Category: Substances

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2023 Oscar Nominated Movies That Include Addiction

Films and TV shows tend to shape how culture views a certain subject (or profession). Recently, the idea of therapists, mental health, and addiction in pop culture became more mainstream. However, some films and shows do more harm than good—overdramatizing addiction and mental health, or just poorly representing it.

Others capture the rawness, truth and importance of addiction and mental health. 

All the Beauty and the Bloodshed 

Winning an Oscar for best documentary, All the Beauty and the Bloodshed recounts photographer Nan Goldin’s experience with addiction. She depicts her addiction to prescription painkiller OxyContin, and her frustration with the Sackler family.  

America’s Opioid Crisis

All the Beauty and the Bloodshed shows that Nan’s addiction began after an injury. Doctors prescribed a common medication at the time, OxyContin – which is highly addictive if taken incorrectly1. It contains oxycodone, which causes a high similar to heroin. 

Nan, like many others, became addicted to OxyContin after a perhaps thoughtless pain management plan. Nan formed P.A.I.N.2, Prescription Addiction Intervention Now, to “speak for the 250,000 bodies that no longer can.”

The Sackler family, owners of Purdue Pharma, received backlash for pushing OxyContin prescriptions when they perhaps weren’t needed. Nan worked to get museums and other Sackler-supported institutions to publicly separate from the family. 

America’s opioid crisis may have begun with overprescription of pain meds3, but it’s since grown for new reasons, like cheap, accessible products. Fentanyl, too, plays a large role in the 1,500 opioid-related deaths per week.

Treatment Options for Opioid Addiction

Many rehabs treat opioid addiction. In a residential setting, you’ll likely go through a medically supervised detox first, then begin therapeutic treatment. 

Therapies for opioid addiction could range from talk therapies to contingency management plans, which offer rewards for each step you complete in treatment. Talk therapies like cognitive behavioral therapy (CBT) will help you work through the thoughts and emotions causing your behaviors. Then, you’ll learn new ways to process and manage what you feel.

You’ll learn coping tools for the future, relapse prevention strategies, and typically engage in an aftercare program to keep you well supported. 

All the Beauty and the Bloodshed explored prescription medication addiction. Other nominated movies this year blazed new trails, like The Whale.

The Whale Explores Grief And Binge-Eating

The Oscars nominated Brendan Fraser for Best Lead Actor. The Whale depicts Charlie’s (Fraser) journey through binge eating, grief, and depression. His coping mechanism began after the death of his partner. 

The story highlights the power of grief and the hold of eating disorders, and how they can function as a coping tool. Different characters in the film try to help Charlie, but as it often is, his grief is persistent. 

What Is Binge Eating Disorder?

Binge eating is eating without control4—it might feel impossible to stop. Sometimes, after binging, a purge happens; this is the pattern of bulimia nervosa5. You might purge through throwing up, taking laxatives, excessive exercise, or starving yourself. It’s meant to “undo” the binge. Not every binge eater purges, though. 

Binge eating might be your coping tool, especially if you’re dealing with something as powerful as grief.

Grief And Depression

Depression is a stage of grief6, as proposed by Kübler-Ross. In The Whale, Charlie mourns the loss of his partner, who died by suicide. Depression became a strong stage in his mourning. 

If you or someone you know is considering suicide or self-harm, you can call or text the number 988.

The film suggests binge eating became Charlie’s own way of committing suicide.

Getting Help for Grief And Depression

There’s help for the millions of others like Charlie. Grief and depression can weigh heavily—sometimes unbearably so. But you do have options to heal. 

Complicated grief therapy (CGT)7, for example, can help with grief and all its stages. Using loss- and restoration-focused care, “the therapist works to facilitate the progress of grief to help the client come to terms with the death.” 

Cognitive behavioral therapy (CBT) can help with depression and grief7. Using CBT, your therapist can help you modify your thoughts and change your behaviors. For grief, CBT could help you process your loss in a more productive way.

To Leslie And Blonde

Both To Leslie and Blonde highlight drug and alcohol addiction. They were also both nominated for Best Leading Actress in the 2023 Oscars. Ana de Armas played Marilyn Monroe in Blonde, and Andrea Riseborough played Leslie in To Leslie.

To Leslie depicts a mother’s struggle with addiction, spurred on by a seemingly-ideal lottery win. Leslie reaches new lows and eventually seeks help for her daughter’s sake and herself. 

Blonde retells the life story of Marilyn Monroe, who tragically and famously died after an overdose. 

Drug And Alcohol Addiction: Not Just for The Famous

Movies like Blonde make addiction seem almost ritzy—something only people with deep pockets can do. Then, To Leslie goes and proves that wrong. So which is true? 

It’s both. 

Addiction doesn’t discriminate. In each movie, despite the contrasts in leading women, their reasons for substance abuse were similar. The case remains true for many today. Stressors, mental illnesses, or trauma can start a habit you can’t stop on your own. 

Stories like Leslie’s and Monroe’s can help the larger public see this through a cleaner lens. Addiction wasn’t a moral failing of either woman. It was how they coped. 

But there’s more than one way to find that same sense of control. Treatment can help you see that.

Treatment Options for Drug And Alcohol Use

Many rehabs treat drug and alcohol addiction. Here, you’d have constant monitoring, individualized care, and a structured treatment schedule. Most residential rehabs also offer on-site detox. 

Depending on your situation, you might find an intensive outpatient program (IOP) or partial hospitalization program (PHP) more suitable. Each of these programs provides effective treatment, and you get to go home at night. IOP is less intensive, usually lasting 3-5 hours a day, while PHP could go for 5-8. 

In these treatment settings, you’ll learn relapse prevention skills and work on the thoughts behind your behaviors. Rehabs typically offer a variety of therapies to meet your needs. 

You can browse our list of rehabs to see reviews, pricing, and insurance information, and more.

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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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7 Essential Coping Skills For Drug and Alcohol Use

Finding healthy coping skills for drug and alcohol use can feel overwhelming, especially when you’re already preoccupied with other stressors. Sometimes addictions form because they seem like means to deal with uncomfortable situations and feelings. And, as a result, substance use has the potential to turn into a coping mechanism; however, it’s a harmful one. 

Learning the tools to navigate recovery, and applying them, can be extremely rewarding. Through therapies, groups, and moments in between, you can apply the skills that reinforce sobriety. Building a long lasting recovery toolkit can help you on your journey. Exploring programs that include individual, group, and family therapies can also be beneficial to jumpstarting that journey and serve as the foundation to continued healing.

What are Coping Skills?

Coping skills are instruments and methods that we use to work through stressful situations. These can look different for everyone.

Adopting healthy coping strategies can help you regulate your emotions and behaviors, helping you live a more positive lifestyle. There is a wide range of opportunities, or pearls, if you will, that you can gift yourself to make the possibilities a reality. It’s all about finding what works best for you and your recovery journey. Here are 7 “pearls” for you to consider. 

7 Essential Coping Strategies: The “Pearls”

1.Talk Therapy 

One of the most important ways you can cope with and heal your addiction is by seeking professional help. Talking regularly with a therapist can help you develop healthier, more effective habits. Your therapist will help you in an objective, non-judgemental way. And you can talk about a variety of topics to get to the root cause of your substance use. 

Aside from how your addiction is physically affecting you, you can also explore its emotional impact. Ultimately, your explorations will help you understand how to incorporate and value the new tools you acquire.

2.Mindfulness

Mindfulness can be a powerful way to work through addiction. This practice can reduce cravings and help your sobriety journey. The goal of mindfulness is to increase awareness of yourself and your surroundings. In doing so, you enable yourself to be the observer of your own thoughts and behaviors, and you then have the opportunity to move past negative patterns. As you’re going through recovery, you can use mindfulness to reflect on your progress and give yourself more grace.

Different meditation and mindfulness apps are a good starting point for your mindfulness journey. They can guide you through meditations, focus on different areas of growth, and are easily accessible to practice on your own time. 

3. Fitness

Exercise creates positive structure and routines, which can help you stay on track with other sobriety aspirations. And the endorphins we release when we work out can boost overall mood and motivation.

Exercise can help you physically, mentally, and spiritually. It’s important to nurture the lifelong relationship that you have with your mind and body. And keeping fit can lower your chances of relapse. 

There are a variety of fitness apps that help you reach your goals. Some offer virtual classes, while others track your progress. Whatever your needs are, there are tools out there to help you on your journey.

4. Practice Gratitude

Finding gratitude through your recovery process is extremely empowering. Focusing on the positive and where you want your life to go will help you stay in line with your goals. Practicing gratitude also allows you to seek out healthy experiences and relationships instead of resorting back to old ways. And gratitude helps you develop a personal arsenal of strengths needed to live a sober and happy life. 

5. Support Groups

Emotional support can be part of the framework for healthy sobriety. Surrounding yourself with others who support your recovery, and those in recovery themselves, can help reinforce your goals and maintain morale. Identifying with and feeling accepted by a group can give us a greater purpose. 

Different support groups like AA allow you and others in similar situations to come together. You’ll dive into addiction topics and open up about feelings that are often universally experienced. 

