Kayla Gill - Recovery.com Resource Library

July 4, 2022July 17, 2025

Equine Therapy for Addiction Recovery: Science-Backed Benefits Explained

Equine therapy (ET), also known as equine-assisted therapy (EAT), is an increasingly popular method of addiction treatment. In this therapy, your interactions with a horse will help you achieve therapeutic goals. Specifically, you might work on social skills, sensory processing, and physical wellness. You may also gain insight into how your behavior affects those around you.

Because ET doesn’t require much conversation, you may feel more at ease working through issues that you don’t feel comfortable addressing in traditional talk therapy. While you may already have an affinity for horses, this therapy can still be beneficial even if you’ve never interacted with these animals before–many people report that horses seem like nonjudgmental creatures that make them feel safe. If this sounds appealing to you, you may choose to explore rehab programs that offer equine therapy.

What Is Equine Therapy?

During equine therapy, your therapist will guide you through a series of tasks with the horse. This can include anything from riding to ground activities like grooming or walking, depending on the type of ET your treatment center offers. Session lengths vary, but you can usually expect them to last around 30-90 minutes.

One study determined the following common factors in equine-assisted therapies:¹

The goal of the interaction is a positive outcome for the participant.
Treatment occurs through the interactions between the horse and human, which are purposeful and regulated.
A trained facilitator, such as a therapist, is present with the horse, in addition to the human receiving the therapy.

Throughout the session, your therapist will be able to learn about you through your interactions with the horse. This process can help you work through whatever comes up—sometimes it’s not at all what you expect.

Equine-assisted therapies are becoming more popular² in Europe and the U.S. since their inception in the ‘90s. But what, exactly, takes place during one of these sessions?

What are the Different Types of Equine-Assisted Therapies and Activities (EAAT)?

There are several different kinds of equine-assisted therapies and activities (EAAT) that you may encounter at rehab centers. While there are some discrepancies about the terms used for various types of equine therapy, we’ll look at some of the more popular options below.

Note that offerings vary from rehab to rehab depending on their facilities, staff, and treatment approach. You can contact the admissions team at a center you’re considering for more details about their specific program.

Equine-Assisted Psychotherapy (EAP)

One that you’ll encounter often at many different rehab centers is equine-assisted psychotherapy (EAP). Contrary to popular belief, EAP doesn’t involve riding the horse. During this experiential therapy, the therapist leads the client and horse through a series of activities on the ground. The whole process is slow and gentle, and helps encourage personal growth, responsibility, and healing.

Don Lavender, program director at Camino Recovery in Spain, has worked with horses for over 40 years, and even helped bring the treatment to the U.S. in the early 2000s. According to Don, “It’s become a really effective therapy. It’s therapeutic for the person because they get to learn connection with others.” Don also says that this connection can replace their substance use, and be an integral part of the healing process.

Therapeutic Horseback Riding (THR)

THR includes horseback riding,³ and may include activities like leading the horse around or through obstacles, or simply walking or trotting, depending on the rider’s experience level. This may also include grooming and caring for the horse.

Therapeutic Carriage Driving

In therapeutic carriage driving,³ clients drive the horse while riding in a carriage. This can give the person driving feelings of empowerment and responsibility, especially if other people are present in the carriage. In addition, people who may be unable to ride a horse due to physical difficulties can still experience benefits from THR through this activity.

Interactive Vaulting

Interactive vaulting sessions³ can include gymnastics while riding the horse and group problem solving tasks.

What Happens During an Equine-Assisted Psychotherapy Session?

It may depend on the center, but at Soberman’s Estate, clients are eased into this type of therapy. Equine & Meditation Coach Janice Story doesn’t have the client participate in any particular activities on the first day. Instead, she simply lets the person bond with the horse. “I’ll have them just sit and pet the horse, and see what comes up for them,” she says.

Later, they might go on walks, practice leading the horse, and eventually work their way up to various trust-building and communication practices. During some of these sessions, the client has a blindfold on. Story, or another client, then leads the blindfolded client to the horse and through a series of trust-building tasks, such as picking up their feet. “It teaches clients that they can do something without really knowing how,” she says. “We give them tools and relate it to how they can take it with them when they leave, when they try to navigate their journey back into life.”

At Camino Recovery, Lavender has the client start by grooming the horse, and allows both parties to get to know each other. Eventually, they move towards “lunging.” This involves getting the horse to move around the pen with their personal energy rather than with a rope. To do this requires the client to understand, read and tend to the horse’s emotions.

These are just a few examples of what you might expect during equine-assisted psychotherapy. While it may seem intimidating, Story is confident that the experience will be a positive one. “When our clients first show up, some of them say, ‘I don’t know what this equine therapy is going to do for me,’” she says. “By the end of an hour they’re asking me when we come back.”

How EAT Can Improve Mental Health

Equine-assisted therapy can improve mental health³ in several ways. Research shows that it can increase self-esteem. It can also inspire feelings of freedom, independence, and competency.

Our own beliefs about these creatures play a role in this process. According to researchers, interacting with horses creates “visual imagery of power and beauty,” which can empower recipients of this therapy. What’s more, horses have been human companions for thousands of years.⁴ We’re used to seeing them as pets, working animals, transportation, and entertainment. This familiarity can help clients establish trust.

Horses Provide Connection and Comfort

Equine therapy can also facilitate connection.⁵ According to one study, “many people find that human-horse bonding results in a comforting and affectionate relationship.”

Horses are pack animals, and they need a connection with their herd. And that doesn’t just mean connecting with other animals—they can also bond with people. Experts believe horses may actually “perceive humans as herd members.” This allows them to form close bonds with ET clients during treatment.

In another study, scientists observed that equine therapy was an effective treatment for combat veterans.⁶ “When you’re with a horse they give you kindness and compassion and love and they don’t expect anything,” one participant explained. “They don’t want to give you advice and they don’t want to make things seem less than they are. They’re just there for you.”

These relationships can be extremely grounding for people in addiction recovery. Many people report that it feels comforting to connect with such a large, powerful animal. By slowly building a rewarding bond based on mutual trust and respect, as ET clients gain the horse’s trust, they learn to trust themselves.

Sharing Your Emotions Becomes Easier

Equine-assisted therapy provides a nonjudgmental place⁷ for people to express themselves. By interacting with a non-verbal animal, you may feel safe to share thoughts you normally wouldn’t mention to another person.

After over 30 years of working with horses, Janice Story understands the animals, and how much they can truly help her clients, very well. “The horses are really amazing at creating a safe space for our clients. When clients first come in, oftentimes they haven’t felt any emotions for a long time. Horses will bring that up for them.”

EAT Can Boost Your Confidence

Equine-assisted activities can improve your self-esteem.⁸ Horses are large animals, and some people may find this intimidating, especially if they haven’t interacted with them before. But when they overcome these challenges successfully, they feel empowered, which boosts their sense of self-confidence.

Because horses are pack animals, they naturally look for a leader. If the person doesn’t become the leader, the horse will. Therefore, the person must establish themself as the leader, and work on becoming assertive and confident in order to gain the horse’s respect. This process can teach you valuable leadership skills.

Building Self-Awareness

Horses have evolved to be on the lookout for predators. Because of this, they’re highly attuned to their environment. And in equine therapy, that awareness includes empathy.

Horses easily understand and react to human emotions.⁹ And they’re not afraid to give you feedback. If you make a horse feel uncomfortable, you can trust it to let you know. This dynamic is intended to help you improve your self-awareness. Instead of acting on impulse, you’ll learn to control your emotional reactions to help the horse stay calm.

According to Story, horses act as mirrors, reflecting the client’s emotions back to them. “If the client needs to work on holding some boundaries, they might not know it, but the horse will show that to them,” she says. “And then at the same time, they’ll help them work through it. So it actually teaches them how to hold their boundaries.”

In that way, equine therapy differs from talk therapy. Janice points out that, in traditional therapy, “the issues might arise but sometimes the solution is not instant. Where with the horses, they’ll teach them at the same time.” This real-time feedback can help the client work through the issues that they’re dealing with right then and there.

Equine Therapy for Specific Mental Health Concerns

Equine therapy is used to treat various mental health concerns such as anxiety, depression, and post-traumatic stress disorder (PTSD). Many of these conditions occur alongside substance use disorders. And thus, equine therapy can be helpful in treating mental health concerns that arise because of, or separately from, drug misuse.

Post-Traumatic Stress Disorder (PTSD)

One study found that equine-assisted therapy can help alleviate PTSD symptoms.¹⁰ After just 6 weekly, 2-hour EAP sessions, participants reported feeling significantly less intense responses to trauma, and minimized PTSD symptoms. Additionally, they experienced less anxiety and reduced depressive symptoms.

Equine therapy may work especially well for symptoms of PTSD¹¹ in part because horses are prey animals. This makes them hypervigilant, and unlike dogs, humans need to gain their trust over time. People with PTSD often experience the same hypervigilance, which can help them relate better to the horse. And because horses communicate primarily through body language, people can work to improve other PTSD symptoms, such as emotional numbness and bodily dissociation.

Anxiety

Numerous studies show that equine therapy helps reduce anxiety. A participant in one study said that therapeutic horseback riding helped her minimize her anxiety¹² through the “teamwork” experienced between her and the horse. In this process, clients move “in sync with the horse’s body,” and the horse intuitively responds to the rider.

Aggression

One study found that equine-assisted psychotherapy can also treat aggression.¹³ This may be due to the horse’s larger size, which can make them seem more intimidating. People may realize that, if they can’t control their anger impulses, there is a possibility that the horse can cause them harm. This helps them to learn to react calmly and carefully. And because the horse gives instant feedback, patients can learn quickly exactly which behaviors are hurtful and work to correct them.

Autism Spectrum Disorder (ASD)

Another study looked at children with autism spectrum disorder (ASD) who did 10 weeks of therapeutic horseback riding.¹⁴ Children with ASD are sometimes rough with pets, but participants in this study were reportedly more caring towards them after the study ended. The control group, which learned about horses but did not interact with them, did not show as much of a change in their behavior.

A similar study discovered that adolescents with ASD showed significant improvements in social behaviors and communication.¹⁵ The researchers theorized that the reason for these positive changes was due to the “shared attention experience” that came from working with the horse. Horses mirror and respond to humans’ body language, which can help those with ASD better understand social cues and behaviors. The children also showed decreased irritability and hyperactivity, which may be due to the relaxing effect of horse riding.

A Program for Veterans

The Professional Association of Therapeutic Horsemanship (PATH) International Equine Services for Heroes® program is an equine-assisted therapy program that specifically works with veterans.¹⁶ Because veterans are more likely to experience PTSD after returning home from service, PATH developed this unique program just for them. Each veteran receives a horse intended to help them heal both physically and mentally. In this particular study, 13 veterans completed 24 weeks of both riding and ground activities (grooming and walking).

Afterwards, the veterans involved in the study reported feeling more confident, less isolated, and more trusting of others. Their depressive symptoms decreased over the course of treatment. “You’re forced to bring [problems] up and deal with them to the horse,” said one participant. “It’s pretty interesting. It’s amazing.”

Another participant stated that “I learned that even though I have issues in my life, I can come here to this program and get past my issues by working with the horse.”

Reconnect With Yourself Through Equine Therapy

Horses can teach you communication, confidence, and even interpersonal skills. Don Lavender may summarize it best: “Equine therapy is about connection, learning to connect to self by first learning to connect to another.”

Through your connection with a horse, you can learn how to reconnect with yourself.

To learn more about this powerful approach and see photos, reviews, insurance information, and more, visit our searchable directory of equine therapy rehab centers.

July 2, 2022February 14, 2024

Finding Treatment for Cocaine Addiction

Cocaine addiction can wreak havoc on a person’s life. And once you’re caught in the cycle of substance misuse, healing may seem out of reach. That’s a misperception. Recovery is always possible. For some people, rehab for cocaine addiction is the best place to start.

“Cocaine is the most commonly reported illicit stimulant used in the U.S.”¹ Because its abuse is so common, this drug has been the subject of widespread research. As a result, many treatment programs are well-equipped to help patients recover from cocaine misuse.

The Prevalence of Cocaine Addiction

Cocaine is a stimulant² derived from the coca plant native to South America. It can briefly increase a person’s energy, self-confidence, sociability, and mood. Because the effects of cocaine³ are so short-lived, it can quickly become habit-forming. Long-term use may cause less desirable effects, such as cause paranoia, hypersensitivity, and irritability.

The history of cocaine⁴ is strongly connected to mental health. In fact, its popularity can be traced back more than a century. “In 1884, Sigmund Freud detailed his experiments with cocaine, recommending it for treatment of opiate addiction and melancholia.” However, he did not account for its negative effects, and reportedly struggled with addiction for much of his life. Unfortunately, his endorsement of the drug helped make it socially acceptable for some time, for both medical and recreational purposes.

Reported drug abuse statistics⁵ paint a clear and distressing picture of cocaine use today. According to the National Center for Drug Abuse Statistics, 2% of people in the U.S., or 5.5 million people, reported taking cocaine in 2018. As of 2022, more recent data is not yet available. Researchers also caution against comparing current data about drug use and health⁶ with surveys taken before 2020, since the COVID-19 pandemic has changed the way surveys are conducted.

Cocaine use can have serious ill effects on both physical and mental health. Deaths caused by cocaine overdose in the U.S.⁷ have skyrocketed in recent years, increasing from nearly 4,000 in 1999 to nearly 16,000 in 2019. Because cocaine increases blood pressure⁸ and heart rate, it may cause strokes or respiratory failure. “Even first time users may experience seizures or heart attacks, which can be fatal.”

Because of these potential outcomes, cocaine misuse is extremely dangerous. However, patients don’t develop substance use disorders by choice. You may be highly susceptible to addiction despite your own better judgment, or desire to remain healthy. And some patients may be at a higher risk for developing a psychological dependence on cocaine.

