support Groups and Therapy

Some women find it difficult to share their feelings in mixed-gender groups.19 Perhaps you’ve experienced trauma that makes it hard to trust men. In addition, men tend to dominate conversations with women, even unintentionally. In rehab, women-only support groups and group therapy invite you to open up in a protected space. 

Some mixed-gender rehabs have women’s groups, and other programs only treat women. For Andrea, a client at Georgia Strait Women’s Clinic, attending women-only rehab was the key to recovery. “An all women’s program allowed for a safe environment for group work and other activities,” she explains.

Trauma-Informed Therapy for Women

Most women with addiction have a history of sexual assault,20 physical abuse, or both. Trauma-informed care helps clients explore the complex impacts of trauma. It also provides a safe, supportive environment for healing.

Kristi P., who attended the women-only rehab Awakenings by the Sea, says this of her experience: 

“I needed a safe place of refuge to escape my life and the chaos I was going through…I found women who were searching to heal from trauma the way I was searching.”

Relapse Prevention

For women, the risk of relapse is tied to societal pressures.21 Experts describe 4 themes among women who relapse: 

  1. A low sense of self-worth, especially in the context of romantic partnerships
  2. Negative feelings and conflict in relationships
  3. The inability to build a new, sober support network
  4. Little knowledge about drugs, alcohol, and relapse prevention skills

This data suggests that women can benefit from rehabs with a strong focus on relapse prevention. These programs can help you make a long term recovery plan that accounts for your specific risk factors. For example, your plan might include family therapy to help you improve close relationships.

Gender-Specific Treatment Options for Women

Women face unique risks and challenges when healing from addiction. The good news is that there are a myriad of ways to get the support you need. Gender-specific treatment can help you explore the root cause of your addiction, and empower you to start recovery.


No matter your sex or gender, you deserve care that meets your unique needs. Explore rehabs for women including centers with trauma-informed care, relapse prevention, and more.


Frequently Asked Questions About Women and Addiction

How does addiction affect women differently than men?

Addiction can affect women differently than men due to biological, psychological, and social factors. Women may experience more intense cravings and faster progression of addiction, have a higher risk of relapse, and may face greater stigma and social isolation. Women also tend to have more complex mental health needs, such as anxiety and depression, which can contribute to addiction.

What are the unique challenges women in addiction recovery face?

Women in recovery may face gender-specific issues, such as pregnancy, childcare responsibilities, or financial dependence on a partner. Women are likelier to have experienced trauma, such as sexual abuse or domestic violence, which can complicate recovery. Other challenges include lack of access to treatment, societal stigma, and shame associated with addiction.

What treatment options are available for women with addiction?

Treatment options for women with addiction include inpatient and outpatient rehab programs, behavioral therapies, medication-assisted treatment, and support groups. Treatment may also address co-occurring mental health conditions like anxiety or depression. It’s important for women to receive treatment that addresses their unique needs and challenges in recovery.

Tai Chi for Addiction Recovery

Tai Chi is an ancient martial art. Today, you can also use it as a complementary therapy in addiction treatment. Like any other form of gentle exercise, it can help you stay physically healthy during recovery. What’s more, a growing body of evidence shows that Tai Chi can improve your mental health. Many rehabs offer Tai Chi to help clients reduce stress, practice mindfulness, and begin to heal the relationship between their minds and bodies. 

What is Tai Chi? 

Tai Chi began as a Chinese martial art.1 Over time, it’s grown into a type of mindful movement that promotes physical health. While it’s often taught to small groups, you can also practice Tai Chi on your own. 

Compared to some other martial arts, Tai Chi is gentle2 and non-combative. It combines slow movements with mindful breathing and meditation. In most classes, practitioners flow smoothly from one pose to the next instead of sparring with each other. To a casual observer, this type of movement can look a lot like dancing.

What Are the Physical Health Benefits of Tai Chi? 

Tai Chi is a highly accessible form of exercise. It’s safe for people of all ability levels,3 you can practice it anywhere, and its fluid movements improve strength and flexibility. For people in addiction recovery, some of Tai Chi’s physical effects are especially important. 

Decreases Blood Pressure

Consistently practicing Tai Chi can reduce your blood pressure.4 This makes it a powerful treatment for clients recovering from alcohol addiction, which is a risk factor for high blood pressure.5 As your body continues to heal, Tai Chi can help you find a new normal.

Improves Circulation

Data shows that practicing Tai Chi for at least a year greatly improves blood circulation.6 Cycling fresh blood and oxygen throughout the body keeps your brain healthy,7 your organs working smoothly, and your immune system strong. For those in recovery, this boost in circulation can help your body repair damage caused by long-term substance use. 

Relieves Chronic Pain

Tai Chi can alleviate chronic pain8 associated with several conditions, including fibromyalgia, arthritis, tension headaches, and osteoporosis. Because of the correlation between chronic pain and addiction,9 this is often important during recovery. 

In particular, data implies that chronic pain makes people more vulnerable to opioid addiction. If that’s your experience, you’ll learn safer ways to manage your pain during rehab. If you find Tai Chi helpful, it can become part of your ongoing plan of care. 

Reduces Stress

Tai Chi is more than a form of physical exercise. This mindfulness practice also improves mental health and relieves stress.10 And because stress has a direct impact on physical well-being,11 this can be extremely important in early recovery.

Without proper support, stress makes you more vulnerable to addiction.12 But sustainable, fulfilling outlets like Tai Chi help you manage stress in the long term. If you find it helpful, you can continue practicing this martial art long after you leave rehab.

How Does Tai Chi Help With Addiction?

Experts agree that Tai Chi can help with addiction recovery.13 It’s most effective as a complementary approach, alongside treatments like talk therapy or medication. 

Promotes Sleep

Good sleep is foundational to addiction recovery.14 Getting enough sleep regulates stress hormones and helps your body heal. However, many people with addiction also have insomnia or other sleep disorders. This is especially common during early recovery. 

Data shows that Tai Chi improves sleep15 habits, which can in turn improve cognitive function. It also boosts your energy levels, making it easier to participate in therapy. 

Reduces Impulsiveness and Cravings

Your desire to use drugs or drink may never entirely disappear. But in rehab, you’ll learn healthy ways to cope with cravings if and when they arise. Studies show that tai chi improves impulse control,16 which can help you maintain sobriety in every stage of recovery.

Because Tai Chi also reduces cravings,17 you experience fewer triggers. Researchers note that the spiritual aspects of Tai Chi are essential here. As one study explains, mindfulness empowers people in recovery to have “an aware reaction rather than an automatic response” to difficult situations.

Strengthens the Mind-Body Connection

Like other complementary therapies, Tai Chi strengthens the connection between your mind and body.18 And that mindfulness can help you resist the desire to take drugs or drink. You’ll learn to accept your feelings just as they are, instead of trying to fix or change them. This improved self-awareness can help you stay grounded even when you face triggers and other challenges.

Connects You With Community Support

Addiction can be isolating. Because Tai Chi is usually taught in small groups, it invites you to connect with your peers. And building community in rehab can be a very important part of healing. 

Over time, your peers in Tai Chi class can become a strong support network. According to one study, “tai chi may have a significant impact on social support19 as a result of the shared group experience and group motivation components.”

How to Find a Rehab That Incorporates Tai Chi Into Your Treatment Process

Tai Chi is a holistic approach to addiction recovery. This practice promotes mindfulness and general well being. In conjunction with traditional treatments, it can be a powerful way to work through the symptoms of addiction.


If you’re interested in supplementing your addiction recovery with Tai Chi classes, search for rehabs that offer Tai Chi to find the right center for your needs.


Frequently Asked Questions About Tai Chi for Addiction Recovery

How does Tai Chi help with addiction?

Tai Chi can help with addiction recovery as a complementary approach, alongside traditional treatments like talk therapy or medication. Tai Chi promotes good sleep, reduces impulsiveness, strengthens the mind-body connection, and connects people with community support. These benefits can improve overall mental and physical health and support long-term recovery from addiction.

What are the mental health benefits of Tai Chi?