6. Connecting with Loved Ones

Outside of groups, having supportive loved ones in your life makes all the difference. Psychoeducation for loved ones, family therapy and/or couples counseling are great options for finding common ground and working through the pervasive aspects of addiction alongside the important people in your life. Your loved ones will learn more about addiction, what you’re experiencing, and how to work through issues together. 

7. Accountability Partner

While it’s important to be self-reliant, having someone support you along your journey can be a gamechanger. Oftentimes, your accountability partner is someone from a support group that you’re a part of, like AA. 

You should first decide what your goals, expectations, and boundaries are for your recovery. Communicating clearly and honestly is important throughout this process. You’ll focus on moving forward together, and they can also encourage and reinforce self compassion and morale. Sometimes, others can have tips that open your perspective and scope for your own rehab journey.

How Do They Help?

Healthy coping mechanisms can help reduce cravings for drugs and alcohol. They can also prevent relapse by teaching you how to identify warning signs. 

Beyond the physical cravings, healthy coping skills benefit all areas of your life. You’ll discover a new positive life perspective, improve communication skills, and follow through with new goals. Professionals at Gateway Foundation describe even more benefits learned from healthy coping mechanisms:

  • Manage strong impulses and emotions
  • Increase confidence
  • Better resilience
  • Improve overall health and wellness

Building Skills to Last a Lifetime 

A strong foundation for your future is built day by day. By setting realistic goals and timelines, you can create an action plan. 

Creating your game plan can be easy. First, identify your inner narrative. Acknowledge your hurdles, and then shift the energy you would have used on the hurdles towards reinforcing the positive. In taking this mindful approach, you can be more aware of how your thoughts impact your actions. Finally, be your own best friend. Give yourself kindness and grace as you carve out your journey.

Once you lay that groundwork, there are many ways you can sustain the skills that you learn. Here are some ideas: 

  • Start a new hobby that feels fulfilling and reinforces your new lifestyle.
  • Maintain healthy relationships, in and outside the recovery community. 
  • Write your own narrative. Reflect on why sobriety is important to you, what challenges you have overcome, and what wins you have embraced. You can go back and read your story on days that are harder than others to remind yourself of how far you have come.

While life can be full of stressors as you navigate through your rehabilitative journey, the skill toolkit you build can be with you every step of the way. You can explore programs that help you build and enhance your coping skills, so you find a lifetime of happiness.

Download your free Self-Care Check-In below:

daily self care check in


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Is My Loved One Using Cocaine? How to Tell If Someone Is Using Cocaine

Cocaine doesn’t have to control your loved one. The first step to their recovery might be recognizing signs of use, and then you can help them find a rehab for cocaine addiction. 

You both have resources for recovery. But the more you know about cocaine use, and how to spot it, can help you help the ones you love. 

How to Spot Cocaine Use

Spotting cocaine use can be tricky. It has a seemingly endless list of slang names and pseudo-identities, making it hard to decipher what your loved one might be talking about. They could hide their behavior with more than sneaky names, too. But there are signs to look for1. 

Physical Signs

  • Dilated pupils
  • Lack of appetite—it might seem like they barely eat
  • Rapid weight loss
  • Poor sleep
  • Disheveled appearance, lack of hygiene 

Emotional And Mental Signs

  • Paranoid without reason
  • Hyperactivity—“bouncing off the walls”
  • Irritability
  • Anxious, more so than usual 
  • Extreme startle reactions, like jumping at the sound of a cabinet shutting

Along with knowing the signs of cocaine use, you can also familiarize yourself with the street names for cocaine.

Slang Names for Cocaine

The nicknames for cocaine2 might surprise you. They’re creative, to put it positively. And they change based on the form of cocaine (crack, regular cocaine) and what it’s mixed with. 

There’s a lot to keep track of, but knowing even just a few can help.

  • Snow
  • Stardust
  • Stash
  • Bouncing Powder
  • Coke
  • Coca
  • Flake
  • Devil’s Dandruff
  • Florida Snow
  • Joy Flakes

You can also educate yourself on cocaine itself, and how it affects the mind and body.

What Is Cocaine?

Cocaine comes from the leaves of the coca plant1. It grows in South America. From there, it’s smuggled all across the globe.

Cocaine causes a rush of euphoria3, which can last 2-20 minutes. This rush comes from a build up of dopamine in the brain—dopamine stacks up on the transmitters meant to receive it4, causing an intense flood of pleasure. 

Neurotransmitters like dopamine jump between nerves and target cells. If the receptors aren’t working, all the received dopamine has nowhere to go—causing the high. Altering the usual transmission of dopamine can actually change the structure and function of your brain over time. 

The crash, or comedown, from this high can quickly prompt a redose, sometimes until supplies or money run out. This is considered a binge1.

You can ingest cocaine in multiple ways1. Some snort the white powder up their nose. Or, you might mix it with water and inject the mixture into a vein, using a syringe. If it’s crack cocaine, you can smoke it.

Is There a Difference Between Cocaine and Crack?

Chemically, no. Cocaine and crack are the same thing5, just in different forms. Crack isn’t any cheaper, either6. But it is more potent, easy to ingest, and wildly addictive.

Crack looks like rocks, or crystals. It’s a smokeable version of cocaine5, derived from the same coca plant as cocaine. 

For crack cocaine, you might see some of these slang terms:

  • Rock
  • Moon Rock
  • Apple Jack
  • Dice
  • Sleet
  • Yahoo
  • Yale
  • Top Gun
  • Base, Basing

Mucous membranes absorb cocaine and crack cocaine7. You have a huge plane of mucous membrane in your lungs—the alveoli responsible for bringing oxygen to your blood. The inhaled crack smoke absorbs into the alveoli in the lungs rapidly, causing a nearly immediate high.

A crack cocaine high fades faster, though. To avoid the crash, people might keep smoking until they run out of crack. And the more they ingest, the more likely they are to overdose and have negative long-term effects8. 

The Effects of Cocaine Use

Cocaine use can lead to heart problems8, like cardiac arrest and strokes. Inhaling it as crack can cause respiratory conditions. Snorting it could completely degrade your nasal passage over time. 

Short-term, the effects of cocaine could range from paranoia to seizures9. And rarely, cocaine can cause sudden death after just one use. 

Repeated use takes up more and more money and time. And the more it’s used, the more your brain changes. Addiction and tolerance to the drug can set in quickly1. 

Cocaine use can also have unpredictable effects, usually caused by what it’s been cut with. The cutting agent could be harmless, but that’s not always the case.

What Is Cocaine Cut With?

Dealers may cut cocaine to up their profit10, selling a “watered down” version to unsuspecting buyers. Powder cocaine could be cut with baking soda, caffeine, sugars, or anesthetics. Visually, you’d likely never know it wasn’t pure cocaine.

But cocaine could have harmful additives. Levamisole, a veterinary drug that kills parasites10, has made its way into 70% of cocaine in America. It causes necrosis11, which kills and rots the skin. 

You can also mix cocaine with other drugs for new, sometimes preferred, effects.

Cocaine Mixtures

Users seeking a different high mix cocaine with other substances, like marijuana and tobacco. Nicknames for these mixtures include Woo-Woo, Woolies, Candy Flipping, Cocoa Puffs, and Boy-Girl.

Certain blends, like alcohol and cocaine, are notably more dangerous. Cocaine and alcohol react12 and form a heart-toxic chemical, cocaethylene. Heroin and cocaine mix to form a speedball9, or an opiate and depressant blend. But cocaine wears off faster than heroin, potentially slowing your breathing to null as the full sedative effect of heroin hits.

No mixture is predictable, or safe. Neither is cocaine by itself. But, for single and blended use, you can find recovery. 

Treatment for Cocaine Addiction

Cocaine addiction often requires a multi-pronged approach—detox, therapy, and medications13. And the more research scientists do, the better these options become. There’s even a cocaine vaccine in the works14. 

Your loved one will most likely need to detox from cocaine in a safe, clinically monitored setting. There, they’ll have constant supervision, comfort medications, and begin the therapeutic healing process. This could be at a detox center or a residential rehab with on-site detox. 

Once cocaine has left their system, inner healing work can begin.

Therapy for Addiction

Therapy can address and heal the causing factors of addiction. It can also motivate and empower your loved one to commit to their recovery, even when it gets hard. 

Behavioral therapies like cognitive behavioral therapy (CBT) can challenge unhelpful thoughts and beliefs15. You’ll learn to shift your perspective of yourself to one that’s more positive. Rather than thinking “I’ll never get better”, CBT would challenge the thought with “Why not?”.

Dialectical behavioral therapy (DBT)16 addresses black-and-white thinking. Your loved one can accept the problem of cocaine use and know they can get better. DBT can help with relapse too, as it helps patients identify unhelpful thoughts that could lead back to old coping mechanisms. 

The 12 Steps

The 12-Step program offers a place for members to connect and recover in a respected treatment program. Members follow 12 steps together, learning responsibility, accountability, and forgiveness. And the 12 Steps can run in and out of treatment—you don’t have to be in rehab to find a local group to attend. 

The 12 Steps are often called AA (alcoholics anonymous) meetings. For cocaine use, you’ll likely see them called CA (cocaine anonymous). Each uses 12-Step practices to help members stay accountable and sober.