Risk Factors for Cocaine Addiction

Certain demographics are especially vulnerable to cocaine misuse. Patients who exhibit one or more of the following risk factors may be at higher risk for this condition, or may require specialized care.

Adolescence

Teenagers may be more susceptible to developing cocaine addictions.⁹ Relative to adults, “adolescents show greater intake of cocaine, acquire cocaine self-administration more rapidly, work harder for the drug and are less sensitive to increases in price.” In layman’s terms, young people do more of this drug than adults, and are willing to work harder to obtain it.

Adolescents also face social pressures that may not impact adult behavior. Specifically, many teenagers develop substance use disorders¹⁰ while trying to fit in with their peer groups. Parents of adolescents should take note of any drastic behavioral changes, as these may indicate the onset of addiction. Teens with substance use disorders may show less interest in activities they used to enjoy, pay less attention in school, or start spending time with new friends who encourage these behaviors. By itself, any one of these signs may be a normal part of adolescence; however, sudden and extreme behavioral changes can be a cause for concern.

Novelty-Seeking Personality Traits

According to one study, “cocaine addiction has been associated with several distinct behavioral/personality traits.” For example, novelty-seeking behavior is associated with cocaine abuse.¹¹ And in particular, people with sensation-seeking tendencies may be more vulnerable to cocaine use. However, people with high impulsivity are more vulnerable to cocaine addiction.

These traits may be genetic, learned, or influenced by a person’s environment and life circumstances. More research is needed to understand the link between personality, behavior, and substance use disorders.

Neurochemical Effects of Cocaine Use

Cocaine has a direct effect on the way the brain processes dopamine, which regulates the reward system.¹²

During normal brain activity, this neurotransmitter is released, binds to dopamine receptors, and is then recycled by a protein called the dopamine transporter. “If cocaine is present,” however, “it attaches to the dopamine transporter and blocks the normal recycling process, resulting in a buildup of dopamine in the synapse, which contributes to the pleasurable effects of cocaine.”¹³

In the short term, this can be enjoyable. In the long term, however, cocaine use can change brain function.¹⁴ The drug causes neurochemical imbalances, which make it difficult for the patient to feel a sense of pleasure or achievement without substance misuse. Over time, “the brain will gain a tolerance to feelings of pleasure and it will take more and more of the drug to achieve the same level of euphoria.”

What’s more, the act of abusing any substance affects dopamine levels.¹⁵ This is because the experience of ingesting a drug can trigger the release of the chemical, whether or not that drug has an effect on dopamine levels. This feeds into the cycle of addiction, in which the patient continues using illicit substances in order to feel any sense of reward. This effect is amplified with substances that have a direct effect on dopamine to begin with.

Treatment for Cocaine Addiction

Substance use disorders are treatable. No matter how long you’ve been using cocaine, or what impact it’s had on your life, change is always possible. And because its misuse is so prevalent, experts have been perfecting cocaine addiction treatment options¹⁶ for decades.

At present, “there are no medications approved by the U.S. Food and Drug Administration to treat cocaine addiction,¹⁷ though researchers are exploring a variety of neurobiological targets.” However, there are a number of effective therapeutic and behavioral interventions. And the first step toward healing is to learn about the options available.

Detox

Cocaine withdrawal¹⁸ may or may not have any physical symptoms. Unlike alcohol and opiates, detox from this substance is rarely life-threatening. That being said, it can be extremely uncomfortable and psychologically distressing.

If at all possible, it’s best to go through this process under medical care. If you attend a detox program, you’ll be closely monitored by a team of doctors, nurses, and therapists, possibly including a psychiatrist. Patients may receive non-addictive prescriptions to help them manage the symptoms of withdrawal. This experience can also help you transition into a longer-term rehab program.

Learn More: What You Need to Know About Detox

Rehab

Studies have shown that long-term rehab for cocaine dependence can be extremely effective.¹⁹ By attending a residential program, patients can take time away from triggers and difficult life circumstances, which may have been caused or exacerbated by their substance use. During that time, they can begin talk therapy, attend support groups, and make plans to live a healthier, more sustainable life after treatment.

Psychotherapy

Several therapeutic modalities can be effective in treating cocaine misuse. Researchers are most optimistic about contingency management (CM), a behavioral therapy that activates the patient’s reward system.

According to one study, contingency management is “perhaps the most effective psychosocial treatment” for cocaine use disorder.”²⁰ In this treatment, patients receive vouchers redeemable for goods and services in the community, contingent upon achieving a predetermined therapeutic goal. CM treatment has been found to be especially effective in promoting initial abstinence from cocaine.”

Cognitive behavioral therapy (CBT) has also been shown to help these patients, although it may not be as productive as CM. This might be because CM has a more direct impact on brain chemistry, whereas CBT is skills-based.

Long-Term Recovery From Cocaine Addiction

Patients with a history of cocaine abuse can improve dramatically. In fact, detox and recovery from cocaine misuse can help you recover brain function.²¹ One 2017 study provided “early evidence that individuals with cocaine use disorder have the potential to at least partially reverse prefrontal cortex damage accompanying cocaine misuse, and regain associated cognitive abilities important for executive functions when cocaine use is stopped or significantly decreased.” In other words, you may be able to physically heal your brain during recovery.

But healing isn’t just about physical improvement. It’s also the process of building a better life. And in order to achieve that, patients must stay focused on recovery even after completing inpatient treatment. This ongoing commitment to healing may include regular talk therapy, attending support groups, or other modalities. For example, some studies have found that “greater participation in self-help programs” is an important factor in sustained recovery from cocaine dependence.²² ((McKay, J. R., Van Horn, D., Rennert, L., Drapkin, M., Ivey, M., & Koppenhaver, J. (2013). Factors in sustained recovery from cocaine dependence. Journal of Substance Abuse Treatment, 45(2), 163–172. https://doi.org/10.1016/j.jsat.2013.02.007))

Building a Better Life

When you have a history of substance misuse, recovery is often a lifelong process. That being said, it is absolutely possible to live a fulfilling life without cocaine use. Healing can even be fun! As you recalibrate your internal system of rewards, it’s important to do things you find enjoyable and exciting.

As you learn to make healthier choices, you can also begin building a new kind of confidence. And, best of all, you won’t be held back by the destabilizing pattern of substance abuse. Over time, you may find that joy is both more accessible and more sustainable.

If you’re ready to begin recovery, you can find a rehab center that treats cocaine addiction here.

Frequently Asked Questions About Cocaine Addiction Treatment

What are the treatment options for cocaine addiction?

Treatment options for cocaine addiction often include a combination of behavioral therapies, counseling, support groups, and medication in some cases. Individualized treatment plans are designed to address the specific needs of each person seeking recovery.

How long does treatment for cocaine addiction typically last?

The duration of treatment for cocaine addiction varies depending on factors such as personal progress, treatment goals, and circumstances. Treatment usually ranges from 2 weeks to 60 days. Some people benefit from longer treatment and ongoing aftercare support.

What should I look for in a luxury rehab for cocaine addiction?

When searching for a luxury rehab for cocaine addiction, it’s important to consider factors like clinical expertise, the level of personalized care, comfort, staff credentials, and confidentiality. It’s also important to verify accreditation and success rates. Most centers list accreditations directly on their site; CARF and the Joint Commission are the most common accreditation bodies.

June 30, 2022November 13, 2024

Could Sunny Malibu Be the Perfect Place for Your Recovery?

If you love the sun, beautiful beaches, and holistic healing in a laid-back atmosphere, then attending a rehabilitation facility in Malibu could be a great choice for you. Malibu is known for its year-round warm weather and beautiful scenery, as it’s located between the Pacific Ocean and the Santa Monica Mountains. It’s hard to believe that Los Angeles is only a 30-minute drive away.

Many Malibu treatment centers take advantage of their location and temperate climate, offering programs like surf therapy in addition to outdoor excursions like beach walks or hikes. Holistic therapy is also a popular method of treatment throughout California, and several centers in Malibu embrace this approach.

You may want to start your journey to mental health and addiction recovery in Malibu if you enjoy ocean views, a warmer climate, and unique therapy techniques focused on the outdoors and alternative medicine.

Malibu’s Inviting Climate and Landscapes

Malibu is in close proximity to nature, with stunning views in every direction. Malibu’s 11 public beaches are located along 21 miles of coastline on the famous Pacific Coast Highway, and include some of the best beaches in California, including Zuma Beach and El Matador State Beach.

Several recovery centers, such as Oceanside Malibu, are located right on the coast. You’ll be able to hear the sounds of the waves from Malibu Beach as you work on healing, take long walks by the water, or participate in beach fitness activities.

Mountains rise up behind the city, providing an abundance of hiking opportunities with beautiful views. Malibu has plenty of parks, including the Santa Monica Mountains National Recreation Area, which has over 5,000 miles of hiking trails on 156,000 acres of land. Solstice Canyon Park and Malibu Creek State Park are 2 other popular outdoor recreation areas that people enjoy exploring.

Some centers, like Cliffside Malibu, are located in the mountains themselves. This scenic landscape offers plenty of space for peaceful reflection. You can either explore the trails nearby or relax on the sun deck to take in the stunning views of the Pacific Ocean.

Malibu’s Mediterranean climate means you can comfortably enjoy outdoor activities like swimming, hiking, and biking in any month of the year.

Unique, Recovery-Focused Activities

Many centers offer activities that are best experienced in the California sunshine. Between the ocean and the mountains, there are endless opportunities to explore the outdoors. And because California is such a multicultural hub, some centers offer opportunities to visit nearby museums and attractions.

Surf Therapy

Several rehabs, including Oceanside Malibu and Cliffside Malibu, offer surf therapy for their clients. Surf therapy is a healing modality¹ that “combines surf instruction, surfing, and structured individual and/or group activities to promote physical, psychosocial, and psychological well-being.” One study found that surfing improved overall well-being for combat veterans with post-traumatic stress disorder (PTSD),² and offered both a respite from the symptoms of this condition, and increased positive feelings gained from connecting with peers.

cliffside malibu slide 8 — Perched in the mountains of Santa Monica, Cliffside Malibu offers therapies ranging from reiki to surf therapy.

Surf therapy is also a promising method of treatment for adolescents. Research shows that surf therapy has a positive impact on mental health,³ improving emotion regulation, social competencies, and social connections, while decreasing behavioral problems and depressive symptoms in youth experiencing psychological difficulties. Another study found surf therapy improved adolescents’ self-confidence⁴ through the feelings of accomplishment that come from mastering a new skill, a sense of escape, and strengthened social connections. Paradigm Teen & Young Adults Treatment understands the positive effects that surf therapy can have, and offers this activity to its adolescent and young adult clients.

Other Outdoor Activities and Experiential Therapies

Because Malibu is so close to the beach, many centers invite their residents to go on beach walks, or engage in related activities like swimming and hiking. The region’s warm weather gives clients plenty of opportunities to relax in the fresh air throughout every season. Milestones Ranch even holds therapy sessions while walking on the beach.

According to research, exercise can help clients navigate addiction recovery,⁵ and participating in new activities can build confidence through the mastery of a new skill. Oceanside Malibu encourages clients to participate in surf therapy, rock climbing, horseback riding, fishing, and other adventure outings. These exciting experiences can help clients find new hobbies and improve the mind-body connection, all while working through difficult emotions that may not easily come up during talk therapy.

Events and Cultural Outings

Milestones Ranch offers exposure therapy activities both on and off their 160-acre private property. This center’s take on exposure therapy, which they term “supervised sober recreation,”⁶ lets clients participate in activities while sober that they may have only previously done with drugs or alcohol. Clients can attend musical performances and dance parties at the ranch, in addition to weekly outings at comedy clubs, museums, concerts, movie theaters, and more off the property. According to this treatment team, participating in exposure therapy helps “build the client up through social and sober activities, providing the practical skills and confidence needed to socialize without the use of drugs.”

After some time in treatment, Milestones Ranch even gives clients opportunities to plan outings themselves with other friends from nearby sober living houses. This can help clients get accustomed to being in social settings while sober.

Specialized Treatment for Teens and Young Adults

Building community is important in recovery, as studies show that people with more close friends are more likely to recover from addiction.⁷ And oftentimes, people may find it easier to make friends with peers that they can relate to. Because of this, it may be beneficial for adolescents and young adults to attend teen-specific treatment centers surrounded by others of their own age.

According to Visions Adolescent Treatment, “Adolescents need to be approached differently than adults because they are still developing their emotional and environmental understanding.” With this in mind, the center only treats adolescents between the ages of 13-18. They provide daily activities and hold events at their rural rehab center, set in the Malibu hills to minimize distractions and keep the focus on recovery.

visions adolescent treatment slide 4 — Visions Adolescent Treatment is tucked away on 25 acres of tranquil grounds in Malibu.

“When I came to Visions, I was extremely depressed and emotionally volatile. I was anxiety-ridden and I really didn’t see the point in life,” says JuliAnn Crommelin, a Visions Adolescent Treatment alum. “Visions not only got me sober, but they gave me the life that I never knew I always wanted.”

“It’s About a Non-Judgmental, Supportive Environment”

Paradigm Teens & Young Adults Treatment caters to clients aged 12-26, although teens and young adults are treated separately. Paradigm Treatment conducted a study that followed up with 195 of their clients a year after completing treatment and found that their depression, anxiety, and stress levels significantly decreased during rehab,⁸ compared to reported levels at their intake.

Paradigm focuses on creating a community-based environment that fosters healing and space for reflection. Dustin Wagner, Paradigm’s COO, explains:

“We know right off the bat it’s about building a relationship. It’s about a non-judgmental, supportive environment…Where other clients are also supporting each other. This program is transforming lives and providing hope to these families.”