Tai Chi is a form of mindfulness practice that can help you manage stress and improve your overall mental well-being. It can improve your cognitive function, while also reducing cravings that may arise in early recovery. Tai Chi can help you become more self-aware and better equipped to resist triggers and other challenges.

How can I find a rehab that incorporates Tai Chi into my treatment process?

If you’re interested in incorporating Tai Chi into your addiction recovery, search for rehabs that offer Tai Chi classes. These holistic practices can be a powerful way to work through addiction symptoms alongside clinical approaches.

Substance Abuse in Nursing: Recognizing the Signs and Finding Help

All too often, the pressures of nursing can lead to addiction. Nurses are the backbone of our healthcare system. But that responsibility can be overwhelming. Rehabs that treat professionals recognize the unique challenges that people in demanding jobs, like nurses, face during recovery. 

Understanding Substance Abuse in Nursing

Between 2-10% of nurses experience addiction.1 Another 14-20%  experience unhealthy drug or alcohol behaviors without developing dependency. But many researchers believe that the actual number is higher, due to underreported addiction cases.2 And experts say this issue is  getting worse, partly due to COVID-19 and the ongoing nursing shortage

Whys Some Nurses Develop Substance Use Disorders

Nursing is a very difficult profession.3 Nurses work long hours, performing physically and emotionally exhausting tasks. And despite their efforts, they get less recognition than doctors. 

Certain factors increase the risk of addiction among nurses:

Stress and Burnout Among Healthcare Professionals

As physician Lewis Thomas said, a hospital “is held together, glued together, enabled to function as an organism, by the nurses.”3 Despite how essential their work is, many nurses experience unsustainable working conditions:4 

  • Long shifts, including 12-hour, overnight, or on-call shifts
  • Short-staffed work environments
  • Physically and emotionally taxing duties, like lifting patients and making emergency clinical decisions
  • Lack of control over their schedule
  • Unsafe workplaces with a high risk of contamination and violence
  • Financial insecurity 
  • Lack of support from administrators 
  • Constant exposure to pain, trauma, sickness, and death

Consistently living with this level of stress takes a toll on your body and mind. For some nurses, using drugs or alcohol to cope with stress5 is the path of least resistance. For example, if you’re working overnight shifts, you may not be able to have dinner with a supportive friend. But you might have easy access to prescription drugs. 

Some nurses also use drugs in order to get their jobs done. If you work in a short-staffed clinic, you might use stimulants to boost your energy6 so you can meet your patients’ needs.

People with different nursing specialties face different risks of substance abuse.7 For example, surgical, hospice, home health, and long-term care nurses are more vulnerable to addiction. These jobs are hugely demanding, and the people who do them experience high stress.

Mental Health and Emotional Strain

This stress can quickly lead to burnout. In fact, 50% of nurses experience burnout8 symptoms:

  • Emotional exhaustion
  • Lack of motivation and productivity
  • Decreased quality of life
  • Increased desire to quit their jobs

Burnout can lead to compassion fatigue.9 This condition is common for healthcare professionals. Ongoing exposure to patients’ suffering can cause serious physical, social, and emotional symptoms:

  • Constantly feeling on edge, or feeling numb to everything
  • Exhaustion and difficulty sleeping
  • Irritability
  • Difficulty making decisions, caring for patients, and feeling empathy for others
  • Feeling disconnected from colleagues, family and friends
  • Isolating yourself 

Compassion fatigue, stress, and burnout all increase your risk of addiction.10 This is exactly what happened to Shannan Fiorenza, a nurse in addiction recovery.11 After a kidney stone operation, she received prescription painkillers. She explains:  

“When I got those pain pills and they hit my bloodstream, it really helped me feel numb. And I think that’s what I was looking for, a way to escape at that time. I quickly destroyed my life.” 

Like Shannan, many nurses self-medicate with drugs or alcohol to manage mental health symptoms. 

How Common Is Substance Abuse in Nursing?

Nurses are at a higher risk of developing certain mental health conditions:12

It’s very common for anyone with these diagnoses—including nurses—to self-medicate with drugs or alcohol. And in the short term, substances can help manage or numb your symptoms. But over time, that behavior often leads to addiction. 

Increased Access to Medications 

Nurses also have access to medications that most non-healthcare workers don’t. Studies show this increased access may make nurses more vulnerable to substance abuse.13 What’s more, nurses are at a higher risk of addiction to prescription medications than the general public. 

It’s common for healthcare professionals to diagnose and treat themselves.14 But without a supervising prescriber, you’re responsible for monitoring your own drug use. This makes it all too easy for nurses to take drugs in secret, leading to a higher likelihood of substance abuse amongst nurses.

Signs and Symptoms of Substance Abuse in Nursing Professionals

Many nurses know how to hide their drug and alcohol use.15 And without specialized training, many healthcare professionals miss the signs of substance abuse in their colleagues. It’s important to learn how to recognize these symptoms to keep both patients and nurses safe.

Many nurses show behavioral changes as their addiction develops:16

  • Mood swings
  • Withdrawal from colleagues, friends, and family
  • Increased absences and tardiness
  • Defensiveness or dishonesty
  • Aggression
  • Changes in appearance
  • Frequent use of gum or mints
  • Heavy intoxication at work events like holiday parties
  • Expressing paranoia, feelings of pain, or depression

You might also notice physical symptoms:17

  • Dilated pupils or bloodshot eyes
  • Slurred speech
  • Unsteady gait
  • Rapid weight changes
  • Lack or excess of energy
  • Runny nose
  • Tremors

In more severe cases, nurses with addiction show signs of impaired practice:18

  • Frequent errors in administering, ordering, recording, or disposing of medications 
  • Patients complaining about reduced pain relief
  • Consistently offering to administer medication for other nurses
  • Showing up at work on days off
  • Frequently leaving to use the bathroom, or go to the parking lot

If you notice signs of addiction in a colleague, it’s important to report it. Often, nurses will only receive treatment after a colleague does this. In many U.S. states, for example, state boards require healthcare professionals to report any signs of substance abuse19 from a coworker. 

What Happens When a Nurse Develops a Substance Use Disorder?

Nurses with substance use disorders face unique consequences and barriers to treatment. 

Patient Care From Nurses Experiencing Addiction

In healthcare settings, nurses provide most of the direct care to patients.20 Because a patient’s condition can change at any time, nurses have to be ready to make clinical decisions at a moment’s notice. When you’re drinking or using drugs, your judgment is limited. You can’t react as quickly, think as clearly, or notice as many details. In many situations, that can put a patient’s health at risk.

Addiction Stigma in the Healthcare Industry

Unfortunately, many healthcare professionals harbor negative beliefs about people experiencing addiction.21 So nurses that develop addiction may fear how their colleagues will judge them. They also may feel shame about using substances despite being a healthcare professional. 

Because of this stigma, nurses don’t always report their suspicion of a colleague’s addiction.22 They may fear social backlash at work, or fear what will happen if their colleague gets fired. Some hospital administrators even ignore reports of impaired care. In the short term, this can seem like a way to avoid malpractice lawsuits or staff shortages. But it can also be a barrier to treatment for nurses with addiction.

Barriers to Treatment for Nurses With Addictions

For many nurses, stigma delays treatment for substance abuse.23 Healthcare professionals are unlikely to get help until their substance use is severe enough to have serious consequences.

Nurses also face other barriers to drug and alcohol treatment:

  • The belief that they can stop on their own because of their medical training
  • Fear of legal and professional consequences like losing their license
  • Financial concerns about how to pay for rehab, especially if they lose their job

Resources for Nurses Seeking Help With Substance Abuse

Government and national nursing organizations recognize that substance abuse harms both nurses and patients. So some U.S. states now offer certain resources to nurses seeking addiction treatment.24 Many of these programs protect you from professional discipline if you follow certain rules. 

Alternative to Discipline (ATD) Programs 

Alternative to Discipline (ATD) programs are a common treatment option25 for nurses with substance use disorders. They are state board-run, confidential, and not mandatory. In most U.S. states, a nurse’s employer will refer them to an ATD program as soon as they learn of the nurse’s addiction. If you stay in that program you might be protected from prison time, losing your license, or getting fired.

