Category: Substances

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Can You Go to Rehab for Multiple Addictions?

Addiction takes many forms. For some people, it means relying on a particular drug. But it’s not always that simple. If you’re consistently taking more than one drug at a time, or switching between drugs, you might have polysubstance use disorder.

This condition looks a little different for everyone. You might feel like it’s safer to take more types of drugs, so you don’t start depending on any of them. Or, you might be mixing substances to get a certain result. But this behavior doesn’t protect you from addiction.

If you’re ready to make a change, there are several ways to approach recovery and rehab. And in treatment, your care team can help you understand the nuances of this complex issue.

Can You Have More Than One Addiction?

The CCD defines polysubstance use as “the use of more than one drug,” adding that “this includes when two or more are taken together or within a short time period, either intentionally or unintentionally.” Often, this behavior is socially acceptable. Have you ever smoked a cigarette while drinking a beer? If so, you’ve engaged in polysubstance use.

Addiction is, among other things, a behavioral issue. In other words, you can have addiction even in the absence of physical symptoms like cravings or withdrawal. And at first, you might not even notice. It’s all too easy to use multiple drugs at the same time, especially if you’re taking illicit substances. Street drugs like heroin and cocaine aren’t regulated, and might be mixed with other things.

Addiction Can Sneak Up On You

Stigma plays a complex role in many types of addiction. Because drinking is so socially acceptable, it can be hard to know when you have alcohol addiction. On the other hand, meth addiction is so stigmatized that it’s easier to recognize the problem—even if it’s still hard to get help.

When you’re switching between substances, this metric can work against you. For instance, you might not be doing enough of any single drug to be worried about addiction. But are you taking drugs every day? This behavior can quickly become a slippery slope.

Legality makes some substances seem safer, but mixing any drugs has unpredictable results. Think of alcohol, marijuana, and nicotine. In many U.S. states, all 3 are both legal and socially acceptable. It makes sense that people mix these substances without thinking twice. But taking substances together can have unintended, even dangerous, effects.

The Effects of Combining Drugs

Combining drugs can be unpredictable. That’s especially true when you’re taking illegal, untested drugs, but it can even be an issue with prescriptions. For example, taking MDMA along with certain antidepressants can lead to serotonin syndrome. This condition is rare, but extremely dangerous. And it’s just one of several drug combinations to watch out for.

The following combinations can also put you at risk of serious side effects:

  • Drinking with benzodiazepines, like Xanax, makes it easier for your body to process the benzos. This can exponentially raise the concentration of drugs in your bloodstream. And because you can’t control or measure that increase, you might increase your risk of overdose.
  • Cocaine and alcohol heighten the risk of cardiotoxicity, or heart damage.
  • Mixing opioids and stimulants—or “speedballing”—is dangerous and unpredictable. If the 2 drugs effectively cancel each other out, you might even feel sober. And if you respond by taking more, then you risk overdosing. Speedballing can also cause serious heart problems.
  • Mixing multiple opioids is easy to do by mistake. Many sources mix drugs like heroin with fentanyl, a cheaper synthetic opioid. Because fentanyl is stronger than other similar drugs, this makes it difficult to dose properly—especially if you don’t know you’re taking it. And even accidental use of fentanyl can increase your risk of addiction.
  • Mixing alcohol with any drug can have a direct impact on your mental health. This can cause anxiety and increase drug cravings, making it harder to begin recovery.

Numerous Ways to Treat Multiple Addictions

Recovering from even one addiction can be a complex process. And if you’ve been taking several different substances, you may need highly specialized treatment. Your care team can help you decide which types of therapy are most appropriate. A comprehensive treatment program might include therapies like the following:

Prescribed Medications

When taken under a doctor’s supervision, certain medications can support your recovery from multiple addictions. However, this may not be appropriate for all patients. For instance, if you have a history of misusing prescription drugs, talk therapy may be a safer treatment.

Even if you find meds helpful, they’re just one part of recovery. It’s important to combine this approach with other therapies, and with healthy lifestyle choices.

Exercise and Movement

Physical fitness has a huge impact on mental health. That makes it important for everyone. But data suggests it matters even more if you’re healing from addiction.

For people with multiple addictions, exercise decreases cravings and improves your mood. Experts say physical fitness might even guard against relapse. And best of all, you can put this data to work for you in any stage of recovery. During treatment, you might benefit from a form of movement that gets your blood pumping. And after you return home, you can take up yoga, go swimming, or just jog around the block.

Fitness can also aid in recovery by helping you build a healthy routine. Doing things you genuinely enjoy is an important part of long-term healing. Sustainable habits, like exercise, can give you the strength you need to stay on track.

Contingency Management

Contingency management (CM) activates your internal reward system. In treatment, patients get material rewards for achieving specific goals. For example, you might get free movie tickets after your 5th negative drug test in a row.

Data shows that CM can effectively treat patients with multiple addictions. This therapy can protect against relapse both during and after inpatient rehab. It even works as a virtual treatment.

Finding the Right Tools for Recovery

Multiple addictions are a complex issue. So when you start recovery, you’ll need a treatment approach that covers all your bases.

Talk to your care team about which combination of therapies will work best for you. The act of designing your treatment plan is the first step toward a healthier future. And that future can be as multifaceted and exciting as your past, even if the details are different.

Browse our list of rehab centers to learn about their locations, treatments offered, and insurance options, and to start planning your recovery.

Reviewed by Lisa Misquith

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What Happens When You Get Sober?

When you’re living with an addiction, it can be hard to imagine recovery. Many people get lost in the negative, thinking about life without drugs or alcohol. But what about life with more time, energy, and emotional stability?

Addiction eats away at your resources. People lose money, relationships, their physical health—the list goes on and on. When you start healing, you’ll have so much more to work with. If you decide to attend a residential treatment center, experts can help you put those assets to use. And from there, you’ll start dreaming of—and planning for—a better future.

1. Your Mental Health Gets Better

Addiction affects both your physical and mental health. ((Addiction and health. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/addiction-health)) And when you’re actively using drugs, the idea of withdrawal might sound even worse. That’s a valid fear. But it might not be a reality. With the right support, detox doesn’t have to be dangerous. Best of all, withdrawal and detox are temporary. And unlike continued substance use, they offer a lot to look forward to on the other side.

Focus More Easily

Addiction makes it hard to focus, ((Gould, T. J. (2010). Addiction and cognition. Addiction Science & Clinical Practice, 5(2), 4–14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120118/)) reason, and learn new things. It can also interfere with your memory. This is because drugs quite literally change your brain. You might not even notice these issues at first, since they start so gradually. But shortly after getting sober, you can expect your mental state to improve. ((Module 10: Sobriety Sampling. (n.d.). Boston Center for Treatment Development and Training. https://www.mass.gov/doc/module-10-sobriety-sampling-0/download))

Manage Co-Occurring Symptoms

Studies show that 50% of people with addiction also have a mental health condition. ((Part 1: The connection between substance use disorders and mental illness. National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness)) Because of this, many rehabs treat co-occurring disorders.

In these programs, you’ll learn how to manage your conditions in a healthy way. You may even find that just one type of treatment helps you heal from both addiction and another health issue. ((Pettinati, H. M., O’Brien, C. P., & Dundon, W. D. (2013). Current status of co-occurring mood and substance use disorders: A new therapeutic target. The American Journal of Psychiatry, 170(1), 23–30. https://doi.org/10.1176/appi.ajp.2012.12010112))

2. Your Physical Health Improves

Addiction takes a serious toll on your body, as well as your mind. And before treatment, you may not even be aware of all your physical symptoms. Most rehabs can treat these issues alongside your mental health. And during recovery, your health may start to improve in some unexpected ways.

3. You Kickstart a Healthy Lifestyle

There’s more to recovery than therapy. Even in rehab, you can engage in fun, fulfilling hobbies, like martial arts or cooking. These healthy coping tools can help you stay grounded after you complete treatment.