Both Beachside Teen Treatment Center and Pacific Teen Treatment also focus exclusively on treatment for teens and their families. Pacific Teen Treatment even offers academic activities so that teens don’t fall behind in school during their recovery process.

As their parent, you may need to make treatment decisions for your teen. As JuliAnn from Visions Adolescent Treatment says,

“I’m grateful that my mom knew what to do with me, because at that point in my life I didn’t know what I needed, and looking back on it, I needed a parent who knew to call the professionals.”

Malibu’s Top-Notch Care

Malibu’s treatment facilities are highly regarded nationwide. Cliffside Malibu and Seasons in Malibu rank among the best rehab centers in California,⁹ according to Newsweek. The survey reviewed addiction recovery programs throughout the U.S. based on their quality of service and overall reputation.

Some centers focus on smaller group sizes in order to offer more personalized treatment. For example, Oceanside Malibu only accepts 6 people at a time. This allows them to offer each client a highly individualized experience. They also focus on building community within this small number of clients.

Director Dave Johnson describes Oceanside Malibu’s welcoming atmosphere:

“When people come to Oceanside, we try to create a family-like environment where people are allowed to heal and feel safe enough, and in doing that we try and break down that shame and guilt and get rid of it because it doesn’t serve any purpose.”

A Holistic Approach to Healing From Addiction

Mindfulness is a powerful way to approach recovery.¹⁰ According to experts at UC Berkeley’s Greater Good Magazine, mindfulness is defined as “maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment, through a gentle, nurturing lens.” This practice encourages you to focus on the present moment, which helps alleviate anxiety about past painful or stressful situations and potential future ones. Studies have shown that meditation can aid in addiction recovery¹¹ by decreasing cravings and improving control over one’s emotions.

Many centers incorporate mindfulness practices into their treatment programs, taking a holistic approach to treatment. Summit Malibu, for example, blends Eastern and Western mindfulness practices to help clients with the physical, mental, and spiritual symptoms of addiction. Clients can participate in yoga, art therapy, meditation, relaxation therapy, somatic experiencing, and more. William Oswald, the center’s CEO and Founder, says:

“To treat substance abuse and mental disorders¹² we must go deeper than the physical being. As a recovering addict, I know that healing comes from within. That’s our mission at Summit Malibu.”

Avalon Malibu incorporates experiential therapies like traditional Chinese medicine (TCM), herbs, and neurofeedback into their programs, along with mindful practices like meditation, yoga, and qi gong. TCM includes natural products and acupuncture, which are especially helpful in treating opiate addiction. Acupuncture may help alleviate withdrawal symptoms¹³ and possibly even help clients avoid a relapse. This modality can also improve the immune system, have a positive effect on memory, and decrease the likelihood of neurological disorders.

Cliffside Malibu offers many different forms of holistic therapies and treatments, like Reiki, acupuncture, hypnotherapy, and more. These practices can help bring clients peace and promote healing, especially when combined with Malibu’s beautiful natural setting.

Ease of Travel to Malibu

Malibu is easily reachable by plane, and is just a short drive from Los Angeles International Airport (LAX), one of the largest airports in California and busiest in the U.S. It’s hard to believe that this coastal haven is so close to such a busy metro area, but that certainly makes travel much more convenient.

Since Malibu is located right along Highway 1, which has some of the best views in California, it’s also easily accessible by car.

Peaceful Addiction and Mental Health Recovery on the Coast

It’s up to you to determine the best place to start recovery. Traveling to Malibu for rehab might make sense if you’d like a more peaceful, quiet setting surrounded by mountains and beaches, and would like to try beachside experiential therapies.

Malibu’s tranquil surroundings may offer you clarity and a sense of calm, so you can focus all your energy on healing. However, this setting may be too quiet for some clients. Even with Los Angeles so nearby, treatment in Malibu may not be a good fit if you feel more comfortable in a big city.

See our collection of rehabs in Malibu for an inside glimpse into treatment, including virtual tours, pricing, and reviews.

Frequently Asked Questions About Malibu Rehabs

What rehab programs are available in Malibu?

Malibu treatment centers take advantage of their ideal location and climate, offering activities like surf therapy, beach walks, and hikes. Holistic therapy is popular in California, and several centers in Malibu embrace this approach.

Why go to rehab in Malibu?

You may want to start your journey to mental health and addiction recovery in Malibu if you enjoy ocean views, a warmer climate, and unique therapies focused on nature and alternative medicine.

What city in California has the best rehab?

Malibu’s treatment facilities are highly regarded nationwide. Cliffside Malibu and Seasons in Malibu rank among the best rehab centers in California, according to Newsweek (based on quality of service and overall reputation).

May 30, 2022January 4, 2024

Healing From Post-Traumatic Stress Disorder

Everyone deals with trauma differently. At times, experiencing traumatic events can develop into post-traumatic stress disorder (PTSD). Although this disorder may feel isolating, remember that many people are diagnosed with PTSD—probably more than you realize. And because of this, there are so many different resources available that can help you along your recovery process.

Rehab is one of those resources. Attending a treatment center can help you process your emotions and feelings related to the trauma you’ve experienced, and to learn to cope with them in a healthy way.

Finding a rehab that treats PTSD can be an effective and supportive place to begin your recovery journey.

What is PTSD?

PTSD is a disorder that develops in response to a traumatic event. ((Ptsd basics – ptsd: National center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/understand/what/ptsd_basics.asp)) Symptoms from PTSD may develop soon after the trauma occurred, but can also arise months or even years later. You may have PTSD if you have any of the symptoms below and notice that they last longer than 4 weeks, are extremely stressful, and significantly affect your life.

The symptoms of PTSD include (but aren’t limited to) the following:

Reliving the event: This may involve nightmares or flashbacks, especially when a trigger is present. A trigger is something that reminds you of the event, such as a loud noise or seeing an accident similar to the one you experienced, that elicits a strong emotional reaction.
Avoiding anything or anyone that reminds you of the event.
Experiencing intrusive thoughts and emotions on a consistent basis after the event: For example, you may feel guilt or shame, lose interest in things you once enjoyed, or feel numb.
Feeling on edge: You may feel you have to be “ready for anything” and find it difficult to sleep, concentrate, or may be easily startled.

It may feel daunting to realize that you might have PTSD. However, know that it’s not just you—according to the National Center for PTSD, PTSD in adults is not rare. ((How common is ptsd in adults? – Ptsd: national center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/understand/common/common_adults.asp)) They estimate that 6 of every 100 people will be diagnosed with PTSD during their life.

The Many Treatment Options for PTSD

Trauma-informed care approaches treatment with a focus on trauma. This may look different from patient to patient, but the idea is that providers understand the nature of trauma and take that into account during treatment.

Trauma-specialized rehabs also offer trauma-specific therapies, which are very effective for PTSD. ((Ptsd treatment basics – ptsd: National center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/understand_tx/tx_basics.asp)) These therapies center the patient’s attention on the memory or meaning of the traumatic event, and may use visualization, talking, or thinking to help you work through the experience.

Exposure therapy, eye-movement desensitization and reprocessing (EMDR), and cognitive processing therapy are the most popular treatment options for PTSD. However, there are several other options, and your treatment provider can help you choose which will work the best for you.

Prolonged Exposure (PE)

During PE, patients learn to face uncomfortable feelings in order to gain control over their experience. Patients will discuss any traumatic experiences with a counselor, as well as participate in events they’ve avoided related to the event. This treatment is highly effective for PTSD ((Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating ptsd: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258)) according to research—one meta analysis found that 41-95% of people who participated in PE no longer had PTSD symptoms by the end of treatment. Another study discovered that PTSD symptoms significantly lessened in people who had PE during treatment, as compared to supportive counseling, relaxation training, medication, and “treatment as usual.” Because PE can provoke feelings of anxiety, you should only do it with a trained professional.

Eye-Movement Desensitization and Reprocessing (EMDR) Therapy

EDMR has the patient think about the traumatic experience while performing lateral eye movements, ((van den Hout, M. A., & Engelhard, I. M. (2012). How does EMDR work? Journal of Experimental Psychopathology, 3(5), 724–738. https://doi.org/10.5127/jep.028212)) usually by following a light or the therapist’s finger. This helps move traumatic memories into long-term storage, so that when they’re brought up, patients are less activated. The goal of EMDR is to minimize the vividness and emotion that results from these thoughts.

Cognitive Processing Therapy (CPT)

CPT teaches patients to challenge and change their negative thoughts surrounding the traumatic event through talk therapy and writing assignments. CPT treatment shows a significant reduction in PTSD symptoms ((Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating ptsd: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258)) in several different samples of veterans, sexual assault survivors, and others with PTSD. These statistics remained similar during 5 and 10-year follow ups.

Cognitive Behavioral Therapy (CBT)

In CBT, patients reframe their thoughts and feelings from negative to more positive, and learn healthy coping skills and strategies to manage them in the future. One study determined that PTSD patients using CBT in their treatment plan ((Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating ptsd: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258)) worked better than supportive therapy or self-help booklets.

Written Narrative Exposure (WNE)

Patients write about the trauma they’ve experienced and discuss it with a therapist afterwards.

Brief Eclectic Psychotherapy (BEP)

This approach helps the patient adjust negative emotions to help relieve them of shame and guilt. In addition to talk therapy, patients may learn relaxation skills, write about their traumatic experience, and even work through a ritual to help them leave the traumatic event in the past and start over.

Narrative Exposure Therapy (NET)

Patients craft a story consisting of stressful events that occurred in their lives. This therapy is often used with people who experienced war, conflict, or violence.

Medications

Antidepressant medications known as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) help patients experiencing PTSD. There are 4 prescribed medications commonly used for PTSD:

Sertraline (Zoloft)
Paroxetine (Paxil)
Fluoxetine (Prozac)
Venlafaxine (Effexor)

Potential Causes of PTSD

Not everyone is affected by trauma in the same way. For example, 2 people can have the same experience, but one may develop PTSD while the other doesn’t.

People can develop PTSD from many different stressful situations or events. Combat veterans and survivors of sexual trauma and intimate partner violence may be more likely to develop PTSD. People that have witnessed or been in a serious accident or catastrophic event may find themselves feeling differently afterwards, and be unable to process what happened to them.

While your experience is unique, remember that other people have gone through similar situations. You may find support by surrounding yourself with others who share your experience, and finding a rehab with a specialized PTSD program can help you connect with them in treatment.

The Link Between PTSD and Addiction

Trauma is strongly correlated with drug and alcohol addiction. ((International Society for Traumatic Stress Studies. Traumatic Stress and Substance Abuse Problems. [Pamphlet]. https://istss.org/ISTSS_Main/media/Documents/ISTSS_TraumaStressandSubstanceAbuseProb_English_FNL.pdf)) People who experienced traumatic events in their lifetimes are more likely to use drugs and alcohol as a way to deal with the negative thoughts and feelings that arise from the experience. And unfortunately, substance abuse only worsens the problem.

Some studies found that the relationship between substance use and PTSD ((Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depression and Anxiety, 27(12), 1077–1086. https://doi.org/10.1002/da.20751)) was significantly high in adolescents. Additionally, experiencing trauma in adolescence can heighten your stress response. This trauma can elevate plasma cortisol levels, making it more likely that they may develop PTSD and other conditions.

However, substance use can actually make the effects of PTSD much worse. It can increase emotional numbing, depression, anxiety, and more. If you have both a substance use disorder and PTSD, you may want to find a rehab that specializes in co-occurring disorders.

How PTSD Can Affect Your Life and Relationships

Some people with PTSD struggle with family and friendships, ((Relationships – ptsd: National center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/family/effect_relationships.asp)) even if they had trusting relationships in the past. People may avoid closeness with others to avoid negative feelings, or being reminded of the event by someone who was present at the time. Close relationships may feel downright dangerous, as many trauma survivors feel a need to be on guard. On the contrary, people may also go in the opposite direction and lean heavily on their loved ones.

If you’re going through this, don’t worry—most people are able to restore their relationships to where they were before the trauma occurred. And whether you’re avoiding closeness or depending on others too much, the right treatment can help you learn to mitigate these situations in a healthy way so you can feel more at ease with your loved ones. It may even be helpful to attend therapy with one of these people, and to consider marital or family counseling.

The Differences Between PTSD and CPTSD

Complex post-traumatic stress disorder (CPTSD) ((Complex ptsd – ptsd: National center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp#subone)) is similar to PTSD, with some slight differences. CPTSD might arise from exposure to repeated traumatic events over a longer duration of time, such as survivors of childhood or sexual abuse, or veterans that were deployed on active duty for longer periods of time.

According to Dr. Judith Herman of Harvard University, CPTSD symptoms include the following:

Behavioral issues
Emotional suffering
Cognitive difficulties
Interpersonal problems
Somatization (physical reactions to stress)

While CPTSD isn’t yet officially recognized, many clinicians treat it as a serious condition. Other disorders also often occur alongside CPTSD, such as addiction, dissociation, borderline personality disorder, and sleep problems. Fortunately, the treatments for CPTSD also help treat these issues.

Empower Yourself to Move Past Your Trauma

Although PTSD can feel debilitating at times, you can move forward with your recovery. Be gentle with yourself as you focus on healing. This isn’t the time to push yourself too hard—instead, try to remember how far you’ve come.

Dealing with past trauma isn’t easy. You’ll have good days and bad days, and that’s completely normal. The right treatment can help you develop the skills and coping strategies to manage the bad ones in a healthy, positive way.

Don’t be afraid to reach out for help–it’ll be there when you need it.

To learn more about treatment options and see information on pricing, insurance, special programs, and more, see our directory of centers offering PTSD treatment near you.

Reviewed by Rajnandini Rathod

May 27, 2022July 14, 2025

Resilience in Recovery From Childhood Trauma

Childhood trauma doesn’t just go away. You may continue to feel its effects throughout your adult life. Some people—although certainly not all—develop mental health conditions, like post-traumatic stress disorder (PTSD), as a result of these painful experiences. And because the past can’t be undone, it can be hard to imagine moving forward.