The idea behind these programs is that most nurses will choose to get help if they can do so safely. Studies show that ATD programs effectively help nurses avoid relapse,26 return to work, and improve patient care.  

When you’re in an ATD program, you’ll usually sign a return-to-work agreement27 to uphold certain standards for a set period of time:

  • Complete a recognized treatment program 
  • Work less intensive hours, such as avoiding overnight shifts
  • Avoid situations where you’d work alone, like home healthcare
  • Refrain from handling or administering narcotics 
  • Submit to random drug tests or alcohol screenings
  • Attend regular support groups meetings or 1:1 therapy sessions
  • Check in with administrators on a regular basis
  • Disclose addiction and treatment plan to future employers

Some nursing specialities require stricter standards.28 For example, anesthesia nurses must have 1 year of sobriety before they can return to work.

Employee Assistance Programs (EAPs)

Some employers have in-house programs for employees with substance misuse.29 These employee assistance programs (EAPs) vary widely across institutions. However, most EAPs are employer-paid and confidential. 

Some EAPs only offer health promotion and awareness activities. Others can refer you to a treatment center or provide treatment themselves. Once you’ve completed treatment through an EAP, they’ll likely monitor your progress with check-ins and random drugs tests. 

To find out if your employer offers an EAP, you can get in touch with a human resource manager. You can also look through the employee handbook or orientation materials if you’re not ready to talk to a colleague. 

Peer Support Groups for Nurses

Sobriety support groups30 can supplement more formal substance abuse treatment. And nurses can attend support groups just for other nurses and healthcare workers in recovery:

Some hospitals also offer 12-Step meetings for employees. There, you can connect with other people who understand the unique challenges of nursing while you’re in recovery. And you’ll be able to find mentors who have successfully returned to work while staying sober.

Residential and Outpatient Rehab Programs for Nurses

Some rehabs have treatment programs specifically for nurses and other healthcare professionals. You might access them through an ATD program or an EAP, or you can attend on your own. Depending on your employer’s requirements, you can choose between outpatient or residential treatment

Some outpatient programs may allow you to work during treatment. But if your substance use is more severe, you might need to start recovery in residential rehab.

Learn more about getting time off for addiction treatment here.

You’ll have access to a variety of treatment options, depending on your rehab program:

These therapies can help you work through triggers and address the root cause of your substance misuse. If and when you return to work, you’ll be able to keep everyone safe—both yourself and your patients.
To get the specialized care you need, explore rehab for professionals to learn more about pricing, insurance coverage, and therapy options.


Frequently Asked Questions About Substance Abuse in Nursing

What are the risk factors for substance abuse among nurses?

Stress and burnout from long shifts, short-staffed work environments, physically and emotionally taxing duties, and constant exposure to pain and trauma can increase the risk of substance abuse among nurses.

What treatment options are available for nurses struggling with substance abuse?

Alternative-to-discipline (ATD) programs, employee assistance programs (EAPs), peer support groups, and residential and outpatient rehab programs are options for nurses seeking help. Treatments might include individual, group, and family therapy, evidence-based approaches, and complementary therapies.

How can I support a loved one who is a nurse struggling with substance abuse?

It’s important to approach the situation with empathy and compassion. Consider having a private conversation with them about your observations and offer to help them find resources for treatment. Remember that recovery is a journey that requires ongoing support and care. Encourage them to seek help from a specialized rehab center that caters to professionals.

Understanding Family Roles in Addiction: How to Break the Cycle

One person’s drug use can affect their whole community. That includes family, friends, colleagues, and anyone close to you. Whether you or someone you love is in treatment for addiction, understanding family roles in addiction can help you heal.

Addiction and Family Systems

Addiction always has a context. Most people turn to drugs and alcohol as coping mechanisms. You might be dealing with mental health symptoms, trauma, or just the stress of daily life. Any of these issues—including addiction itself—can relate to your family dynamic. 

To heal a dysfunctional family system, it might help to think about family roles. Family therapist Sharon Wegscheider-Cruse introduced this framework in her 1989 book Another Chance: Hope and Health for the Alcoholic Family. In it, she describes common ways that family members interact when one person has addiction. 

This model isn’t universal, and it might not describe your experience perfectly. But learning about these different roles can give you insight into your own behavior. That newfound understanding can empower you to communicate your needs, set clear boundaries, and build stronger relationships within your family.

The 6 Family Roles

Wegscheider-Cruse describes 6 different family roles that support addiction.1 Each one has specific emotions, needs, and patterns of behavior. 

The Person With Addiction

The person actively using drugs or drinking is at the center of this dynamic. Even if you feel isolated, your addiction can influence everyone around you. That doesn’t mean you’re responsible for everything that happens in your family. Sometimes, it’s just the opposite.

Successful addiction treatment addresses the underlying cause of your behavior. For example, your addiction might stem from childhood trauma. Your family may be the cause of that trauma or they may have survived it alongside you—or both. Sometimes, you’ll need to let go of these relationships to move forward. In other cases, rebuilding them can be vital to your recovery.

The Caretaker

The caretaker, or enabler, tries to protect their loved one with addiction. Because addiction and codependency go hand in hand, that can be counterproductive. It might feel like you’re keeping them safe. But in reality, you’re shielding them from the consequences of their own actions. And that makes it harder for them to realize they need help.

Enabling someone with addiction also puts the caretaker in harm’s way. You can find yourself bearing the brunt of someone else’s behavior. For example, imagine your loved one can’t pay their bills because they’re spending too much money on drugs. By lending them money, you risk your own financial security. 

The Hero

This person, often the oldest child, sets out to save the family’s reputation. They put on a brave face and work hard to achieve their goals. To outsiders, they appear stable and successful. While that’s sometimes accurate, it’s not always the hero’s primary goal. 

The hero feels responsible for their family’s safety and security. They may experience parentification,2 in which a child takes on the role of a parent. Sometimes that means caring for their siblings or earning money at a young age. Heroes might also provide emotional support to adults in the family. People in this role tend to feel overwhelmed, anxious, and depressed.

The Mascot

The mascot is like a class clown. This person tries to distract their family from the impacts of addiction. They use humor and kindness to keep everyone happy. In the short term, their behavior lightens the mood. But in the long term, it can lead to serious problems.

As a child, the mascot resolves conflict with jokes or distractions. As an adult, this can prevent them from building strong relationships. They may not know how to face communication issues or power struggles. And if humor is their primary coping mechanism, other people might not take them seriously. 

The Lost Child

Caught up in the whirlwind of addiction, family members ignore the lost child. This person might be “the quiet one,” or seem like they live in their own world. Perhaps they love reading, video games, or another kind of escapism. Without the emotional support they need, they look for other ways to cope.

The lost child is isolated, often feeling sad and lonely. Many develop an intense fear of abandonment. Data suggests lost children might be more vulnerable to personality disorders,3 especially avoidant personality disorder. 

The Scapegoat

Like the mascot, the scapegoat distracts their family from the person with addiction. But instead of using humor, they act out. This person might start using drugs themselves, or spending time with friends who do. They also take unnecessary risks, requiring other family members to solve their problems. 

This behavior can interfere with a child or teen’s social development. Scapegoats are at higher risk for educational, interpersonal and even legal problems as they get older. 

Finding Help for Families

These Family roles in substance abuse describe patterns of behavior, not permanent parts of your identity. Think of them as a tool for recovery, and not a way of justifying harmful dynamics. Understanding your relationships can help you improve them. 

Most rehabs offer some form of family therapy. Depending on your program, this could mean anything from virtual sessions to an intensive family program. Treatment can help each person understand their family role in the context of addiction recovery. 

Family therapy is available for families of every structure. You can look for a program that treats teens and their parents, married couples, or entire chosen families. Some providers have even more specific areas of expertise. For example, you can easily find a rehab program for LGBTQ+ clients.

Family involvement also empowers each person to heal on their own. In addition to group sessions, family members with and without addiction can benefit from individual therapy. This treatment offers you a safe, private space to explore your own feelings. You can also learn practical ways to improve your behavior, both for your family’s sake and your own. 

Search our list of rehabs to find programs with family therapy, treatment for loved ones, and other types of specialized care.

