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Substance Abuse in Nursing: Recognizing the Signs and Finding Help

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

Understanding Substance Abuse in Nursing

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

Whys Some Nurses Develop Substance Use Disorders

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

Certain factors increase the risk of addiction among nurses:

Stress and Burnout Among Healthcare Professionals

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

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

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

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

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

Mental Health and Emotional Strain

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

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

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

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

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

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

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

How Common Is Substance Abuse in Nursing?

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

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

Increased Access to Medications 

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

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

Signs and Symptoms of Substance Abuse in Nursing Professionals

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

Many nurses show behavioral changes as their addiction develops:16

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

You might also notice physical symptoms:17

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

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

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

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

What Happens When a Nurse Develops a Substance Use Disorder?

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

Patient Care From Nurses Experiencing Addiction

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

Addiction Stigma in the Healthcare Industry

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

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

Barriers to Treatment for Nurses With Addictions

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

Nurses also face other barriers to drug and alcohol treatment:

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

Resources for Nurses Seeking Help With Substance Abuse

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

Alternative to Discipline (ATD) Programs 

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

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

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

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

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

Employee Assistance Programs (EAPs)

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

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

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

Peer Support Groups for Nurses

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

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

Residential and Outpatient Rehab Programs for Nurses

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

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

Learn more about getting time off for addiction treatment here.

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

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

Frequently Asked Questions About Substance Abuse in Nursing

What are the risk factors for substance abuse among nurses?

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

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

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

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

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

Homelessness and addiction are related. Despite this relationship, the correlation is not a certainty. But many think they are, so myths and speculations abound: 

Myth 1: “All homeless are addicts. They just need to stop using and things will get better.”

Myth 2: “Addicts always become homeless. It’s their fault.”

Myth 3: “Homeless people are violent because they’re always on drugs.”

Research, time, and empathy have proven both statements (and related ones) wrong. But homelessness and substance abuse do connect in some ways.

The 2 have a bidirectional relationship1—they can both feed into each other. Rehabs for drug and alcohol addiction can sometimes help with both issues at once, but usually, homeless people rely on shelters and specific resources for their population2. 

Homelessness and Addiction Statistics

A 2022 study by Statista found that roughly 55,000 unsheltered homeless people experience addiction3. In other studies, a third of addiction treatment patients say they’ve experienced homelessness1. And, 

Looking at the numbers, you can see addiction and homelessness connect. Addiction isn’t always the cause, but it definitely can be—and vice versa. 

How Does Addiction Lead to Homelessness?

Addiction doesn’t exclusively lead to homelessness, but it can cause it. Economic statuses, marital statuses, family relationships, and social-economic factors can all make addiction a cause of homelessness.

As an example, someone making minimum or median income would feel the financial effects of addiction almost immediately. As their limited income depletes, paying rent gets harder. 

For additional context, street prices of illicit and prescribed drugs average out to $356 per gram6. The price can be as high as $500 for heroin. An average 24-pack of beer costs around $17. 

Addiction isn’t cheap.

Many homeless adults don’t have the option of staying with family when they can’t afford rent. Their loved ones may have cut them off, moved away, or passed on. Their only viable option could be living in a shelter or on the street.

…And Does Homelessness and Drug Use Lead to Addiction?

It can. Some homeless people use opioids, weed, alcohol, and other substances to cope with the trauma of becoming homeless5. Others do it to fit in with the community. 

Homeless people may also start using substances to stay awake, sleep, or stay energized when they’re malnourished. Drug addiction can become a crutch for living homeless that takes up the funds, time, and energy they could otherwise use to get help. Homeless people might also run into legal trouble and tarnish a clean record.

And even though help exists, it’s not always easy for this population to get it.

Understanding The Challenges And Seeking Help

Whatever the cause may be of addiction and homelessness, getting help has its challenges. A lack of money, support, and knowledge leaves many thinking there’s no way out.

But there is. 

Barrier #1: Shelter And Safety

Getting help for addiction might not seem like a top priority if you don’t have somewhere safe to stay. You might be more concerned with getting cover, keeping yourself safe from others, and keeping yourself out of trouble. You likely wouldn’t have much time or mental energy to focus on treatment. 

Not all homeless people have access to shelter, even temporary overnight lodging. If they do find shelter, it’s rarely long term. 

Having a home base, even if it’s a temporary living situation in a shelter, can help your fight-or-flight mode ease down. Then, thinking about help and taking the next steps might not seem so unfeasible. 

Barrier #2: No Social Support Network

Many homeless adults don’t have anyone to help them help themselves. They don’t have anyone cheering them on. Getting help rests almost entirely on their shoulders, which can be overwhelming. 

And, if addiction is the norm in your community, you might lose what little social support you have if you stop. This could be the case for many homeless people. Even when they want to stop, change their lives, and get help, they might feel pressured to keep using. 

Barrier #3: Mental Illness And The Effects of Addiction

Mental illnesses like schizophrenia, bipolar disorder, depression, and PTSD can prevent homeless individuals from wanting–and getting–help. Treatment for these conditions may also be difficult to maintain. Homeless people might miss treatment sessions, have to relocate, or feel unable to add repeated treatment to their lifestyle. These factors can make healthcare providers less willing to work with the homeless population1. 

Active addiction could also make getting short and long-term help difficult.

The symptoms and effects of addiction can mirror some mental illnesses, like schizophrenia. Some drugs, like lysergic acid diethylamide (LSD) and opioids7, can cause psychosis. Many substances, including alcohol and weed, put you in an altered state of mind. This can make decisions difficult, even important ones about your health and wellbeing.

But for each barrier to treatment, even if they seem insurmountable, you have opportunities to reach them. Help awaits.

Find Support for Homelessness and Addiction

Homelessness and drug addiction don’t have to be your story. 

You can begin your recovery journey by finding shelter, if you’re living unsheltered. Some shelters take in men only or women only, while others welcome all genders. Others specifically welcome teens and runaways. Here’s a few options to consider:  

While shelters offering treatment options for substance use disorders (SUDs) aren’t as common as regular homeless shelters, they do exist across America. Most of these SUD-specific shelters provide medication-assisted treatment8 (MAT) for opioid use to combat the growing opioid epidemic. They also provide encouragement, hope, and can lower the mortality rates of addiction and overdose.
You can also find treatment in a residential rehab center as your journey continues. To see rehabs that treat drug and alcohol addiction, you can browse our list of centers with pricing, reviews, photos, and insurance.

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Group Therapy in Rehab: How It Works and Why It Matters

Addiction isolates you from other people. In a rehab program with group therapy, you can learn how to reconnect. This treatment invites you to build strong relationships with your peers. It also teaches valuable interpersonal skills that can help you navigate every stage of recovery.

What Is Group Therapy?

Group therapy brings together 6-12 patients for regular sessions, guided by at least one therapist. You might meet weekly, twice a week, or even daily. The exact frequency depends on your program.

In a rehab setting, this treatment helps you connect to other patients. Since you’ll likely be around the same people for 28+ days, it’s important to feel comfortable with them. Group therapy facilitates these relationships and aids in your recovery.

Most group therapy techniques come from styles of one-on-one therapy. Group therapists often use evidence-based practices like cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and motivational interviewing techniques.

Types of Group Therapy

Groups often focus on a specific topic. You might learn anger management skills in one group, and talk about family dynamics in another. Some groups also hold space for clients with specific identities. For example, rehabs might offer a women’s group, a veterans’ group, or a group for young people.

Groups will likely be based on one of several group therapy models commonly used in addiction treatment:

  • Psychoeducational groups to teach patients about addiction and related behaviors
  • Skills development groups to teach healthy coping skills
  • Cognitive-behavioral groups, which focus on making behavioral changes
  • Support groups to provide patients with emotional support as they experience the joys and challenges of recovery
  • Interpersonal process groups, in which therapists leverage group dynamics to help patients identify and change their patterns
  • Relapse prevention groups, where patients learn strategies for avoiding relapse

Your specific group could be open or closed. In open groups, people come and go as they enter and leave rehab. Closed groups only accept patients on certain dates, keeping the same set of people together until treatment ends.

paradigm teen and young adults treatment patients
At Paradigm Teen & Young Adults Treatment in Malibu, California, “peer community is a crucial aspect of recovery and healing.”