Sobriety can help you get your life on track in measurable, practical ways. Studies show that most people’s finances improve during addiction recovery. ((Laudet, A. (2013). Life in Recovery [Report on Survey Findings]. Faces and Voices of Recovery. https://facesandvoicesofrecovery.org/wp-content/uploads/2019/06/22Life-in-Recovery22-Report-on-the-Survey-Findings.pdf)) And that, in turn, can improve your mental and even physical health. Experts agree that financial stability decreases your chance of depression, ((Bialowolski, P., Weziak-Bialowolska, D., Lee, M. T., Chen, Y., VanderWeele, T. J., & McNeely, E. (2021). The role of financial conditions for physical and mental health. Evidence from a longitudinal survey and insurance claims data. Social Science & Medicine, 281, 114041. https://doi.org/10.1016/j.socscimed.2021.114041)) anxiety, and heart disease. This solid foundation can empower you to take healthy risks, like meeting new people.

4. You’ll Build a Sober Community

Sobriety can improve your relationships. ((Kemp, R. (2019). Addiction and addiction recovery: a qualitative research viewpoint. Journal of Psychological Therapies. 4. 167-179. https://www.researchgate.net/profile/Ryan-Kemp-3/publication/337410578_Addiction_and_addiction_recovery_a_qualitative_research_viewpoint/links/5e54e278299bf1bdb8395e12/Addiction-and-addiction-recovery-a-qualitative-research-viewpoint.pdf?_sg%5B0%5D=started_experiment_milestone&origin=journalDetail)) Many residential programs are built to support this.  In rehab, you’re surrounded by people who support your healing goals. And once you start to repair your relationship with yourself and others, you’ll get to build a support network that has your back as you continue your journey.

This new community can be found through 12-Step meetings, non-12-Step support groups, sober living, or outpatient aftercare. Or, you could connect with people who share your interests. Whether you find a new hobby or pick up an old one, this can be a fun, low pressure way to find like-minded people.

If your previous social circle was built around drug use, this is your chance to form new, healthy relationships. And because forming social connections with other sober people can help prevent relapse, ((Study shows impact of social interactions on addictive behavior. (2018, October 15). National Institute on Drug Abuse. https://nida.nih.gov/news-events/news-releases/2018/10/study-shows-impact-of-social-interactions-on-addictive-behavior)) it’s an important part of your recovery.

5. You Have the Chance to Reconnect With Loved Ones

Addiction damages close relationships ((Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: From theory to practice. Social Work in Public Health, 28(0), 194–205. https://doi.org/10.1080/19371918.2013.759005)) with both given and chosen family. But recovery empowers you to hone your interpersonal skills. And, in time, those skills might help you heal your family dynamic.

For Michael Waggoner, sobriety is an opportunity to reconnect with family. ((Michael waggoner. (2020, September 9). Faces & Voices of Recovery. https://facesandvoicesofrecovery.org/story/michael-waggoner/)) “I am rebuilding relationships with my family, I am rebuilding trust,” he says. “I am able to be a dad today and a positive influence in my son’s life.”

6. You Can Realize Your Higher Purpose

Experts say that “addiction is a response to boredom, loneliness, meaninglessness, and other existential struggles.” ((Thompson, G. R. (n.d.). Meaning Therapy for Addictions: A Case Study. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1026.5596&rep=rep1&type=pdf)) Sobriety can help you find your purpose, and go on to live a meaningful life. Instead of just coping with a series of problems, you can build confidence and start moving toward the future you want for yourself.

When he was addicted to alcohol, James Gibbon had “no hope for the future.” ((James gibbons. (2020, September 9). Faces & Voices of Recovery. https://facesandvoicesofrecovery.org/story/james-gibbons/)) He faced  legal, financial, and relationship problems as a result. “I accepted the fact that I would never own a home, have a career, graduate from college, meet somebody special, and start a family,” he says. But after treatment:

“I began to see potential in myself. My confidence began to grow.”

The hard work of recovery can help you resolve past trauma, and teach you healthier coping strategies. With those skills, James achieved all the goals he thought were beyond him. And that isn’t unusual. When you stop using drugs and enter recovery, your potential for success only grows.

Sobriety Is Just the Beginning

It takes hard work to get and stay sober.

Healing isn’t just about stopping drug use. It’s about starting a new chapter.

And once you commit to recovery, you might be surprised by your own strength. That self-confidence is a powerful starting point.

Visit our directory of inpatient rehabs to learn more about their locations, services, pricing, and more.

Reviewed by Rajnandini Rathod

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Alternatives to 12-Step Recovery

12-Step programs are a popular method for addiction recovery. It’s easy to access free meetings, both online and in person. You can even find rehab centers that support your journey through the Steps. And while these programs have clear benefits, they’re not the only way to heal from addiction.

Recovery is a personal process, and principles of 12-Step recovery aren’t right for everyone.

There are as many pathways to healing as there are people in recovery.

If you’re looking for an alternative to Alcoholics Anonymous or other 12-Step fellowships, non-12-Step rehabs and support groups can help.

Non-12-Step Treatment Models

In 12-Step rehabs, providers use the Steps to frame your healing process. You might attend A.A. or N.A. meetings, receive chips to mark sobriety milestones, or talk through each Step with your therapist. But if this approach doesn’t resonate with you, you may feel excluded or disconnected during addiction treatment.1  In that case, these other approaches to recovery may be a better fit.

Evidence-Based Treatments

If scientific studies show that a treatment is effective, it can be called an evidence-based method. And it’s easy to find evidence-based treatment in rehab. But even the most respected methods may or may not be effective for you. Talk to your treatment provider about which types of therapy are the best fit for your personal recovery goals.

The most common evidence-based treatments are medication-assisted treatments (MAT) and behavioral therapies:

Medication-assisted treatment (MAT) uses pharmaceuticals to treat addiction and prevent overdose. These prescriptions are usually combined with talk or behavioral therapy. Studies show that MAT can decrease the risk of relapse  and increase treatment retention rates. If you’re curious about MAT, talk to your treatment team about your options. Medications can be helpful for some people, but you should only ever take them as prescribed.

Behavioral therapies teach you skills to manage your thoughts and feelings about addiction. The idea is that by improving your behavior, you can also improve your mental health. There are several popular types of behavioral therapy:

  • In cognitive-behavioral therapy (CBT), patients learn how to identify and interrupt behavioral patterns related to addiction.
  • Motivational enhancement therapy (MET) boosts your motivation to recover 2 and stay sober using motivational interviewing techniques.
  • Dialectical behavior therapy (DBT) teaches you specific strategies for coping with life’s challenges. This treatment is formatted like a class and has a focus on mindfulness.

Experiential Therapy in Rehab

In a rehab that offers experiential therapy, patients heal through fun, interesting activities. These treatments let you learn new skills, discover your strengths, and process your emotions in a different environment.

There are many types of experiential therapy:

  • Animal-assisted therapies like equine-assisted therapy to improve your communication skills
  • Nature immersion therapies to reconnect with yourself
  • Adventure therapy to build resilience and self-confidence
  • Fitness activities to release stress
  • Art therapy to express your feelings in a new medium

Because these activities let you heal by doing, they can be a welcome break from talk therapy. And since most of them are group activities, they also help you work on interpersonal skills.

These sessions can be fun and engaging, but they’re no substitute for other treatments. Rehabs typically offer experiential therapies alongside other modalities, like talk or behavioral therapies. This combined approach lets patients get to know themselves from several different angles. And it may give you a more complete picture of your own needs.

Holistic Treatment for Addiction and Mental Health

Holistic rehabs use a variety of treatment methods to address recovery. The goal is for people to heal not just from their addiction, but also from any other mental, physical, and spiritual issues they’re facing.

Many of these centers offer individualized treatment plans for all their patients. They may offer a wide range of holistic therapies:

  • Mindfulness exercises, like meditation and body awareness
  • Recreational therapy
  • Massage
  • Art therapy
  • Mindful movement like dance therapy or Tai Chi
  • Psychiatric care including talk, behavioral, and medication-assisted therapy
  • Nutrition therapy
  • Spiritual or faith-based activities

Experts say that holistic therapies empower patients4 to “develop a stronger sense of self-identity, self-esteem, and self-confidence.”