Contingency Management: An Evidence-Based Approach to Addiction Recovery

Recovering from addiction is hard work. It can take conscious effort to resist cravings. However, some treatment centers use contingency management to reward you for continuing abstinence from drugs or alcohol. And those rewards help you focus on healing, even during stressful times.

What Is Contingency Management (CM)?

Contingency management (CM) is a behavioral treatment option1 for people recovering from substance use disorder. This therapy revolves around positive reinforcement. In other words, patients get rewards for certain activities, encouraging them to keep it up. When you’re in addiction recovery, you might get rewards for sobriety or just for staying in treatment.

Contingency management theory is based on the idea that changing your environment can change your behavior. In an environment that rewards sobriety, you’re more likely to commit to addiction treatment. Treatment rewards include tangible prizes, like vouchers or even cash.

For example, if you submit a drug-negative urine sample or attend your scheduled therapy session, then your therapist might give you a voucher. And the longer you sustain this positive behavior, the larger the rewards get. So after one day of drug-free urine samples, you could receive $1. After a year of proven, sustained abstinence, you could receive up to $100. But if you relapse, your rewards will reset back to the beginning.

How Does Contingency Management Work?

The first step in many contingency management therapy programs is writing a contract between the provider and the patient.2 In this contract, you’ll agree to:

  • Perform a specific type of desired behavior (like abstinence from drugs and alcohol or attending other therapy sessions)
  • Stay in treatment for a certain amount of time
  • Submit drug tests on a set schedule

In turn, your provider will commit to giving you specific, predictable rewards based on your behavior. If you keep the commitments in this contract, you’ll know exactly which rewards to expect.

Most people are in contingency management programs for a year3 or less. Depending on your program, you may have to submit urine tests daily4 or 2-3 times a week. You may test in your therapist’s office before attending a counseling session, or you might have to submit tests through a third-party testing center.

The rewards you earn also depend on your program. One popular reward option is a voucher that you exchange for goods, which increase in value the longer you stay sober. Other programs give you money, gift cards, or the opportunity to win prizes like movie passes. Some states limit the total amount5 that patients can earn. For example, in Virginia, patients can only earn up to $75 annually.

CM can be helpful in every phase of recovery. For example, many patients use this approach during detox from substances like opioids, in combination with other treatments. It may also be a good aftercare option for people leaving residential rehab.

Contingency Management as Part of Your Larger Treatment Plan

Contingency management is a supplementary therapy, so it likely won’t be the only addiction treatment you use. Most providers combine this treatment with medication, talk therapy, or other types of care.

Contingency Management and Pharmacotherapy

If your treatment plan includes medication-assisted treatment for substance use, like methadone, your CM program may reward you for taking your medication. You might also get rewards for safely taking methadone doses at home,6 or reaching other recovery milestones.

CM is very effective for patients using methadone maintenance therapy7 and other addiction medications. Participating in contingency management therapy actually improves the outcomes of these treatments.

Because drug tests are a regular part of most contingency management programs, make sure your entire team knows about any medications you’re taking. Most providers will include that information in your initial CM contract. This helps patients stay accountable throughout treatment.

Contingency Management With Other Psychosocial Therapies

Combining contingency management with other types of therapy can maximize the benefits of treatment. Rehabs like Renaissance Recovery in California integrate contingency management into their programs for this very reason. Patients attend both behavioral and psychotherapy sessions to learn new relapse prevention techniques. For example, you might combine CM with cognitive behavioral therapy (CBT).

Some studies suggest that contingency management helps most in the short term,8 while other methods like motivational interviewing can help you commit to long-term sobriety. However, other studies show that patients who have undergone contingency management therapy in the past continue to abstain from drugs9 or alcohol even after they stop getting rewards.

Can Contingency Management Help With Addiction?

Contingency management is a very effective treatment10 option for addiction to opioids, stimulants, alcohol, benzodiazepines, marijuana, and tobacco. Researchers from Washington State University describe contingency management as “one of the most effective behavioral interventions11 for initiating and maintaining abstinence from alcohol and drugs.” Dr. Nora Volkow, Director of the U.S. National Institute on Drug Abuse takes it even further, saying “we don’t need more science to show the effectiveness of contingency management.12 We need more treatment centers to implement it.”

CM works because of the way addiction affects your brain’s reward systems.13 As addiction develops, your brain starts to only recognize pleasure (the reward) when you drink or use drugs. Even things that used to bring you pleasure—like family time or career success—start to feel less rewarding. Contingency management replaces the reward of getting high with that of getting a prize. It motivates patients to sustain abstinence because of this potential reward.

Contingency Management for Teens

Data supports contingency management as a treatment for teens14 with addiction. Experts say that family involvement is vital to this process. Some rehabs can facilitate that through group therapy sessions. For example, your program may offer CM as part of family therapy.15

Contingency management can help teens with more than addiction recovery. It’s also effective for young people on probation15 and students using CM to stay in school.

Other Benefits of Contingency Management

CM can also help adults with a variety of goals. For example, some treatment programs strategically use their vouchers to promote drug-free activities.17 So you may receive a voucher for a free class at the local yoga studio, which encourages you to learn a new skill and have fun without using drugs. Finding new ways to enjoy yourself is an essential part of recovery.

Contingency management also helps patients build confidence.18 Tangible signs of your own success can boost your self-worth. It’s also easy to track your progress as each reward increases in value. Plus, earning small rewards consistently can add moments of happiness as you begin a new chapter of your life.

Contingency Management Rewards You for the Hard Work of Recovery

For many people, sustained recovery doesn’t come from a single type of therapy. Because addiction impacts every aspect of your life, treatment has to do the same. Talk therapy can teach you healthier coping skills, and complementary treatments can help you explore your emotions. While you’re doing that, contingency management both validates and rewards your progress.

Search rehabs to find a program that meets your needs and reach out to centers directly.

Overcoming Addiction: How to Approach Recovery

If you have a severe addiction, it can affect every part of your life. It might feel like a mental health issue, a behavioral problem, a physical condition, a spiritual wound—or like it’s your whole world. You may want to learn long-term coping skills or overcome habits that enforce addictive behaviors. And by the time you decide to get help, you might not know where to start.

That’s partly because healing looks different for everyone. And there are countless types of addiction treatment for behavioral and substance use disorders. Before you decide which one is right for you, you can learn more about how addiction works.

What Makes Something Addictive?

The National Institute on Drug Abuse defines addiction1 as compulsively taking drugs or drinking in spite of the negative impact it has on your life. Several different factors can contribute to substance use disorders:

Because it’s a little different for everyone, addiction impacts people’s lives in different ways. The more severe your addiction, the more areas of your life it can affect. For example, if you always drink too much at the bar, you may start losing friendships. And if you start drinking at your desk, you might lose your job. The severity of your symptoms can determine which type of treatment you need.

The Different Types of Addiction

There are 2 basic types of addiction: chemical and behavioral. They may look different on the outside, but they can have similarly destructive effects on your life.

  1. Chemical addictions are drug or alcohol addictions. Even serious chemical addictions may or may not include physical health issues. To explain this, researchers note the difference between physical vs. psychological drug dependence.5 Being physically dependent on your asthma medication, for example, isn’t often an issue. On the other hand, drinking too much can cause serious problems even if you’re not physically addicted to alcohol. 
  1. Behavioral addictions are patterns of destructive behavior that you just can’t seem to stop. For example, gambling in moderation can be perfectly harmless. But if you’re gambling away your life savings, you might need treatment. These addictions can be just as severe as chemical ones. In fact, data shows neurochemical similarities between behavioral and drug addictions.6 

How to Tell if You or a Loved One Has an Addiction

Whether you’re dealing with a drug addiction or a behavioral one, it can be hard to know when you need help. If you think you or someone you love might need treatment, you can start by answering these questions:

  • How often do you use drugs, drink, or engage in a certain behavior?
  • How much time do you spend thinking about the next time you’ll drink, use drugs, or engage in the behavior?
  • Do you take risks in order to obtain drugs or alcohol, have sex, gamble, etc?
  • Do you lie about how much you engage in this behavior?
  • Is it hard to focus at work because you’re drinking, using drugs, or planning risky behaviors?
  • Have you ever missed an important meeting or family commitment because you were drunk, high, at a casino, shopping, etc?
  • Have you gone into debt to afford this behavior, including for the purchase of drugs or alcohol?