Group Therapy for Addiction

During rehab, you and your group will learn practical skills to support addiction recovery. These might include stress management and relapse prevention strategies. You’ll also learn how to identify common triggers. You might even role play triggering scenarios together, so you can practice ways to respond.

Depending on the group, you might also talk about your personal history of addiction. Sharing your story can be extremely validating, since your peers can offer unique insight into what you’ve been through. And by supporting them in return, you might even develop compassion for yourself.

What Happens in Group Therapy?

In most group therapy sessions, you’ll sit in a private room with your peers and your counselor. During the first session, you’ll probably make introductions. You might talk about yourself, get to know the other members, or learn some basic ground rules. Your therapist will also describe the group’s overarching goals.

Going forward, your conversations will probably follow a similar format in each meeting. That exact format varies between groups. You could go around the circle and check in, or reflect on what’s happened since your last session. Or, your therapist might teach you certain skills, almost like you’re taking a class. Many groups also have time for open discussions, so you can connect directly with your peers.

Sessions might last anywhere from 30-90 minutes. Some rehabs offer short but frequent groups, while others have longer sessions. In most programs, you’ll attend these meetings in addition to 1:1 therapy and complementary treatments, like art or music therapy.

A Safe Space to Make Mistakes

Group therapy is a dynamic experience. Your healing process can be an example for the people around you, and vice versa. In this context, you’re not the only person who can learn from your mistakes. So even emotional setbacks can be hugely valuable.

Because group therapy occurs in a protected space, you can try new behaviors on for size without fear of judgment. Programs like All Points North Lodge, for example, encourage patients to “practice these skills in a supportive environment with clinician guidance.”  So your therapist might comment directly on your interactions with the group. Their feedback can empower you to grow, both personally and in relation to your peers.

The Role of a Group Therapist

In a rehab setting, group therapists understand the nuances of addiction treatment. Think of them as a guide. They’ll facilitate conversations and teach you practical skills. But they’ll also allow the group to communicate organically—while making sure each conversation stays respectful and on topic. Your therapist will give everyone a chance to be heard, and encourage you to support each other as equals.

all points north lodge patients
At All Points North Lodge in Vail Valley, Colorado, patients use group sessions to practice new skills “in a supportive environment with clinician guidance.”

The Benefits of Group Therapy

The unique lessons of group therapy can be an important part of recovery.

Interpersonal Skills

As one researcher notes, “people are fundamentally relational creatures.” Connecting with peers in therapy lets you practice building healthy relationships. And relationships can inspire emotional growth. That’s true in both individual friendships and more complex communities.

For example, connecting with a group can break down the stigma of addiction.  It’s powerful to watch other people grapple with the same issues you’re facing. And by sharing mutual support, you can become a part of something greater than yourself.

Treatment for Co-Occurring Disorders

Addiction often co-occurs with other mental health issues. So if you’re healing from more than one diagnosis, you might attend rehab for co-occurring disorders. For example, some programs treat patients with both addiction and depression, or addiction and post-traumatic stress disorder (PTSD).

In these programs, group therapy treats more than addiction. It might also address your other symptoms. And healing alongside people with similar diagnoses can help you commit to recovery.

Positive Peer Pressure

Peer pressure isn’t always a bad thing. Sometimes it can even be helpful. In group therapy, you’ll spend time with other patients who share similar goals. And connecting with them can encourage you to abstain from drug use.

Your group can also hold you accountable. If they know you well, they’ll be able to catch warning signs you might miss in your own behavior. And you can do the same for them. With each other’s support, all of you can keep moving toward your goals.

Support for Teens in Recovery

The social aspect of group therapy is particularly helpful for teens and young adults. According to experts at Paradigm Teen & Young Adults Treatment, mental health issues and addiction can distance teens from their peers. Because of this, the “willingness, openness, and courage to actively re-engage in their peer community is a crucial aspect of recovery and healing.”

Group therapy teaches teens how to be vulnerable. And opening up to each other in session can help you build friendships outside of therapy. This skill is valuable at any age, and in any phase of recovery.

Limitations of Group Therapy

This treatment doesn’t work for everyone. For some clients, it can even be counterproductive.

Certain diagnoses make individual treatment more effective. Some trauma survivors, for example, might not feel comfortable sharing their experience in a group. And patients in active psychosis may struggle to communicate in this setting. So people in treatment for schizophrenia and addiction might benefit more from 1:1 therapy than group sessions.

No matter what your symptoms are, group therapy still might not be a good fit. For instance, many high-profile clients prefer the privacy of 1:1 treatment. While group therapy offers social support, it blurs the lines of confidentiality. If you’re concerned about your story getting out, you might have a hard time engaging in this treatment.

Working Toward Recovery as a Team

Recovery is a deeply personal process. But it doesn’t happen in a vacuum. During treatment, you can start to redefine what you want out of relationships. Group therapy invites you to do that in practice. By connecting with your peers in rehab, you can prepare to build a new community after rehab.

Explore rehab programs with group therapy to compare pricing, amenities, customer ratings, and more.

Reviewed by Rajnandini Rathod

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Growing Past Addiction With Horticulture Therapy

Gardening can be more than a relaxing pastime. It also has clear mental health benefits—and it even supports addiction recovery. Rehabs with horticultural therapy help patients get grounded, literally. This treatment can inspire an appreciation for nature, give you a new hobby, and help you get to know yourself again. 

What Is Horticultural Therapy (HT)?

In horticultural therapy, a therapist guides you through nature-based activities.1 That could mean gardening, weeding, or just spending time outside. You might even learn how to cook the food you grow.

Horticultural therapy looks different for everyone. In some programs, you’ll tend to a small window box of herbs. Others, like Mountainside Treatment Center, have more outdoor space for clients to explore. 

mountainside treatment center campus
Mountainside Treatment Center in Cannan, Connecticut has plenty of outdoor space for clients to explore.

What to Expect in HT, Whether Your Garden’s Big or Small

Specially trained therapists facilitate HT2 in rehab. You might see them one on one, or meet with a group of your peers. Treatment takes place in a natural setting, like a greenhouse, outdoor garden, or vegetable patch. In any of these places, you’ll learn about gardening and what different plants need to survive. Then, you’ll put it into practice. 

Like most complementary therapies, HT also invites you to process your feelings. You might talk while you’re watering, or check in after you finish weeding for the day. Specifically, gardening teaches patients to be mindful.3 This skill is hugely important during addiction recovery.

How Can Gardening Help With Addiction?

Plants don’t judge you.4 They don’t know if you have an addiction or any other diagnosis. The way you treat them is the only thing that matters. And what’s more, they depend on you for care. You’ll learn how to show up for them every day, doing your best even if you feel your worst. And that skill can help you commit to every phase of addiction recovery. 

Experts at Enlightened Recovery, a rehab focused on sustainability, believe that gardening echoes the cycle of recovery.5 They explain:

“This lesson that all things must grow, live, perish, and in turn be put back into the land is a part of our holistic outlook on recovery and living.” 

In their program, gardening becomes a metaphor for your personal growth. The act of starting rehab can be a challenge, even before you begin treatment. HT reminds patients that letting go of the past is empowering. And what comes next can be beautiful.

enlightened solutions garden
Enlightened Recovery in Egg Harbor City, New Jersey shows clients how gardening echoes the cycles of recovery.

The Benefits of HT in Rehab

Rehabs around the world use horticultural therapy to treat mental health issues, including addiction. And even after treatment, the benefits of gardening can support your ongoing recovery. 

Treatment for Co-Occurring Disorders

Horticultural therapy helps people heal from more than one diagnosis at a time. If you’re recovering from addiction and a co-occurring disorder, this treatment might be a great fit. Gardening is especially helpful for patients with certain mental health issues,6 like depression and anxiety. 