Non-12-Step Support Groups

Many people are drawn to 12-Step groups because they’re so easy to access. You can attend them in rehab, in your hometown, or even online. But if these support groups don’t meet your needs, there are other ways to build community while you recover.

There are a few reasons the 12 Steps might not be right for you. But commonly, A.A. and similar groups work best for people who find strength in spirituality. If you prefer a more scientific approach, you might consider alternative support groups.

SMART Recovery

SMART Recovery (Self-Management and Recovery Training)5 is a secular approach that encourages self-empowerment to overcome addiction. Meetings are free and led by people who have used SMART in their personal recovery. Members support each other in learning healthier coping skills throughout recovery.

As a social worker in New York explains, SMART Recovery helped them recover6 because they are a “free thinker who is more oriented to understand addiction in logical and behavioral terms rather than spiritual or disease terms.”

Instead of adopting the 12-Step belief that you are powerless over your addiction, SMART Recovery teaches that you are capable of changing your life by consciously working on yourself, alongside peers and professionals.

Secular Organizations for Sobriety

Secular Organizations for Sobriety (S.O.S.) is a “nonprofit network of autonomous, nonprofessional local groups dedicated solely to helping individuals achieve and maintain sobriety.” Their meetings take place both in person and online.

These meetings are open to anybody trying to live a sober lifestyle. They welcome religious and non-religious people to support each other in a secular setting. According to their founder, James Christopher, S.O.S. is inclusive of all pathways to recovery.7 In other words, you can attend S.O.S. meetings as part of a larger recovery plan.

Women for Sobriety

Women for Sobriety (WFS) hosts meetings in the US and Canada for women recovering from addiction. Led by women, WFS provides an inclusive environment for recovery for all women, including members of the LGBTQ+ community.

The meetings are based on 13 emotional and spiritual affirmations, and are facilitated by a person who has achieved 1 year of sobriety within the WFS program. They start with a reading of the affirmations, followed by introductions. Then group members take part in a discussion around the weekly topic.

One member explains that the WFS approach is “wonderful for women8 because it’s such a positive program. It met my needs and built my self-esteem.”

LifeRing Secular Recovery

LifeRing Secular Recovery is an anonymous organization that encourages abstinence through their 3-S philosophy: sobriety, secularity, and self-help.

They require members to remain completely abstinent. And while these groups welcome members of any religious belief, LifeRing supports “recovery methods that rely on human efforts9 rather than on divine intervention.”

Moderation Management

For people who want to change their relationship with alcohol, rather than become completely sober, Moderation Management (MM) is a harm reduction non-profit group that encourages bringing mindfulness to your consumption of alcohol.

MM promotes moderation as a pathway towards a healthier lifestyle. Through small, attainable steps, and peer-led group meetings, they support participants in their journey towards more manageable drinking.

As one member explained,

The support and encouragement of the MM groups has been invaluable to me! Never judgement or blame; always positive reinforcement and motivation.10

While harm reduction can be helpful for some people, it’s not the right approach for everyone. For example, if you have high-functioning alcohol addiction, you might not even realize how much of a toll drinking takes on your life. In that case, harm reduction could just push the problem farther down the line. Instead, finding treatment that helps you get completely sober—12-Step or not—might be a better choice.

Explore Alternative Pathways Towards Recovery

You have a wide array of choices for rehab. And while the 12 Steps are hugely popular, they’re not the only option. You have the right—and even the responsibility—to heal in a way that meets your needs. If 12-Step treatment isn’t right for you, there are countless other ways to start recovery.

Connect with a non-12-Step rehab today to learn about different treatment philosophies, insurance options, locations, and more.

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Is 12-Step Recovery Right For You?

You’ve probably heard of the 12 Steps, but what exactly does this approach to recovery entail? The 12 Steps provide a guideline to recovery itself, and the programs supplement treatment. Attending meetings provides you with social support and the means to maintain sobriety after rehab. Many people enjoy these aspects of this approach, and choose to attend 12-Step meetings in rehab and after returning home.

But while popular, 12-Step rehab isn’t for everyone. For one, the 12 Steps are rooted in Christianity, which may not resonate with people of different religious backgrounds or frameworks for understanding the world. And while these groups provide important social support, they’re not the only way to find community. But many people enjoy the spirituality component, as well as the robust social structure these groups provide.

Let’s take a closer look at what 12-Step recovery entails, and what other options exist, as you determine what approach sits best with you.

What Is 12-Step Recovery?

In 12-Step programs, people follow 12 designated steps to recovery. Members gather regularly as a group to review the Steps, share their stories, and get support for their challenges. These 12-Step meetings can be in person (called face-to-face, or F2F), online, or via phone, all around the world. Meetings might take place in a number of places: office buildings, churches, rehab centers—even parks or beaches.

After you finish rehab, you can continue attending meetings with 12-Step groups. Most cities have some kind of 12-Step program. Membership is open to anyone—the only requirement is a desire to change.

Many people attribute their recovery success to their involvement with the Steps. In fact, numerous studies reveal that involvement in A.A. increases the likelihood that people will stay sober.1 Members take comfort in the structure and social support the community provides, which could contribute to higher rates of abstinence.

What Happens at 12-Step Meetings?

Most 12-Step programs follow a similar format. For example, A.A. meetings often open with a “chair” (an A.A. member who leads the meeting) reciting the A.A. Preamble (a short passage about A.A.’s mission).2 They might follow the passage with a moment of silence or a prayer. Newcomers can introduce themselves, which is encouraged but not required. Then, members might read from “The Big Book,”3 which outlines a template for recovery. Depending on the meeting, members might discuss a chosen topic, speak about their journeys, or review a Step. After meetings, people might mingle, meet newcomers and others, and exchange contact information. This format is similar to other 12-Step programs.

In A.A., meetings can be open or closed.4 Open meetings invite anyone to attend, even friends or family of the person with the addiction. Closed meetings are only open to members themselves.

And according to Alcoholics Anonymous, the purpose of all A.A. meetings5 is for people to “share their experience, strength and hope with each other that they may solve their common problem and help others to recover.” This is the foundation for the 12 Steps.

How The 12 Steps Guide Your Path to Recovery

According to A.A., the 12 Steps are a “set of spiritual principles”6 that serve as guidelines for a “way of life.” These fundamentals pave the way for life in sobriety.

The idea is that working through these steps will help you heal. But there aren’t necessarily any rules about how you approach them—you can follow them in order, or not. You can come back to different steps whenever you need to—whichever feels most relevant to what you’re going through. And while many of the steps reference “God,” you’re welcome to replace that with a higher power of your own choosing.

Spirituality and the 12 Steps

While the 12 Steps refer to a higher power—in this case, God—and have roots in Christianity, you don’t have to be Christian to attend meetings. In fact, you don’t need to have any religious background. It is helpful to be open to some degree of spirituality, especially since the goal of the 12th Step is to have a spiritual awakening. The program encourages members to develop a spiritual practice and to incorporate activities like meditation and prayer into their lives.

While spirituality is an important part of the 12 Steps for many people, the social factor is just as important—if not more.

Social Support in 12-Step Programs

People receive almost instant social support from 12-Step groups. You’ll be in a room full of people that have similar experiences and goals—and that makes it much easier to feel connected. And meeting other sober people is an essential part of the recovery process. People in A.A. find hope in being around others on the same journey.7 “The people I met thought like me,” said one member. “For the first time in my life, I felt like I wasn’t so crazy.”

Another member reflects: “I remember sitting in the A.A. meeting, and thinking, I’ve finally found a place where I belong.”

Research shows that people who have a good social support system are more likely to stay in addiction treatment longer,8 and less likely to relapse after rehab. Whether that’s friends, family, or friends you make at meetings, it’s important to surround yourself with those who support your journey.

Cutting ties with people who cue you to do things you’re working hard not to is a painful part of the recovery process. But the upside is that it creates more room in your life for relationships that support your well-being and growth. 12-Step groups make it easy to meet people with common goals, and even facilitate deeper connections by encouraging people to find sponsors. Sponsorship can have a profound impact on your success in sobriety—especially as a newcomer.