Once you go through this list, share your answers with a doctor, therapist, or other addiction expert. They’ll perform a full evaluation and give you specific advice about what to do next.

Preparing for Recovery

There’s a lot to consider when you first begin healing. If you’re the person starting rehab, choosing a program can be a vulnerable process. Even if you have to move quickly, you can still talk to the admissions teams at a few different centers. They’ll give you a clear idea of what to expect from treatment.

You’ll also need to take care of certain logistics before you start rehab. For example, you might need to request time off work or arrange for a house sitter. If you’re traveling to rehab, make sure you bring someone with you. That person could be a friend, family member, or even a staff member from your program. They can handle the logistics while you focus on your recovery journey. 

If you’re helping someone else with addiction, there’s even more to think about. In some situations, you can admit your loved one to rehab. But that’s not always possible. If it seems necessary, you can also consider staging an intervention.

Planning an Intervention

Successful interventions take a lot of preparation. This is too big a task for just one person. You can hire a professional intervention leader or get support from mutual friends and family. 

Take some time and think about what you want to say in advance. Perhaps more importantly, think about what you’d like to happen next. Are you hoping your loved one will start treatment? If they refuse, will you set new boundaries? Be as clear and specific as possible, and take your notes with you to the conversation. That way, if things get emotional, you can trust the decisions you’ve already made.

You can also refer to this intervention checklist while you’re planning what to say. 

Choosing a Type of Treatment

When you’re planning to attend rehab, you’ll have plenty of options to choose from. You might look for a center that treats co-occurring mental health conditions, or one that focuses on medical care. Certain addictions are harder to break than others, and may require specialized treatment. Ask your doctor or another expert for advice about which approach might be best for you.

Medical Detox

When you first stop drinking or using drugs, this short-term treatment helps you handle any withdrawal symptoms. You’ll probably work with a team of doctors, nurses, and therapists during your 5-14 day program. 

While medical detox isn’t always necessary, it’s extremely important for certain people. When you’re detoxing from alcohol,7 opioids,8 or benzodiazepines,9 medical supervision is essential. Without proper treatment, withdrawal from these substances can be life-threatening. 

These programs can also be a good fit for people with other health problems. Your care team can help you detox as safely and comfortably as possible. Most of these centers require you to enroll in longer-term rehab before you arrive on site. When you finish detox, you’ll go directly into your next phrase of treatment.

Inpatient Rehab

In most residential rehab centers, treatment lasts for about 30 days. Clients attend talk therapy, support groups, and complementary therapies. You might also work with a medical team. 

Traditional rehab programs will help you address the root cause of your addiction. When you step back from the stress of your daily life, you’ll gain new insight into your own behaviors. This empowers clients to identify triggers and learn new coping skills. You’ll also plan ways to prevent relapse. This process sets you up for success when you transition out of rehab. 

Outpatient Treatment

If you need more flexibility while you recover, outpatient treatment might be a better fit. Most outpatient rehab programs fall into 1 of 2 categories: 

  • Partial hospitalization programs (PHPs) offer intensive outpatient care. Think of a PHP like a full-time job, except you’re attending therapy instead of going to work. Patients live off site but spend most of their time in treatment.
  • Intensive outpatient programs (IOPs) give clients a little more independence than PHPs. With less time in therapy, some people keep going to work throughout recovery. These part-time programs are a good fit for people with less severe symptoms, and those with strong support networks at home.

Support Groups

Social support is hugely important during recovery.10 But because addiction can damage your relationships, you may need to build a new community while you heal. Support groups are one way to accomplish that.

  • 12-Step groups, like Alcoholics Anonymous, are free and easy to find anywhere in the world. You can even go to online meetings. Members commit to addiction recovery through faith in a higher power. 
  • SMART Recovery is a secular organization. These free meetings focus on self-empowerment instead of spirituality. 
  • LifeRing participants connect with each other just as they are in the present moment, instead of sharing stories of past trauma. Members encourage each other to maintain their sobriety.

Each of these groups also host meetings just for loved ones of people with addiction. These spaces let friends and family members connect with people who understand what they’ve been through. Anyone can attend these free support groups in any stage of recovery—even during rehab. 

Search our list of luxury treatment centers around the world to find a particular type of therapy, location, or approach to addiction recovery.

What to Expect From Dialectical Behavior Therapy (DBT)

When you find the right type of therapy for you, it can change your life. And if you’re considering rehab, you might already know what you need to be different.

Dialectical behavior therapy (DBT) can help you make those changes. But here’s the thing: it won’t change who you are.

Rehab programs with DBT address the patterns that keep you from living your best life. They do that by validating your feelings, without trying to change them. And when you learn to accept yourself, just as you are, you can let go of behaviors that aren’t serving you.

What Is Dialectical Behavior Therapy?

Dialectical behavior therapy (DBT) is an evidence-based treatment. ((Chapman AL. Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont). 2006 Sep;3(9):62-8. PMID: 20975829; PMCID: PMC2963469.)) It was originally developed by Dr. Marsha Linehan to treat patients with borderline personality disorder (BPD). Today, therapists use it for a much wider variety of mental health issues, including addiction.

DBT incorporates some tenets of Zen Buddhism ((Robins, Clive J. “Zen Principles and Mindfulness Practice in Dialectical Behavior Therapy.” Cognitive and Behavioral Practice, vol. 9, no. 1, Dec. 2002, pp. 50–57. ScienceDirect, https://doi.org/10.1016/S1077-7229(02)80040-2.)) and has a strong focus on mindfulness. This treatment differs from other popular therapies, like cognitive behavioral therapy (CBT), in a few ways. For one, DBT encourages you to accept your feelings (( “Foundations of Dialectical Behavioral Therapy.” Wisconsin Department of Health Services. https://dhs.wisconsin.gov/non-dhs/dcts/5-nov-2020-foundations-dialectical-behavioral-therapy.pdf)) instead of challenging them. A cognitive behavioral therapist might have you question negative thought patterns, reasoning your way out of them. But in DBT, you’ll validate your own emotions—even painful ones. Group therapy is also a key element of DBT.

The idea of a dialectic, or discussion, is central to this treatment. ((May JM, Richardi TM, Barth KS. Dialectical behavior therapy as treatment for borderline personality disorder. Ment Health Clin. 2016 Mar 8;6(2):62-67. doi: 10.9740/mhc.2016.03.62. PMID: 29955449; PMCID: PMC6007584.)) Patients learn to embrace seemingly opposite ideas at the same time. For instance, your therapist might tell you that you are doing your best, and you can do better. DBT teaches you to accept both of these ideas as equally true, and equally important. And you can apply that skill to other parts of your recovery. So if you’re healing from addiction, for example, you might accept that you can have cravings, and choose not to drink or take drugs.

The 4 Modules of DBT: What You’ll Learn in Session

DBT might feel more like a class ((May JM, Richardi TM, Barth KS. Dialectical behavior therapy as treatment for borderline personality disorder. Ment Health Clin. 2016 Mar 8;6(2):62-67. doi: 10.9740/mhc.2016.03.62. PMID: 29955449; PMCID: PMC6007584.)) than traditional talk therapy. Patients work from a textbook, discuss new ideas with a group, and even do homework assignments. During treatment, you’ll progress through 4 separate modules. All of them are related, but each one focuses on a specific topic.

Mindfulness

Mindfulness is a central theme in DBT. The lessons in this module can help you focus on the here and now. This empowers patients to avoid negative thought spirals. And when you’re grounded in the present moment, you can take action that aligns with your recovery goals.

Emotion Regulation

Many people try to minimize difficult feelings, like shame and grief. And in one sense, that’s normal. Avoiding pain is a survival strategy. But when it comes to your mental health, avoidance isn’t sustainable. And it can lead directly to addiction.