No matter how much you’ve been through, you can learn to carry your memories in a less painful way. There are rehab programs specifically for those struggling with trauma that can help you cope with your symptoms and learn how to move forward. The first step in taking back your personal power is choosing which type of treatment feels right to you.

Choosing Trauma-Informed Care

Whether or not trauma is your primary reason for seeking treatment, you may benefit from choosing a treatment program that offers trauma-informed care. This approach centers each person’s unique experience, creating a safe and respectful environment for healing. With guidance and support, you can become empowered to live a life you love.

Trauma-informed care is an approach, not a therapy. However, many trauma-informed facilities offer therapies with proven success in treating trauma:

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a form of talk therapy¹ that helps people manage difficult feelings, urges, and behaviors. In conversation with a therapist, you’ll discuss and analyze various aspects of your internal emotional landscape. Your provider will teach you practical strategies you can use to navigate challenging situations.

For example, the American Psychological Association (APA) recommends that therapists “encourage patients to re-evaluate their thinking patterns and assumptions in order to identify unhelpful patterns (often termed ‘distortions’).” By stepping back and assessing your thoughts objectively, you may be able to regulate your emotional response.

Data shows that CBT is a highly effective treatment for PTSD.² In one study, “92% of participants no longer met criteria for PTSD” after a series of CBT interventions. However, it’s not the only available form of therapy. Also, some clients may benefit from specialized types of CBT, such as prolonged exposure therapy (PE).

Prolonged Exposure Therapy (PE)

Experts strongly encourage the use of prolonged exposure therapy as a treatment for trauma.³ During a PE session, you’ll recount the details of a traumatic event, speaking in the first person and the present tense. For example, instead of just saying “I was in a car accident when I was a kid,” you might begin the story with “I’m 5 years old. I’m in the back seat of my mom’s car. It’s raining, and I can see the drops of water on the window to my right.” Patients describe their memories in as much detail as possible, and reexperience painful emotions within the safe context of a therapy session.

Over time, and with repetition, the goal is for you to move past your most intense reactions to the initial trauma. You may also be assigned homework between sessions, in which you seek out triggering stimuli in order to confront your own responses. To overcome trauma associated with a car accident, for example, you might practice driving or riding in a car on the highway. These exercises ramp up slowly over time, and you’ll process each one in your next therapy session.

Although this form of treatment can be extremely difficult, it’s also highly effective. Multiple studies have demonstrated that PE is an appropriate therapy for adults with a history of trauma.⁴ Some experts also suggest that combining PE with eye movement desensitization and reprocessing (EMDR)⁵ may improve patients’ commitment to ongoing treatment.

Eye Movement Desensitization and Reprocessing (EMDR)

Somewhat like PE, EMDR invites people to revisit traumatic memories safely,⁶ with the support of a therapist. During each session, you’ll relate a present-day emotional state to a challenging past experience. For example, you might start by talking about an argument you’re currently having with a friend, and then go on to compare it to a fight you had with a parent during your childhood. Your therapist will instruct you to engage in certain activities, such as repetitive eye movements or tapping on your arms with your hands, while you revisit the memory of a difficult emotion.

EMDR helps you work through unprocessed adverse experiences,⁷ so you can release the emotions associated with them. Evidence suggests that this therapy might actually change the way traumatic memories are stored in the brain. Specifically, experts posit that EMDR might move those memories “from implicit and episodic memory to explicit and semantic memory systems.” In other words, patients become conscious and aware of thoughts they may never have considered before. “Consequently, the disturbing life experience becomes a source of strength and resilience.”

Yes, You Can Go to Rehab for Trauma

Contrary to popular belief, inpatient rehab isn’t just for addiction recovery. You can also attend residential treatment for a variety of diagnoses, including trauma-based disorders like PTSD, complex PTSD, and others. By taking time away from your daily life to focus on treatment, you may be able to kickstart the healing process.

Rehabs may employ a variety of therapeutic techniques, including CBT, PE, and EMDR. Some centers also teach life skills, empowering patients to practice self-reliance. Depending on your program, you may also be encouraged to connect with your recovery peers, which lets you practice valuable interpersonal skills. Research shows that community is extremely important during the process of healing from trauma,⁸ and the act of sharing mutual support may give you insight into your personal history.

The Impact of Adverse Childhood Experiences

Developmental trauma results from adverse childhood experiences, or ACEs. It can sometimes be hard to recognize these events as traumatic until years later. When you’re young, you simply haven’t had the time to encounter diverse ways of living. As a result, it’s difficult to compare your own life to “the norm.” You might take highly distressing circumstances for granted, and not fully understand the harm you experienced until after you reach adulthood.

Whether or not you can identify childhood trauma at the time, it has a lasting impact. You may develop coping mechanisms that help you survive in the short term, but get in the way of living a healthy and meaningful life as an adult. For example, many trauma survivors learn to dissociate⁹ as a way of protecting themselves from emotional pain. That strategy might help you endure parental abuse, but interfere with later romantic partnerships. The first steps toward healing are understanding what caused your symptoms, and validating your own experience.

Understanding Adversity

Childhood trauma can take many different forms. The American Psychiatric Association (APA) defines ACEs as “disruptions to the promotion of safe, stable, and nurturing family relationships and are characterized by stressful or traumatic events that occur during an individual’s first 18 years of life.”¹⁰

The more different types of adversity you experienced as a child, the higher your ACE score. If you have a history of trauma in only one of the defined areas, you could be said to have a low ACE score—even if that type of trauma happened repeatedly. People with higher ACE scores are at a greater risk of ongoing health and behavioral concerns. For example, research shows that people with high scores are more vulnerable to addiction, depression, and heart disease. However, that risk is just one part of the story.

Experts caution against thinking of ACE scores as the only predictors of wellness. Jack Shonkoff, Director of the Center on the Developing Child at Harvard University, explains that “there are people with high ACE scores¹¹ who do remarkably well.” Certain protective factors, like trauma-informed therapy, may mitigate the health risks associated with trauma. And not every type of trauma has the same effect.

The Lasting Effects of Emotional Abuse

Every person grows up with a unique set of risk and protective factors for the development of mental health issues. Based on your unique combination of experiences, a traumatic event may or may not cause you to have trauma-related symptoms.¹² And it can be extremely difficult to predict exactly which experiences will have long-term effects.

Mental health professionals distinguish between traumatic experiences in a number of ways. For example, some experts categorize these events as either “big T” or “small t” traumas. Examples of big-T traumas are listed as the “exposure to actual or threatened death, serious injury, or sexual violence,” while small-t traumas may include parental neglect or humiliation.

However, these terms can be misleading. At first glance, it might sound like big-T traumas are more serious, while small-t traumas can be easily dismissed. For some patients, the exact opposite is true. Research shows that survivors of interpersonal trauma usually exhibit more severe PTSD symptoms than survivors of non-interpersonal trauma. And many types of small-t trauma are interpersonal.

“It Could Have Been Worse”

Unfortunately, it’s quite common for trauma survivors to feel guilt and shame about what happened to them. This can make it difficult to accept the magnitude of an event’s impact. And as a result, you may delay getting the help you need.

Preliminary research has found that many people minimize the effects of their trauma.¹³ More data is needed to understand why and how this happens, and how it can interfere with the recovery process. But even without that data, this tendency is widely recognized within established support systems for trauma survivors.

Sexual Assault Survivors Anonymous (SASA), for example, has published resources that describe the phases of processing trauma after sexual assault.¹⁴ In what they term the “Outward Adjustment Phase,” the survivor goes about their apparently “normal” life despite emotional dysregulation. SASA lists 5 primary coping mechanisms to watch out for during this time. The first of these is minimization, in which you might pretend “‘that ‘everything is fine’ or that ‘it could have been worse.’”

And yes, of course it could have been worse. Here you are, reading this article, with the emotional resources to think about healing. Not everyone gets this far. That doesn’t mean what happened to you was okay. Your feelings are valid, and you deserve to get support while you heal. That’s true for everyone who lived through developmental trauma—even if you blame yourself, even if you feel ashamed, and even if you can’t clearly remember what happened.

The Minefield of Memories

Traumatic events can directly affect brain function¹⁵ and structure. One study found that people with PTSD may present with changes to the amygdala, hippocampus, and prefrontal cortex. Researchers say that “these brain areas play an important role in the stress response. They also play a critical role in memory, highlighting the important interplay between memory and the traumatic stress response.”

As a result, trauma survivors may struggle to trust their own memories.¹⁶ According to experts at the International Society for Traumatic Stress Studies (ISTSS), multiple scientific studies have “demonstrated a connection between childhood trauma and amnesia.” Some survivors repress their memories as a defense mechanism, even if it is “established fact that the traumatic events occurred.”

Over time, you may or may not remember the details of what happened to you. In some cases, rediscovering those memories can inspire people to begin recovery in earnest, finally seeking out the support they need. Others may never remember the specifics of their trauma, even if they’re actively engaged in therapy. Healing is always possible, whether or not you remember exactly what happened in your childhood.

Healing From Trauma You Don’t Remember

Kati Morton, LMFT, explains how it’s possible to heal from trauma even if you don’t clearly remember it.¹⁷ Even people who have repressed their worst memories are likely to have a noticeable response when confronted with triggers. Morton puts the most likely responses into 2 categories:

With body memories, the body responds to triggering thoughts, conversations, or events with a noticeable sensation. For example, you might feel tightness in your jaw whenever you talk about your childhood.
Emotional flashbacks can be triggered just like body memories, but may be harder to define. Instead of physically sensing pain or discomfort, you might feel an overwhelming sense of fear, sadness, anger, or any other emotion. It can be hard to tell whether these feelings are a proportionate response to your current circumstances, or a learned response to a painful repressed memory.

According to Morton, “identifying and understanding” these responses helps people “find better ways to manage them.” During treatment, your therapist can help you learn how to respond to triggers in a more effective way, without engaging in unhealthy behavior. This is especially important for people who have a history of both trauma and addiction.

Addiction and Developmental Trauma

A wealth of research links childhood trauma with addiction during adulthood.¹⁸ Multiple studies have found “extraordinarily high percentages of childhood trauma of various sorts, including physical, sexual and emotional abuse” among people with a history of substance abuse.

Perhaps because of this connection, some of the same techniques can be used to treat either or both of these diagnoses. In particular, prolonged exposure therapy can effectively treat both PTSD and addiction.¹⁹ If you’d like to address the 2 conditions at once, you might benefit from attending a rehab program for people with co-occurring disorders.

It’s also important to note that addiction itself can cause additional trauma.²⁰ If you experienced trauma as a child, this can quickly become a vicious cycle: getting triggered can make you want to take drugs, and the situations that arise because of your drug use can be even more triggering. Many people need professional support in order to break free of this pattern.

You Can Learn to Thrive

Healing from trauma isn’t easy, simple, or fast. If you remember what happened to you, those memories probably won’t just disappear. And even after completing treatment, you may continue to face triggering situations. Recovery can’t undo the past—but it can help you imagine a better future.

Learn more about programs that can help, and see reviews, therapies offered, virtual tours, and more, in our searchable list of trauma rehabs.

May 27, 2022January 4, 2024

Stop Smoking, Start Living: Rehabs That Can Help You Quit

It’s notoriously difficult to quit smoking, especially since it’s such a habitual part of everyday life. However, the physical and emotional effects of nicotine dependence are less than desirable, and you may have decided it’s time to put a stop to them. If you’ve tried unsuccessfully to quit before, you may feel understandably frustrated.

Did you know that there are rehabs and retreats specifically designed to help you stop smoking? Some treatment regimens can even help alleviate the effects of withdrawal. When you’re ready to quit for good, you can get the support you need from experts.

Deciding to Stop Smoking

There are many reasons why people decide to stop smoking, and yours may be personal to you. These might include health concerns, high costs of tobacco products, smoking bans at work or at home, or maybe you’re a parent concerned about the well-being of your children. Understanding your motivations can help you stay focused.

The good news? You don’t have to do it alone. Plenty of addiction professionals help people stop smoking, and yes—you can even go to rehab for this.

Treatment Options for Nicotine Dependence

Fortunately, there are many effective treatments that can help you quit smoking, ((Abuse, N. I. on D. (–). What are treatments for tobacco dependence? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence)) including behavioral therapies and medications. Regardless of which treatment method you choose, it’s important to consider your own needs and reasons for smoking. Per the National Institute on Drug Abuse (NIDA)’s Tobacco, Nicotine, and E-Cigarettes Research Report, “some people smoke to avoid negative effects of withdrawal while others are more driven by the rewarding aspects of smoking.”

Determining why you smoke can help you choose a treatment approach designed to address that issue.

Residential Rehab

Smoking addictions can be very serious. You may be tempted to dismiss the severity of this condition, simply because cigarettes aren’t as taboo as some other substances. However, the accessibility of a drug doesn’t make it any less dangerous. And several rehab centers treat nicotine dependence.

During inpatient treatment, you can engage in a variety of therapies designed to help you quit smoking, permanently. Before you choose a specific program, know that many rehab centers permit residents to smoke. If being around cigarettes is a trigger for you, it’s important to find a rehab center that can accommodate your needs.

Cognitive Behavioral Therapy (CBT)

This form of therapy helps patients determine why they smoke, and teaches them skills and coping strategies they can use to avoid smoking, even when faced with difficult situations.

Motivational Interviewing (MI)

Motivational interviewing helps patients determine where their ambivalence about quitting smoking is coming from, and increases their motivation to create a healthier lifestyle.

Remote Help: Phone, Web, and Apps

There are various ways to get help for quitting smoking without attending an in-person treatment program. For example, every state in the U.S. has free “quitlines” that people can call and receive support from a counselor, such as 800-QUIT-NOW.