Aftercare

Contingency management (CM) can inspire greater dedication, during and after residential treatment. CM programs usually give out money, snacks, or vouchers as a reward13. And since you’ll actually get a reward for staying sober, attending recovery meetings, and going to treatment, you might find yourself more motivated to do it. 

Your loved one can also keep attending 12-Step meetings as a form of aftercare. If they go to a residential rehab, they might have the opportunity to attend alumni groups, too. 

Continued therapy and medications, if prescribed, can both contribute to long-term success. That’s why they’re both common forms of aftercare for cocaine addiction. If your loved one goes to rehab, they might offer continued 1:1 therapy with the same therapist. If not, they’ll likely connect you to further therapy as part of their discharge service.

Find Power Through Recovery

If you think your loved one is using cocaine, know that they, and yourself, have recovery resources. They can find new power and hope through recovery—addiction isn’t the end. 

You can browse our list of rehabs for cocaine to see pricing, reviews, insurance, and photos of each facility. 


Family members, you can check out these support groups: Co-Anon, Families Anonymous, and Stronger Together.

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Confidential Drug Addiction Hotlines

Addiction is overwhelming, both for the person who’s struggling with it and their loved ones. Looking for treatment can feel complicated, especially if you’re unfamiliar with your options. If you’re not sure where to start, drug addiction hotlines can be a helpful and confidential resource for learning more about addiction, recovery, and local treatment options. You can also search our collection of residential rehabs to find unbiased information about treatment centers and connect with them directly.

What Is a Drug Addiction Helpline?

A drug addiction helpline (or hotline) is a resource for people with addiction, their loved ones, and the public. They’re typically toll-free and confidential, which means that there’s no risk of negative consequences for calling. The advisors who work at hotlines are not law enforcement professionals and won’t share your information with law enforcement. 

Most hotlines can’t provide counseling services. Instead, they provide guidance on how to get help for drug addiction and substance use disorders. Hotline advisors are knowledgeable about addiction and treatment and can connect you with resources to learn more yourself. 

There are many different hotlines, some more helpful than others. Government-run helplines like the Substance Abuse and Mental Health Services Administration helplines are toll-free and confidential. They connect you to local resources to help you start your recovery journey safely. And they’ll be able to answer your questions about addiction, its effects and symptoms, and the treatment process.  

However, some for-profit treatment centers also own addiction helplines. They’re not objective and will only connect you with rehabs that pay them for referrals. You can avoid these fake hotlines by looking for government or non-profit-run hotlines. 

Learn more about avoiding addiction treatment scams here. 

Hotlines to Call

  • Substance Abuse and Mental Health Services Administration (SAMHSA): Call 1-800-662-4357 to find local treatment centers, support groups, and community services.
  • Crisis Text Line: Text HOME to 741741 or chat with a Crisis Counselor on their website or via WhatsApp.
  • National Drug Helpline: Call 844-289-0879 to talk to a counselor about treatment options in your area.
  • Partnership to End Addiction: Call 1-855-378-4373 to talk to a trained advisor about a child’s addiction. 
  • National Suicide Prevention Lifeline: Dial 988 to connect with a counselor and talk through your thoughts and feelings.

Emergency vs. Non-Emergency: Who to Call?

If someone is experiencing an overdose or other medical emergency, call 911 or go to the closest emergency room. You can also call Poison Control’s emergency toll-free number at 1-800-222-1222 to talk to an expert about how to spot warning signs and prevent overdose. 

In non-emergency situations, a substance abuse helpline can provide guidance for starting recovery. (These are not staffed by medical professionals who can safely advise you during an overdose or medical emergency.)

What Happens When You Call a Drug Abuse Hotline?

Calling a drug addiction helpline can open a path forward. The advisor will ask you a few questions to get more context about what you’re calling about. And you’ll be able to ask questions, too. 

What Questions Will I Be Asked?

The call usually starts with the advisor asking questions about you and why you’re calling:

  • Is this a medical emergency? If so, the advisor will tell you to call 911. 
  • What is your zip code? Advisors may ask you your zip code to connect you with local support. They will not attempt to identify you and won’t ask for more specific location information.
  • Who are you calling about? They’ll have different resources for people with addiction, their loved ones, and the general public. 
  • What substance are you calling about? How long have you been experiencing addiction? Different addictions require different treatments and considerations. 
  • Do you have any other mental or physical health issues? With this information, your advisor will determine if a rehab that treats co-occurring disorders would be best for you. 
  • Do you want to start treatment for your addiction? If so, they’ll refer you to local treatment services.  

Answering these questions may feel intimidating, but your advisor can best help you when you answer honestly. And they won’t judge or criticize you—they’re there to help you start your recovery journey with as much information as possible. 

For People With Addiction

If you’re struggling with addiction, helpline advisors can give you advice and information about addiction and the recovery process:

  • Local treatment options and services, including information about nearby rehabs for drug addiction and free community resources 
  • The cost and insurance coverage of any treatment services they mention 
  • Signs of overdose
  • How withdrawal and detox works, including safety information about medical detox 
  • How the addiction treatment process works

For Loved Ones

If you’re concerned about your loved one, you can call a drug addiction hotline to learn more about addiction and recovery:

  • How to talk to somebody about their addiction 
  • How to stage an intervention, including a referral to local intervention providers
  • The signs and symptoms of addiction and overdose
  • Information about codependency 
  • Available local treatment options 
  • Information about local support groups for loved ones 

Can I Begin Addiction Treatment at the Time of My Call?

When you call most drug hotlines, they’ll be able to refer you to local treatment services at the time of your call. But hotlines don’t provide addiction treatment themselves. However, they can connect you with helpful resources that can keep you safe until you enter rehab.

While most hotlines are open 24/7, 365 days a year, most inpatient rehabs’ admissions offices are not. So you may have to wait for business hours to actually connect with a rehab. 

If you’re looking for more information about treatment options, you can learn more about treatment options and contact centers directly by searching our collection of residential and inpatient rehabs.

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How Long Does Alcohol Stay in Your System?

Alcohol affects everyone a little differently. Some people get drunk easily, while others have a high tolerance that makes it difficult to feel its effects. A few factors impact intoxication levels and how long alcohol can actually stay in your system. 

Here’s how your body metabolizes alcohol, how long tests can detect it, and what happens in your body when you drink.

How Alcohol Affects the Body

Alcohol is a depressant, meaning it slows down the central nervous system. That’s why drinking alcohol makes you feel more calm, euphoric, or even drowsy. By inhibiting your nervous system, alcohol also reduces your motor coordination, reaction time, and ability to think critically. 

Here are some of the ways alcohol affects your body in the short term:1

  • Brain: Alcohol makes it hard to focus or make decisions. When you’re intoxicated, you have lower inhibitions and are more likely to act impulsively. And with heavy drinking, you might become dizzy, lose consciousness, or have gaps in your memory the next day (often called a blackout). 
  • Mood: Drinking can change your mood, making you feel relaxed, excited, angry, or depressed. It can also increase your sexual desire.
  • Physical ability: Drinking can cause changes in your hearing, vision, and depth perception. It can also make it harder to walk or remain coordinated. Your speech may be slurred, and your reaction time slows down. 
  • Organ function: Alcohol is taxing on your liver and digestive tract. Because it affects the nervous system, heavy drinking can cause slowed breathing. You might feel nauseous after drinking, or vomit or have diarrhea. 

While the short-term effects of drinking may not last very long, that doesn’t mean they’re insignificant. Impulsive behavior, slowed reaction time, and changes in your mood can impact your life in ways that have far-reaching effects, from accidents and injuries to poor decision-making. 

How Alcohol is Measured Inside Your Body

The level of alcohol in your body is measured by blood alcohol concentration, or BAC.2 This number measures the amount of alcohol present in your bloodstream, and is expressed as the ratio of how many grams are present per 100 milliliters of your blood. 

You can also measure BAC by breath, which counts how many grams are present per 210 liters of breath. To learn more about blood alcohol concentration, try out this BAC calculator.3 

Factors That Impact the Length of Time Alcohol Stays in the Body

Alcohol affects people differently. How intoxicated one person gets and how quickly, as well as how long alcohol stays in their body, depend on a few variables.

  • Gender: “After drinking the same amount of alcohol, women tend to have higher blood alcohol levels4 than men, and the immediate effects of alcohol usually occur more quickly and last longer in women than men,” according to the U.S. Centers for Disease Control and Prevention.
  • Body fat percentage: Because it holds less water than muscle, fat absorbs alcohol from your blood at a lower rate.5 This means that for 2 people who weigh the same, the person with a higher body fat percentage will have a higher BAC after drinking the same amount. 
  • Age: In general, the older you get, the longer alcohol stays in your system.5 That’s because your ability to process alcohol worsens over time. According to Harvard Health, older adults have a higher BAC than younger people after drinking the same amount.
  • How much you’ve eaten: If there’s food in your stomach, your body will absorb less alcohol. Studies show that “the consumption of foods before or together with alcohol6 reduces peak blood alcohol concentration, decreases absorption and slows metabolism. In particular, ‘high-energy’ meals may slow down alcohol metabolism and reduce subjective intoxication.”
  • Other drugs present in your system: Some medications affect how your body handles alcohol.7 This includes blood pressure medication, antidepressants, muscle relaxants, and anti-inflammatory drugs. 

How Long Does It Take to Feel the Effects of Alcohol?