The Importance of Sponsorship in 12-Step Programs

Most 12-Step organizations connect people with a sponsor.9 A sponsor is a more senior member who supports your recovery journey. They’re available to talk to outside of meetings and can be a real lifeline in times of need. Sponsors also benefit from this relationship. Sharing what they’ve learned provides an opportunity to give back to the A.A. community, while reinforcing their own choice to live a sober life. It’s often helpful to find a sponsor with a similar background or experience, who can relate to you. They can share advice, hold space for what you’re going through, and be a place to turn to when you come up against an inevitable challenge.

One Crystal Meth Anonymous (C.M.A.) member describes how he owes much of his recovery to his sponsor.10 “I often think about how simple this tool is,” he says. “It helped me stay clean and sober that first year, especially in the face of so many challenges and temptations.” For example, soon after getting sober, he received a text from someone inviting him to do drugs again. He immediately thought of his sponsor, and how disappointed he’d be if he accepted. So instead of replying, he blocked the number.

“Everyone thinks their sponsor is the best, but I really believed it,” he said.

My sponsor demonstrated brotherly love, invested many, many hours, and instilled in me an unshakeable faith that gave me the strength and commitment to rebuild my life. For that, I am forever grateful.

How to Decide if 12-Step Recovery Is For You

If you still feel unsure whether or not 12-Step treatment is right for you, asking rehab admissions staff the following questions is a good place to start.

  • In this program, is attending 12-Step groups mandatory?
  • How much time will I spend in individual therapy, compared to time spent in groups?
  • Do all of your 1-on-1 therapists use the 12 Steps as a framework for recovery?
  • Will I be able to choose my own therapist?
  • Do your 12-Step groups include a sponsorship program?
  • In your philosophy, what does it mean for clients to connect with a higher power?
  • Does your program welcome people of all faiths?
  • Do you connect alumni with local support groups or 12-Step meetings after they complete inpatient treatment?

The more you know, the better. This will help prepare you for both rehab and your new life afterwards. But if you make the decision that the 12-Step approach isn’t for you, there are plenty of other options.

What Is Non-12-Step Recovery?

Non-12-Step programs are exactly that—any approach that doesn’t follow the 12-Step methodology. This can be anything from experiential to holistic to evidence-based treatment, and so much more. How you choose to go about recovery is entirely up to you.

Popular Non-12-Step Approaches to Choose From

While non-12-Step approaches can fall into many different categories, some are more commonly seen in treatment:

Non-12 Step programs are usually secular, meaning they don’t follow any particular religious guidelines. However, you can also attend rehab facilities that don’t follow a 12-Step approach but still have a spiritual emphasis. These may cater to specific faiths or be non-religious.

Note that while these are just some treatment approaches available outside of 12-Step, many more exist. Exploring rehabs by treatment approach can be a great way to learn more.

Building Sober Community Outside of 12 Step

12-Step programs are renowned for their fellowship aspect, but that doesn’t mean you can’t find sober community without one! While you’ll form relationships in rehab, it’s important to have a plan in place for securing a support network beyond it.

Non-12-Step Support Groups

And not all support groups for people in recovery follow the 12 steps. Some organizations don’t follow a spiritual model at all, like SMART Recovery and LifeRing. Similar to 12-Step programs, these groups have meetings in person or online, all over the globe.

Interest-Based Groups and Activities

Finding ways to have fun without substances is an important part of staying sober. Abstinence without meaning and joy isn’t very motivating! Boredom and loneliness are common in early recovery—and are also known relapse triggers. Getting involved in new hobbies, meet-up groups, and activities can be a great way to avoid feeling idle and make new friends in the process. These can range from picking up an old sport to learning a new skill. Look for adult classes, meet-ups, and community events in your city. Your rehab may even offer to help with this as part of your relapse prevention and aftercare plan.

Stepping Into a New Life Chapter

The 12-Step method may just be what works best for you. Or it may not be your thing, and that’s completely fine. It’s also possible (and common) to combine recovery approaches. For example, you might choose to enroll at a non-12-Step rehab, then attend 12-Step groups to maintain your sobriety after treatment. There are multiple paths to recovery, and facilities that can offer exactly what you’re looking for.

With any approach you choose, remember to be patient with yourself. Healing isn’t always straightforward. You might hit bumps in the road here and there, but it’s important to keep going. Remind yourself why you started your recovery journey, and reach out for help when you need it.

See rehab facilities that offer 12-Step and non-12-Step programs to find options that interest you, compare prices, take a virtual tour, and more.

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Successful Treatment, Despite Experiencing Post-Acute Withdrawal Syndrome (PAWS)

So you’ve done the hard work of detoxing. But now you’re having trouble remembering details. Or, you’re even more anxious than you were when you first quit. These feelings can be overwhelming, and you might not understand why. For many people, there’s a simple answer.

Post-acute withdrawal syndrome (PAWS) refers to a group of symptoms that continue long after you stop using drugs or alcohol. This condition can make it hard to focus on the work you’re doing in rehab. Thankfully, many rehab centers are prepared to treat PAWS. Talk to your providers, so they can help you manage your symptoms and avoid relapse.

What Is Post-Acute Withdrawal Syndrome?

PAWS, sometimes known as prolonged withdrawal syndrome, is a set of symptoms you experience after you’ve already gone through initial detox and withdrawal. ((Post-Acute Withdrawal Syndrome (PAWS) | Semel institute for Neuroscience and Human Behavior. (n.d.). Retrieved from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS)) It can last for weeks to years after you last use drugs.

Almost all drugs have the potential to cause this condition. And if you’re recovering from alcohol, benzos, or opioids, you’re more likely to experience PAWS. In fact, 90% of people recovering from opioid addiction and 75% of people recovering from alcohol or other drug addictions have post-acute symptoms.

The Symptoms of PAWS

While regular withdrawal symptoms are mental, physical, and emotional, PAWS symptoms are mainly psychological. It’s common to feel these effects of protracted withdrawal: ((Substance Abuse Treatment Advisory: Protracted Withdrawal. (2010). Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment.))

  • irritability
  • depression
  • difficulty concentrating
  • short-term memory issues
  • fatigue
  • sleep problems like insomnia
  • anxiety
  • decreased sex drive
  • mood swings
  • intense drug or alcohol cravings
  • physical complaints of pain without a cause

These symptoms are similar for most people, but some substances lead to specific issues. For instance, people recovering from marijuana addiction often have strange dreams. And recovering from a benzodiazepine addiction can trigger obsessive-compulsive disorder or schizophrenia.

If you have acute withdrawal symptoms, they’ll set in immediately after detox. Some people also experience PAWS after that, but it may not set right away. You might not even have symptoms until 1-2 months into abstinence. Those symptoms might ebb and flow over time, or be triggered by stressful events.

The Causes of PAWS

When you consistently overuse a substance for a long time, it can make long-lasting changes to brain function. Usually, those changes are in the emotional or behavioral control centers. ((Abuse, N. I. on D. (2022, March 22). Drugs, Brains, and Behavior: The Science of Addiction. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain)) This explains why most PAWS symptoms are psychological.

How PAWS Affects Treatment

PAWS is frustrating at best. And at worst, it can interfere with your recovery. Data shows that PAWS is a common cause of relapse. ((Melemis, S. M. (2015). Relapse prevention and the five rules of recovery. The Yale Journal of Biology and Medicine, 88(3), 325–332. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/))

Stressful events can be triggers, and starting residential treatment is stressful. It’s no wonder that PAWS can get worse when you arrive at rehab. In this early stage of recovery, patients’ ability to deal with stress is already reduced by recent substance abuse. Add in lack of sleep, mood swings, or increased anxiety, and it gets very difficult to stay focused on recovery.

In this phase of treatment, patients are still learning healthy coping skills.

PAWS can mirror the same feelings that lead to addiction.

If you used alcohol to deal with anxiety, then PAWS-related anxiety might be even harder to handle. Or, if you used benzos to sleep, insomnia caused by PAWS might trigger cravings.