In addition to telephone calls, people can sign up for mobile text messages that provide motivation and advice for quitting smoking. ((ABROMS, L. C., AHUJA, M., KODL, Y., THAWEETHAI, L., SIMS, J., WINICKOFF, J., & WINDSOR, R. A. (2012). Text2quit: Results from a pilot test of a personalized, interactive mobile health smoking cessation program. Journal of Health Communication, 17(Suppl 1), 44–53. https://doi.org/10.1080/10810730.2011.649159)) Messages may include information related to smoking and relapse prevention, as well as motivational texts from other ex-smokers and medication reminders. You can also use interactive components, such as a cigarette tracking feature and a craving trivia game. One study found that the number of people who were still abstinent 6 months after quitting smoking almost doubled in the group using Text2Quit, ((Text2quit: Mobile-based intervention for smoking cessation. (2017, March 7). Recovery Research Institute. https://www.recoveryanswers.org/research-post/text2quit-mobile-based-intervention-for-smoking-cessation-2/)) as opposed to the group that didn’t receive any texts at all.

Another similar text messaging service, run by the National Cancer Institute, is called SmokefreeTXT, and lasts for 6-8 weeks. They even offer a program specifically for vets called SmokefreeVET, in which texts are tailored to veterans, in addition to ones personalized to moms and teens. An example of one of these texts, according to the Smokefree website, ((Frequently asked questions | smokefree. (n.d.). Retrieved from https://smokefree.gov/tools-tips/text-programs/faqs)) looks like this: “Cravings can be triggered by seeing other people smoking. Spend time in places where smoking isn’t allowed. Try malls, museums, or the movies.”

One app by Smokefree, called quitSTART, ((Quitstart | smokefree. (n.d.). Retrieved from https://smokefree.gov/tools-tips/apps/quitstart)) is a personalized program that sends tips, motivation, and challenges based on your smoking history. It teaches you to manage negative feelings, what to do if you relapse, how to deal with cravings, and more. This app is best used before you actually quit—it’ll send you information to help you stop smoking in anticipation of your quit date.

Medications

Several different medications are proven to be effective treatments for nicotine dependence. ((Abuse, N. I. on D. (–). What are treatments for tobacco dependence? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence))

- Nicotine replacement therapy (NRT): NRTs reduce or eliminate uncomfortable nicotine withdrawal symptoms and cravings by triggering brain receptors normally affected by nicotine. NRTs come in different forms, such as the transdermal patch, gum, and lozenges, and are available over the counter. You can also purchase an inhaler or nasal spray with a prescription. They are all equally effective, and even more so when the transdermal patch is used with another NRT, especially when the treatment is taken beyond 12 weeks. NRT is estimated to boost quit rates by 50-70%.
- Bupropion: This antidepressant stops the reuptake of 2 neurotransmitters, dopamine and norepinephrine, and also releases them. Studies show that it’s just as effective as NRT.
- Varenicline: This medication triggers the same brain receptor affected by nicotine to minimize cravings. There is evidence that it works better than just 1 NRT alone, and studies also suggest that it’s more effective than bupropion.
- Medication combinations: Research shows that combining medications may be the most effective approach for people who want to quit smoking. For example, one study gathered data from research literature and determined that using both varenicline and the NRT transdermal patch together worked better than varenicline alone.
- Precision medicine: Pharmacogenetics aims to help health professionals tailor medications to the genetics of the individual, and may help you quit smoking. For example, some gene variations make people metabolize nicotine differently. ((Lerman, C., Schnoll, R. A., Hawk, L. W., Cinciripini, P., George, T. P., Wileyto, E. P., Swan, G. E., Benowitz, N. L., Heitjan, D. F., Tyndale, R. F., & PGRN-PNAT Research Group. (2015). Use of the nicotine metabolite ratio as a genetically informed biomarker of response to nicotine patch or varenicline for smoking cessation: A randomised, double-blind placebo-controlled trial. The Lancet. Respiratory Medicine, 3(2), 131–138. https://doi.org/10.1016/S2213-2600(14)70294-2)) People who metabolize nicotine at a faster rate smoke more, are more dependent, and find it more difficult to quit.

Mindfulness

In mindfulness-based sessions, ((Abuse, N. I. on D. (–). What are treatments for tobacco dependence? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence)) patients learn how to “increase awareness of and detachment from sensations, thoughts, and cravings that may lead to relapse.” They learn how to notice the thoughts that arise related to cravings and change them to be more tolerable. They’re also taught methods to help them deal with negative emotions in a healthy way, without the use of tobacco products.

Tobacco Use and Your Mental Health

Smoking often co-occurs with other psychiatric disorders, ((Aubin, H.-J., Rollema, H., Svensson, T. H., & Winterer, G. (2012). Smoking, quitting, and psychiatric disease: A review. Neuroscience and Biobehavioral Reviews, 36(1), 271–284. https://doi.org/10.1016/j.neubiorev.2011.06.007)) such as substance use disorder or depression. Depression and schizophrenia, in particular, are associated with higher tobacco use due to their sensitivity to its desired effects, such as better concentration and cognition, relief of stress and feelings of sadness, and pleasurable sensations. Data suggests that between 70-85% of people with schizophrenia also smoke tobacco. ((Abuse, N. I. on D. (–). Do people with mental illness and substance use disorders use tobacco more often? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often)) However, new research also indicates that stopping tobacco use may actually help alleviate negative mental health symptoms, ((Minichino, A., Bersani, F. S., Calò, W. K., Spagnoli, F., Francesconi, M., Vicinanza, R., Delle Chiaie, R., & Biondi, M. (2013). Smoking behaviour and mental health disorders—Mutual influences and implications for therapy. International Journal of Environmental Research and Public Health, 10(10), 4790–4811. https://doi.org/10.3390/ijerph10104790)) especially if it’s coupled with mental health care.

Nicotine dependence is more likely in people with anxiety, depression, and substance use disorders. ((Abuse, N. I. on D. (–). Do people with mental illness and substance use disorders use tobacco more often? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often)) In addition, they may be more prone to relapse when faced with stress or uncomfortable feelings. However, new research shows that tobacco use is correlated with poor behavioral and physical health in people with mental disorders, and that quitting smoking will lead to an overall better quality of life.

If you use tobacco regularly and also have a substance use disorder, you may be wondering whether you should try to quit both at once. Studies show that receiving treatment for both nicotine dependence and substance misuse does not negatively impact either case, ((Smoking interventions can help individuals in addiction treatment quit cigarettes, although questions remain about cessation effects on treatment outcomes. (2019, April 21). Recovery Research Institute. https://www.recoveryanswers.org/research-post/smoking-cessation-addiction/)) and another study found that they were actually both improved when patients were offered monetary rewards during addiction treatment. ((Quitting cigarettes in addiction treatment? (2017, March 8). Recovery Research Institute. https://www.recoveryanswers.org/research-post/quitting-cigarettes-in-addiction-treatment/))

Smart Strategies for Long-Term Abstinence From Smoking

Learn Your Triggers (And How to Deal With Them)

It’s easy to be triggered or socially pressured to smoke, even years after you’ve quit. In order to stay abstinent from smoking, ((How to stay smokefree | smokefree. (n.d.). Retrieved from https://smokefree.gov/stay-smokefree-good/stick-with-it/how-to-stay-smokefree)) it’s important to learn your triggers, or situations that entice you to smoke. For example, stress is a trigger for many people. In this instance, you’d want to devise a plan that consists of healthy behaviors that can alleviate stress, such as exercise. You can help learn more about these skills and coping mechanisms in CBT.

Have a Plan for When Cravings Hit

You should also come up with other activities you can do when cravings hit that prevent you from smoking. For example, you can go for a walk, engage in an enjoyable hobby, or call a friend. And remember—the longer you go without smoking, the fewer cravings you’ll experience.

Take Time to Reward Yourself

Don’t forget to reward yourself for not smoking. Quitting smoking is hard—there’s no doubt about that—so it’s important to celebrate and treat yourself to things you enjoy, like the movies or cooking classes. Take time to look at how far you’ve come.

Social Support is Important

Social support is crucial when quitting tobacco use. You may want to choose designated friends or family members that you can call when you feel like smoking again, and they can help you remember your reasons for abstaining from tobacco. A peer or mentor that has quit smoking in the past can be an invaluable source of support.

Technology Can Help Too

Sign up for an app or texting service like the ones described above, or see our article on finding online treatment for more resources.

Live a Healthier, Smoke-Free Life

Although it can be difficult to quit smoking, there are many different resources available that can help, making the process much easier. You can replace your smoking habit with activities that boost your mental and physical health, like exercise and therapy. In turn, these healthy hobbies can help you stay abstinent and help prevent relapse.

When you’ve decided it’s time to quit, know that there are many different programs that can help. See program highlights, pricing, insurance information, and more in our directory of smoking cessation rehabs.

Reviewed by Rajnandini Rathod

May 24, 2022April 23, 2025

How to Recognize High-Functioning Alcohol Addiction

If you’re keeping up the appearance of a healthy lifestyle, it can be hard to know whether you have a high-functioning alcohol addiction. However, this condition can have just as many negative effects as more recognizable alcohol misuse. If drinking is having any negative impact on your life at all, you don’t have to wait for the problem to get worse. By connecting with a rehab that treats high-functioning alcohol addiction, you can assess your own behaviors. And, if necessary, you can get the help you need to start recovery.

When Drinking Becomes a Problem

According to the CDC, drinking in moderation is defined as “limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed.” Note that these gender differences are based on scientific research, and not on evolving social norms. Also, keep in mind that a “standard” drink has only 14 grams of pure alcohol. These are examples of what counts as one drink, ((What is a standard drink? | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved May 24, 2022, from https://www.niaaa.nih.gov/alcohols-effects-health/overview-alcohol-consumption/what-standard-drink)) according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA):

12 ounces of regular beer (usually about 5% alcohol)
5 ounces of wine (12% alcohol)
1.5 ounces of distilled spirits (40% alcohol)

These numbers are far lower than most people assume. And even in casual settings, friends may unintentionally enable you to drink more than you should. They may not recognize the signs of high-functioning alcoholism at first—and as a result, you may not immediately get the support you need.

Alcoholism Hides in Plain Sight

Drinking is a normalized activity in most cultures around the world, and some people can drink without developing an alcohol use disorder. ((Witkiewitz, K., Litten, R. Z., & Leggio, L. (2019). Advances in the science and treatment of alcohol use disorder. Science Advances, 5(9), eaax4043. https://doi.org/10.1126/sciadv.aax4043)) Because drinking is so socially acceptable, however, it can be difficult to realize or admit that you have this particular addiction. People with high-functioning alcohol use disorder are often said to be leading double lives, in which everything looks perfect to a casual observer. However, the underlying reality is much more dangerous than it appears.

Someone with a high-functioning alcohol addiction can still function in their daily lives, despite heavy alcohol use. People around them may not realize the amount of alcohol they’re drinking, although they may have suspicions. Someone with a high-functioning alcohol addiction may still perform well at work, spend time with family and friends, and participate in hobbies, all while consuming much more alcohol than what experts consider healthy.

“My Success was the Mask”

Sarah Allen Benton is a mental health counselor who once had a high-functioning alcohol addiction ((Brody, J. E. (2009, May 4). High functioning, but still alcoholics. The New York Times. https://www.nytimes.com/2009/05/05/health/05brod.html)) herself, although you might have never guessed—she has a Master’s degree from an esteemed university and a job as a mental health counselor at a prestigious college in Boston. She recounted her experience in an interview with the New York Times:

“Having outside accomplishments led me and others to excuse my drinking and avoid categorizing me as an alcoholic. My success was the mask that disguised the underlying demon and fed my denial.”

In the same interview, she went on to describe the following criteria, which may help you determine whether your drinking is, in fact, problematic:

You can’t seem to control how much you drink, even if you set intentions to limit your alcohol intake.
You think about alcohol obsessively, making plans around the next time you’ll be able to drink.
Your behavior when you’re sober is markedly different than it is when you’ve been drinking.
You sometimes drink so much that you black out.

“It’s not the number of drinks that defines [someone with an alcohol addiction],” said Ms. Benton. “It’s what happens to you when you’re drinking.”

Deciding to Get Sober

High-functioning alcohol addiction is a common condition—probably more common than most people realize. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that about 19.5% of alcohol addictions in the U.S. are considered high-functioning, ((Researchers identify alcoholism subtypes. (2015, September 29). National Institutes of Health (NIH). https://www.nih.gov/news-events/news-releases/researchers-identify-alcoholism-subtypes)) and most people are well-educated with secure careers and families. Even if your life appears to be sustainable, you might still benefit from receiving care.

If you recognize the signs of alcohol addiction in a loved one, you may be able to help them get treatment. Make sure you care for yourself by setting appropriate boundaries throughout this process. Remember that their condition is not your fault—and ultimately, it’s not your responsibility to “fix” the problem.

When people do decide to seek treatment for high-functioning alcohol addiction, it’s often because of concern from others. They may also experience a “wake-up call” that makes them fear for their own safety. For example, someone may realize the severity of their alcohol addiction after a DUI, an arrest, or a serious health problem that arises related to your drinking.

Starting Recovery from High-Functioning Alcohol Addiction

When you’re ready to get treatment for a high-functioning alcohol addiction, you can choose between a variety of healing modalities. For alcohol, even more than other substances, it’s important that you begin healing under proper medical supervision.

Medical Detox

You may need to undergo medically supervised detox, depending on the severity of your alcohol use. During this time, a team of medical professionals will supervise you throughout the process and help ease your withdrawal symptoms. This may involve the use of non-addictive medications to help make you feel more comfortable. Even people who can perform the functions of daily life may be drinking at a level that requires detox, and it’s extremely dangerous to attempt this process alone. It’s very important that you seek medical advice before you begin detoxing, as withdrawal can be fatal without proper care.