Stress Relief

Stress raises your risk of addiction.7 So throughout recovery, it’s important to engage in calming activities. And data shows that horticultural therapy relieves stress.8 Having regular access to plants—either indoors or outdoors—can greatly improve your mental health.

summit malibu campus
Summit Malibu in California teaches clients how to cook with veggies they harvest themselves.

Nutrition

Scientists believe that growing the food you eat may have physical health benefits.9 And in rehabs like Summit Malibu, it’s easy to see why. After coming in from the garden, patients here learn how to cook with their own harvest. This process can help you reconnect to your own body, and find joy in healthy hobbies. It can also teach you about the importance of nutrition during recovery. 

“Everything you do in the garden is an act of love.”

Gardening lets patients connect to nature. Every day you can see, feel, and even taste your own impact on the world around you. At rehabs like Mountainside Treatment Center, that perspective is crucial. Sheree Surdam, overseer of their horticultural therapy program,10 explains why.

Gardening gives “people a sense of purpose and stewardship over the natural world,” she says. “Everything you do in the garden is an act of love.”

Root Yourself in Recovery

A healthy plant is tangible. When you smell a rose you grew, you’re breathing in joy of your own hard work. And by learning to nurture your garden, you can learn to nurture yourself. 


Compare rehabs with horticultural therapy to find the right program for you.

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Recover Your Sense of Self With Individual Therapy

Individual therapy puts you at the center of treatment. And in a rehab with 1:1 therapy, you’ll connect with your own deepest goals and values. Those ideals become guideposts, leading you toward the next chapter of your life. This process can empower you to make recovery your own.

What Is Individual Therapy?

Individual therapy, or 1:1 therapy, includes you and your therapist—no one else. These private conversations are a crucial part of most rehab programs. Your therapist might function almost like an advisor, supporting you as you navigate the rest of the program. Usually, they’ll also play a major role in designing your plan of care.

During rehab, you might meet with your therapist several times a week. You may also see them in other settings. For example, your 1:1 therapist might lead a weekly group session as well. If you’re just going to therapy, and not attending a larger program, it looks a little different. In that case, it’s most common to see your therapist once a week, for about an hour at a time.

Individual Therapy for Addiction Treatment

You can find individual therapy in most residential rehabs. Experts agree that it’s “the most useful form of treatment for substance use disorders.” It can help with almost every aspect of recovery, including complex mental health symptoms. Your therapist can also help you work toward specific goals, like abstinence.

Individual Therapy for Mental Health

1:1 therapy isn’t just for addiction. It can also treat most mental health conditions. At first, your therapist will help you identify goals for treatment. Depending on your needs, these might be very specific or more general. You can go to therapy because you’re feeling a little stressed, or because you want to decrease how many panic attacks you have per day. No matter why you start treatment, your counselor will likely teach you new coping skills, help you process your past, and empower you to move forward.

Types of 1:1 Counseling

There are many different types of individual therapy. Depending on your personal history, one or more of these methods may work well for you. And during rehab, you may even try a few different approaches.

Acceptance and Commitment Therapy (ACT)

In ACT (pronounced like the word “act”) you’ll learn that fighting against a feeling can actually make it stronger. With that in mind, ACT teaches you to accept strong feelings as they come. Mindfulness and self-compassion help patients tolerate triggers instead of acting on them.

ACT also helps you identify your values. In one of your first sessions, your therapist will likely help you take an inventory of your own highest ideals. You can return to that inventory throughout treatment, and after rehab. While your values may change over time, it’s almost always helpful to know what they are. That way, you can build a life that honors them.

Cognitive Behavioral Therapy (CBT)

CBT can be a vital part of addiction treatment. This 1:1 therapy teaches you to modify your thought and behavioral patterns. You’ll also learn practical coping skills, which can help you process even the most difficult feelings.

Addiction often starts as a coping mechanism. And when you’re triggered, you might run the risk of relapse. CBT skills offer an alternative. Instead of taking drugs, you might say a mantra you learned in therapy, go for a run, or text a friend. Over time, these new responses start to feel natural.

In a session, your therapist will prompt you to confront your thoughts head-on. Then, you’ll learn to distinguish between thoughts, feelings, and facts. For example, you might feel like you’re going to relapse after you leave rehab. But that’s just a feeling. And in reality, you have the power to make a different choice.

Narrative Therapy

Narrative therapy offers you a fresh perspective on your personal history. Your therapist will encourage you to think of it as a story, with a narrative arc and ongoing themes. Then, they’ll establish you as the author of your own life.

This treatment helps clients understand the nuances of their own mental health. For example, imagine getting over a breakup. Painful though it is to be newly single, you can learn a lot in that process. Narrative therapy helps you deconstruct old patterns and start rebuilding yourself.

Eye Movement Desensitization and Reprocessing (EMDR)

In EMDR, you’ll focus on gentle stimuli as you work through past trauma. For example, you might look at a light as it moves back and forth. Or you might rub your arms while you describe a memory. These cues help you process the strong feelings associated with what you’ve been through. And over time, those feelings will subside. As a result, EMDR helps you grow less sensitive to triggers.

Addiction itself is traumatic. And sometimes, fears of a relapse can feel debilitating. EMDR is commonly used for trauma, but it can be just as effective for the memories and fears linked to addiction.

Benefits of Individual Therapy

Meeting with a clinician in private can make it easier for you to feel safe. But it’s not just about how you feel. Individual therapy also has some unique practical advantages.

Confidentiality

In a 1:1 therapy, you’ll talk to your therapist alone. And for the most part, your conversations are private. There are some exceptions to this, of course. In residential rehab, they may share information with other clinicians on your treatment team. And if you make certain threats, or describe ongoing abuse, they might be obligated to report it. Your therapist can tell you exactly what information they would have to report.

If you’re over the age of 18, your therapist won’t share private information with your family, your friends, or other patients without your consent. So you can trust that your conversations will stay private. This helps many clients feel safe enough to explore vulnerable topics during treatment.

A Close Therapeutic Relationship

This type of therapy invites you to build a strong relationship with your clinician. And data shows that the therapeutic relationship directly affects the success of addiction treatment.

It’s natural to feel safer around people you trust. That’s true in almost any situation. Walking through the woods at night is a little easier when you’re with a friend. And exploring the depths of your psyche can be less daunting when you trust your therapist.

Your bond can also get stronger over time. In every session, you and your therapist will get to know each other a little better. That makes it easier to share more personal information, so you can tackle even deeper issues. And the resulting connection you feel with your individual therapist can make rehab even more effective.

Forging Your Own Path Toward Recovery

Above all, 1:1 therapy teaches you about yourself. Working through past issues can help you build resilience. And in turn, you’ll gain self-confidence in your own ability to heal. This commitment to recovery can inspire you to keep growing, no matter what happens after treatment.

Explore rehabs with individual therapy to see their locations, reviews, insurance options, and more.

Reviewed by Rajnandini Rathod

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The Complex Relationship Between Addiction and Depression

Depression can be either a cause or symptom of addiction. Some people try to self-medicate their symptoms, which leads to addiction. Others get depressed because of their substance use. But there’s a reason these 2 conditions appear together so often. If you have signs of both, you might need specialized treatment at a rehab for depression and addiction.

Common Causes of Depression and Addiction

Depression and addiction often occur at the same time. And in fact, having depression doubles your chance of developing addiction. But the link goes both ways. Taking drugs can also cause depressive symptoms.

What’s more, these 2 diagnoses have overlapping causes. The same factors that put you at risk for depression can also make you vulnerable to drug abuse:

Addiction and depression cause similar brain activity. And acute symptoms activate the same neural pathways over and over again. If you have depression, that happens during a depressive episode. With addiction, it happens when you take drugs. Both conditions make those pathways more and more sensitive over time. So without proper treatment, either one will continue getting worse. And, you’ll become even more vulnerable to the other.