These symptoms can lead to other mental health issues. For instance, PAWS might make you feel like you’re not making any progress. You might wonder why you’re still dealing with the lingering effects of your addiction long after you’ve stopped using. People with PAWS sometimes even “catastrophize their chances of recovery.” ((Melemis, S. M. (2015). Relapse prevention and the five rules of recovery. The Yale Journal of Biology and Medicine, 88(3), 325–332. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/)) And these fears are valid. But with the right coping strategies, you can avoid relapse and recover from your addiction.

Plan for Success in Rehab

Recovery means more than quitting a substance. After detox, you’ll face the emotional issues that caused your addiction in the first place. It’s a lot for anyone to handle, even with professional support. And during early recovery, people are especially vulnerable to stress. (The Rebound Effect. (n.d.-a). Substance Misuse Prevention Newsletter: A Collection of Readings, 4(4). Thankfully, you can use certain techniques to manage that stress. And that’s the first step in healing from PAWS.

Come Prepared

You can prepare for PAWS even before you start detox. If you’re in inpatient treatment, you’ll be surrounded by experts who know how to help. If you’re not in rehab, you can talk to your doctor, therapist, or another healthcare provider. They’ll help you come up with a plan to manage ongoing symptoms. Then, if and when you’re triggered, you’ll already know what to do first.

Build Your Support System

Community support is vital to addiction recovery. ((Social support and stress as predictors of relapse in early recovery from alcohol and substance abuse—ProQuest. (n.d.). Retrieved from https://www.proquest.com/openview/89aae0f1bce52fe4e89b92a9caaa3bee/1?pq-origsite=gscholar&cbl=18750&diss=y)) In residential rehab, you can connect with other patients in the program. And outside a program, there are many different places to find support. Start by telling your therapist or doctor what symptoms you’re experiencing, so they can help you manage them. You can also attend group therapy or support groups to find peers going through the same thing.

Let your loved ones know how you’re feeling. Some symptoms, like mood swings or irritability, can put a strain on your relationships. By telling your support network about your symptoms, you’re offering them validation and support. In turn, that will help them support you.

Give Yourself Time Limits

A lot of people struggle with concentrating when they’re going through PAWS. And it can be frustrating to feel like you can’t focus. But there are several ways to work through this common symptom.

Instead of forcing yourself to concentrate, set a timer. Give yourself a limited amount of time to focus on one task. Start small. Limit yourself to 10 or 15 minutes, and then take a break. As your attention span improves, you can gradually increase the amount of time on the timer. Gradually increase the amount of time as you notice you’re able to concentrate for longer.

Keep Moving

Physical exercise can be a valuable part of addiction treatment. Staying active gives you a way to focus your excess energy. It also lets you practice new coping skills, which you can continue using in every stage of recovery. And best of all, the benefits of physical activity match up with some of the most common issues caused by PAWS.

Physical fitness improves both physical and mental health. ((CDC. (2022, June 16). Benefits of physical activity. Centers for Disease Control and Prevention.)) Specifically, it helps people sleep, reduces anxiety and depression, and improves thinking and judgment skills. Keeping active can also help you manage your stress, which may help prevent flare-ups.

As effective as physical activity can be, it’s not right for everyone. If your body is still recovering from addiction, you might not be ready for strenuous exercise. That’s also true for people with chronic conditions, including chronic pain. It’s important to know your own limits. The better you understand your needs, the more easily you can meet them.

Learn Your Triggers

Because stressful events can intensify PAWS, managing stress can help you heal. Start by identifying stressful situations. In some cases, you can avoid these. If reality TV stresses you out, you can just change the channel. But it’s not always that simple. Sometimes, types of stress are unavoidable. For instance, talking about trauma in therapy can be stressful. But that doesn’t mean you should avoid it. Instead, prepare yourself before entering these situations. Rehab can help you grow coping skills you can use to face triggers.

Be Patient With Yourself

It can take anywhere from 6 to 24 months to recover from PAWS. ((Carty , B. (2016). Post-Acute Withdrawal Syndrome. University of Texas Health School of Biomedical Informatics. https://sbmi.uth.edu/heroes/documents/Post-Acute-Withdrawal.pdf?language_id=1)) Some people may find themselves dealing with it for years after that. Eventually, though, your symptoms will go away. Until then, be patient with your progress. Celebrate small wins. Some days may be more difficult than others, but every moment is another step forward. Treatment can also pave the way for a faster recovery—or just an easier one.

Treatment Options for PAWS

Coping strategies are essential, but they’re just one part of healing. You can also make use of more formal treatments to heal from PAWS. ((Post-Acute Withdrawal Syndrome (PAWS) | Semel institute for Neuroscience and Human Behavior. (n.d.). Retrieved from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS)) Talk to your care team to see which of these options fits into your recovery plan:

  • medications, such as acamprosate ((Post-Acute Withdrawal Syndrome (PAWS) | Semel institute for Neuroscience and Human Behavior. (n.d.). Retrieved from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS)) for recovery from alcohol addiction, or methadone ((Protracted Withdrawal.(2010). Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/sites/default/files/d7/priv/sma10-4554.pdf)) for recovery from opioid use disorder
  • psychotherapy
  • behavioral therapy
  • group therapy sessions

Depending on your needs, these modalities may be a good fit in many stages of recovery. Because of this, they can help treat long-term symptoms of PAWS. Some treatments, like talk therapy, may even be helpful long after you complete inpatient rehab.

Managing PAWS Is a Step Toward Recovery

Early recovery can be overwhelming. Your life is changing rapidly—and so is your brain chemistry. PAWS symptoms can make it feel hard to keep up.

Remember that you set the pace of your recovery. There’s no external timeline you have to follow. By accepting your own symptoms, you can practice self-compassion and self-love. And that’s an important part of healing from addiction.

Don’t let PAWS get in the way of your recovery. Connect with an inpatient rehab center to learn about their treatment methods, onsite medical care, pricing, and more.

Reviewed by Rajnandini Rathod

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When Drinking Doesn’t Help: The Connection Between Alcohol and Social Anxiety

Alcohol and anxiety are closely related. Many people with social anxiety disorder (SAD) feel like drinking alleviates their symptoms. In the short term, that might even be true. But over time, any alcohol consumption can make matters worse. Heavy drinking not only increases anxiety; it can also turn into addiction.

If you have either of these conditions, treatment can help. You can attend inpatient rehab to treat a drinking problem, social anxiety, or both at the same time. During recovery, you’ll learn better ways to cope with your symptoms. And with those skills in hand, you won’t have to self-medicate with alcohol.

“Getting to the Root of My Anxiety”

If you’re using alcohol to cope with social anxiety, ((Efilnikufecin. (2021, October 18). I became an alcoholic due to Social Anxiety [Reddit Post]. R/Socialanxiety. www.reddit.com/r/socialanxiety/comments/qau9cf/i_became_an_alcoholic_due_to_social_anxiety/)) you might feel stuck in a cycle. But according to one anonymous Reddit user, there’s always a way out:

Alcohol “was like a miracle cure,” they write in a post. “Super confident, I’d walk up and talk to anyone. And embarrass myself obviously. I’d blackout drunk every single time because I never wanted the feeling to end. I didn’t want to go back to being scared.”

Over time, this person’s symptoms got worse, but “the increasing anxiety made me drink more.” They would experience withdrawal whenever they were sober. It turned into a vicious cycle. When drinking got in the way of their parenting, they knew something had to change.

“Getting to the root of my anxiety and feelings of self hatred was the important thing,” they explain on the Social Anxiety subreddit. “It’s been 4 years now and I haven’t had a drop.” It may feel like you need alcohol in order to function—but in reality, drinking just compounds the problem.

When Social Drinking Becomes a Problem

Many people feel like they need alcohol to be social. And it can be hard to spend time around drinkers without joining in. But anxiety disorders and alcohol addiction go hand in hand. ((Book, S. W., & Randall, C. L. (2002). Social anxiety disorder and alcohol use. Alcohol Research & Health, 26(2), 130–135. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683821/)) If you have SAD, you may be at a higher risk of developing a drinking problem.