In this module of DBT, you’ll first learn how to identify your emotions. Just naming them can help you accept what you feel, without judgment. And when you consistently validate your own feelings, they naturally become more manageable. For a lot of patients, this approach is even more effective than resisting an emotion.

Interpersonal Effectiveness

This module teaches you how to build strong relationships. Patients learn specific, practical skills to help with that:

  • Identifying and articulating your own needs
  • Setting and maintaining healthy boundaries
  • Handling disagreements calmly
  • Balancing your needs with someone else’s

You’ll practice these skills within the group and in between sessions. You might even roleplay certain scenarios in therapy. In that case your therapist will give you direct feedback, suggesting ways to improve.

Distress Tolerance

Much as you might want to avoid it, pain is an inevitable part of life. DBT doesn’t change that. Instead, it gives you the tools to work through stress. These strategies are clear and simple, so it’s easy to recall them when you’re under stress:

  • Radical acceptance ((Görg, Nora, et al. “Trauma-Related Emotions and Radical Acceptance in Dialectical Behavior Therapy for Posttraumatic Stress Disorder after Childhood Sexual Abuse.” Borderline Personality Disorder and Emotion Dysregulation, vol. 4, no. 1, July 2017, p. 15. BioMed Central, https://doi.org/10.1186/s40479-017-0065-5.)) teaches you to identify and sit with painful feelings, without trying to change them in any way.
  • Urge surfing ((Schubert, Kimberly N., “Evaluation of a Brief “Surf the Urge” Intervention” (2018). UNLV Theses,
    Dissertations, Professional Papers, and Capstones. 3382.
    http://dx.doi.org/10.34917/14139909 )) can be especially helpful during addiction recovery. You can use it when you experience an urge that could be harmful, like a drug craving. Instead of acting on that desire, you’ll just observe it. Most urges grow, crest, and then subside, like ocean waves.
  • Self-soothing skills ((Perepletchikova F, Axelrod SR, Kaufman J, Rounsaville BJ, Douglas-Palumberi H, Miller AL. Adapting Dialectical Behaviour Therapy for Children: Towards a New Research Agenda for Paediatric Suicidal and Non-Suicidal Self-Injurious Behaviours. Child Adolesc Ment Health. 2011 May 1;16(2):116-121. doi: 10.1111/j.1475-3588.2010.00583.x. PMID: 21643467; PMCID: PMC3105788.)) engage the 5 senses. You might touch a soft blanket, drink a cup of tea, or light a scented candle. Activities like these can help you stay calm.

The skills you learn in DBT won’t make your problems disappear. But they can keep you centered, making it easier to face life’s challenges.

What to Expect in a Dialectical Behavior Therapy Program

Most outpatient DBT programs last about 6 months. ((May JM, Richardi TM, Barth KS. Dialectical behavior therapy as treatment for borderline personality disorder. Ment Health Clin. 2016 Mar 8;6(2):62-67. doi: 10.9740/mhc.2016.03.62. PMID: 29955449; PMCID: PMC6007584.)) Traditional DBT has 3 components:

In a residential rehab, your DBT program may look a little different. It will probably be shorter than 6 months with more frequent meetings. But you’ll still have group sessions, and you’ll cover the same subject matter.

Group Therapy

In DBT, group therapy is an essential part of treatment. A therapist guides your group through skill-building activities in each of the 4 modules. They’ll assign homework so you can practice those skills between meetings. Then you’ll review it together during the next session.

In many outpatient DBT programs, you’ll meet with your group once a week for about 2 hours at a time. In residential rehab, you may meet more often, or even daily.

Individual Therapy

In addition to group sessions, most DBT programs include individual therapy. Your therapist might be the same person who leads the group, but not necessarily. These sessions give you more freedom to talk about yourself, instead of just the curriculum. Your counselor will help you set and meet recovery goals, and put your new skills in context.

This aspect of DBT offers short-term solutions. While group lessons equip you with important skills, it takes time to put them all together. Your therapist can get to know you as an individual, and give more specific advice to help you along the way.

Texts and Calls With Your Therapist

In traditional DBT programs, you can call or text your therapist in between sessions. When you begin treatment, the two of you will discuss specific boundaries and expectations. Some therapists are reachable 24/7, so you can always ask for help in an emergency. Others might silence their phone at night, or have you text instead of calling.

This isn’t always a part of treatment. For example, you might attend a DBT group in one therapy practice, but see another therapist somewhere else. In that case, your therapist might not offer this type of care. And if you’re in a residential rehab, you might have 24/7 access to therapy, but not always with your primary counselor.

DBT for Mental Health Recovery

DBT can treat a range of mental health conditions, both on their own and as co-occurring disorders.

Personality Disorders

The National Alliance on Mental Health (NAMI) calls DBT the “gold standard” therapy for borderline personality disorder. ((“Treating Borderline Personality Disorder.” National Alliance on Mental Illness. https://www.nami.org/Blogs/NAMI-Blog/June-2017/Treating-Borderline-Personality-Disorder)) This treatment targets the specific symptoms of BPD, so patients can heal in a sustainable way. It also helps people with other personality disorders.

Studies show that DBT is one of the most effective personality disorder treatments. ((Rosemery O. Nelson-Gray et. al. “Assessment and Treatment of Personality Disorders: A Behavioral Perspective.” The Behavior Analyst Today, Volume 10, Number 1. https://files.eric.ed.gov/fulltext/EJ862336.pdf)) And treatment can improve these patients’ other mental health symptoms. For instance, DBT often reduces symptoms of depression in patients with personality disorders.

Depression

DBT is also a popular treatment for depression ((Harley R, Sprich S, Safren S, Jacobo M, Fava M. Adaptation of dialectical behavior therapy skills training group for treatment-resistant depression. J Nerv Ment Dis. 2008 Feb;196(2):136-43. doi: 10.1097/NMD.0b013e318162aa3f. PMID: 18277222.)) as a primary diagnosis. It’s especially helpful for patients with treatment-resistant depression. And studies show that DBT for depression can even be a short-term treatment. ((Lothes JE, Mochrie KD, St. John J (2014) The Effects of a DBT Informed Partial Hospital Program on: Depression, Anxiety,
Hopelessness, and Degree of Suffering. J Psychol Psychother 4: 144. doi:10.4172/2161-0487.1000144)) Many patients show marked improvement after only 29 days of therapy. So even if you stop attending DBT when you leave rehab, it can still make a huge difference in your ongoing recovery.

Even if you don’t have a diagnosis of depression, research supports DBT as a treatment for suicidal ideation. ((McCauley E, Berk MS, Asarnow JR, et al. Efficacy of Dialectical Behavior Therapy for Adolescents at High Risk for Suicide: A Randomized Clinical Trial. JAMA Psychiatry. 2018;75(8):777–785. doi:10.1001/jamapsychiatry.2018.1109)) The practical skills you learn in therapy can help you manage crisis situations, intrusive thoughts, and the urge to self-harm.

If you or someone you know is thinking about suicide or self-harm, get help right away. Call the National Suicide Prevention Lifeline at 1-800-273-8255 for free, 24/7.

You can also learn more about supporting someone with suicidal ideation.

Trauma Recovery

Some providers offer specialized DBT to treat trauma symptoms. ((Bohus M, Kleindienst N, Hahn C, Müller-Engelmann M, Ludäscher P, Steil R, Fydrich T, Kuehner C, Resick PA, Stiglmayr C, Schmahl C, Priebe K. Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse: A Randomized Clinical Trial. JAMA Psychiatry. 2020 Dec 1;77(12):1235-1245. doi: 10.1001/jamapsychiatry.2020.2148. PMID: 32697288; PMCID: PMC7376475.)) You might benefit from this therapy if you have post-traumatic stress disorder (PTSD), complex PTSD (c-PTSD) or a history of trauma.

The skills you’ll learn in DBT directly address some common symptoms of trauma: ((Karatzias T, Cloitre M, Maercker A, Kazlauskas E, Shevlin M, Hyland P, Bisson JI, Roberts NP, Brewin CR. PTSD and Complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania. Eur J Psychotraumatol. 2018 Jan 15;8(sup7):1418103. doi: 10.1080/20008198.2017.1418103. PMID: 29372010; PMCID: PMC5774423.))