Just like there’s no standard length of time that alcohol stays in your body, the time it takes to feel the effects of alcohol varies from person to person. Typically, you’ll feel the effects of drinking alcohol anywhere within 15-45 minutes,8 depending on the strength of the drink and how quickly you drink it. 

After the first 15-45 minutes, you’ll likely feel the relaxing effects of alcohol. If you continue to drink, especially at a rate faster than one drink per hour, you’ll feel progressively intoxicated. At a BAC of .02%, you might feel relaxed and euphoric.9 At a BAC of .05%, you may start to experience lowered inhibitions, impaired judgment, and loss of coordination.  

BAC of .02%, you might feel relaxed and euphoric

How Your Body Metabolizes Alcohol

When you drink, alcohol enters your stomach and then travels on to the small intestine. From there, small blood vessels carry the alcohol to your bloodstream. Roughly 20% of alcohol gets absorbed through the stomach.10 The majority of alcohol is absorbed through the small intestine, though about 10% is eliminated via your breath, sweat, and urine. 

Alcohol is primarily broken down in your liver. Using the enzyme alcohol dehydrogenase (ADH), your liver breaks down alcohol molecules into acetaldehyde. Acetaldehyde is then broken down into acetate, which is then metabolized into water and carbon dioxide. At this point, your body can eliminate these molecules easily. 

How Long Does It Take the Body to Metabolize Alcohol?

A good rule of thumb is that most healthy people can metabolize about one standard drink per hour.11 Of course, factors like age, body fat percentage, and gender can greatly impact the rate at which your body processes alcohol. 

So, when does alcohol leave your system? If you consume more than one standard drink per hour, your liver has too much to process at once. The additional alcohol remains in your bloodstream and body tissues until your liver can metabolize it. This is what makes you feel drunk. 

What is One Standard Drink?

Here’s what one standard drink12 means, according to the U.S. National Institute on Alcohol Abuse and Alcoholism:

  • 12 ounces of normal-strength beer (4-5% alcohol)
  • 1.5 ounces of liquor (40% alcohol)
  • 5 ounces of wine (12-13% alcohol)

Can You Speed Up the Process?

No, you cannot speed up the alcohol metabolization process.13 Once you’ve consumed alcohol, it has entered your bloodstream and can only be eliminated via the enzymes in your liver and through your sweat, breath, and urine. While some things might make you feel more alert—like drinking caffeine, water, or taking a cold shower—they will not remove alcohol from your system. 

How Long Can Tests Detect Alcohol in the Body?

Alcohol can remain in your system for up to 72 hours. How long alcohol can be detected depends on the kind of tests used: 

  • Blood tests can detect alcohol for roughly 6 hours.
  • Urine tests can detect alcohol for 12-24 hours.
  • Breath and saliva tests can detect alcohol for 12-24 hours. 
  • Hair tests can detect alcohol for up to 90 days.

When Excessive Drinking Becomes an Addiction

Alcohol is often socially acceptable, which is why it can be so hard to tell when your drinking is becoming a problem. While there is no safe level of drinking, guidelines for moderation14 are much lower than most people realize. 


If you’re concerned about your drinking and think you may need treatment to stop, search alcohol rehab centers and reach out directly to learn about available options.

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Adult Children of Alcoholics: Healing From Childhood Trauma and Learning to Thrive

Growing up with a parent addicted to alcohol can make for a difficult childhood. And that struggle continues to affect many into adulthood. Some adult children of alcoholics, (or ACoAs) turn to alcohol themselves, while others find themselves disconnected from the world around them. Others may develop a mental health condition that holds them back from fully living life. No matter how your childhood affects you in the long term, rehabs that treat trauma can help you release the hurt of a childhood affected by alcohol. 

Understanding Adult Children of Alcoholics

Adult children of alcoholics (ACoAs) are people who grew up in a home with one or more parents addicted to alcohol. And while many ACoAs enter adulthood without any long-lasting effects,1 some people continue to experience problems stemming from trauma during their childhood. Whichever camp you’re in, it’s important to remember that whether or not you develop issues from your childhood is not a reflection of your character. 

In many cases, an alcoholic home is also an abusive home. Parental alcohol addiction increases a child’s risk of sexual and physical abuse. According to one study, 85% of reported child abuse cases involve alcohol.2 Child neglect is also common. 

It may seem like nobody understands what you’ve been through, but you’re not alone. In the U.S., there are over 76 million adult children of alcoholics,3 many of whom have shared experiences. 

One common experience for ACOAs is growing up in a home with many unspoken rules that they have to follow to avoid trouble:

  1. Keep the addiction and any other family problems a secret.
  2. Don’t express your feelings.
  3. Always be perfect.
  4. Taking care of your own needs is selfish.
  5. Don’t relax or play.
  6. Avoid conflict at all costs.

These rules of operation create an environment where trusting others, expressing your needs, and having feelings is bad. And learning these kinds of lessons when you’re developing your understanding of the world means you may carry them into adulthood.

Common Traits of ACoAs

Because so many children of alcoholics experience similar trauma, many ACoAs face similar challenges. 

Distrust of Others

It’s common for parents addicted to alcohol to show affection inconsistently.4 One moment they may be loving, while the next they’re cold or cruel. And when someone becomes addicted to alcohol, drinking becomes the priority.5 As a result, working, providing food, and attending school functions fall by the wayside. So many ACoAs quickly learn that they can’t trust people6 for love or survival. 

The outside world becomes a scary place when you have a parent addicted to alcohol. Your parents may have taught you to keep their secrets so they wouldn’t get into trouble. Or maybe you couldn’t confide in your friends or teachers for fear of losing your family or getting into trouble yourself. People and systems that are there to protect you instead become something you fear. 

This distrust then makes it difficult to accept love from others. You become so accustomed to doing everything on your own that it may be scary to lean on someone else for your needs. And even when you do start to rely on others, it’s very common for ACoAs to fear abandonment.7 The volatility of your childhood makes it difficult to believe that love can be consistent.  

Hyper-Responsibility or Lack of Responsibility

It’s common for ACoAs to feel responsible for their parent’s addiction and its consequences. Sometimes that’s because a parent directly places blame on their child through their words or actions. Children start to believe that they’re responsible for any negative event that happens, but positive events are the result of luck. And feeling this way can lead to a dysfunctional sense of responsibility. 

Many ACoAs also grow up feeling like it’s their job to keep their family afloat. You may have started working to earn money for your family very early in life or taken on a parental role to younger siblings. This hyper-responsibility doesn’t disappear when you turn 18 or move out. Many ACoAs will continue to feel responsible for the happiness and well-being of everyone around them—an impossibly big task. 

On the flip side, some children growing up with addicted parents fully reject any responsibility.8 They become dependent on others for functioning. This is because they never had someone show them how to healthily identify, label, and communicate their needs. And because they rely on others for almost anything, it’s common for these children to grow up feeling like they can’t do anything right. They lose all confidence in their abilities because they never have to practice them. And that makes adulthood much harder. 

Perfectionism

Many ACoAs seek recognition from the outside world for their achievements as an escape from the dysfunction at home. When you don’t receive consistent affection just for being you, you grow up feeling worthy only because of your accomplishments. And especially when you’re young, the only parts of your life in your control are often your performance in school or extracurriculars. 

This obsession with external success combined with self-blame for your parent’s addiction quickly turns into perfectionism for many ACoAs. Your focus becomes avoiding any reason for people to criticize or blame you. And in turn, you feel like you can never make mistakes. It’s also very common for ACoAs to have a hard time having fun. Life is not about being happy, but about being in control. 

This is an exhausting way to live, and can easily lead to burnout. It’s important to remember that you’re worthy of love and kindness regardless of your resume or report card. Pursuing healing through rehab or therapy can help you develop a truer sense of self-love. 

Negative Self-View

Studies show that having a parent addicted to alcohol causes lower self-esteem9 in many cases. One reason for this is that many children of alcoholics believe they’re to blame for their parent’s addiction. Your parents may tell you that they drink to deal with your misbehavior. Or they’ll purposefully create conflict with you so that they “need a drink to calm down.” And when you blame yourself for such an intense issue at a young age, you may begin to believe there’s something wrong with you.

Another underlying cause is the theme of selfishness in an alcoholic home.10 ACoAs learn that their emotional needs are less important than everyone else’s and that they’re selfish if they prioritize themselves. Your sense of worth becomes rooted in how well you take care of others. But the truth is that your needs are important too, and learning how to communicate them is essential in adult relationships.  

Emotional Dysregulation

Many ACoAs also have trouble regulating their emotions.11 You most likely didn’t grow up with a positive model of emotional self-control because you may have seen your parents use alcohol to cope with unwanted feelings. Or you may have witnessed them become extremely emotionally volatile while drinking. So you didn’t have a chance to learn how to manage your emotions or react to others’ emotions in a positive way. 

Anger is especially difficult to deal with for ACoAs. Witnessing a parent’s rage at a young age is frightening. You may start to fear your own anger, needing to control it at all times. But bottling up your emotions or avoiding them isn’t healthy. Through rehab and therapy, you can develop the skills to be able to mindfully react to feelings without feeling threatened. 