Defining Alcohol Abuse

The official criteria for alcohol abuse ((Drinking levels defined | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved July 5, 2022, from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking)) might surprise you. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines heavy drinking as follows:

  • For men: Over 4 drinks in 1 day, or 14 drinks in 1 week
  • For women: Over 3 drinks in 1 day, or 7 drinks in 1 week

(These definitions are based on biological differences between cis male and female drinkers. They may not be accurate for people of all genders.)

These numbers might help you identify an addiction. But any quantity of drinking can cause anxiety. ((Social anxiety disorder and alcohol abuse | anxiety and depression association of america, adaa. (n.d.). Retrieved July 5, 2022, from https://adaa.org/understanding-anxiety/social-anxiety-disorder/social-anxiety-and-alcohol-abuse)) According to the Anxiety and Depression Association of America, “Even moderate amounts of alcohol can affect one’s mood and anxiety level.”

Alcohol use is so socially acceptable that it can take time to even realize you have a problem. But this addiction is all too common in people with anxiety. A study found that “about ⅕ of patients with social anxiety disorder also suffer from an alcohol use disorder.” ((Book, S. W., & Randall, C. L. (2002). Social anxiety disorder and alcohol use. Alcohol Research & Health, 26(2), 130–135. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683821/))

How Alcohol Impacts Anxiety

Drinking has a complex effect on mental health. On one hand, alcohol is an anxiolytic ((Gilman, J. M., Ramchandani, V. A., Davis, M. B., Bjork, J. M., & Hommer, D. W. (2008). Why we like to drink: A functional magnetic resonance imaging study of the rewarding and anxiolytic effects of alcohol. Journal of Neuroscience, 28(18), 4583–4591. https://doi.org/10.1523/JNEUROSCI.0086-08.2008)) —meaning that it reduces anxiety. However, data shows that alcohol abuse “can also lead to increased anxiety.” ((Lingford-Hughes, A., Potokar, J., & Nutt, D. (2002). Treating anxiety complicated by substance misuse. Advances in Psychiatric Treatment, 8(2), 107–116. https://doi.org/10.1192/apt.8.2.107)) And when the same behavior makes your symptoms both better and worse, it can be hard to imagine recovery. But with expert support, you can absolutely break out of this cycle.

Treatment for Co-Occurring Social Anxiety and Alcohol Addiction

It may feel like drinking is the best way to manage your symptoms—but in rehab, you’ll find healthy alternatives. If you’ve been drinking to self-medicate your anxiety, ((Turner, S., Mota, N., Bolton, J., & Sareen, J. (2018). Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and Anxiety, 35(9), 851–860. https://doi.org/10.1002/da.22771)) you can recover from both. Experts say that treating these issues at the same time is “the current ‘gold standard’ model of care.” There are several ways you can approach treatment.

Detox

When you first quit drinking, medical detox is almost always necessary. This process can have serious side effects, and some people need 24-hour care. Your specific needs will depend on the amount you’ve been drinking and your physical health.

Anxiety is a common symptom of quitting alcohol. ((Saitz, R. (1998). Introduction to alcohol withdrawal. Alcohol Health and Research World, 22(1), 5–12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/)) If you have SAD, your symptoms may get worse during detox. In an inpatient program, you might get a prescription to help with this side effect.

Medications for Social Anxiety Disorder

A wealth of data supports treating social anxiety disorder ((Rose, G. M., & Tadi, P. (2022). Social anxiety disorder. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK555890/)) with medications. You might take SNRIs (ex. Cymbalta, Effexor) or SSRIs (ex. Prozac, Zoloft). A doctor or psychiatrist can determine whether any of these are the right fit for you.

Your physical and mental health should stabilize during your time in rehab. As that happens, your needs will change, too. Some people keep taking meds long after they start recovery, while others stop after a short time. No matter how long you spend taking meds, you should stay in close contact with your doctor the whole time. This is an important way to guard against relapse.

Cognitive Behavioral Therapy (CBT)

Research shows that CBT is a highly effective therapy for social anxiety disorder. ((Evren C. An overlooked combination in treatment: addiction and social anxiety disorder comorbidity. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2020;33:331-333. https://dusunenadamdergisi.org/storage/upload/pdfs/1614849083-en.pdf)) It is also a well-regarded treatment for alcohol addiction. ((Kiluk, B. D., Ray, L. A., Walthers, J., Bernstein, M., Tonigan, J. S., & Magill, M. (2019). Technology‐delivered cognitive‐behavioral interventions for alcohol use: A meta‐analysis. Alcoholism: Clinical and Experimental Research, 43(11), 2285–2295. https://doi.org/10.1111/acer.14189)) If you’re healing from both these conditions, it could be very helpful.

During CBT, you’ll meet with a therapist in 1:1 sessions. They’ll teach you practical skills that help you live with your anxiety. You’ll learn to reframe your thoughts and respond to triggers in a healthy way.

CBT is no substitute for traditional talk therapy. As a behavioral treatment, it’s designed to help you change your daily habits. However, you won’t spend much time talking about your past. And in order to move forward, it’s important to look back on where you’ve been. If you do CBT in rehab, it will likely be combined with other types of therapy.

Exposure Therapy

In exposure therapy, patients face stimuli that would normally trigger them. This involves creating a hierarchy of situations that cause anxiety and includes telling the story of a time you were triggered in real life. You’ll speak in the present tense, describing the event in great detail. Then, you and your therapist will talk through your emotional response. Preliminary research also shows that virtual reality exposure therapy can reduce social anxiety. ((Chesham, R. K., Malouff, J. M., & Schutte, N. S. (2018). Meta-analysis of the efficacy of virtual reality exposure therapy for social anxiety. Behaviour Change, 35(3), 152–166. https://doi.org/10.1017/bec.2018.15))

Some data suggests that a version of this treatment called cue exposure therapy (CET) can treat alcohol addiction. ((Mellentin, A. I., Nielsen, B., Nielsen, A. S., Yu, F., & Stenager, E. (2016). A randomized controlled study of exposure therapy as aftercare for alcohol use disorder: Study protocol. BMC Psychiatry, 16(1), 112. https://doi.org/10.1186/s12888-016-0795-8)) However, much more research is needed on the subject.

Mindfulness

Mindfulness strategies can treat many mental health issues, including anxiety and addiction. One study looked at mindfulness-based interventions (MBIs) as a treatment for social anxiety. ((Liu, X., Yi, P., Ma, L., Liu, W., Deng, W., Yang, X., Liang, M., Luo, J., Li, N., & Li, X. (2021). Mindfulness-based interventions for social anxiety disorder: A systematic review and meta-analysis. Psychiatry Research, 300, 113935. https://doi.org/10.1016/j.psychres.2021.113935)) Researchers found a “a dose-response relationship between MBIs duration and effect size.” In other words, the longer you spend practicing mindfulness, the more effective it can be in reducing anxiety.

For people recovering from an alcohol addiction, mindfulness can help prevent relapse. ((Zgierska, A., Rabago, D., Zuelsdorff, M., Coe, C., Miller, M., & Fleming, M. (2008). Mindfulness meditation for alcohol relapse prevention: A feasibility pilot study. Journal of Addiction Medicine, 2(3), 165–173. https://doi.org/10.1097/ADM.0b013e31816f8546)) Learning mindfulness techniques early in recovery may set you up for future success.

Support Groups

For people with social anxiety, the very idea of going to a meeting can be a trigger. But for people with alcohol addiction, support groups can improve treatment outcomes. ((Tracy, K., & Wallace, S. P. (2016). Benefits of peer support groups in the treatment of addiction. Substance Abuse and Rehabilitation, 7, 143–154. https://doi.org/10.2147/SAR.S81535)) Talk to your primary therapist about whether attending a support group is a good idea for you.

If you decide to try it out, there are many options available. Most peer-led support groups host free meetings all over the world. You can even connect with your peers online, from anywhere. In these groups, you can connect with people who share some part of your experience. If you feel anxious to be around them, that’s okay. They might feel that way, too. Talking about it can help you build meaningful relationships. And that’s an essential part of healing.