  • Difficulty regulating emotions
  • Trouble forming and maintaining healthy relationships
  • Impulsive behavior

Research shows that DBT helps people with PTSD ((Bohus M, Kleindienst N, Hahn C, Müller-Engelmann M, Ludäscher P, Steil R, Fydrich T, Kuehner C, Resick PA, Stiglmayr C, Schmahl C, Priebe K. Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse: A Randomized Clinical Trial. JAMA Psychiatry. 2020 Dec 1;77(12):1235-1245. doi: 10.1001/jamapsychiatry.2020.2148. PMID: 32697288; PMCID: PMC7376475.)) and c-PTSD commit to treatment, and it reliably reduces their symptoms.

Treating Addiction With DBT

DBT is a highly effective treatment for addiction. ((Dimeff LA, Linehan MM. Dialectical behavior therapy for substance abusers. Addict Sci Clin Pract. 2008 Jun;4(2):39-47. doi: 10.1151/ascp084239. PMID: 18497717; PMCID: PMC2797106.)) After Dr. Linehan developed this therapy for BPD, she noted how common it was for her patients to have addiction as well. So she and Dr. Linda Dimeff went on to design a specialized type of DBT to treat these conditions together.

While most of the research focuses on drug addiction, some studies show that DBT can also treat behavioral addictions, ((“How Might Dialectical Behavior Therapy Work for Individuals with Addictive Behaviors?” Recovery Research Institute, 27 July 2020, https://www.recoveryanswers.org/research-post/dialectical-behavior-therapy-individuals-addictive-behaviors/.)) like gambling or shopping addiction. And in any DBT program, you’ll learn similar skills. But DBT specifically for addiction ((Dimeff LA, Linehan MM. Dialectical behavior therapy for substance abusers. Addict Sci Clin Pract. 2008 Jun;4(2):39-47. doi: 10.1151/ascp084239. PMID: 18497717; PMCID: PMC2797106.)) has some unique benefits:

((Priddy SE, Howard MO, Hanley AW, Riquino MR, Friberg-Felsted K, Garland EL. Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications. Subst Abuse Rehabil. 2018 Nov 16;9:103-114. doi: 10.2147/SAR.S145201. PMID: 30532612; PMCID: PMC6247953.))

((Shorey RC, Gawrysiak MJ, Elmquist J, Brem M, Anderson S, Stuart GL. Experiential avoidance, distress tolerance, and substance use cravings among adults in residential treatment for substance use disorders. J Addict Dis. 2017 Jul-Sep;36(3):151-157. doi: 10.1080/10550887.2017.1302661. Epub 2017 Mar 6. PMID: 28358236; PMCID: PMC6126664.))

  • Strong interpersonal relationships ((Pettersen H, Landheim A, Skeie I, Biong S, Brodahl M, Oute J, Davidson L. How Social Relationships Influence Substance Use Disorder Recovery: A Collaborative Narrative Study. Subst Abuse. 2019 Mar 9;13:1178221819833379. doi: 10.1177/1178221819833379. PMID: 30886519; PMCID: PMC6410387.)) are an important part of successful addiction recovery.
  • Data shows that regulating your emotions can minimize cravings ((Choopan H, Kalantarkousheh SM, Aazami Y, Doostian Y, Farhoudian A, Massah O. Effectiveness of Emotion Regulation Training on the Reduction of Craving in Drug Abusers. Addict Health. 2016 Apr;8(2):68-75. PMID: 27882203; PMCID: PMC5115639.)) and protect against relapse.

In most rehabs, this is just one of many approaches to treatment. So your care plan will probably include several different types of therapy. But the philosophy of DBT can be central to your long-term recovery.

Create Your Own Positive Change

DBT doesn’t “fix” your mental health. In fact, it rejects the idea that your emotions are problems for you to solve. Instead, it teaches you to validate your own feelings and center yourself in present reality—and that self-acceptance can be the foundation of your recovery.

Browse a list of rehabs with DBT to learn about their pricing, locations, housing options, and more.

Reviewed by Rajnandini Rathod

Wisconsin Rehabs Tailor Treatment to You

Perhaps best known for its people’s love of all things dairy, Wisconsin is a charming state. Rolling green hills, Lake Michigan beaches, and a kind, gentle culture make it a comfortable place to heal. Best of all, Wisconsin rehabs are accessible to patients from all walks of life. These programs offer a lot of flexibility, welcoming people with all sorts of recovery goals.

Wisconsin’s Restorative Natural Beauty

Wisconsin has acres of beautiful forests, coastline, and rivers. This tranquil scenery is perfect for reflecting on the progress you’ve made, and many local rehabs let you enjoy the great outdoors during treatment. You might join an adventure therapy program, or just explore your center’s vast campus.

For example, at The Manor, you’ll start healing on their 40-acre campus in the Kettle Moraine Forest. During treatment there, you can go hiking or rock climbing, or participate in equine therapy. And at rehabs like Rogers Behavioral Health, you can try horticulture therapy or explore the labyrinth garden between sessions.

rogers behavioral health oconomowoc
At Rogers Behavioral Health in Oconomowoc, you can try horticulture therapy or explore the labyrinth garden between sessions.

Experience “Midwest Nice” for Yourself

People from the Midwest, including Wisconsin, are known for their friendliness. And that goes far beyond being polite. In fact, Midwesterners tend to form closer friendships ((Joshua Day and Savanha Drew. “Midwest Nice, Southern Hospitality, and Coastal Cool.” University of Wisconsin. https://minds.wisconsin.edu/bitstream/handle/1793/74306/DaySpr15.pdf?sequence=2)) than people from other regions in the U.S.

Even if you’ve never been to Wisconsin before, it’s easy to feel at home once you get there. And if you go to a Wisconsin rehab, you’ll be surrounded by genuine warmth and opportunities to build relationships. This isn’t just comforting; it’s also a vital part of addiction treatment. Data shows that social connections can protect you from relapse, ((NIDA. 2020, March 24. New biological clues linking social connectedness to reduced drug craving and relapse. Retrieved from https://nida.nih.gov/news-events/science-highlight/new-biological-clues-linking-social-connectedness-to-reduced-drug-craving-relapse on 2023, March 8)) especially in early recovery.

Specialized Care in Wisconsin Rehabs

If you’re a state resident, Wisconsin Medicaid covers residential addiction treatment. ((“Substance Use: Care and Coverage.” Wisconsin Department of Health Services, 28 Sept. 2016, https://dhs.wisconsin.gov/aoda/hccindex.htm.)) With over 500 rehabs in the state, you’ll have plenty of options for local care. Whether you prefer a holistic program, 12-Step treatment, or something else entirely, you can probably find it in Wisconsin. And some of these rehabs offer highly specialized care that might be hard to find in other areas.

the manor kettle moraine
Patients can go hiking or rock climbing, or participate in equine therapy on The Manor’s 40-acre campus in the Kettle Moraine forest.

Flexible Outpatient Treatment

Many of the rehabs in Wisconsin’s cities offer intensive outpatient programs (IOPs) or partial hospitalization programs (PHPs). If you’re already in the state, these programs might be more convenient than residential rehab. In an IOP or PHP, you’ll keep living at home while you attend treatment. That way you can still keep up with work or family commitments while getting the care you need.

Connections Counseling in downtown Madison even has a specific program for local college students. Group therapy sessions take place on UW-Madison’s campus. This invites clients to connect with their peers in a few ways. You can support each other through recovery and in your academic goals.

Court-Ordered Rehab

Sometimes going to rehab isn’t your choice. But even court-ordered treatment can be an effective way to heal. In fact, studies show that people who attend rehab because of a court order ((Coviello DM, Zanis DA, Wesnoski SA, Palman N, Gur A, Lynch KG, McKay JR. Does mandating offenders to treatment improve completion rates? J Subst Abuse Treat. 2013 Apr;44(4):417-25. doi: 10.1016/j.jsat.2012.10.003. Epub 2012 Nov 26. PMID: 23192219; PMCID: PMC3578041.)) might even be more likely to complete treatment.