Conflict Avoidance

In many alcoholic homes, conflict is intense and prevalent. And without a healthy model of conflict resolution, many children develop avoidance techniques like hiding in their room or dissociating.12 The cause of this is completely natural: you’re just trying to survive and stay out of harm’s way. But the result is that you never learn how to resolve conflicts in a healthy way. You might even learn that it’s your job to keep your family dynamic running smoothly, which means sweeping major issues under the rug. As such, many children of alcoholics continue to avoid conflict in their adult lives, which affects their mental, physical, and social health. 

When left untreated, these issues can continue well into adulthood. In fact, issues stemming from addicted parenting can still impact older adults. 

The Impact of Growing Up with an Alcoholic Parent

Growing up in an alcoholic home is chaotic. It’s hard to predict your parents’ next move and you never really know if your needs are going to be met or ignored. And that kind of unpredictability can create problems down the line. 

Increased Risk of Substance Abuse

ACoAs are up to 10 times more likely to become addicted to alcohol13 themselves. Having a father addicted to alcohol increases both men’s and women’s risk of alcoholism while growing up with a mother addicted to alcohol tends to increase women’s risk more than men’s. And ACoAs are also at greater risk for addiction to drugs other than alcohol. 

This could be because of a genetic predisposition for addiction, or because you learned to cope with stress by drinking after watching your parent do the same. Childhood abuse also increases your risk of addiction in adulthood.14

Difficulties in Relationships

Many ACoAs have trouble both forming and maintaining healthy relationships,15 especially romantic ones. Growing up without being able to trust others or even rely on your parent for consistent affection may make you fear intimacy in adulthood. And if your relationship model growing up involved somebody addicted to alcohol, you may not have a good blueprint for what a healthy relationship looks like. 

Every relationship involves some level of conflict. But because ACoAs didn’t have the chance to learn positive resolution skills, conflict can quickly trigger aggressive behavior. Or you may be conflict avoidant, meaning you handle conflicts by pretending they don’t exist. 

Physical Health Issues

Growing up with an alcoholic parent also affects your physical health. In fact, ACOAs face a higher risk of many physical health conditions:16

  • Diabetes
  • Sleep problems including insomnia
  • Fatigue and delirium
  • Gastrointestinal disease
  • Cancer
  • Heart disease
  • Cirrhosis 

Mental Health Issues

Instability in your childhood can affect your mental health17 into adulthood. Studies show that ACoAs have an increased risk for certain mental health conditions:18

In addition to these mental health conditions, post-traumatic stress disorder (PTSD) is a common result of growing up with a parent addicted to alcohol.19

Simple and Complex Post-Traumatic Stress Disorder (cPTSD)

The intensity and chaos of alcoholism is traumatic. And childhood trauma tends to stay with us in many forms, sometimes without us realizing it. Many ACoAs experience the symptoms of post-traumatic stress disorder (PTSD) as a result of their childhood. For example, hypervigilance is a common symptom of PTSD. And studies show that ACoAs learn to be hypervigilant20 from a young age to protect themselves. 

Many ACoAs also have all 3 of the defining symptoms of complex PTSD (cPTSD):21

  1. Difficulty managing emotions
  2. A negative self-view
  3. Trouble forming and keeping healthy relationships

Even if you don’t have a diagnosed mental health condition, the trauma of your childhood can affect you in many ways. But it doesn’t have to follow you forever. Many rehabs offer trauma-informed programs to help you heal from your past, and learn healthy ways to communicate and cope.

Overcoming the Lingering Effects of Alcoholic Parenting: Strategies for Healing and Moving Forward

Emotional Sobriety

Tian Dayton, psychologist and author of ACoA Trauma Syndrome, compares growing up with addiction to secondhand smoke:

We inhale the thinking, feeling and behavior of the addict emotionally, psychologically and behaviorally; we take who they are while using, into our own inner world…Many of the clients that I treat have never had a problem with substance abuse. But they still act drunk.

“Emotional sobriety,”22 a term first coined by AA founder Bill Wilson, is what people in recovery gain once they learn to regulate their emotions. Because this is often a major theme for ACoAs, learning to feel and work through emotions healthily is a crucial step in the recovery process.   

Rehab for Adult Children of Alcoholics

Thankfully, there are plenty of places to find support.

Some rehabs have dedicated treatment programs for ACoAs. Residential rehab programs give you access to multiple therapies and a supportive community to help you in your healing journey. Some rehabs even specialize in treating ACoAs. For example, one of the 9 phases of Affect2U’s treatment program focuses on ACoA-specific challenges. And if you’re not sure if a rehab you’re looking into offers informed support, you can always call their admissions team to ask. 

Going to rehab can help you resolve the trauma of your childhood, manage resulting mental health conditions, treat your addiction, and learn positive coping skills. And attending a residential program allows you to take a step back to give you space to re-evaluate your life. You’ll have access to professionals who understand what you’ve experienced in childhood and how it’s still affecting you. And you can work through your struggles through a variety of therapy methods. 

Treatment Options in Rehab

One treatment option that can help ACOAs is family therapy. This can open up lines of communication that have been shut down, helping you and your family heal the ways in which you relate to each other. Learning healthy conflict resolution alongside loved ones can help your relationship function more positively. 

Behavioral therapies are another option for ACoAs.23 Treatments like cognitive behavioral therapy (CBT) can help you learn new ways to resolve conflict, communicate your needs, and cope with stress. Your therapist will teach you how to identify and monitor your emotions and give you strategies to deal with unwanted feelings like relaxation techniques. The goal is to interrupt your regular patterns of reacting to emotional situations and replace them with more positive behaviors.

Resources for Adult Children of Alcoholics and Their Families

Support Groups

Rehab offers a supportive community to heal. At many rehabs, you can find support groups for people experiencing the same issues. You may attend meetings like Alcoholics Anonymous, which even if you aren’t addicted to alcohol could help you gain an understanding of what your parents have experienced. Some rehabs also offer Al-Anon meetings, specifically for loved ones of people with addiction. There are also rehabs for parents.

You can also attend support meetings outside of rehab. You’ll find others who understand what you’re going through and can support your healing journey. Al-Anon and other organizations offer virtual meetings for your convenience. 

Books for ACoAs

Books about growing up with addicted parents that can expand your understanding of your own experiences:

It may initially feel daunting to uncover past traumas, but you can heal—and multiple pathways can help you get there. 

Take Back Control of Your Life in Rehab

When you’re a child, life is mostly out of your control. And growing up with a parent with addiction makes it feel even more so. But you’re no longer a child. You are in charge of what happens next. And you’re in charge of your own healing. 

You don’t have to heal on your own: going to a rehab that treats ACoA-related trauma can provide the expertise and support you need. 

Explore rehabs that treat trauma to learn more about treatment methods, pricing, and more, and reach out to centers directly. 

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The Hidden Risks of Club Drugs

Synthetic drugs can be misleading. It’s easy to take them by mistake, because they’re often mislabeled or poorly described. Maybe a friend offered you “pure” molly at a festival. Or you saw packages of “legal weed gummies” in your local convenience store. But many synthetic drugs contain other harmful substances. And they’re often unregulated, or even unlabeled. And when you don’t know what you’re taking, you can’t predict the risks.

These drugs carry high risks of bad interactions and overdose. As with all drugs, there’s also a risk of addiction. And when you’re gambling with substances and dosages, it can sneak up on you. When you’re ready to recover, you might consider attending a rehab program for synthetic drug use.

What Are Synthetic Drugs?

Synthetic drugs—sometimes called club drugs or designer drugs—are drugs manufactured in labs.1 They’re supposed to mimic the effects of “natural” drugs like marijuana or cocaine that are derived from organic substances like the cannabis plant or coca plant.

You can sometimes find synthetic drugs in convenience stores2 or smoke shops with labels like “not for human consumption” or “for cleaning purposes.” These labels help sellers avoid detection by law enforcement. But that plausible deniability creates misinformation. As a result, synthetic drugs aren’t always easy to spot. In order to stay safe, it’s important to know how to recognize them.

Synthetic Marijuana

Some stores sell synthetic marijuana as an alternative to weed.3 They might also call it an “herbal supplement,” “K2,” or “Spice.” But it’s usually a combination of plant materials and synthetic chemicals, despite labels claiming to contain only natural substances. These drugs can cause severe agitation and even hallucinations.

Because synthetic marijuana is unregulated, you likely won’t know what you’re buying. It’s also much stronger than regular marijuana, and can include heavy metals or other dangerous chemicals. If you regularly smoke weed, taking synthetic marijuana may seem like a safe alternative. But despite its similar name, it’s a completely different drug.

Bath Salts

Bath salts are a synthetic stimulant.4 They normally come in a crystal powder form packaged as plant food or phone screen cleaner. Bath salts may produce paranoia, hallucinations, increased sex drive, or panic attacks. In some cases, taking bath salts leads to violent behavior. The term “bath salts” can refer to a variety of specific drugs. Among these, a drug called flakka is increasingly popular.5

Because bath salts are typically cheaper and stronger than other stimulants, they’re especially addictive. According to the National Institute on Drug Abuse, many people report “intense, uncontrollable urges” to use bath salts6 repeatedly.