Remember that detox is not recovery, but a preliminary step to receiving treatment. To fully and sustainably overcome any addiction, you’ll need to work on the underlying issues that caused it. This may require residential addiction treatment, or some combination of the treatment methods listed below.

Inpatient Rehab

During inpatient treatment, patients stay at a rehab facility, usually for a minimum of 28 days. You’ll work with therapists and most likely attend both 1:1 sessions and group therapy, in addition to receiving medical attention when needed. Depending on your specific rehab program, you may also participate in therapeutic activities such as hiking or swimming.

Each treatment facility is different. Some rehabs have a special focus on treating alcohol addiction, while others would be a good fit for patients with co-occurring disorders. Whatever your diagnosis, your time in residence should help you plan for a future without alcohol. Remember that while inpatient rehab will allow you to begin the healing process, recovery continues after you return home.

Intensive Outpatient Programs

In some situations, you may choose to attend an intensive outpatient program (IOP) instead of staying at a residential rehab. This type of treatment is often appropriate for patients who would benefit from treatment, but can’t spend that much time away from home due to work, school, family, or other time commitments. Your insurance might also cover an IOP even if it won’t cover inpatient treatment.

During an IOP, you’ll live at home and attend therapy and other treatments during the day. You may be onsite for several hours a day, several days a week; the time commitment is similar to that of a job. This flexibility is very important for some patients, but it’s not sufficient for everyone. You may still be vulnerable to triggers at home that you wouldn’t encounter while attending an inpatient rehab.

Medications

The U.S. Food and Drug Administration (FDA) has authorized 3 medications for treating alcohol dependence: ((Treatment for alcohol problems: Finding and getting help | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#pub-toc1))

Naltrexone makes drinking less desirable by blocking the pleasurable effects of alcohol.
Acamprosate reduces alcohol cravings.
Disulfiram causes uncomfortable symptoms —such as nausea and flushing of the skin—if you drink, making alcohol less appealing.

A medical professional can prescribe these non-addictive medications for use alone or along with other forms of treatment. You may have to experiment to find which medications work best for you. You can also choose to combine these medications with talk therapy, or if using medication doesn’t work for you, focus on talk therapy alone.

Talk Therapy

According to the National Institute on Alcohol Abuse and Alcoholism, there are several different behavioral therapies that may successfully treat alcohol addiction. ((Treatment for alcohol problems: Finding and getting help | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#pub-toc1)) These may include 1 or more of the methods below.

Cognitive behavioral therapy (CBT) focuses on helping you change your own thoughts and behavioral patterns from negative to positive. This treatment helps you understand the feelings and situations that may trigger you to drink, and teaches strategies for managing that stress in a healthy way.
Motivational enhancement therapy helps you find the motivation to change your drinking habits. During these sessions, you’ll create a plan to stay sober, focus on building your confidence, and develop the skills you need to stay on track with your plan.
Family therapy works on healing the relationships between spouses and within families, since support from loved ones is crucial during the recovery process.

Support Groups

Social support is extremely beneficial when recovering from alcohol abuse. ((Groh, D. R., Jason, L. A., Davis, M. I., Olson, B. D., & Ferrari, J. R. (2007). Friends, family, and alcohol abuse: An examination of general and alcohol-specific social support. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 16(1), 49–55. https://doi.org/10.1080/10550490601080084)) Research has found that people with bigger social circles and stronger relationships have a greater likelihood of abstaining from alcohol. If you’re looking to build relationships with people who can support you during recovery, you may benefit from attending a support group.

Alcoholics Anonymous (A.A.) ((What is a. A.? | alcoholics anonymous. (n.d.). Retrieved from https://www.aa.org/what-is-aa)) is a free program that is “open to anyone who wants to do something about their drinking problem.” Members can attend peer-led meetings regularly or casually in order to share mutual support. This 12-Step program’s primary goal is to help people achieve sobriety through 12 spiritual principles.

Faith-based recovery is right for some, but not for everyone. Other free support groups, like SMART Recovery, ((Self-help addiction recovery program | addiction support groups. (n.d.). SMART Recovery. Retrieved from https://www.smartrecovery.org/)) are available for people who prefer a more scientific approach. In any group, you’ll have the opportunity to connect with people who share your experience.

Social support is a hugely important component of recovery. You can find that support in groups, and also by strengthening relationships with friends, family, and chosen family who want to see you heal. Some rehab programs have an especially strong focus on this issue, and will incorporate it into your process of planning for aftercare. Depending on your exact needs, your relapse prevention plan may include personal relationships, ongoing therapy, a rehab alumni network, and in-person or online support groups.

Sober Living Environments

After you’ve completed treatment, you may choose to stay in a sober living home (also known as a therapeutic community) before transitioning to life back home. This entails living with others in recovery, which will allow you to exchange mutual support and build relationships with people at a similar stage of their journey.

Sober living environments allow you to start reintegrating into the wider world, while still providing the structure and support of a substance-free environment and recovery-focused daily schedule. Not everyone needs sober living, but it can be a great fit for some while stepping down from residential care.

It’s important to note that each of these communities has their own set of rules. For example, you may be required to attend therapy, participate in group activities, or test negative for drug and alcohol use in order to maintain residence. This kind of structure is designed to support your continuing process of recovery.

Long-Term Effects of Alcohol Abuse

Long-term exposure to alcohol can impact on every aspect of your health. Alcohol addiction can even change your brain chemistry, ((Brochures and fact sheets | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://pubs.niaaa.nih.gov/publications/aa77.pdf)) affecting the function of neurotransmitters. As you progress in your recovery journey, you may need to make long-term plans not just for your mental health, but also for your physical recovery.

Physical Effects

High-functioning alcohol addiction can sneak up on you. As your alcohol tolerance slowly increases, you may find yourself drinking more and more just to achieve the same effect. Many people don’t even realize the sheer quantity of alcohol they’re consuming on a regular basis. And unfortunately, higher alcohol consumption is associated with more severe health risks, regardless of how intoxicated it makes you feel.

High-functioning alcohol addiction can cause a plethora of negative effects on the body. ((Alcohol’s effects on the body | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body)) Over time, alcohol misuse can cause problems with your heart, liver, pancreas, and brain. Research has found neurons in the brain may become smaller in size due to alcohol misuse, ((Alcohol and the brain: An overview | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-and-brain-overview)) causing cognitive dysfunction. You may develop a compromised immune system, which can make you more vulnerable to disease and illness, and can even lead to cancer. Eventually, consistent alcohol abuse can be fatal.

Social and Emotional Problems

Alcohol misuse has a negative effect on mental health, ((Understanding alcohol use disorders and their treatment. (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/topics/substance-use-abuse-addiction/alcohol-disorders)) and increases your risk for depression and anxiety. Excessive drinking also causes social challenges, ((Rehm, J. (2011). The risks associated with alcohol use and alcoholism. Alcohol Research & Health, 34(2), 135–143. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307043/)) and may damage the most important relationships in your life. When you stop drinking, you can expect your social circle to change significantly—and not always in the ways you might expect.

In the best case scenario, you’ll be able to repair relationships that were undermined by your addiction. However, you’ll probably also need to let go of relationships with people who once enabled your behavior. Research has found that it’s more likely for people to begin drinking again when they surrounded themselves with loved ones who still drank alcohol ((Groh, D. R., Jason, L. A., Davis, M. I., Olson, B. D., & Ferrari, J. R. (2007). Friends, family, and alcohol abuse: An examination of general and alcohol-specific social support. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 16(1), 49–55. https://doi.org/10.1080/10550490601080084)) and encouraged drinking. The opposite was true for people who spent more time around sober friends and family. Never underestimate the importance of strong, supportive relationships during your recovery. According to one study, positive support from friends was the most important predictor in abstinence from alcohol ((Groh, D. R., Jason, L. A., Davis, M. I., Olson, B. D., & Ferrari, J. R. (2007). Friends, family, and alcohol abuse: An examination of general and alcohol-specific social support. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 16(1), 49–55. https://doi.org/10.1080/10550490601080084)) for adults.

You can live a full, happy life that’s also a sober one. And in order to do that sustainably, you’ll learn how to enjoy yourself while sober. That could mean going on early morning hikes, taking up painting, or learning how to cook. The good news is, you can still do these things with the important people in your life. In fact, many people find they have more fun in recovery than they did while they were drinking – and that their relationships are more genuine.

Get Your Life Back in Recovery

Although it may seem difficult to imagine life without alcohol now, it’s entirely possible. Recovery isn’t just about abstaining from substances—it’s about creating a life that you love. And that has everything to do with discovering what fulfills you and finding a lifestyle that’s aligned with your values.

The most important thing to remember is that recovery is about what works best for you. Only you can determine what your life will look like moving forward, but know that support is available to help you get there.

If you’re concerned about your drinking, learn more about available programs and connect with admissions team members who can offer you an initial assessment via our directory of inpatient alcohol rehabs.

Reviewed by Rajnandini Rathod

May 24, 2022June 26, 2025

Healing From Heroin Addiction—and Stigma

Because heroin addiction is so highly stigmatized, it can be difficult to ask for help. And recovery can be overwhelming without the proper support. Fortunately, many rehab programs specialize in heroin addiction treatment.

You may be tempted to delay treatment for many reasons, including the associated stigma, the risks of detox, or a sense of isolation. Remember, though, that you can overcome these challenges with the help of experienced healthcare providers. In the right context, with an expert team at your side, recovery is absolutely possible.

Stories of Recovery From Heroin Addiction

People are often motivated to begin healing from heroin misuse because they’re unhappy with how addiction has negatively impacted their lives. They may not like the detrimental mental and physical impacts that heroin has had on them, and they may have cut ties or damaged relationships with family and friends.

“I’m Living Proof That Recovery Is Possible”

For Tracey Helton Mitchell, her desire to heal from heroin addiction³ was related to a deep unhappiness about the way she was living her life. “I had multiple soft tissue infections related to an unsterile injection technique, and I had become extremely thin,” she said. “I had no meaningful relationships. Most of all, I was tired of living to use and using to live.”

After being arrested, she decided to seek help at a rehabilitation center, and has been sober ever since “The important thing to remember is that you can get your life back,” she said. “Within less than a week, your whole life can start to turn for the better. I am living proof that recovery is possible.”

Addiction Is Not a Moral Failing

It’s far too common for heroin addiction to isolate people from social support. And unfortunately, the stigma associated with substance use disorders⁴ can directly interfere with the healing process. As you begin healing, look for ways to practice self-compassion. This is easier said than done, but with the help of a trained therapist, it can have a huge impact on your continued recovery.

“The thing that I think that people are quickly understanding is that opiate addiction does not discriminate and is not a moral failing,” says John, who was addicted to opiates⁵ himself. “Many of us that have become addicted are intelligent, valuable people who lost control after experimentation, curiosity or having the opiates prescribed. I didn’t ever intend to be a heroin addict; it quickly got out of control.”

You are more than your heroin addiction. The good news is that it’s very possible to overcome this disorder with the right help and care. Long-term recovery rates from heroin addiction⁶ are especially good for those who stay sober for at least 5 years after stopping use. Every person’s recovery journey is different, and it’s important to find the best program to cater to your own specific needs. Luckily, there are a variety of treatment options that you can customize to fit your specific situation.

Treating Heroin Addiction

Healing looks different for everyone. But during recovery from heroin addiction, certain therapies are especially effective. Most patients either seek pharmaceutical or behavioral approaches, or both. Research shows that these 2 treatment methods for heroin use disorder⁷ are most effective when combined. But no matter which form of treatment you engage in, it’s best to begin by undergoing detox.

Medical Detox

Detoxification—the period of withdrawal from a drug—can be very uncomfortable and even dangerous. The symptoms of opiate withdrawal⁸ may include nausea, vomiting, diarrhea, muscle aches, hot and cold flashes, and more.

Without proper supervision, this process can be life-threatening. Because of this, medical detox is highly recommended for people in recovery from heroin misuse. This process normally lasts a maximum of 10-14 days. During that time, you’ll be closely monitored by a team of doctors, nurses, and mental health professionals. These experts can also prescribe medications that help make the process more comfortable and reduce negative symptoms.

Medication-Assisted Treatment (MAT) for Heroin Addiction

It’s possible to become both psychologically and physiologically addicted to opiates, including heroin. Because of this, most patients benefit from both mental health treatment, like talk therapy, and medical treatment, like prescribed pharmaceuticals. Some medications may even be helpful before you begin detox.

For example, naloxone is a drug used as a temporary strategy to prevent opioid overdose.⁹ This is not a long-term treatment for heroin addiction; it’s a short-term solution to a life-threatening emergency. The availability and ease of acquiring Naloxone varies by location. In some areas, you may be able to get it free of charge from a pharmacy or community-based health group. After you complete detox, this medication will likely be unnecessary.

During detox and recovery, opioid replacement therapy¹⁰ is the best pharmacological treatment option for heroin addiction. This consists of replacing heroin with another opioid that has a longer duration of action, making it safer and less harmful.

There are three different kinds of medications that do this. They are agonists, partial agonists, and antagonists. Agonists and partial agonists both work by activating opioid receptors (partial agonists just have a lower efficacy), while antagonists prevent the receptor from binding at all. The following is a list of the most common medications used in helping treat heroin use disorder.

Methadone (Dolophine or Methadose)
Methadone is an opioid agonist that slowly reduces the “high” heroin produces, while simultaneously preventing any withdrawal symptoms. This therapy stops heroin cravings¹¹ and is less likely to cause overdose.

However, there is still some risk of overdose if methadone is not taken as prescribed. It also interacts with other medications, affects people differently, and contains long-lasting active ingredients, making it crucial that the dosage be constantly monitored and reevaluated.