Specialized Care, in a Protected Space

And it can be hard to treat just one of these issues at a time. Instead, experts recommend integrated treatment for addiction and social anxiety. ((Nguyen, A., Mirbaba, M., Khaleghi, F., & Tsuang, J. (n.d.). Current treatment options for co-morbid anxiety and alcohol use disorders: A review. Journal of Addictive Behaviors and Therapy, 1(1), 0–0. Retrieved from https://www.primescholars.com/abstract/current-treatment-options-for-comorbid-anxiety-and-alcohol-use-disorders-a-review-106758.html)) In layman’s terms, that means starting recovery for both diagnoses at once.

Many rehabs offer this kind of specialized care. A team of providers can design a treatment plan to meet your needs. And in the privacy of an inpatient program, you can focus on what’s most important: your own recovery process.

In the right program, you’ll get the coordinated care you need. Connect with a rehab that specializes in treating co-occurring anxiety and alcohol addiction here.

Reviewed by Rajnandini Rathod

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Finding Treatment for Cocaine Addiction

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

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

The Prevalence of Cocaine Addiction

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

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

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

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

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

Risk Factors for Cocaine Addiction

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

Adolescence

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

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

Novelty-Seeking Personality Traits

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

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

Neurochemical Effects of Cocaine Use

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

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

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

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

Treatment for Cocaine Addiction

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

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

Detox

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

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

Learn More: What You Need to Know About Detox

Rehab

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

Psychotherapy

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

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

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

Long-Term Recovery From Cocaine Addiction

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

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

Building a Better Life

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

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

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

Frequently Asked Questions About Cocaine Addiction Treatment

What are the treatment options for cocaine addiction?

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

How long does treatment for cocaine addiction typically last?

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

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

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

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Behavioral Therapies for Meth Addiction Recovery

Because meth addiction is so highly stigmatized, it can be intimidating to admit you have a problem. And it’s perfectly valid to fear that you’ll be judged for doing so. Fortunately, there are expert providers who can help. By connecting with a rehab that treats meth addiction, you can begin healing in a safe and supportive environment.

You can approach this journey in a variety of ways. Behavioral therapy has been proven to work especially well for meth recovery, and research is being done on alternative forms of treatment. Remember that you have options, and that learning to make healthy choices is an important part of the process.

Treatment Options for Methamphetamine Addiction

Meth addiction can be very isolating, and if you’re struggling, it can sometimes feel like you’re the only one. However, research shows that methamphetamine use is extremely common. ((Abuse, N. I. on D. (–). Overview. National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/methamphetamine/overview)) According to the National Institute on Drug Abuse (NIDA), meth is “one of the most commonly misused stimulant drugs in the world.” Because of this, many rehab programs are well-versed in treating this condition.

Unfortunately, no medications currently stop or minimize the use of methamphetamine, ((May, A. C., Aupperle, R. L., & Stewart, J. L. (2020). Dark times: The role of negative reinforcement in methamphetamine addiction. Frontiers in Psychiatry, 11. https://www.frontiersin.org/article/10.3389/fpsyt.2020.00114)) although scientists continue to research the issue. At present, behavioral therapies are the most effective known treatments for methamphetamine misuse. ((Abuse, N. I. on D. (–). What treatments are effective for people who misuse methamphetamine? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/methamphetamine/what-treatments-are-effective-people-who-misuse-methamphetamine)) These options are especially helpful in the context of inpatient rehab or intensive outpatient programs.

Cognitive Behavioral Therapy (CBT)

It’s unrealistic to try and build a life entirely free of challenges or triggers that might tempt you to relapse. CBT practitioners recognize this, and help you develop the skills to manage your most difficult emotions. Specifically, patients learn how to replace negative thought patterns with positive or neutral ones. By accepting your feelings, and responding to them calmly and rationally, you can make healthy choices and work toward a more sustainable lifestyle.

Contingency Management (CM)

Contingency management rewards positive behavioral changes with incentives, such as rewards or vouchers. For example, if you might get a voucher every time you test negative for methamphetamine use. You can then exchange those vouchers for prizes, like movie tickets, retail items, or snacks. This technique reinforces healthy behavior, helping patients build sustainable habits.

This treatment is especially helpful because of the way methamphetamine use affects neurochemistry. ((Christenson, K. (2021, February 22). Zorba paster: Promising research on meth treatment is a reminder of addiction crisis. Wisconsin Public Radio. https://www.wpr.org/zorba-paster-promising-research-meth-treatment-reminder-addiction-crisis)) According to family physician and personal health expert Dr. Robert Zorba Paster, “Long-term meth use causes changes in the brain visible on MRI scans. This potent stimulant, like other addictive drugs, hijacks the reward system of the brain.” By retraining your brain to respond to healthier rewards, you can reinforce more sustainable patterns of behavior.

Motivational Interviewing (MI)

Unlike other approaches, motivational interviewing is not technically a type of therapy. Instead, it’s a conversational style that can be implemented by a variety of providers, including talk therapists and doctors. This approach invites you to address the reasons you might feel ambivalent towards change. The goal is to empower patients, motivating them to replace negative responses with positive ones. Although this technique can be effective on its own, it’s most often used in concert with other therapies like CBT or CM.

Mindfulness-Based Relapse Prevention (MBRP)

During MBRP, patients use mindfulness techniques to stay in the present moment, accepting uncomfortable feelings as they are. By simply acknowledging your triggers, you can learn to work through them without resorting to substance use. Mindfulness can help you interrupt spiraling negative thought patterns that may lead to relapse. ((Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, J., Clifasefi, S., Garner, M., Douglass, A., Larimer, M. E., & Marlatt, A. (2009). Mindfulness-based relapse prevention for substance use disorders: A pilot efficacy trial. Substance Abuse, 30(4), 295–305. https://doi.org/10.1080/08897070903250084))

The Matrix Model

This treatment method is specifically designed to treat stimulant addiction. Both inpatient and outpatient rehab facilities utilize the Matrix model, although it’s more widely used in outpatient care. Several studies have shown that the Matrix model significantly decreases patients’ stimulant use. ((Abuse, N. I. on D. (–). The matrix model(Stimulants). National Institute on Drug Abuse. https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/matrix))

The Matrix Model integrates family education, ((Center for Substance Abuse Treatment. Counselor’s Family Education Manual: Matrix Intensive Outpatient Treatment for People With Stimulant Use Disorders. HHS Publication No. (SMA) 13-4153. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2006. https://store.samhsa.gov/sites/default/files/d7/priv/sma13-4153.pdf)) behavioral 1:1 therapy and group sessions with the 12-Step model. Patients receive positive reinforcement for non-drug-related hobbies, learn recovery skills, and attend education sessions with family members. These are distinct from family therapy; instead of delving into interpersonal dynamics, providers teach participants. Social support groups are also a core component of the Matrix Model.

Support Groups

Crystal Meth Anonymous (C.M.A.) is a 12-Step program in which participants follow 12 principles designed to help people achieve and maintain sobriety, “one day at a time.” Members attend meetings and connect with peer sponsors, sharing mutual support with people who have similar personal histories of addiction. Although C.M.A. is a faith-based program, they accept people of all beliefs and religions. Their only condition for membership is a “desire to change.”

Not all support groups are 12-Step programs. If faith-based recovery isn’t a good fit, you can connect with a group that takes a more scientific approach. For example, Self-Management and Recovery Training (SMART Recovery) empowers each member to define what healing means to them, specifically. In this group, you’ll connect with people who are committed to healing on their own terms.

Many residential rehabs host peer-led support group meetings, in addition to structured group therapy sessions. And after you complete residential treatment, you can easily find similar meetings either online or in your area.