Ecstasy

Also known as molly or MDMA, ecstasy acts as both a stimulant and hallucinogen.7 It can alter your perception of time and space, and increase pleasure and energy. However, it can also cause sleep problems, anxiety, and memory issues. Molly comedowns are notoriously depressing—that’s because it depletes your brain of its natural pleasure chemicals.8 A study published in Neurology found that,

Striatal levels of serotonin and those of its metabolite 5-hydroxyindoleacetic acid were severely depleted by 50 to 80% in the brain of a chronic user of methylenedioxymethamphetamine (MDMA)… Our data suggest that MDMA exposure in the human can cause decreased tissue stores of serotonin and therefore some of the behavioral effects of this drug of abuse could be caused by massive release and depletion of brain serotonin.

Because ecstasy is unregulated, it’s frequently mixed with other drugs. Even when it appears in crystal form, it’s almost certainly combined with additives like methamphetamine, bath salts, ketamine, and fentanyl. And because many people use ecstasy at clubs or festivals, it’s common to mix it with alcohol and other drugs. This creates a dangerous situation that can potentially lead to overdose.

Synthetic Opioids

Synthetic opioids, like fentanyl, replicate the effects of natural opioids, like morphine. But synthetic opioids produce stronger narcotic effects9 than natural opioids, increasing the risk of overdose. Synthetic opioid addiction often resembles addiction to natural opiates like heroin and morphine, though it may be compounded by the effects of other ingredients. Most rehabs treat these opioid addictions in the same way.

Designer drugs have some unique risks. And that’s not only because of their chemical makeup. Their legal and cultural statuses also play a role.

Lack of Regulation

One of the main dangers of club drugs10 is their lack of regulation. FDA-approved drugs like benzodiazepines can also lead to addiction. But if you choose to, you can track your dosage. And that information might make it easier to know when you need help.

Designer drugs are different. Because they’re made in labs without oversight, chemists don’t have to follow a precise formula. They might even switch between different chemicals because of changing supply chains. Then, distributors can add other substances to bulk up the quantity and increase their profit margins.

When you mix these substances with alcohol or other drugs, they can be a deadly combination. And you may not recognize the warning signs of overdose. In order to reduce overdoses from laced drugs, some nonprofits and governments have started to offer drug testing kits.11

Increased Availability of Designer Drugs

Synthetic drugs are also dangerous12 because of how accessible they are. To buy them, you don’t need to learn a secret code, or meet up with anyone covertly. Instead, you can just walk into a store and buy them with a credit card. And many people only take club drugs at events,13 which can feel like special occasions. So even if you go clubbing every weekend, it might feel like your drug use is under control. And that can make it harder to notice a growing addiction.

Designer drugs are typically cheaper than other drugs, so some people may prefer them for practical reasons. This also means that synthetic drugs are more accessible to young people.14 And people who start using drugs during adolescence are more likely to develop addiction.

Misunderstood Risks

There’s a misconception that some synthetic drugs are natural—especially synthetic marijuana. While some brands do contain plant material, they also include other chemicals. Some types of synthetic marijuana may even contain synthetic opioids15 like fentanyl.

Experts are still researching the best treatment methods for synthetic drug addiction. As of now, there’s no standard treatment program for synthetic drug abuse.16 But certain behavioral therapies appear to be helpful.

Cognitive Behavioral Therapy (CBT)

CBT is a popular treatment method for addiction and other mental health issues. Studies have proven CBT effective for treating psychoactive drug addiction,17 which includes synthetic drugs.

In CBT, you’ll learn new coping skills for handling emotional stress. Treatment also helps you work through and change unhealthy thought patterns. Your therapist might ask you how you feel before, during, and after taking synthetic drugs, to help you identify triggers. For example, maybe you take molly when you go out with friends because you have social anxiety. Once you recognize this, you can practice new ways to manage difficult emotions.

CBT can also include motivational interviewing (MI). With MI, your therapist will help you identify what changes you want to make in life and why. By reminding yourself why you want to change, you can commit more fully to recovery.

Behavioral Therapy for Teens

Synthetic drug addiction is especially common among teens,18 and young people have unique needs during treatment. For example, teens benefit greatly from group therapy with peers. This helps them connect with others who share their experiences, offering them invaluable camaraderie and social support for their recovery.

Experts also recommend family therapy for adolescents recovering from synthetic drug addiction. This empowers teens in recovery, their parents, and other family members to support each other’s healing.

Get Expert Help

Rehabs have been treating synthetic drug use for decades. So while it may seem like there are a lot of unknowns, your chance for a successful recovery doesn’t have to be one of them.

Search for rehabs that treat synthetic drug addiction to learn about their pricing, treatment approaches, and more.

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Breaking the Cycle: How to Heal From Addiction and Anxiety

Anxiety can be more than a feeling. It also affects your behavior. And if it’s getting in the way of your daily life, it makes sense that you’d look for ways to cope. But not all coping strategies are healthy. Some—like drug use—can even make your anxiety worse. In rehab for anxiety, you can learn safer, more sustainable skills.

Recognizing Anxiety

Anxiety disorders ((What are the five major types of anxiety disorders? [Text]. 2013, February 9. HHS.Gov. https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html)) look different for different people. They can even be invisible to others. But even for high achievers, anxiety can get in the way of important goals. If anxiety is interfering with your daily life, you may have one of these diagnoses:

Everyone feels stressed from time to time. But if your anxiety interferes with the rest of your life, you might have one of these diagnoses. And while it’s normal to search for ways to manage these feelings, not all coping mechanisms are healthy.

The Connection Between Anxiety and Drug Addiction

Anxiety and addiction ((Smith, J. P., & Book, S. W. (2008). Anxiety and substance use disorders: A review. The Psychiatric Times, 25(10), 19–23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/)) are 2 of the most common diagnoses in the U.S. And they often occur together. Some people develop addiction in an attempt to self-medicate anxiety. Others feel anxiety about their addiction. Whichever comes first, one thing is clear: anxiety and addiction are a volatile combination. ((Nguyen, A., Mirbaba, M., Khaleghi, F., & Tsuang, J. (2017). Current treatment options for co-morbid anxiety and alcohol use disorders: A review. Journal of Addictive Behaviors and Therapy, 1(1), 0–0. https://www.primescholars.com/abstract/current-treatment-options-for-comorbid-anxiety-and-alcohol-use-disorders-a-review-106758.html))

What’s more, each of these conditions can make the other one worse. And that’s true even if a drug helps with your short-term symptoms. For example, benzodiazepines are commonly prescribed for anxiety. But some benzos, like Xanax, have a rebound effect. ((Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A review of alprazolam use, misuse, and withdrawal. Journal of Addiction Medicine, 12(1), 4–10. https://doi.org/10.1097/ADM.0000000000000350)) They’re hugely effective at relieving the symptoms of panic attacks. But, if you reduce your dosage, your anxiety might spike. This can easily lead to relapse.

The complex relationship between addiction and anxiety has an impact on treatment. ((Brady, K. T., Haynes, L. F., Hartwell, K. J., & Killeen, T. K. (2013). Substance use disorders and anxiety: A treatment challenge for social workers. Social Work in Public Health, 28(0), 407–423. https://doi.org/10.1080/19371918.2013.774675)) Specifically, it can be hard to treat underlying anxiety while you’re actively taking drugs. When you’re ready to heal from either of these conditions, you might benefit from treatment for co-occurring disorders.

Treating Both Addiction and Anxiety

There’s a silver lining here. Because these issues are so common, experts have sought out many effective therapies. In residential rehab, you might try one of these, or combine them as part of a comprehensive care plan.

Cognitive Behavioral Therapy

Data shows that cognitive behavioral therapy (CBT) can effectively treat anxiety and co-occurring addiction. ((Alamdarloo, G. H., Khorasani, S. M., Najafi, M., et al. (2019). The effect of cognitive-behavioral therapy on depression, anxiety, and stress levels in iranian males with addiction. SAGE Open, 9(1), 215824401882446. https://doi.org/10.1177/2158244018824466)) This type of talk therapy helps you recognize unhealthy thought patterns. When you understand the reason behind your own behaviors, you can learn to respond in a healthier way.

Your therapist will act as a guide, teaching you practical coping strategies. As you incorporate those skills into your daily life, you’ll learn to regulate your emotions. This healthy behavior can make it easier to work through anxiety without taking drugs.

Yoga

There’s more to yoga than physical exercise. It also teaches mindfulness, breathwork, and emotional endurance. It can even give you a sense of community. For these reasons and more, research shows that yoga reduces anxiety. ((Kuppili, P. P., Parmar, A., Gupta, A., & Balhara, Y. P. S. (2018). Role of yoga in management of substance-use disorders: A narrative review. Journal of Neurosciences in Rural Practice, 9(1), 117–122. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812135/))

This is part of why yoga is often used in addiction treatment. Specifically, this mind-body practice can reduce drug cravings, helping you kick-start recovery. And over time, it can help you reconnect with yourself in an even deeper way.

Biofeedback

Biofeedback uses sensors to track your physical responses ((Banerjee, S., & Argáez, C. (2017). Neurofeedback and biofeedback for mood and anxiety disorders: A review of clinical effectiveness and guidelines. Canadian Agency for Drugs and Technologies in Health. https://www.ncbi.nlm.nih.gov/books/NBK531603/)) to certain stimuli. For example, you might wear a heart rate monitor during a therapy session. Then, with a clinician’s help, you’ll review the data it collected. This helps patients understand their own reactions to stress.