Because of these potential risks, methadone is normally administered with a practitioner present,¹² although some patients may eventually take it at home after a certain period of time. This progression will be determined by a medical professional.

Buprenorphine (Subutex)
This medication is a partial opioid agonist that prevents heroin cravings without the high. There is less risk of overdose, but because it’s still an opioid, there’s a chance that it can be misused. While buprenorphine can be taken at home, it still needs to be prescribed by a doctor.

Naltrexone (Vivitrol)
This opioid antagonist works to stop any opioid action and is not addictive. Naltrexone is best for people who have already gone through detox from opioids, since it can cause debilitating withdrawal symptoms if not. A licensed healthcare provider can supply a prescription for Naltrexone.

Substituting and tapering methadone or buprenorphine are the 2 most effective medication-based treatments for heroin addiction.¹³ When used in conjunction with psychotherapy, these medications have proven to be extremely successful in helping patients recover.

Behavioral Treatment Options

Heroin addiction is associated with a variety of emotional symptoms,¹⁴ including depression, negative self-image, and a sense of meaningless and isolation. Because of this, mental health treatment is an essential component of recovery.

Counseling services are offered in both outpatient and residential facilities, and can be crucial in giving patients the tools and confidence they need in order to successfully recover from substance use disorders. According to one study, patients who focus on improving self-confidence and treating mental health symptoms in therapy have an improved chance of sustained and stable recovery from heroin misuse.¹⁵

Cognitive behavioral therapy (CBT) has proved to be successful in treating heroin addiction,¹⁶ especially when combined with medication. Contingency management, in which individuals gain ‘points’ for negative drug tests that they can then exchange for vouchers, is another effective strategy.

You can talk to your doctor about the right method(s) for you. It’s important to tailor your treatment plan to fit your needs, and to determine what will benefit you the most on your road to recovery.

Inpatient vs. Outpatient Treatment

Inpatient treatment requires patients to live at a rehabilitation facility for a specified duration of time. In an outpatient program, you would stay in your home but frequently visit the center to participate in therapy and other forms of treatment.

One study found that residential treatment is especially helpful in treating opioid addictions ¹⁷ such as heroin use disorder, since it helps reduce the social and environmental triggers that may lead to relapse. Because of this, it’s not surprising that fewer people finish outpatient treatment for this condition. If heroin misuse is your primary concern, inpatient rehab may be a better option for most patients.

Preparing for Rehab

It’s important to prepare for rehab in order to make the process as smooth as possible. This will help you ease into your healing journey, and allow you to focus on the work of recovery.

Planning Ahead

While getting ready for rehab, stay in close communication with the admissions team at your chosen treatment center. They can answer any questions or concerns you may have about attending a rehab facility, including what to bring with you, what to expect when you arrive at rehab, and other helpful ways to prepare.

It’s crucial to minimize stress while you’re attending treatment in order to really focus on healing. To do this, take care of as many tasks as you can beforehand, both for work and in your personal life. This includes setting up automatic payments for bills, planning for childcare, and booking a house or pet sitter. Take the time you need to consider what this means for you.

Taking Leave From Work

You may need to take some time off of work to go to rehab, especially if you decide to attend an inpatient facility. While it may seem intimidating to approach your workplace about taking a leave of absence to attend treatment, remember that you need to do what’s best for you. Ultimately, your work will suffer if you put off getting the help you need.

Know that there are laws in place to keep you employed while you attend a treatment center. In addition, most employers prioritize the overall well-being of their staff members, and understand that this will lead to a better workplace environment for everyone.

Many employers will support your decision to seek care. There’s also a high chance that the addiction or detox center that you choose will help you navigate this discussion with your workplace. You may want to prepare for the conversation by learning about your company’s policies, as well as your employee rights. Be honest with your employer, and explain your plan for seeking treatment.

Creating a Healthy Support System

It can be extremely beneficial to have a support system of people that you can talk to during your recovery process. They can help motivate you to see the process through, and comfort you on difficult days.

For some people, this support network can include family and friends. However, that’s not possible for everyone. Because heroin addiction can be so stigmatized and isolating, you may arrive at rehab without an established community. If that’s the case, you can focus on connecting with the people in your cohort. Your peers can offer valuable support, and it may be helpful to lean on people with similar experiences to yours.

Long-Term Recovery From Heroin Misuse

Your recovery may begin with residential treatment, but that’s just the first step. If you have a history of heroin addiction, it’s important to plan for long-term care to avoid relapse and manage your physical health.

Heroin addiction can have negative effects on the brain,¹⁸ and is particularly associated with brain functions that play a role in decision making. On a related note, long-term heroin addiction may lead to impulsive and dangerous decisions.¹⁹ Heroin use disorder may also lead to scarred veins, bacterial infections of blood vessels, liver and kidney diseases, insomnia, and lung complications.

If you’ve taken heroin intravenously, you may be vulnerable to disease. The widespread sharing of syringes and frequent injections increase the risk of contracting HIV, hepatitis B, C and other blood-borne infectious diseases.

During residential rehab, your providers can help you plan for aftercare. Your specific plan may include ongoing medical treatment, psychotherapy, support groups, and a variety of other healing modalities.

Hope Is Right Around the Corner

When your diagnosis impacts the rest of your life, it can be hard to imagine a way to heal. Remember that you deserve care. And fortunately, there are treatments available. It is possible to overcome heroin addiction, no matter how difficult it may seem.

“I think because there are so many unsuccessful and sad stories out there we miss the successful stories,” says Brittney, who has been sober from opioids for 8 years.²⁰ “The stories where mothers and children are being reunited, the stories where women are standing on their own two feet and working towards goals and achieving them, the stories where that lost girl finds her way and makes it. These are the stories of hope, if you look hard enough they’re on every corner.”

If you’re ready to seek help for a substance use disorder, search our list of rehabs that treat heroin addiction.

May 5, 2022October 16, 2024

Focus on Recovery: Finding Treatment for Prescription Stimulant Addiction

In our accelerating world, it can be hard to keep up. It’s no wonder that some people turn to prescription stimulants to cope. Drugs like Adderall, Ritalin, Dexedrine, and Concerta —sometimes called “smart drugs” or “study drugs”—can be very helpful for people with ADHD, narcolepsy, and major depression, when taken as prescribed. But if you’re vulnerable to addiction, they can quickly get out of hand.

If stimulants are having a negative impact on your life, you may need treatment for a substance use disorder. Recovery is possible for anyone—even people who began taking stimulants for an underlying condition. You can work with a team of providers to find a more sustainable way to manage your other symptoms, while still moving beyond the cycle of addiction.

Treatments for Stimulant Use Disorder
A variety of therapies are proven to be effective in combating smart drug addiction. Most treatment plans focus on behavior and mental health, because stimulant addiction can be hard to treat with medication. According to a review from the U.S. Department of Veterans Affairs, there are currently “no accepted FDA-approved pharmacotherapy treatment options available” for stimulant use disorders. ((Chan, B., Kondo, K., Ayers, C., Freeman, M., Montgomery, J., Paynter, R., & Kansagara, D. (2018). Pharmacotherapy for stimulant use disorders: A systematic review. https://www.ncbi.nlm.nih.gov/books/NBK536789)) Despite this, patients can engage in a variety of treatments, including psychotherapy and behavioral therapy.

Contingency Management

Contingency management is a behavioral treatment for stimulant misuse. ((Substance Abuse and Mental Health Services Administration. Treatment for Stimulant Use Disorders. Treatment Improvement Protocol (TIP) Series 33. SAMHSA Publication No. PEP21-02-01-004. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2021. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP21-02-01-004.pdf)) It provides patients with tangible rewards to incentivize recovery. For example, you might get a certain number of vouchers for attending therapy, or testing negative for substance use. This strategy is shown to reduce cravings and risky behaviors.

Motivational Interviewing (MI)

Motivational interviewing is not a type of therapy, per se. Instead, it’s a conversation style that can be adopted by any healthcare provider, including doctors, nurses, and counselors. This client-centered approach puts the patient in the driver’s seat. Rather than forcing you to accept a specific form of treatment, your clinician will make space for you to process feelings of ambivalence, trusting that you know what course of action is right for you. Evidence suggests that motivational interviewing can decrease the duration and quantity of patients’ stimulant use. ((Substance Abuse and Mental Health Services Administration (SAMHSA): Treatment of Stimulant Use Disorders. SAMHSA Publication No. PEP20-06-01-001 Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2020.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a type of 1:1 talk therapy that identifies and modifies harmful thinking and behavior. In this treatment approach, you’ll work with a counselor to develop healthier responses to the impulses that aren’t serving you. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), CBT helps patients decrease the quantity and frequency of their stimulant use, ((Substance Abuse and Mental Health Services Administration (SAMHSA): Treatment of Stimulant Use Disorders. SAMHSA Publication No. PEP20-06-01-001 Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2020. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-06-01-001_508.pdf)) and decrease risky sexual behaviors.

Because medical interventions aren’t always helpful for patients with stimulant addiction, your plan of care will probably focus on behavioral modalities. But if you have a co-occurring disorder, like ADHD, the recommended treatment approach may be more complex.

Stimulant Misuse and Co-Occurring Disorders

Stimulants are most often prescribed to treat attention deficit hyperactivity disorder (ADHD), ((Abuse, N. I. on D. (2018, June 6). Prescription stimulants drugfacts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/prescription-stimulants)) and may also be used to treat narcolepsy or depression. When used correctly, they can be very effective. However, their high risk of abuse can be dangerous for people who are vulnerable to developing addictions. And furthermore, some experts are concerned that these study drugs are being overprescribed.

While the opioid epidemic has been the center of most addiction therapy legislation and research in recent years, the rising trends in the use of prescription stimulant addiction and mortality ((Piper, B. J., Ogden, C. L., Simoyan, O. M., Chung, D. Y., Caggiano, J. F., Nichols, S. D., & McCall, K. L. (2018). Trends in use of prescription stimulants in the United States and Territories, 2006 to 2016. PLoS ONE, 13(11), e0206100. https://doi.org/10.1371/journal.pone.0206100)) paint a concerning picture. And much like opiates, stimulants have a high risk of diversion ((Piper, B. J., Ogden, C. L., Simoyan, O. M., Chung, D. Y., Caggiano, J. F., Nichols, S. D., & McCall, K. L. (2018). Trends in use of prescription stimulants in the United States and Territories, 2006 to 2016. PLoS ONE, 13(11), e0206100. https://doi.org/10.1371/journal.pone.0206100))—being sold or given away by a person with a prescription, and subsequently taken by someone else. Whether or not you have a prescription for stimulants, their overuse can be extremely dangerous.

Neurochemical Effects of Stimulant Abuse

Stimulants increase levels of neurochemicals norepinephrine and dopamine, ((Sofuoglu, M., & Sewell, R. A. (2009). Norepinephrine and stimulant addiction. Addiction Biology, 14(2), 119–129. https://doi.org/10.1111/j.1369-1600.2008.00138.x)) boosting the speed at which the brain communicates. The result is increased physiological activity and reduced time for messages to travel from the brain to the body and back. In the short term, this makes many people feel alert and energized.

Based on your exact brain chemistry, though, you may have a different reaction to study drugs. For instance, if you have ADHD and take an appropriate amount of Adderall, it should alleviate your symptoms and help you focus. Whether or not you have this diagnosis, overusing a stimulant can have negative effects. ((Substance Abuse and Mental Health Services Administration. Treatment for Stimulant Use Disorders. Treatment Improvement Protocol (TIP) Series 33. SAMHSA Publication No. PEP21-02-01-004. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2021. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP21-02-01-004.pdf))

Unfortunately, tolerance to smart drugs builds quickly. The effect of stimulants on dopamine ((Yanofski, J. (2011). The dopamine dilemma—Part ii. Innovations in Clinical Neuroscience, 8(1), 47–53. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036556/)) is so volatile that, in some cases, this can happen within a matter of hours. Most users require increasingly larger doses over shorter periods of time to achieve the same result.

According to SAMHSA, stimulant overuse can also cause dangerous side effects ((Substance Abuse and Mental Health Services Administration (SAMHSA): Treatment of Stimulant Use Disorders. SAMHSA Publication No. PEP20-06-01-001 Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2020. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-06-01-001_508.pdf)) like “panic attacks, hostility, paranoia, psychosis, and even violent behavior.” These side effects can be signs of a serious addiction. And if you first started using stimulants because of another diagnosis, you might need to consider alternative treatment in order to begin recovery.

ADHD and Stimulant Misuse

Scientists believe there is a complex relationship between ADHD and substance use disorders. ((Mariani, J. J., & Levin, F. R. (2007). Treatment strategies for co-occurring adhd and substance use disorders. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 16(Suppl 1), 45–56. https://doi.org/10.1080/10550490601082783)) According to one study, these 2 conditions frequently co-occur in the same patients. And although prescribed stimulants are the primary treatment for ADHD, these medications can interfere with recovery from substance misuse.

If you have both of these diagnoses, it’s important to work with a team of healthcare providers who have experience with co-occurring disorders. Together, you can weigh the risks and benefits of different treatment options. If you do use medication to control your ADHD, you may need to be monitored for signs of addiction even after you complete the initial phases of treatment.

Depression and Stimulant Misuse

While stimulants can be prescribed for people with major depression, they’re far from the only treatment option. If you’re in recovery from a stimulant use disorder, you may be a better candidate for other prescriptions. Many people with depression see improvement with SSRIs, SNRIs, and other non-addictive medications.

Narcolepsy and Stimulant Misuse

Because of the neurological processes involved with narcolepsy, it’s highly unlikely for these patients to develop substance use disorders. And since narcolepsy is commonly treated with stimulants, ((Turner, M. (2019). The treatment of narcolepsy with amphetamine-based stimulant medications: A call for better understanding. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 15(5), 803–805. https://doi.org/10.5664/jcsm.7788)) people with this condition often have prescriptions for these drugs of abuse. This ease of access can be a risk factor for addiction, either for them or the people around them.