Getting the Right Diagnosis

To get the right type of treatment, you first need an accurate diagnosis. And that can be more complex than it sounds. For example, if your depression is the result of drug use, your recovery will need to include addiction treatment.

Depression can co-occur with a wide variety of health issues. These can include mental health conditions, like anxiety, and even physical ones. For example, diabetes is linked to depression. And sometimes it’s just a symptom of a more complex diagnosis.

Depression as a Symptom of Bipolar Disorder

Bipolar disorder is a mood disorder that occurs in over 50% of people with addiction. People with this condition experience periods of depression interspersed with mania. And because it’s a primary symptom, bipolar is often misdiagnosed as major depression.

If you get the wrong diagnosis, it can interfere with your recovery. And it doesn’t just delay your progress—it can also make your symptoms worse.  For a person with bipolar, antidepressants can trigger manic episodes. They can also cause intense swings between mania and depression, called rapid cycling.

Addiction can exacerbate your mood disorder symptoms. That’s true whether you have bipolar disorder, major depression, or something else. If you’re healing from both addiction and any other mental health issue, you might consider going to rehab for co-occurring disorders.

Treatments for Depression and Addiction

Depression and addiction are receptive to similar types of treatment. That means you can heal from both simultaneously. You might even find that focusing on one condition helps you heal from the other. For example, data shows that most depressive symptoms resolve during addiction treatment. But that’s not true for everyone.

When you enter recovery, you might not know which condition came first. But you can work with your care team to answer that question. If your depressive symptoms fade after detox, you might just focus on healing from addiction. But if you do have clinical depression, there are several ways to approach treatment.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) teaches patients to cope with difficult thoughts. You’ll learn practical skills that help you live with and regulate even the most intense emotions.

CBT treats depression and addiction by helping people build self-confidence. And data shows that it has lasting effects, supporting your long-term recovery. You can also combine this therapy with other types of treatment, like medication.

Medication for Depression

Depending on your physical health, your care team may recommend prescribed medication. For example, it’s common to treat depression with selective serotonin reuptake inhibitors (SSRIs), like Prozac or Zoloft. Preliminary data shows that SSRIs may also support addiction recovery. Specifically, they might help people quit smoking or heal from sex addiction.

SSRIs typically take full effect after 6 weeks. And while they’re a common treatment for depression, they aren’t right for everyone. You may need to try a few medications before you find the right fit. Or, if you have treatment-resistant depression, you might need to take a different approach.

Alternative Treatments

If traditional therapy and medication aren’t working for you, there are many other ways to treat depression. Some of these methods are experimental, while others are highly researched but less well known.

These alternative treatments aren’t replacements for traditional medical care. But you can combine them with other therapies, or even attend a holistic rehab program. There’s no right or wrong way to plan your recovery—just the way that works best for you.

Clearing the Clouds

Depression and addiction have so much in common, it can be hard to tell which one has the greater impact on your life. But there’s a silver lining to their overlapping symptoms. With the right treatment, recovery can be straightforward. In the long term, you can use the same coping skills to manage any ongoing symptoms. But most importantly, healing means learning about the complex relationship between these conditions. And doing that will teach you more and more about yourself.

Browse rehab centers that treat depression to learn about their amenities, photos, and reviews.

Reviewed by Rajnandini Rathod

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How Long Does Rehab Last?

The short answer is: it depends. Many factors influence the length of your stay in residential rehab. You can plan around some of these in advance. For example, your insurance might only pay for certain types of care, but other issues may arise while you’re in treatment. Ultimately, you’ll work with a team of experts to come up with a plan. And by following it, you can move toward your personal recovery goals.

How Long Is Rehab for Addiction?

Different types of rehab last for different amounts of time. Some programs—like initial detox—might last only a few days to a week. Others can go on for months or even years. And according to the National Institute on Drug Abuse (NIDA), “good outcomes are contingent on adequate treatment length.” ((Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). (2014). National Institute on Drug Abuse. https://nida.nih.gov/sites/default/files/podat-3rdEd-508.pdf)) NIDA recommends at least 90 days of treatment for most patients.

As you prepare for rehab, consider which types of treatment are right for you. But remember that your plan may change after you start recovery. It’s important to stay present with yourself, so you can meet your evolving needs.

Detox

Medical detox from addiction ((Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.)) usually lasts 10 days or less. If you detox in an inpatient setting, a care team will help you navigate the process. You may receive prescription medications, attend therapy, or get other medical treatment during withdrawal.

If your symptoms are more severe, your stay might last longer. That’s especially likely if you’re detoxing from certain substances. Withdrawal from alcohol, ((Kattimani, S., & Bharadwaj, B. (2013). Clinical management of alcohol withdrawal: A systematic review. Industrial Psychiatry Journal, 22(2), 100. https://doi.org/10.4103/0972-6748.132914)) benzodiazepines, ((Pétursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction (Abingdon, England), 89(11), 1455–1459. https://doi.org/10.1111/j.1360-0443.1994.tb03743.x)) and opioids ((Yes, people can die from opiate withdrawal | NDARC – National Drug and Alcohol Research Centre. (n.d.). Retrieved October 14, 2022, from https://ndarc.med.unsw.edu.au/blog/yes-people-can-die-opiate-withdrawal)) is especially risky. It’s essential to get medical attention when you start recovery from any of these substances.

Detox is often the first step in recovery—but it’s not the last. Some programs even require you to have a plan for longer-term recovery before you start treatment.

Inpatient Treatment

In one review of inpatient addiction treatment options, ((Reif, S., George, P., Braude, L., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Residential treatment for individuals with substance use disorders: Assessing the evidence. Psychiatric Services, 65(3), 301–312. https://doi.org/10.1176/appi.ps.201300242)) researchers found that “most planned stays now range from weeks to months, depending on the program and the person’s needs.” Most addiction rehab programs last at least one month, ((Center for Substance Abuse Treatment. What Is Substance Abuse Treatment? A Booklet for Families. HHS Publication No. (SMA) 14-4126. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2004.)) and some can last as long as 1 year.

Several issues can affect your total length of stay in rehab. If you want to plan ahead, you can start by answering these questions for yourself. Then, share your thoughts with your care team. They’ll help you make a plan that accounts for your current health status, and your long-term goals.

  • What is your physical health status? Do you need close medical supervision?
  • Are you recovering from any co-occurring disorders, along with addiction?
  • Do you have any ongoing legal obligations? For example, are you required to complete rehab in order to fulfill a court order?
  • What types of addiction treatment does your insurance cover?
  • What are your plans for aftercare?

Healing isn’t linear, and your answers to these questions will probably change over time. But with the right support, you can stay on track before, during, and after inpatient treatment.

Outpatient Treatment

There are several types of addiction treatment programs. Whether or not you attend inpatient rehab, you can also consider outpatient recovery. For example, you could attend a partial hospitalization program (PHP), or an intensive outpatient program (IOP). In either of these, you would live off-site, and travel to the center for therapy. In a PHP, patients attend up to 30+ hours of treatment per week. IOPs offer more flexibility, with an average of 10-15 weekly hours.

Outpatient programs can work well if you’re in good physical health, but still need support during recovery. And if your insurance won’t cover residential treatment, it may still pay for an IOP or PHP. You can also get outpatient aftercare once you finish inpatient rehab. Outpatient addiction treatment ((Center for Substance Abuse Treatment. What Is Substance Abuse Treatment? A Booklet for Families. HHS Publication No. (SMA) 14-4126. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2004.)) typically lasts somewhere between 2 months and 1 year. If you’re healing from a dual diagnosis, like co-occurring addiction and depression, that may also affect your recovery timeline.

How Long Is Rehab for Other Mental Health Issues?

Rehab isn’t just for addiction. You can also get inpatient treatment for diagnoses like anxiety and depression. There are even rehab programs that treat grief. It’s harder to predict the appropriate length of stay for these conditions, since recovery means something different for every patient.

Your treatment plan will depend on your exact symptoms. And with the help of your rehab’s admissions team, you might be able to predict how long you’ll need to stay in treatment. For example, rehab for depression normally lasts for a few weeks. But if you need more support, it can continue for a matter of months.