This treatment gives you valuable information about how your body reacts to certain emotions. You can then use that data to change your physiological response using different relaxation techniques. The goal is to empower you to make different choices—ones that will support your long-term health. As a result, biofeedback reduces both anxiety and drug cravings. ((Khatami, M., Woody, G., O’Brien, C., & Mintz, J. (1982). Biofeedback treatment of narcotic addiction: A double-blind study. Drug and Alcohol Dependence, 9(2), 111–117. https://doi.org/10.1016/0376-8716(82)90056-4))

Moving Forward, on Your Own Terms

Often, anxiety is the fear of things you can’t control. Some of those things—like the weather—will always be out of reach. That’s okay. In recovery, you can learn to accept your emotions just as they are. And by doing that, you can take back control of the best parts of your life.

Browse a list of anxiety treatment centers to learn about their housing, treatment options, insurance, and more.

Reviewed by Rajnandini Rathod

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Exploring the Link Between ADHD and Addiction

Attention-deficit/hyperactivity disorder (ADHD) is a serious mental health issue. From the name, it’s easy to think this condition is a set of behavioral problems. But those are just the symptoms. In reality, ADHD comes from a neurochemical imbalance—and it’s remarkably similar to the brain chemistry of addiction.

If you’re considering treatment for ADHD and addiction, you can start by learning how they relate to each other.

The Brain Chemistry of Addiction and ADHD

People with ADHD have much a higher risk of addiction. ((Davis, Caroline, et al. “Attention-Deficit/Hyperactivity Disorder in Relation to Addictive Behaviors: A Moderated-Mediation Analysis of Personality-Risk Factors and Sex.” Frontiers in Psychiatry, vol. 6, Apr. 2015, p. 47. PubMed Central, https://doi.org/10.3389/fpsyt.2015.00047.)) This is true across age groups, affecting both adults and teens with ADHD. ((Schellekens, Arnt F. A., et al. “Often Overlooked and Ignored, but Do Not Underestimate Its Relevance: ADHD in Addiction – Addiction in ADHD.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 169–72. www.karger.com, https://doi.org/10.1159/000509267.)) Experts agree that the 2 conditions have “a shared biological background.” Specifically, both addiction and ADHD have an impact on dopamine, which is a neurotransmitter.

Dopamine relates to the brain’s reward system. ((Watson, Stephanie. “Dopamine: The Pathway to Pleasure.” Harvard Health, 20 July 2021, https://www.health.harvard.edu/mind-and-mood/dopamine-the-pathway-to-pleasure.)) This naturally occurring chemical is released when you do something pleasurable. The brain defines “pleasure” broadly: your dopamine might increase when you buy a new pair of shoes, get a job, or eat a cookie. And when an activity feels good, you’re more likely to do it again.

That can be very healthy. For example, you can get dopamine from exercise. ((“Five Surprising Ways Exercise Changes Your Brain.” Greater Good, https://greatergood.berkeley.edu/article/item/five_surprising_ways_exercise_changes_your_brain. Accessed 14 Dec. 2022.)) Your brain is quite literally wired to make you want to work out. But there’s a downside to dopamine. Plenty of activities—like substance use—feel good while doing serious damage to your health. And for people with ADHD, dopamine might already be hard to come by.

The Biology of ADHD

If you have ADHD, it may take extra effort to concentrate, sit still, or complete important tasks. This often interferes with relationships, schoolwork and career. In severe cases, people with ADHD can qualify for disability benefits. ((Is ADHD A Disability? https://www.disability-benefits-help.org/disabling-conditions/adhd-and-social-security-disability. Accessed 14 Dec. 2022.)) But it also comes with some advantages. Like any other type of neurodivergence, this condition changes the way you see the world. And your unique insight can be a strength.

Biologically, people with ADHD can’t regulate dopamine levels. ((Blum, Kenneth, et al. “Attention-Deficit-Hyperactivity Disorder and Reward Deficiency Syndrome.” Neuropsychiatric Disease and Treatment, vol. 4, no. 5, Oct. 2008, pp. 893–918. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626918/.)) This condition affects at least one of the genes responsible for that process. And that, experts say, “makes it difficult for neurons to respond to dopamine.”

In other words, even if you have healthy dopamine levels, it may not feel that way. So things that “should” be pleasurable might not always feel as good as you want them to.

If nothing feels good enough, it makes sense to go looking for new types of stimulation. This may explain the link between ADHD and risk-taking. ((Shoham, Rachel, et al. “ADHD-Associated Risk Taking Is Linked to Exaggerated Views of the Benefits of Positive Outcomes.” Scientific Reports, vol. 6, no. 1, Oct. 2016, p. 34833. www.nature.com, https://doi.org/10.1038/srep34833.))

Drug use falls neatly into this category.

Dopamine and Addiction

Over time, addiction makes the brain less sensitive to dopamine. ((The Neurobiology of Substance Use, Misuse, and Addiction | Surgeon General’s Report on Alcohol, Drugs, and Health. https://addiction.surgeongeneral.gov/executive-summary/report/neurobiology-substance-use-misuse-and-addiction. Accessed 14 Dec. 2022.)) At first, your brain starts associating drugs with a sense of reward. The act of taking drugs triggers a release of dopamine, whether or not the drug itself does.

As you get used to this repeated flood of dopamine, you’ll feel less satisfaction from taking drugs. This effectively increases your tolerance to the drug, so you need to take more of it to achieve the same result. At the same time, you start feeling less pleasure from other activities. So even if you no longer enjoy the sensation of being high, you might still feel driven to take drugs.

These behaviors quickly become a vicious cycle. Psychiatrist and dopamine expert Dr. Anna Lembke explains that for people in this state, joy is often out of reach. “Now, our drug of choice doesn’t even get us high,” she says. “It just makes us feel normal.” ((Hu, Elise, and Audrey Nguyen. “Too Much Pleasure Can Lead to Addiction. How to Break the Cycle and Find Balance.” NPR, 4 Apr. 2022. NPR, https://www.npr.org/2022/03/31/1090009509/addiction-how-to-break-the-cycle-and-find-balance.))

But if you have ADHD, addiction recovery might not be enough to break the cycle. You might stop taking drugs, but still feel unsatisfied with your life. In order to heal from these co-occurring disorders, it’s important to find treatment for both of them.

Treatment for ADHD and Addiction

ADHD is often diagnosed in children ((Braaten, Ellen. “5 Things Parents and Teachers Need to Know about ADHD.” Harvard Health, 27 Oct. 2017, https://www.health.harvard.edu/blog/5-things-parents-and-teachers-need-to-know-about-adhd-2017102712643. and teens, and some people grow out of their symptoms. But that’s not true for everyone. And recent data shows that you can develop ADHD as an adult, ((“‘Late-Onset’ ADHD May Emerge in Young Adults.” Psychiatric Times, https://www.psychiatrictimes.com/view/late-onset-adhd-may-emerge-young-adults. Accessed 14 Dec. 2022.)) even if you showed no signs of it in childhood.

Because of these complexities, you might need different types of treatment in different stages of recovery. And after you complete rehab, you may benefit from ongoing care for addiction, ADHD, or both. Certain therapies are especially helpful for people with these diagnoses.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a popular treatment for many mental health conditions. And a wealth of data supports CBT as a therapy for ADHD and addiction. ((Zulauf, Courtney A., et al. “The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders.” Current Psychiatry Reports, vol. 16, no. 3, Mar. 2014, p. 436. PubMed Central, https://doi.org/10.1007/s11920-013-0436-6.)) This framework focuses more on practical skills than it does on emotional processing. Your therapist will teach you coping strategies for dealing with difficult thoughts, urges, social situations, and more. In between sessions, you’ll try them out in your daily life.

Integrated Cognitive Behavioral Therapy

As the name implies, integrated cognitive behavioral therapy (ICBT) integrates components of CBT ((Capone, Christy, et al. “Integrated Cognitive Behavioral Therapy (ICBT) For PTSD and Substance Use in Iraq and Afghanistan Veterans: A Feasibility Study.” Journal of Traumatic Stress Disorders & Treatment, vol. 3, no. 4, 2014, p. 1000134. PubMed Central, https://doi.org/10.4172/2324-8947.1000134.)) and other treatment methods. Patients learn about their condition, practice mindfulness, and learn flexible thinking skills. You’ll use a workbook, and your therapist will give you homework assignments to complete between sessions. This format empowers clients to develop practical skills and put them to use in real-life situations.

ICBT is a highly effective treatment for co-occurring ADHD and addiction. ((van Emmerik-van Oortmerssen, Katelijne, et al. “Integrated Cognitive Behavioral Therapy for ADHD in Adult Substance Use Disorder Patients: Results of a Randomized Clinical Trial.” Drug and Alcohol Dependence, vol. 197, Apr. 2019, pp. 28–36. PubMed, https://doi.org/10.1016/j.drugalcdep.2018.12.023.)) One study even found it to be more effective than other forms of CBT. ICBT can also treat post-traumatic stress disorder (PTSD). ((McGovern, Mark. Integrated Cognitive Behavioral Therapy for Co-Occurring PTSD and Substance Use Disorders. Clinical trial registration, NCT01457404, clinicaltrials.gov, 23 Oct. 2015. clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT01457404.)) However, like most types of talk therapy, ICBT focuses on mental, emotional, and behavioral issues. Since ADHD is also a neurochemical issue, many people need medical treatment as well.