Risk Factors for Stimulant Addiction

Many people who misuse stimulants start by taking them as prescribed. ((Compton, W. M., Han, B., Blanco, C., Johnson, K., & Jones, C. M. (2018). Prevalence and correlates of prescription stimulant use, misuse, use disorders, and motivations for misuse among adults in the U.S. The American Journal of Psychiatry, 175(8), 741–755. https://doi.org/10.1176/appi.ajp.2018.17091048)) Over time, as your tolerance goes up, you may be tempted to increase your dose without medical supervision. This is just one of several risk factors for developing a stimulant misuse disorder.

Academic Pressure

Stimulants are known as “smart drugs” because of their prevalence among college students. ((Trudeau, M. (2009, February 5). More students turning illegally to “smart” drugs. NPR. https://www.npr.org/2009/02/05/100254163/more-students-turning-illegally-to-smart-drugs)) There’s a great deal of research connecting substance misuse and the need—or perceived need—for academic enhancement. One study found that students with low confidence in their academic abilities were at especially high risk for misusing prescription stimulants. ((Looby, A., Beyer, D. L., & Zimmerman, L. (2015). Non-medical prescription stimulant use: Investigating modifiable risk factors. Addiction Research & Theory, 23(2), 143–147. https://doi.org/10.3109/16066359.2014.946411)) Another suggested that college enrollment was a risk factor for stimulant abuse ((Herman-Stahl, M. A., Krebs, C. P., Kroutil, L. A., & Heller, D. C. (2007). Risk and protective factors for methamphetamine use and nonmedical use of prescription stimulants among young adults aged 18 to 25. Addictive Behaviors, 32(5), 1003–1015. https://doi.org/10.1016/j.addbeh.2006.07.010)) in and of itself.

Family History

Experts believe there may also be a genetic component to this diagnosis. In one study, researchers reported that “stimulant drug users with a family history of substance abuse ((Just, A. L., Meng, C., Smith, D. G., Bullmore, E. T., Robbins, T. W., & Ersche, K. D. (2019). Effects of familial risk and stimulant drug use on the anticipation of monetary reward: An fMRI study. Translational Psychiatry, 9(1), 1–12. https://doi.org/10.1038/s41398-019-0399-4)) are eight times more likely to develop an addiction than those without a family history.”

It’s important to remember that substance misuse is complex. While genetics may play a role in addiction, they’re far from the only factor. Adverse life experiences can also be risk factors for any substance use disorder, including stimulant addiction.

Intimate Violence

Researchers have linked stimulant abuse with intimate violence. For example, one report found that women with a recent history of sexual assault have a “significantly higher” risk of stimulant misuse. ((Riley, E. D., Shumway, M., Knight, K. R., Guzman, D., Cohen, J., & Weiser, S. D. (2015). Risk factors for stimulant use among homeless and unstably housed adult women. Drug and Alcohol Dependence, 153, 173–179. https://doi.org/10.1016/j.drugalcdep.2015.05.023)) Experts believe that people who receive trauma-informed care after assault may be at a lower risk of developing addictions. However, more research is required.

If you’ve been sexually assaulted, you can get support from the Rape, Abuse & Incest National Network (RAINN). Call the National Sexual Assault Telephone Hotline at 800.656.4673 to access these services.

Reasons for Recovery

Although everyone’s recovery journey is unique, people struggling with stimulant addiction often have certain experiences in common. Many seek recovery after passing their threshold for living with its consequences. As painful as that moment can be, it also has the potential to be inspiring.

In an anonymous survey of people in recovery, one respondent describes how his stimulant misuse damaged his mental health. ((Spencer, L. P., Addison, M., Alderson, H., McGovern, W., McGovern, R., Kaner, E., & O’Donnell, A. (2021). ‘The drugs did for me what i couldn’t do for myself’: A qualitative exploration of the relationship between mental health and amphetamine-type stimulant (Ats) use. Substance Abuse: Research and Treatment, 15, 117822182110608. https://doi.org/10.1177/11782218211060852)) “I hated myself,” he says, “all that self-loathing and… self-hatred. I thought everybody hated me.” After receiving treatment, he now feels “grateful that I hit that rock bottom and I realized I’d had enough.”

Of course, this experience isn’t universal—rock bottom is not a prerequisite to getting sober. And, you may be vulnerable to relapse even after attending rehab or stimulant misuse. When you do start treatment, your clinical team will help you prepare a treatment plan that guides you through the first stages of recovery and includes considerations for relapse prevention as you re-enter your daily life.

It may seem intimidating now, but the first step is the hardest. And you don’t have to do it alone. There are plenty of dedicated professionals with experience helping people just like you successfully recover from prescription stimulant addiction.

For more information on treatment options including facilities, specialized programming, accreditations and more, see our directory of rehabs that treat prescription drug addiction.

Reviewed by Lisa Misquith

May 5, 2022January 28, 2025

How to Set Boundaries With an Addicted Loved One

It is, in fact, possible to love someone too much. When you care about a person with an addiction, it can be hard to stop yourself from giving. But over time, generosity can become counterproductive. In the very attempt to support them, you may be enabling their unhealthiest behaviors. If what they really need is treatment for a substance use disorder, you both might benefit from a little tough love.

Because addiction begets codependency, it’s crucial for you to set and maintain healthy boundaries. This process might be daunting at first. You may be concerned about being too harsh, especially if your loved one is facing other challenges. But setting boundaries is often the first step toward healing—for yourself, your relationship, and the person you love.

Adding ‘No’ to Your Love Language

Good boundaries are an important part of any dynamic, and they are even more critical when your loved one has a substance use disorder. Although it can be painful to establish ground rules, this process is a vital part of building sustainable relationships, and caring for your own mental health.

Think of healthy boundaries as rules or guidelines for how you want to be treated by the people around you. As therapist and somatics teacher Prentis Hemphill says, “Boundaries are the distance at which I can love you and me simultaneously.” ((Boundaries: Definition, examples & how to set them. (n.d.). The Berkeley Well-Being Institute. Retrieved from https://www.berkeleywellbeing.com/boundaries.html))

It’s up to you to define what behavior you will and will not accept, communicate that to your loved ones, and decide what the consequences will be if you’re mistreated. By protecting yourself, you can also provide better, more sustainable support to a loved one with a substance use disorder. And the act of loving yourself can encourage those around you to set their own boundaries. It may even inspire them to begin recovery.

Defining Your Needs

When you’re ready to start this process, begin by looking inward. It might be helpful to talk to a therapist or trusted friend, or spend time journaling about your feelings. Think about your most deeply held beliefs, your goals for yourself, and your needs in this relationship. Make sure your stated boundaries reflect your core values, without sacrificing your well-being for someone else’s sake.

With the big picture in mind, consider what you need from the other person in order to feel safe. This may seem selfish, especially if you’ve been deprioritizing your own needs for a long time. Try to accept that discomfort as part of the process.

Boundaries can be as simple or as complex as you need them to be. The following examples may help you start thinking about what’s right for you.

I won’t pay your bills or give you money.
I won’t answer the phone if you call after a certain time of night.
I won’t communicate with you while I’m at work or busy with other things.
I won’t drink or take other substances when we’re together.
I won’t spend time with you while you’re drunk or high.
I won’t engage in conversations that idealize substance misuse.
I won’t communicate with you again until you’re in treatment.

These are just examples, and they may not suit your specific situation. Once you’ve determined which boundaries you need to set, you can start thinking about how you’ll respond if they’re crossed.

Establishing Consequences

Boundaries are only meaningful when you’re prepared to maintain them. This can prove difficult over time, especially when challenging situations arise. Do your best to plan in advance how you’ll respond if your loved one crosses a clearly communicated line.

Consequences aren’t necessarily punishments; instead, they’re a way to support yourself through difficult relationship dynamics. For example, you might institute some of the following consequences if a loved one disrespects your boundaries:

If you show up at my home unannounced, I won’t let you in.
If you call or text me while I’m at work, I’ll block your number for 24 hours.
If your behavior puts me in physical danger, I will leave immediately, no matter what we’re doing.
If you arrive later than planned because you’ve been drinking or doing drugs, I won’t spend time with you that day.
If you miss therapy or a support group meeting, I won’t speak to you until after you attend your next session.

Make sure these consequences are clear, firm, and realistic. For example, if a long-distance friend lies to you, you can stop speaking to them. That same consequence wouldn’t work for a roommate or live-in partner. Even if you decide to move out and end the relationship, you’ll have to communicate about logistics. If you can’t follow through on these predefined consequences, your loved one may feel empowered to ignore your needs entirely.

Defining your boundaries is an act of self-care. And once you’ve done that work, it’s time to talk to your loved one. This conversation might be difficult, but it’s the first step toward building a healthier dynamic.

Talking it Through

Clear communication is a necessary part of changing a relationship dynamic. And when your loved one has a substance use disorder, you may not be able to rely on them to start these important conversations.

It’s best to schedule this discussion in advance, so that you’ll both have time to emotionally prepare. If at all possible, approach your loved one when they’re calm and sober. If that’s not possible, don’t delay the conversation indefinitely. You have the right to ask for what you need, whether or not they can give it to you.

This is your opportunity to articulate your boundaries as clearly and effectively as possible. You might even take notes in advance, to help organize your thoughts. You can also discuss why you’re putting these guidelines in place, but you don’t have to. Your needs don’t require justification.

Make sure this conversation focuses on the real reason for this new framework: your love for the other person, and your concern for your mutual well-being. If you didn’t want them in your life at all, you could simply walk away instead of doing this work together. Let them know that you care about them, and that this is how you can keep supporting them without burning out or ending your relationship entirely.

Maintaining Healthy Boundaries

After you’ve explained what your boundaries are, it’s up to you to hold the line. Your loved one may be unwilling or unable to respect your limits, especially if their addiction is severe enough to have lasting cognitive effects. Preliminary research suggests that substance misuse may even interfere with empathy, ((Massey, S. H., Newmark, R. L., & Wakschlag, L. S. (2018). Explicating the role of empathic processes in substance use disorders: A conceptual framework and research agenda. Drug and Alcohol Review, 37(3), 316–332. https://doi.org/10.1111/dar.12548)) making it difficult for people to understand others’ needs.

Be prepared for your loved one to ignore or actively disrespect your stated boundaries. This may happen during the initial conversation, if they try to argue or undermine your reasoning. But even if they seem supportive at first, you may come into conflict in the future.

You can prepare for this eventuality by deciding in advance how you’ll react if your boundaries are challenged. While it’s natural to respond with anger, it’s also ineffective. This opens the door for further argument, and may destabilize both your mental health and your relationship.

The other extreme, passivity, is equally unproductive. By quietly allowing the person to disrespect you, you send the message that your needs are not important. This can encourage them to continue treating you poorly, because their bad behavior has no negative consequences.

By planning ahead, you can guard against either of these outcomes. Set the precedent that you deserve love and support. And whether or not you receive care from them, you can give it to yourself. This framework will not only improve your mental health; it can also improve your relationship. It might even show your loved one a much-needed example of self-care, and motivate them to think about recovery.

The Benefits of Healthy Boundaries

It’s ok to be conflicted about setting boundaries. Many people struggle to balance their own needs with the desire to protect loved ones from negative consequences. Remember that this process, while complex, will ultimately benefit you both. In fact, healthy boundaries can improve many aspects of mental health and relationships.

Cultivating Compassion

You can’t pour from an empty cup. When caring for someone depletes your emotional energy, you become vulnerable to compassion fatigue. ((Are you experiencing compassion fatigue? (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/topics/covid-19/compassion-fatigue)) This condition is similar to burnout, and can make it difficult for you to continue supporting the people you love. While the term is normally used to describe burnout in healthcare professionals, anyone can reach a similar limit. And even if you still want to put your loved one’s needs before your own, you might reach a point where you just can’t care for them any more.

By giving yourself room to breathe and recharge through clear-cut boundaries, you can maintain reserves of energy, patience, and mental bandwidth. This practice empowers you to support your loved one in a more sustainable way.

Working Through Codependency

The concept of codependency ((Stafford, L. L. (2001). Is codependency a meaningful concept? Issues in Mental Health Nursing, 22(3), 273–286. https://doi.org/10.1080/01612840121607)) was originally developed to describe maladaptive behaviors of people married to patients with alcohol use disorder (AUD). In recent years, the subject has become controversial. Some researchers believe that this condition is too vague to be clinically meaningful. Nevertheless, many people continue to find help and support by exploring their own codependent tendencies.

According to the American Psychological Association, codependency is “a dysfunctional relationship pattern ((Apa dictionary of psychology. (n.d.). Retrieved from https://dictionary.apa.org/)) in which an individual is psychologically dependent on (or controlled by) a person who has a pathological addiction.” This pattern may present itself in some counterintuitive ways. For example, a codependent person may attempt to control the behavior of their loved ones, without realizing their own actions are causing harm.

Despite common misconceptions, it’s important to note that relationships are not codependent; people are. By uncoupling your identity from your loved one’s identity—and their substance misuse—you can begin to define the boundaries that will protect your energy and mental health.

Turning to Tough Love

If you love someone with a substance use disorder, you may be concerned about their overindulgence. It’s also possible to overindulge in love. And sometimes, the best way to care for someone is by stepping back, and letting them make their own decisions. As much as you might want to help, you can’t go through recovery for them.

Establishing boundaries doesn’t have to mean cutting ties or refusing to help—although it can, if that’s what you need. However, you may be able to rebalance your relationship, providing support from a healthy distance that respects your needs as well as theirs.

To learn more about the recovery process, you can connect with a rehab center to find a good match for your loved one’s recovery journey.

Reviewed by Rajnandini Rathod