How Long Will Insurance Pay for Inpatient Treatment?

Most insurance plans will cover at least 60 days of inpatient rehab, ((Mojtabai, R., Mauro, C., Wall, M. M., Barry, C. L., & Olfson, M. (2020). Private health insurance coverage of drug use disorder treatment: 2005–2018. PLOS ONE, 15(10), e0240298. https://doi.org/10.1371/journal.pone.0240298)) for both addiction and mental health treatment. But every insurer is different, and it may depend on your specific plan. Make sure to confirm the details with your insurance provider before you start treatment. The admissions team at your rehab should also be able answer your questions about pricing.

Learn more about the costs of rehab and how to make sure your insurance covers treatment.

Medicare

If you have Medicare, it may limit which rehab centers you can attend. ((Inpatient rehabilitation care coverage. (n.d.). Retrieved October 14, 2022, from https://www.medicare.gov/coverage/inpatient-rehabilitation-care)) Before you commit to a program, make sure it’s covered by your specific insurance plan. You’ll also need your doctor to confirm that it’s medically necessary for you to attend rehab. If you satisfy these criteria, Medicare will cover 60 full days of inpatient treatment after you meet your deductible.

Private Insurance

In the U.S., most private insurers cover rehab for addiction. ((Abraham, A. J., Andrews, C. M., Grogan, C. M., D’Aunno, T., Humphreys, K. N., Pollack, H. A., & Friedmann, P. D. (2017). The affordable care act transformation of substance use disorder treatment. American Journal of Public Health, 107(1), 31–32. https://doi.org/10.2105/AJPH.2016.303558)) But that’s not universally true. And, there are often strict limitations on how long private insurance will pay for treatment. ((Gerstein, D. R., & Harwood, H. J. (1990). Private coverage. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK235505/)) This varies between different providers, and different insurance plans. Contact your insurance directly to learn more about your options. You can also ask the admissions team at your rehab for assistance. By planning ahead, you’ll avoid unpleasant surprises after you complete treatment. With that peace of mind, you can focus on what matters most: your continued recovery.

How Long Does Addiction Recovery Take?

Many experts believe “recovery from addiction is a lifelong process.” ((Laudet, A. B., Savage, R., & Mahmood, D. (2002). Pathways to long-term recovery: A preliminary investigation. Journal of Psychoactive Drugs, 34(3), 305–311. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852519/)) Because this condition has both psychological and physical components, healing isn’t easy. And the process is different for everyone.

It might be complex, but addiction is highly treatable. ((Abuse, National Institute on Drug. “Treatment and Recovery.” National Institute on Drug Abuse, –, https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery.)) And as you heal, you’ll start to define what recovery means, ((Laudet, A. B. (2007). What does recovery mean to you? Lessons from the recovery experience for research and practice. Journal of Substance Abuse Treatment, 33(3), 243–256. https://doi.org/10.1016/j.jsat.2007.04.014)) on your own terms. For you, success might mean total sobriety from all substances. Or, it might mean that you no longer drink, but you still smoke cigarettes. There’s no wrong answer here. You don’t need to fit into anyone else’s box. The goal is to build a rich, meaningful life that makes you healthy and happy.

Connect with a residential rehab facility directly to learn about their typical treatment timelines, facilities, and programming.

Reviewed by Rajnandini Rathod

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Learning True Strength in Men-Only Rehab 

Men face a unique set of challenges that affect the types of mental health issues they have, their likelihood of seeking help, and their experience in treatment once they do. Thankfully, more rehabs are specializing in care for men, addressing male-specific struggles in a safe and supportive setting.  

Mental Health Challenges Facing Men Today

Growing up in a culture with specific expectations about what it means to “be a man” shapes male psychological development. This impacts the types of mental health issues men have, and the methods they use to cope:  

Because it can be harder for men to voice their problems, this suffering often happens in silence. Men’s mental health researcher Benita Chatmon, PhD says this raises concern: “These statistics are troubling because they reinforce the notion that males are less likely to seek help and more likely than women to turn to dangerous, unhealthy behaviors.”

A Note on Gender

In the past, gender has been thought of as being either male or female, but we now understand it to be far more nuanced. Those who aren’t cisgendered men may still be affected by cultural expectations of masculinity. And those who don’t see gender as a major factor in their experience may not find gender-specific treatment necessary. Ultimately, it’s up to you to decide which aspects of your care are most important.

sobermans estate mens group
Soberman’s Estate in Cave Creek, Arizona offers daily group therapy and equine therapy as part of their men-only treatment program.

Masculine Norms

“Men are subjected to a culture where the standards of masculinity are literally killing them,” says Chatmon. 

This happens through what men’s mental health activist Dan Griffin calls the “internalization of the ‘man rules.”4 Sometimes called “toxic masculinity,” this set of rules tells men how they’re supposed to behave:

  • Don’t show weakness. 
  • Don’t express your emotions. 
  • Don’t cry. 
  • Don’t admit that you’re afraid. 
  • Don’t lose control.
  • Don’t ask for help. 

Unfortunately, following these rules leads many men to struggles with depression, anxiety, stress, and substance abuse. And, it cuts them off from support when they need it most. 

“When men adhere rigidly to the kinds of norms that encourage them to not share their emotions, to be sort of relentlessly self-reliant without seeking the help or support of others, they can have poorer mental health outcomes,” says health behavior professor and men’s mental health expert Wizdom Powell, PhD, “because doing so cuts them off from the social networks and social supports that might help them get through a difficult time.” 

Everyone’s Journey is Their Own

Of course, just because certain issues tend to be more challenging for men doesn’t mean all men experience them in the same way. These norms show up differently for different people, affect men to different degrees, and vary according to context. “A man who enacts a particular masculinity in the boardroom may enact a very different kind of masculinity on the street corner,” says Powell.

Why is it Harder for Men to Ask for Help?

Mental illness is often overlooked in men,5 and is therefore more likely to go untreated. SAMHSA’s guide on Addressing the Specific Behavioral Health Needs of Men states that there are “specific issues facing men that can affect all elements of the treatment process,6 including the decision to seek treatment in the first place.”

Social conditioning can influence how likely men are to talk about their feelings or reach out when they’re struggling. And there’s far more to this picture than what appears on the outside: 

Trauma and Shame 

Intense shame is a common theme for men in recovery,7 in addition to “histories of violence, sexuality, family issues, and difficulty accessing emotions.” Some men feel this as a result of trauma they’ve experienced, or inflicted on others. And some feel shame around violating masculine norms. 

Shame is a powerful emotion.8 It affects the way you see yourself, how you interpret the world around you, and the choices you make. That includes your willingness to address the traumas underlying your addiction, anxiety, or depression. 

But working through shame is a necessary part of healing. Psychologist and former president of the American Psychological Association Ronald Levant explains: “We have to brave the shame. We were made to feel ashamed of ourselves for not being fully masculine,9 and that was nonsense…Those lessons you learn as a child are not valid. A better approach is to have an open heart, an open mind, and to freely express your emotions to the people you care about.” 

That includes yourself. 

Stigma

Mental health stigma exists across all genders, but especially so for men, who are under extra pressure to seem like they have it all together.

In a report from the 2019 Behavioral Health Aspects of Depression and Anxiety in the American Male, experts agreed that “stigma is an extreme barrier to those needing mental health treatment,”10 and that men’s acculturation affects the way they experience mental health issues.

When men do get into treatment, that acculturation also affects how receptive they are to the process.

next step adventure therapy
Next Step Recovery in Asheville, North Carolina is a 12-Step intensive outpatient program offering adventure therapy and optional sober living.

Adjusting to the Treatment Process

Many of these unspoken rules are the opposite of what recovery asks us to do. The healing process requires us to be vulnerable, make room for our emotions, and be unflinchingly honest with ourselves. Residential rehab, where feelings are shared with therapists and in groups, may feel inherently unsafe to someone with little practice doing any of these things. 