Many Wisconsin centers have special programs for those attending court-ordered treatment. These rehabs might help you coordinate with your parole officer, or provide legal advocacy. Some work directly with the Department of Health and Human Services, which can help you plan for aftercare. And others have transition programs for people entering rehab after getting out of jail.

Healing for Survivors of Domestic Violence

Some Wisconsin rehabs offer services for survivors of domestic violence. And in a center with trauma-informed care, you can heal from both addiction and trauma at the same time. In these specialized programs, your care plan can address both your mental health and any practical issues you’re facing. For instance, a social worker might help you decide where you’ll live when you finish treatment. That way, you can look forward to safety and freedom after you leave rehab.

connections counseling madison
Connections Counseling in downtown Madison holds group therapy sessions on UW-Madison’s campus so students can connect with their peers in recovery.

Culturally Competent Care for Indigenous People

Wisconsin is home to 11 different Indigenous American tribes, ((“American Indians in Wisconsin – Overview.” Wisconsin Department of Health Services, 12 Aug. 2014, https://dhs.wisconsin.gov/minority-health/population/amind-pop.htm.)) including Bad River Band of Lake Superior Chippewa, Ho-Chunk Nation, and Menominee Tribe of Wisconsin. Many members of Indigenous tribes live with addiction or mental health issues, ((Dickerson DL, Spear S, Marinelli-Casey P, Rawson R, Li L, Hser YI. American indians/alaska natives and substance abuse treatment outcomes: positive signs and continuing challenges. J Addict Dis. 2011 Jan;30(1):63-74. doi: 10.1080/10550887.2010.531665. PMID: 21218312; PMCID: PMC3042549.)) partly as a result of generational trauma. Everyone deserves culturally sensitive care, and Wisconsin rehabs prioritize that need. And at some centers, the majority of the staff are Indigenous, so they’re particularly qualified to offer culturally informed treatment.

Traveling to and Within Wisconsin

No matter where you’re coming from, it’s relatively easy to get to Wisconsin. There are international airports in Appleton, Milwaukee, and Green Bay. Plus, Madison has an efficient regional airport.

If you’re still having trouble finding the best flight, you can fly into Chicago’s Midway or O’Hare airports. Many Wisconsin rehabs offer complimentary airport pickups, and most admissions teams are happy to help you arrange your arrival.

In spite of the state’s accessibility, it’s a good idea to travel to rehab with a support person. They can help you navigate this hectic time—both emotionally and logistically.

Treatment Tailored to You

Everyone’s journey to recovery is different. But no matter what you went through before treatment, Wisconsin rehabs can meet you right where you are.

Search our list of rehabs in Wisconsin for information about their pricing, specializations, therapy options, and more. Additionally, check out the latest RehabPath News. RehabPath is located in Wisconsin.

Reviewed by Rajnandini Rathod

Why Choose Florida for Drug and Alcohol Detox: Climate, Care Options & Recovery

It’s hard to know what to expect from drug and alcohol detox. Some people need 24/7 medical attention. Others focus more on emotional recovery. But one thing’s true across the board: starting treatment in a beautiful place can make healing a little easier. That’s why so many people choose to attend detox centers in Florida

Sun in All Seasons

Florida’s tropical and subtropical climate boasts warm weather year round. So if your health permits, you might be able to spend time outside during detox. But the weather can make a difference even if you need to stay in your room. Data shows that just looking at a beautiful view can help you heal.

Thanks to the state’s 825 miles of coastline, Florida rehabs cater to people who love the beach. And even if you’re not ready to go off-site during detox, that culture has a direct impact on treatment. For instance, most centers have outdoor pools and patios where you can relax and enjoy the sunshine. With these amenities, you can stay as comfortable as possible in any stage of recovery.

chapel hill medical detox room
Experts at Chapel Hill Medical Detox in West Palm Beach say clients who attend “medically assisted detox are more likely to stay in treatment longer.”

What Happens During Detox?

Detox is often the first step in addiction treatment. And it can be overwhelming. You’ll probably experience both physical and emotional symptoms during withdrawal:2

  • Restlessness
  • Mood swings
  • Irritability
  • Depression
  • Changes to appetite
  • Nausea
  • Vomiting
  • Diarrhea
  • Sleep disturbances

These symptoms are different for everyone. And they can be more severe if you have other health issues, or if you’re healing from certain addictions. It’s especially important to get expert medical care during detox from alcohol,3 opioids,4 or benzodiazepines.5 Without proper treatment, withdrawal from these substances can be life-threatening. 

In a reputable detox program, your care team might include some or all of these specialists: 

These experts provide care during inpatient detox. They can also help you plan for what comes next.

Types of Treatment in Florida’s Detox Centers

Detox is more than a medical process. It’s also a time to prepare yourself for long-term addiction recovery. You can set yourself up for success in a program that shares your values. And Florida’s luxury detox centers support patients with a wide variety of recovery goals. 

gulf breeze recovery beach
Gulf Breeze Recovery in Gulf Breeze combines top-notch medical care with holistic detox treatments.

Medical Detox

According to the team at Chapel Hill Medical Detox in West Palm Beach, clients who attend “medically assisted detox are more likely to stay in treatment longer.”6 With this approach, doctors and nurses will support you through early recovery. You might taper off drug use instead of stopping cold turkey, or take non-addictive medications to help you stay comfortable. And when you’re ready, you’ll probably start seeing a talk therapist or other counselor. 

Programs like these are a good fit for people who need close supervision during detox. Inpatient medical detox provides round-the-clock care, keeping you safe as you adjust to life without drug use. But it’s not the only way to begin addiction treatment. 

Outpatient Detox

Sometimes, it can be better to detox in the comfort of your own home. This might be important for celebrity clients who need strict confidentiality, or people with pressing family commitments. If you’re physically healthy and you have a strong support network, you can consider outpatient detox.

In most of these programs, you’ll live independently but attend daily appointments on-site. Clients get medical and psychiatric care, and may connect with each other in group therapy. If this sounds like a good fit for you, make sure you talk to your doctor before starting treatment. While outpatient detox can make recovery more accessible, it’s not a safe option for everyone.

Holistic Treatment

Medical treatment is an essential part of detox—but it isn’t everything. Centers like Gulf Breeze Recovery combine top-notch medical care with holistic detox treatments. For example, you might get a massage between talk therapy sessions. Or you could learn to manage cravings with mindfulness techniques. This integrated approach helps you get to the root cause of your addiction, so you can heal from the inside out. 

agape detox center facility
Agape Detox Center in Port St. Lucie evaluates each client’s lifestyle, health history, and risk factors for addiction to create a unique plan of care.

Individualized Care

The healing process is different for everyone. That’s true in every stage of recovery, from withdrawal to aftercare. So some of Florida’s rehabs tailor the detox process to suit each client’s needs. 

The team at Agape Detox Center, for example, takes a “targeted, whole-health approach” to recovery. They evaluate each client’s lifestyle, health history, and risk factors for addiction. That information helps them design your unique plan of care. That plan will likely include talk therapy, medical treatment, and nutritional support. In bespoke treatment, you’ll learn more about your own needs. And with that knowledge, you can go on to build a life you love. 

Comprehensive Recovery

Compared to residential rehab, detox doesn’t last very long.7 For most types of addiction, withdrawal symptoms subside in a few days to a week. But that’s not the end of addiction recovery. 

Many detox programs require you to have a long-term treatment plan before you even arrive. Usually, that means enrolling in a residential rehab program. So when you complete detox, you can go directly to your next treatment center (in Florida or elsewhere).

Some Florida rehabs make this process much easier. Providers like Immersion Recovery Center offer both detox and residential recovery. You can still detox in one program and go to rehab in another, but you don’t have to. Instead of moving, you can focus on the transition that matters most: your healing process. 

Comprehensive Care in the Sunshine State

In many places, detoxing from drugs or alcohol can be isolating. That doesn’t have to be true in the Sunshine State. These bespoke programs could be a great fit if you love warm weather—even if you plan to enjoy it through your bedroom window. 

Some of the best rehabs in Florida known for their quality care also accept Medicaid and other state insurance options for individuals seeking treatment and recovery.

Explore Florida’s detox centers to find a program that’s right for you.