Medication for ADHD

Prescribing medication to treat co-occurring ADHD and addiction ((Mariani, John J., and Frances R. Levin. “Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders.” The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, vol. 16, no. Suppl 1, 2007, pp. 45–56. PubMed Central, https://doi.org/10.1080/10550490601082783.)) is a controversial issue. If a patient has ADHD without addiction, prescription stimulants are the standard treatment. But stimulants are highly addictive. Because of this, experts disagree about the best course of action.

This controversy even affects people with ADHD who have no history of drug abuse. Some sources caution against treating ADHD with stimulants ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) because of the risk of future addiction. Others say prescribed stimulants protect against addiction, ((APA PsycNet. https://psycnet.apa.org/record/2013-43688-006. Accessed 14 Dec. 2022.)) because they empower patients to manage symptoms in a healthy way.

During addiction recovery, taking medication of any kind can be complicated. Tell your doctor about your history before you start a new prescription. Together, you can make a plan to keep yourself safe. For example, they might only prescribe you a few pills at a time, and ask you to come back into their office before you can get more.

Whatever treatments you pursue, it’s essential for you to get an official diagnosis first. That can be surprisingly difficult, especially for people of certain demographics.

Getting an Accurate Diagnosis

Because of the overlapping symptoms of ADHD and addiction, ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) doctors can’t always distinguish between them. This means that if you already have an ADHD diagnosis, you might need to start addiction treatment before you can get one. Most rehabs start their program with thorough assessments, so it’s relatively easy to get assessed for ADHD while you’re in residential treatment. Some doctors even recommend screening everyone in addiction treatment for ADHD. ((Matthys, Frieda, et al. “[Summary of the practice guideline for the diagnosis and treatment of ADHD in adolescents and adults with addictions].” Nederlands tijdschrift voor geneeskunde, vol. 157, no. 24, Jan. 2013, p. A6025.))

In some populations, though, ADHD is harder to diagnose. There are several possible reasons for this. Many clinicians have a preconceived image of what ADHD patients look like. This makes it easy to miss the symptoms when they present in a different way. It can also be hard to differentiate between ADHD and other mental health issues.

ADHD in Teens

For children and teens with ADHD, ((“Severity of ADHD in Children Increases Risk of Drug Use in Adolescence, Says Longitudinal Study.” Https://Www.Apa.Org, https://www.apa.org/news/press/releases/2003/08/adhd-drugs. Accessed 14 Dec. 2022.)) early diagnosis is key. That’s because children with more severe ADHD symptoms are at a greater risk of developing addiction later on. However, ADHD symptoms may not appear before puberty. ((Ostojic, Dragana, and Carlin J. Miller. “Association Between Pubertal Onset and Symptoms of ADHD in Female University Students.” Journal of Attention Disorders, vol. 20, no. 9, Sept. 2016, pp. 782–91. DOI.org (Crossref), https://doi.org/10.1177/1087054714535249.)) And because even healthy teenagers go through behavioral changes, that timing can make it difficult for parents to notice a problem. While this can be an issue for teens of any gender, it’s most common among young women.

Women With ADHD

Data suggests that up to 75% of women with ADHD may be undiagnosed. ((Walters, Anne. “Girls with ADHD: Underdiagnosed and Untreated.” The Brown University Child and Adolescent Behavior Letter, vol. 34, no. 11, Nov. 2018, pp. 8–8. DOI.org (Crossref), https://doi.org/10.1002/cbl.30337.)) That might be because women with ADHD often show different symptoms ((Quinn, Patricia O., and Manisha Madhoo. “A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls: Uncovering This Hidden Diagnosis.” The Primary Care Companion for CNS Disorders, vol. 16, no. 3, 2014. www.ncbi.nlm.nih.gov, https://doi.org/10.4088/PCC.13r01596.)) than clinicians expect.

For example, one study found that women were more likely to be inattentive than hyperactive. Inattention primarily affects the person feeling it. Your inability to focus on your book won’t distract a stranger at a bus stop. But hyperactivity, which is common in men with ADHD, can be disruptive in a group setting. Both clinicians and patients’ loved ones commonly miss “internalizing” symptoms like inattentiveness. Instead, women with ADHD are often misdiagnosed with bipolar disorder, anxiety, or depression.

Differentiating Between ADHD and Anxiety

ADHD and anxiety ((Pliszka, Steven R. “ADHD and Anxiety: Clinical Implications.” Journal of Attention Disorders, vol. 23, no. 3, Feb. 2019, pp. 203–05. DOI.org (Crossref), https://doi.org/10.1177/1087054718817365.)) often go hand in hand. While ADHD is not an anxiety disorder, ((ADHD and Anxiety: What’s the Connection? 15 May 2017, https://www.medicalnewstoday.com/articles/315303.
)) they can present with similar symptoms. For instance, either condition might get in the way of finishing your homework. In people with ADHD, that’s probably because you just can’t focus. On the other hand, people with anxiety might be able to focus, but afraid of getting it wrong.

ADHD can also cause anxiety. That’s because its symptoms make it harder to achieve your goals. Some people get anxious about the impact ADHD has on their lives. Without proper treatment, it’s all too easy to get stuck in this loop.

If you have both of these conditions, it’s important to get the right diagnosis before taking medication. Otherwise, you’ll risk making your symptoms worse. ADHD patients commonly take stimulants, which can increase anxiety. ((Stimulants – Alcohol and Drug Foundation. https://adf.org.au/drug-facts/stimulants/. Accessed 14 Dec. 2022.)) Stimulants may still be a good fit for some people with anxiety disorders—it all depends on your specific health history. You can work closely with your doctor to design a care plan that meets your needs.

ADHD May Be a Risk Factor for Depression

There’s less of an overlap between the symptoms of ADHD and depression, but they have a strong correlation. People with ADHD often develop depression ((Riglin, Lucy, et al. “ADHD and Depression: Investigating a Causal Explanation.” Psychological Medicine, vol. 51, no. 11, Aug. 2021, pp. 1890–97. Cambridge University Press, https://doi.org/10.1017/S0033291720000665.)) later in life, even if they grow out of childhood ADHD symptoms.

There may be a genetic link between these conditions. And people with ADHD and depression often have other mental health issues, like addiction or trauma. Recovering from these co-occurring disorders is complex. You may require specialized care, and ongoing treatment even after rehab.

Post-traumatic Stress Disorder

Everyone experiences trauma differently. Something that feels like just a bad day to you might be deeply traumatizing for someone else. And your personal history can make you more or less likely to develop post-traumatic stress disorder (PTSD).

ADHD increases your risk of developing PTSD ((Biederman, Joseph, et al. “Is ADHD a Risk for Posttraumatic Stress Disorder (PTSD)? Results from a Large Longitudinal Study of Referred Children with and without ADHD.” The World Journal of Biological Psychiatry, vol. 15, no. 1, Jan. 2014, pp. 49–55. DOI.org (Crossref), https://doi.org/10.3109/15622975.2012.756585.
)) in response to trauma. That’s especially true for people with both ADHD and alcohol addiction. ((Luderer, Mathias, et al. “ADHD Is Associated with a Higher Risk for Traumatic Events, Self-Reported PTSD, and a Higher Severity of PTSD Symptoms in Alcohol-Dependent Patients.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 245–53. www.karger.com, https://doi.org/10.1159/000508918.)) And data shows that people with ADHD experience a higher number of traumatic events, whether or not they develop PTSD.

If you have trauma symptoms, you might benefit from trauma-informed care (TIC). TIC is a general approach to treatment, not a specific type of therapy. This means you can get trauma-informed care for ADHD, addiction, PTSD, and any other concerns you’re seeking help for.

Many Roads to Recovery

Everyone’s recovery is unique, and that’s doubly true for people with co-occurring disorders. Your provider will help you design a care plan that accounts for your various goals.

The act of healing can empower you to understand the depth of your emotional experience. That’s how it happened for Peach Perkins.

Peach is in recovery from ADHD, alcohol and drug addiction, ((ADHD and Substance Abuse: ADHD Aha! Podcast. https://www.understood.org/en/podcasts/adhd-aha/adhd-and-substance-abuse-peachs-story. Accessed 14 Dec. 2022.)) as they explained on the podcast ADHD Aha! But it took them almost a year of sobriety to understand how those conditions worked together. At first, they thought addiction was “the thing preventing me from doing a good job at work. Now I can really go all in. And I was still at work, just my eyes were crossed and I still couldn’t do what I needed to do. That wasn’t what was in my way.” After that realization, they were able to get an official ADHD diagnosis. With the right diagnosis, they finally got the treatment they needed—and you can too.

Find Balance in Treatment for ADHD and Addiction

ADHD is often, but not always, a life-long condition. Recovery usually doesn’t mean getting rid of your symptoms entirely. Instead, you’ll learn to manage them in a healthier way. And those coping skills can make it easier to heal from co-occurring diagnoses like addiction.

Learn more about rehab programs for ADHD, including their locations, pricing, insurance coverage, and more.