“Men are expected to be independent, self-sufficient, stoic, and invulnerable,” says SAMHSA. This means that, often, men struggle with certain issues during treatment:11 

  • Inability to see or express weaknesses
  • Difficulty opening up to therapists or peers
  • Competitiveness with other patients 
  • Defensiveness 
  • Unwillingness to take direction or accept suggestions 
  • Anxiety around privacy and confidentiality 
  • Lack of ability to connect feelings to the problems they stem from 
  • A false sense of security in their recovery status 
  • Resistance to attending continuing care or ongoing meetings 

Intensive treatment is only the beginning of the recovery journey. After treatment, men return to their home communities, where they face the same societal pressures as before. That’s why it’s important to prepare for life after rehab by gaining tools that reduce your chance of reverting to old coping habits. 

Common Male Coping Strategies 

Suppressing Emotions

Men are often taught that expressing emotions is wrong. But regularly holding them in doesn’t make them go away—it just makes them come out sideways.

“Suppressing emotion in and of itself isn’t necessarily harmful,” says Powell. “It’s when you do it habitually; if it’s your go-to response to all the stress that you experience. Eventually, that suppression will cause a rebound in some other areas, like whack-a-mole. You hit it down in one place and it pops up in another.”

Humans are blessed with an astounding range of emotions—and ideally, we should be fluent in all of them. But this is easier said than done. Many men are limited to just a handful of emotions that are considered acceptable to express. 

Anger 

When we’re stressed, we tend to respond with the emotion that’s most readily available to us. And for men, who may not be well-versed in expressing sadness or fear, that emotion is more likely to be anger. 

Sometimes, we channel anger and other “negative” feelings into behaviors—some of which are harmful to us. Especially if we feel the need to “suck it up” and get through hardships on our own, those behaviors are less likely to look like talking through our problems with a friend or therapist, and more likely to look like social withdrawal, overworking, aggression, or alcohol and drugs. 

Substances 

Substances are a common way to cope with problems we’d rather not face head-on. And for men, anger and the inability to untangle difficult emotions can lead to more substance use. 

Data shows that “men tend to use more alcohol as opposed to women when they are stressed.”12 According to Powell, “we can see higher rates of substance abuse in males because of that anger and emotional response.”

Mental Health Among Minority Men 

Mistrust of treatment professionals comes from a particularly deep-rooted place for men and boys of color. There’s not only a verified link between racism and poor mental health,13 but an established history of racial trauma and access inequities in the American healthcare system.14  

The good news is that this can be changed. “Even with those experiences in the background,” says Powell, “when Black men have more patient-centered, empathic experiences with physicians, they report lower medical mistrust. So in other words, mistrust is not immutable. It can be fixed. It can be intervened upon.” 

Fortunately, some treatment programs are evolving to be more responsive to the societal issues their patients are grappling with. 

How Treatment Can Help  

Looking at deeply held traumas and unprocessed emotions is a necessary step toward healing. “When they feel safe enough, [men] are willing to look at many important, although difficult, issues commonly overlooked in traditional treatment. Some of these are relationships, sexuality and sexual behavior, power and control, criminal behaviors, privilege and entitlement, and grief,” say the authors of Helping Men Recover: A Program for Treating Addiction. 

Rehab can be a safe place to do just that. 

Gender-Responsive Care Takes Men’s Issues Into Account

“The keys to developing effective treatment for men,” says Griffin, “are acknowledging their life experiences and the impact of living as a man in a male-based society.”

In men-only rehab, patients can ease into the treatment process alongside others facing similar issues, with less distraction and a chance to build lasting bonds. 

Soberman’s Estate in Cave Creek, Arizona caters exclusively to adult men. They find that this gender-specific grouping raises the comfort level, leading to more sharing and honesty in group sessions. This creates an environment conducive to recovery, comradery, and true release. And because they make special efforts to accommodate working professionals, business access time is built into the daily schedule. 

For those who prefer to live at home during treatment, Next Step Recovery in Asheville, North Carolina offers a men’s-only intensive outpatient program (IOP) with optional sober living options for men ages 18-40. In addition to a focus on building a healthy daily routine, the center offers a range of therapeutic outdoor activities including river rafting, paintball, and high ropes.

Face the Fears That Keep You From Your Best Life

Being a man doesn’t need to mean foregoing care that will make you well, and ultimately more capable of living to your full potential. 


See our directory of men-only rehab centers to learn more about their programming, facilities, activities, and more.

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4 Alternative Therapies for Trauma

Healing from trauma is complicated, and nonlinear. Symptoms can last for years after you get to safety—and they can change over time. What comforts you on a Monday may be triggering on Tuesday. It can be frustrating to feel like you’re not healing fast enough, even when you’re actively trying to get better.

That frustration can be valuable, if you let it motivate you. Healing is, in part, the process of getting to know yourself again. And in rehab for trauma, you can achieve that in any number of ways. You might even experiment with different forms of treatment, until you find the ones that work best for you. These non-traditional therapies can be powerful components of your recovery.

Somatic Healing

Emotional trauma impacts physical health. ((Ho, G. W. K., Karatzias, T., Vallières, F., Bondjers, K., Shevlin, M., Cloitre, M., Ben-Ezra, M., Bisson, J. I., Roberts, N. P., Astill Wright, L., & Hyland, P. (2021). Complex PTSD symptoms mediate the association between childhood trauma and physical health problems. Journal of Psychosomatic Research, 142, 110358. https://doi.org/10.1016/j.jpsychores.2021.110358)) Research even links childhood trauma to heart disease in adults. As a result, experts believe that body-based therapies can support emotional recovery from trauma. ((Grabbe, L., & Miller-Karas, E. (2018). The trauma resiliency model: A “bottom-up” intervention for trauma psychotherapy. Journal of the American Psychiatric Nurses Association, 24(1), 76–84. https://doi.org/10.1177/1078390317745133)) One study reported that these treatments are “more effective for trauma than currently used cognitive (‘top-down”) and exposure therapies.”

Somatic therapies—or body-based therapies—focus on the mind-body connection. Treatments help you address the trauma stored in both your brain and your body, at the same time.

Bodywork

Studies show that receiving safe, healthy touch can help you process traumatic experiences. ((Strauss, J., & Lang, A. (2012). Complementary and alternative treatments for ptsd. PTSD Research Quarterly, 23(2), 2–7. https://www.ptsd.va.gov/publications/rq_docs/v23n2.pdf)) For example, massage and other types of bodywork may help people heal from the emotional impact of sexual assault.

Trauma and Tension Release Exercises (TRE)

These exercises help patients let go of physical and emotional tension. During a session, you’ll shake your body in a safe, gentle way. Experts say that TRE mimics the natural feeling of shaking in response to trauma. ((Case report of a former soldier using tre (Tension/trauma releasing exercises) for posttraumatic stress disorder self-care. (n.d.). JMVH. Retrieved from https://jmvh.org/article/case-report-of-a-former-soldier-using-tre-tension-trauma-releasing-exercises-for-posttraumatic-stress-disorder-self-care/)) And that sensation can “relieve tension, reduce hypervigilance” and increase feelings of well-being. If you’d like to try TRE, make sure you learn it from a trained practitioner. Once you’re comfortable with the exercises, you can also use them as a type of self-care.