Alternative Treatments

Experts continue to research potential treatments for meth addiction. While more data is still needed regarding the effectiveness of these approaches, some rehab facilities may already offer them to eligible patients. If you’re interested in trying an alternative treatment, you can talk to rehabs about the following options:

  • Transcranial magnetic stimulation (TMS) is a treatment that uses magnetic pulses that stimulate the brain, with the intention of changing brain activity associated with cravings.
  • Neurofeedback is a biofeedback technique ((Neurofeedback and biofeedback for mood and anxiety disorders: A review of the clinical evidence and guidelines – an update. (2014). Canadian Agency for Drugs and Technologies in Health. http://www.ncbi.nlm.nih.gov/books/NBK253820/)) that measures the activity of the central nervous system. In this non-invasive treatment, patients gather information about their own physiological responses, so they can develop coping skills that directly affect brain function.
  • Exercise alleviates feelings of depression during early recovery from methamphetamine misuse ((Haglund, M., Ang, A., Mooney, L., Gonzales, R., Chudzynski, J., Cooper, C. B., Dolezal, B. A., Gitlin, M., & Rawson, R. A. (2015). Predictors of depression outcomes among abstinent methamphetamine-dependent individuals exposed to an exercise intervention. The American Journal on Addictions, 24(3), 246–251. https://doi.org/10.1111/ajad.12175)) —and the more you exercise, the better. One study found that among people in recovery from meth addiction, people “who attended the greatest number of exercise sessions derived the greatest benefit.”

Medication

Scientists are in the process of developing vaccines that would prevent methamphetamine from reaching the brain. ((Gentry, W. B., Rüedi-Bettschen, D., & Owens, S. M. (2009). Development of active and passive human vaccines to treat methamphetamine addiction. Human Vaccines, 5(4), 206–213. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2741685/)) However, it may be some time before these medications become available. Nevertheless, learning more about meth’s impact on your brain chemistry can help you find the most effective treatment for your specific symptoms.

Neurological Effects of Meth

During meth addiction recovery, you’ll work on healing physically as well as emotionally. Because of the way methamphetamine affects brain function, its long-term use often causes neurological symptoms. As you start planning for recovery, you might want to look for a program that provides medical care, or one that treats co-occurring disorders.

Harmful Impacts on the Brain

Methamphetamine use can change the way the brain processes dopamine, the neurotransmitter that creates feelings of pleasure, satisfaction, and motivation. Methamphetamine use actually blocks the reuptake of dopamine ((Abuse, N. I. on D. (–). What are the immediate (Short-term) effects of methamphetamine misuse? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/methamphetamine/what-are-immediate-short-term-effects-methamphetamine-misuse)) while simultaneously boosting its release. In other words, your brain produces more of this chemical, but processes it less efficiently.

Long-term meth use ((Abuse, N. I. on D. (–). What are the long-term effects of methamphetamine misuse? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/methamphetamine/what-are-long-term-effects-methamphetamine-misuse)) can ultimately damage nerve terminals in the brain. In severe cases, this can interfere with your ability to feel pleasure from anything other than methamphetamine. Some neuroimaging studies have also correlated changes in the dopamine system with reduced motor speed and impaired verbal learning.

Over time, meth can even change the physical structure of your brain. ((Thompson, P. M., Hayashi, K. M., Simon, S. L., Geaga, J. A., Hong, M. S., Sui, Y., Lee, J. Y., Toga, A. W., Ling, W., & London, E. D. (2004). Structural abnormalities in the brains of human subjects who use methamphetamine. The Journal of Neuroscience: The Official Journal of the Society for Neuroscience, 24(26), 6028–6036. https://doi.org/10.1523/JNEUROSCI.0713-04.2004)) One study found that the hippocampus, a part of the brain associated with memory, was smaller in people who use methamphetamine. Another showed that methamphetamine addiction can alter the frontal lobe; ((May, A. C., Aupperle, R. L., & Stewart, J. L. (2020). Dark times: The role of negative reinforcement in methamphetamine addiction. Frontiers in Psychiatry, 11. https://www.frontiersin.org/article/10.3389/fpsyt.2020.00114)) these changes may interfere with emotional insight.

Mental Health Conditions

Long-term methamphetamine abuse ((Abuse, N. I. on D. (–). What are the long-term effects of methamphetamine misuse? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/methamphetamine/what-are-long-term-effects-methamphetamine-misuse)) can cause a variety of mental health issues, including anxiety, confusion, insomnia, and mood instability. Some people also experience paranoia, hallucinations, and delusions, which can persist for months or years after starting recovery.

Depression and anxiety are both strongly correlated with methamphetamine addiction. ((May, A. C., Aupperle, R. L., & Stewart, J. L. (2020). Dark times: The role of negative reinforcement in methamphetamine addiction. Frontiers in Psychiatry, 11. https://www.frontiersin.org/article/10.3389/fpsyt.2020.00114)) More research is needed to determine whether these conditions cause methamphetamine use, or vice versa. In some cases, feelings of depression and anxiety might first make you vulnerable to addiction, and then worsen as a result of drug abuse. Alternatively, your symptoms may develop after you start using meth, as side effects of the turbulent cycle of consumption, tolerance, and withdrawal.

Because of this, you may want to look for a rehab center that also treats depression and/or anxiety. Discuss your symptoms with a medical professional to determine the best course of action for you. Luckily, there are many ways to treat both conditions, the most common of which are medication and psychotherapy.

Planning for Aftercare and Long-Term Recovery

Because meth can cause long-term health issues, ((Abuse, N. I. on D. (–). What are the long-term effects of methamphetamine misuse? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/methamphetamine/what-are-long-term-effects-methamphetamine-misuse)) and because the recovery journey extends well beyond rehab, patients should plan for aftercare following residential treatment. Fortunately, with the right treatment, some of these symptoms can improve over time. For example, one study found that self-reported depression and anxiety symptoms were reduced after patients stopped using methamphetamines.

Many of the negative neurobiological effects that result from methamphetamine use disorder can also be reversed, at least partially. Some people show signs of neuronal recovery in certain areas of the brain following at least 14 months of sobriety. It’s important to note that these changes did not appear earlier. To give your brain and body time to reverse the effects of meth addiction, make sure you make a plan to guard against relapse.

Taking Back Control of Your Life

Recovery isn’t easy. But it’s important to remember that this is your chance to build a beautiful life.

As your mind and body heal, you’ll get to try entirely new things and rediscover what brings you joy. That might mean picking up a hobby, building a strong network, or just connecting with the right therapist. You get to decide what comes next.

In a center that meets your needs, you can do more than improve your physical and mental health. The right treatment program for you will also empower you to make better, more sustainable choices. When you’re ready to take that step, talking to admissions staff at a few treatment programs that appeal to you can be a great place to start.

Discover rehab centers across the U.S. with information on pricing, insurance, therapies, and more in our directory of meth addiction treatment centers.

Reviewed by Rajnandini Rathod

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How to Recognize High-Functioning Alcohol Addiction

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

When Drinking Becomes a Problem

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

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

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

Alcoholism Hides in Plain Sight

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

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

“My Success was the Mask”

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

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

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

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

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

Deciding to Get Sober

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

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

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

Starting Recovery from High-Functioning Alcohol Addiction

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

Medical Detox

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

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

Inpatient Rehab

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

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

Intensive Outpatient Programs

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

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

Medications

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

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

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

Talk Therapy

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

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

Support Groups

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

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

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

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

Sober Living Environments

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

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

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

Long-Term Effects of Alcohol Abuse

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

Physical Effects

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

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

Social and Emotional Problems

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

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

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

Get Your Life Back in Recovery

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

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

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

Reviewed by Rajnandini Rathod

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Healing From Heroin Addiction—and Stigma

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

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

Stories of Recovery From Heroin Addiction

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

“I’m Living Proof That Recovery Is Possible”

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

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

Addiction Is Not a Moral Failing

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

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

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

Treating Heroin Addiction

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

Medical Detox

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

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

Medication-Assisted Treatment (MAT) for Heroin Addiction

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

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

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

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

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

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

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

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

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

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

Behavioral Treatment Options

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

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

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

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

Inpatient vs. Outpatient Treatment

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

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

Preparing for Rehab

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

Planning Ahead

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

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

Taking Leave From Work

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

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

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

Creating a Healthy Support System

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

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

Long-Term Recovery From Heroin Misuse

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

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

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

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

Hope Is Right Around the Corner

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

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

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