Emotional Freedom Technique (EFT)

Also called tapping, EFT teaches patients to tap on acupressure points ((Flint, G. A., Lammers, W., & Mitnick, D. G. (2006). Emotional freedom techniques. Journal of Aggression, Maltreatment & Trauma, 12(1–2), 125–150. https://doi.org/10.1300/J146v12n01_07)) to relieve stress. Studies show that emotional freedom technique relieves trauma symptoms, ((Church, D., Hawk, C., Brooks, A., Toukolehto, O., Wren, M., Dinter, I., & Stein, P. (2013). Psychological Trauma Symptom Improvement in Veterans Using Emotional Freedom Techniques. The Journal of Nervous and Mental Disease, 201(2), 153–160. https://doi.org/10.1097/NMD.0b013e31827f6351)) sometimes completely. EFT can also treat clinical depression and anxiety.  ((Bach, D., Groesbeck, G., Stapleton, P., Sims, R., Blickheuser, K., & Church, D. (2019). Clinical eft (Emotional freedom techniques) improves multiple physiological markers of health. Journal of Evidence-Based Integrative Medicine, 24, 2515690X18823691. https://doi.org/10.1177/2515690X18823691))

Mindfulness-Based Treatments

Mindfulness helps with emotion regulation, ((Lee, M. Y., Eads, R., & Hoffman, J. (2022). “I felt it and i let it go”: Perspectives on meditation and emotional regulation among female survivors of interpersonal trauma with co-occurring disorders. Journal of Family Violence, 37(4), 629–641. https://doi.org/10.1007/s10896-021-00329-7)) which is a common issue for trauma survivors. This umbrella term refers to a variety of techniques. Some rehabs offer yoga classes, and others teach you how to meditate. But this approach isn’t right for everyone.

If you have a history of trauma, mindfulness can be triggering. As psychotherapist and trauma researcher David A. Treleaven writes, some patients find “meditation can actually end up exacerbating symptoms of traumatic stress.” ((SoP. (2018, January 28). Is mindfulness safe for trauma survivors? The Science of Psychotherapy. https://www.thescienceofpsychotherapy.com/is-mindfulness-safe-for-trauma-survivors/)) Researchers caution that mindfulness techniques can “destabilize clients who are particularly prone to flashbacks, ((Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018). Mindfulness-based treatments for posttraumatic stress disorder: A review of the treatment literature and neurobiological evidence. Journal of Psychiatry & Neuroscience : JPN, 43(1), 7–25. https://doi.org/10.1503/jpn.170021
)) rumination, or easily triggered trauma memories.”

What works for you might trigger someone else. If you’d like to try healing through mindfulness, make sure to get professional support. These techniques aren’t right for everyone, but some patients find them extremely helpful.

Meditation

Data supports meditation as a treatment for post-traumatic stress disorder (PTSD). ((Talkovsky, A., & Lang, A. (2017). Meditation-based approaches in the treatment of ptsd. PTSD Research Quarterly, 28(2), 2–10. https://www.ptsd.va.gov/publications/rq_docs/V28N2.pdf
)) This spiritual practice also has physical health benefits.

Mindfulness-Based Cognitive Therapy (MBCT)

According to experts in mindfulness at Brown University, MBCT “combines training in mindfulness meditation practices with principles from cognitive therapy.” ((What is mindfulness based cognitive therapy? | mindfulness center | brown university. (n.d.). Retrieved from https://www.brown.edu/public-health/mindfulness/ideas/what-mindfulness-based-cognitive-therapy)) Whether you attend 1:1 or group sessions of MBCT, ((Schroevers, M. J., Tovote, K. A., Snippe, E., & Fleer, J. (2016). Group and individual mindfulness-based cognitive therapy (Mbct) are both effective: A pilot randomized controlled trial in depressed people with a somatic disease. Mindfulness, 7(6), 1339–1346. https://doi.org/10.1007/s12671-016-0575-z)) your therapist will guide you through meditations and cognitive exercises. You may also have homework between sessions. MBCT can treat the symptoms of PTSD. ((Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018). Mindfulness-based treatments for posttraumatic stress disorder: A review of the treatment literature and neurobiological evidence. Journal of Psychiatry & Neuroscience : JPN, 43(1), 7–25. https://doi.org/10.1503/jpn.170021
))

Mindfulness-Based Stress Reduction (MBSR)

In many ways, this therapy is similar to MBCT. For example, you’ll likely go through treatment with a group. But instead of using cognitive therapy, patients learn a wider variety of mindfulness techniques. After about 6 weeks of MBSR, patients go on a brief meditation retreat. ((Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018). Mindfulness-based treatments for posttraumatic stress disorder: A review of the treatment literature and neurobiological evidence. Journal of Psychiatry & Neuroscience : JPN, 43(1), 7–25. https://doi.org/10.1503/jpn.170021)) Experts agree that these mindfulness exercises can relieve trauma symptoms. ((Khatib, L., Riegner, G., Dean, J. G., Oliva, V., Cruanes, G., Mulligan, B. A., & Zeidan, F. (2022). The effects of mindfulness-based stress reduction on trauma in victims of gun violence: A pilot study. Mindfulness, 13(4), 1032–1041. https://doi.org/10.1007/s12671-022-01858-yfOctober))

Non-Traditional Talk Therapy

Mindfulness teaches you to focus on the present moment. Other treatments help you understand the past. In some types of talk therapy, patients learn to live with traumatic events. You might describe or even re-experience your most difficult memories. The goal is not to trigger you, but to help you process what happened.

Psychodynamic Therapy

According to the American Psychological Association (APA), “psychodynamic therapy focuses on the psychological roots of emotional suffering.” ((Psychodynamic psychotherapy brings lasting benefits through self-knowledge. (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/news/press/releases/2010/01/psychodynamic-therapy)) Patients work closely with a therapist to get to the root of their symptoms. Short-term psychodynamic therapy ((Chapter 7—Brief psychodynamic therapy. (1999). Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK64952/)) includes a finite number of 1:1 sessions. Some therapists recommend a much longer treatment program. In that case, you’ll spend the first few sessions free associating, as your therapist gets to know you. Psychodynamic therapy can help with PTSD ((Schottenbauer, M. A., Glass, C. R., Arnkoff, D. B., & Gray, S. H. (2008). Contributions of psychodynamic approaches to treatment of PTSD and trauma: a review of the empirical treatment and psychopathology literature. Psychiatry, 71(1), 13–34. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.456.4171&rep=rep1&type=pdf)) and related conditions, including addiction.

Narrative Exposure Therapy (NET)

By telling your story, you can take control of it. During NET, patients tell the stories of their lives. ((Narrative exposure therapy(Net). (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/ptsd-guideline/treatments/narrative-exposure-therapy)) You’ll focus on traumatic memories, and also talk about some positive ones. Your therapist guides you to re-experience painful emotions, but stay in touch with the present moment.

Inner Child Work

This treatment is just what it sounds like—recognizing that a version of your younger self lives on within you. There are countless ways to connect with your inner child. ((Healing trauma through inner child work | cptsdfoundation. Org. (n.d.). Retrieved from https://cptsdfoundation.org/2020/07/20/healing-trauma-through-inner-child-work/)) For example, you could write them a letter. You can also meditate, picture their face, and start a conversation. It can be especially helpful to ask them simple questions, like “how do you feel?” or “what do you need to feel safe?” This work can bring up repressed feelings and even memories. If you’re new to recovery, it’s best to embark on inner child work with a guide, like a therapist or other professional.

Creative Therapies

Talk therapy can be central to recovery. But it’s not the only way to heal. Creative pursuits help patients unlock deeper emotions and repressed memories. They can also help you release physical, emotional, and even spiritual pain. These therapies empower you to express yourself, working through trauma in the process.

Art Therapy

In art therapy, you’ll create visual art as a way of connecting with your feelings. Sessions may take place 1:1 or in a group setting. By sharing your creations with other people—including your therapist—you practice self-expression. If you enjoy making art, this can become a healthy coping mechanism in the long term. Art can also help you externalize traumatic memories, ((Campbell, M., Decker, K. P., Kruk, K., & Deaver, S. P. (2016). Art therapy and cognitive processing therapy for combat-related ptsd: A randomized controlled trial. Art Therapy : Journal of the American Art Therapy Association, 33(4), 169–177. https://doi.org/10.1080/07421656.2016.1226643)) making it easier to live with them.

Music Therapy

Music therapy can alleviate many symptoms of PTSD. ((Landis-Shack, N., Heinz, A. J., & Bonn-Miller, M. O. (2017). Music therapy for posttraumatic stress in adults: A theoretical review. Psychomusicology, 27(4), 334–342. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5744879/)) According to experts, it’s especially helpful for addressing “negative affect and mood alterations.” Because it has such an emotional impact, listening to or playing music may help you regulate your feelings. It can even help outside of therapy sessions. For example, listening to a happy song might help you calm down after being triggered.

Dance Movement Therapy

Experts write that dance therapy “enhances resilience” in trauma survivors. ((Martinec, R. (2018). Dance movement therapy in the wider concept of trauma rehabilitation. Journal of Trauma and Rehabilitation. https://www.researchgate.net/publication/327418865_Dance_Movement_Therapy_in_the_Wider_Concept_of_Trauma_Rehabilitation)) There are several reasons for this. For example, dance helps people feel whole by including the body in the process of emotional recovery. As a result, it may reduce dissociative symptoms for people with PTSD. Dance can also build up your confidence. This encourages patients to find joy in the process of healing.

Trauma Recovery on Your Own Terms

Living through trauma changes you. You probably won’t ever return to who you were before. But there’s always a way forward. Recovery is the process of finding the path that works best for you, and takes you exactly where you need to go. With the right kind of treatment, you can build a life you love. And you get to decide what that means.

Find out more about what happens in rehab for trauma recovery, including types of therapy, lengths of stay, housing, and pricing.

Reviewed by Rajnandini Rathod

Posted on

Naturopathic Medicine for Addiction Recovery

Naturopathy is a type of medicine based on the idea that the body can heal itself. Instead of just treating your symptoms, naturopaths teach you healthy, sustainable habits. For example, you might alter your diet, take supplements, or start working out. And over time, these gentle changes support your body’s natural impulse to be well. 

A naturopath’s job is to identify the obstacles to your health, and help you move past them. And in a rehab with naturopathic treatments, this can be an important part of addiction recovery. 

What Is Naturopathy?

Naturopathy is sometimes called an alternative medicine.1 According to the American Association of Naturopathic Physicians,2 these specialists are versed in “certain areas of study not covered in conventional medical school. At the same time, aspiring naturopathic doctors receive training in the same biomedical and diagnostic sciences as MDs.” Naturopaths with the right training can even work as primary care providers. 

By law, naturopaths are licensed differently in various locations.3 In the U.S., for instance, insurance only covers this type of treatment in certain states. If you want to try naturopathy, talk to your rehab, and your insurance provider, about your options. 

Treating Addiction With Naturopathy

Naturopathy is a clearly established practice, and not an umbrella term. Many rehabs combine this approach with complementary holistic treatments, like energy healing. And yes, these activities can be part of a naturopathic treatment plan. But you won’t always receive them from the same provider. 

Some rehabs take a naturopathic approach to every aspect of addiction recovery. Others combine naturopathy with more traditional therapies. Either way, most naturopathic doctors4 use similar techniques to help you start healing. 

Nutrition

Most naturopaths will assess your dietary habits, and may suggest changes. This can have a major impact on addiction recovery. Many drugs damage your digestive health.5 And every drug has unique effects. Your personal history will inform your course of treatment. A naturopath might recommend that you take supplements, or cut out certain foods.

Some facilities, like Maison Ila, may even suggest intermittent fasting. At this treatment center, you’ll consult with a naturopath to learn about nutrition. Your bespoke meal plan will then be based on their suggestions. Every menu includes local and seasonal ingredients, sourced from the lush French countryside. 

Ila Maison bedroom
Treatment at Maison Ila in France is tailored to each guest, including bespoke meal plans.

Hawaii Naturopathic Retreat also has a strong focus on nutrition. Clients may try one of several dietary plans, like therapeutic fasting, or a raw food diet. They also offer sugar-free and salt-free options. Each plan is “anti-inflammatory, high in vitamins, minerals, antioxidants and fiber.”6 The goal is to detoxify the body not only from drugs, but also from harmful chemicals. 

Naturopathic Medications

In many areas, licensed naturopaths can prescribe controlled substances.7 So in some programs, your naturopath may treat you using medication. And you might end up taking a well-known Western medication—or you might not. 

Naturopathic doctors can also prescribe botanical medicines to treat addiction.8 For example, some naturopaths use kratom, an herbal painkiller, for patients with opioid use disorder. Others, like the team at The Hermitage Centre, use naturopathy during initial detox. 

The Hermitage Centre patio
Detox regimens are highly-personalized at The Hermitage Centre in Gold Coast, Australia.

Homeopathy

Although it’s a distinct type of treatment, homeopathy is often used by naturopathic doctors.9 And in some ways, it’s very similar to botanical medicine. Homeopathic remedies10 are very small—sometimes microscopic—doses of natural plant extracts. These treatments are usually delivered in pill form. 

While some studies show that homeopathy can treat addiction,11 more research is needed. But if you’re curious about this approach, a naturopath can answer your questions. Rehabs like Le Center for Health and Wellness recommend homeopathy during rehab—but only with close supervision. 

IV Drip Therapy

Pills aren’t the only way to ingest medication. In some areas, naturopaths can legally prescribe IV drip therapy.12 In this controversial method, clients receive vitamins, minerals, and nutrients intravenously. Supporters say IV drip therapy can treat addiction and other mental health issues. But many disagree. 

Ather Ali, a doctor of naturopathic medicine and health researcher at the Yale School of Medicine, falls squarely in the middle. According to his research, IV therapy is a placebo.13 But it’s often an effective one. And “when your child falls down and scrapes their knee, you give them a kiss,” he told NPR. “There’s value in that.”

Manual Therapy

Manual therapy14 can refer to most hands-on healing modalities. Massage therapy, craniosacral therapy, and some physical therapy techniques fall into this category. If they have the right training, your naturopath might offer these treatments during rehab. Or, they might refer you to another specialist for complementary therapy. 

At The River Source, in Arizona, regular naturopathic massages help improve clients’ sleep patterns. These sessions help you let go of the physical and mental stress of recovery. 

The River Source
The River Source in Arizona City uses a holistic approach to treatment.

Exercise as Addiction Treatment

Most primary care providers recommend exercise.15 But, as one study found, few recommend specific types of exercise. This leaves patients wondering what to do next. Naturopathic doctors Jennifer Gibbons and Osemekhian Okojie write that people with their expertise  “are uniquely qualified” to give clients more guidance. “The training we receive in anatomy, physiology, biomechanics, and biochemistry allows us to go beyond the general and broad fitness recommendations that one can find in an average health magazine,” they explain. 

At Hawaii Naturopathic Retreat, exercise is a big part of recovery. Clients go for walks, take yoga classes, and spend time at the gym. And with locations near Kealakekua Bay and Hilo Bay, “opportunities for self-guided exercise are almost limitless.”16 But even if you work out on your own, you’ll be following a treatment plan, tailored to help you recover. 

These activities affect more than your level of fitness. Researchers believe that exercise can also treat addiction.17 Preliminary studies show that working out helps normalize dopamine levels. Dopamine is a neurotransmitter that plays a role in both addiction and the feeling of satisfaction.18 And regulating it can improve both your physical and mental well-being. 

Mental Health Recovery

Le Center Health Wellness Bellevue
A peek into Le Center for Health and Wellness, located in Bellevue, Washington.

Naturopathy doesn’t only heal the body; it also supports mental health. At Le Center for Health and Wellness, lifestyle counseling is an essential part of treatment. And clients at Birch Wellness Center can get naturopathic treatment for anxiety, depression, and stress.

This approach may look different from traditional talk therapy. And it may not be right for everyone. But you don’t necessarily have to choose. Some centers invite you to combine naturopathy with other forms of treatment. The goal is to help you heal as effectively as possible. And that means something different for each client. 

Naturopathy Clears the Path to Recovery

This branch of medicine is rooted in profound trust. Naturopaths don’t just treat your symptoms. They might not even diagnose a cause. Instead, their job is to support you in the natural process of healing. With fewer barriers, and more effective tools, you can take the lead in your recovery journey. And when you’re empowered to heal yourself, life becomes far more sustainable. 


To start planning your recovery, learn more about rehabs that offer naturopathic treatment, including their locations, insurance coverage, and complementary therapies.