Category: Substances

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Does CBD Help or Harm Sobriety?

The process of recovery is different for every person. For some, it includes the use of CBD. However, this is a controversial topic. Many believe that the use of any psychoactive substance, including prescribed medication, interferes with sobriety. And if you’re deciding whether or not CBD will play a role in your recovery journey, it’s important to remember that recovery isn’t about following universal rules. It’s a way to build a life that feels healthy for you.

CBD, or cannabidiol, is one of hundreds of active ingredients in cannabis. It’s readily—and legally—available in many areas. As more and more U.S. states legalize marijuana use,1 for medical and/or recreational purposes, CBD will likely become even more accessible.

Some areas have also decriminalized marijuana,2 with or without officially making it legal. According to the National Conference of State Legislatures, “This generally means certain small, personal-consumption amounts are a civil or local infraction, not a state crime (or are the lowest misdemeanor with no possibility of jail time).” This speaks to a cultural shift in perspective.

Cannabis is becoming more socially acceptable and more accessible over time.3 As this trend continues, more researchers are studying its potential medical applications. Some of this research centers around the use of cannabis to treat mental health.4 Some evidence suggests that CBD, in particular, may be beneficial for people in recovery from substance use.

What Is CBD?

CBD is a cannabinoid.5 That is, it’s a chemical substance that interacts with the human body’s cannabinoid receptors. Cannabis plants are believed to produce between 80-100 different cannabinoids. You may be more familiar with THC, which is the most prevalent cannabinoid we know of, and which produces a “high.” CBD is “the second most prevalent active ingredient in cannabis.”6

The Chemistry of CBD

There is much research to be done on all cannabinoids, including THC and CBD. However, these two chemicals are the best-known, and most-researched, cannabinoids to date.

Many experts describe a simple difference between these two compounds: THC is psychoactive, and CBD is not.7 However, this may be an oversimplification. According to one source, “A chemical is considered psychoactive when it acts primarily on the central nervous system and alters brain function, resulting in temporary changes in perception, mood, consciousness or behavior.” Despite this distinction, it remains true that CBD, unlike THC, is not intoxicating.

There is a clear reason for this: CBD and THC have different neurochemical effects.8 Both CBD and THC act on the brain’s cannabinoid type 1 (CB1) receptors. Even without the feeling of intoxication, CBD has a noticeable impact on brain chemistry and may be able to treat both physical and emotional symptoms.

The Experience of CBD

Research suggests that CBD may help treat anxiety,9 insomnia, chronic pain, inflammatory conditions, and symptoms associated with substance use disorders. Some people use it to help with acute symptoms, such as panic attacks and pain flare-ups. Others take it daily, to manage chronic conditions.

CBD is available in several forms. Tinctures can be added to food or taken sublingually, delivering the cannabinoid directly to the bloodstream. Vape oils and high-CBD plant strains can be inhaled, taking effect more quickly but lasting for a shorter time. Lotions and salves are used topically, for a greater impact on localized physical pain.

The effects of CBD can last for a matter of hours,10 depending on the dosage and your metabolism. In some cases, it can cause mild side effects like nausea, dizziness, and fatigue.

Medical Applications of CBD

Because it’s a relatively new subject of study, experts still have much to learn about the benefits and risks of CBD. To date, it’s believed to have a variety of medical applications.

Reportedly, more than 60% of CBD users find that it alleviates anxiety.11 In 2018, a purified version of the chemical was approved as a treatment for rare pediatric seizure disorders. It also regulates the perception of pain.12 Because of this, it may help treat conditions like fibromyalgia, chronic back pain, and rheumatoid arthritis.

There is some controversy about cannabis as a treatment for mental health conditions. However, preliminary research suggests that CBD may have antidepressant and antipsychotic qualities. And experts agree that CBD for addiction treatment is a promising area of study.13

CBD and Substance Use Disorders

A steadily growing body of research suggests that CBD may alleviate many of the symptoms associated with substance use disorders. According to one study, “the fact that patients with substance use disorders often present with various psychiatric and medical symptoms that are reduced by CBD—symptoms such as anxiety, mood symptoms, insomnia, and pain”14 suggests that this cannabinoid may help people in various stages of detox and recovery.

CBD is an especially promising option for people healing from opiate use. This is because certain cannabinoid receptors are co-localized with opioid receptors in the brain. As a result, CBD can have a direct impact on these receptors, which may help during withdrawal and detox.

Also, many people who overuse opiates do so because they experience physical pain. Because pain relief is one effect of CBD, the cannabinoid may decrease the underlying symptoms that lead to substance use.

Studies show that CBD may also be helpful for people recovering from cocaine and methamphetamines.15 Specifically, it has been shown to reverse “toxicity and seizures induced by cocaine, behavioural sensitization induced by amphetamines, [and the] motivation to self-administer cocaine.”

Beyond its application for recovery from these specific substances, CBD may help to alleviate cravings and other withdrawal symptoms. According to one study, CBD can even help people quit smoking.16

While there are other medical treatments to aid in this process, CBD may be an even safer option, because it has a low risk of chemical dependency. “According to a report from the World Health Organization, ‘In humans, CBD exhibits no effects indicative of any abuse or dependence potential17…To date, there is no evidence of public health-related problems associated with the use of pure CBD.’”

Am I Still Sober if I Use CBD?

Although CBD is not believed to be habit-forming, it is still a substance. And people in recovery need to be mindful of how they use all medications. Because of this, it may or may not be appropriate for a person in recovery to use CBD.

One important part of recovery is learning to define what health means specifically for you. And your definitions of health and sobriety may change over time. As you approach these issues, it’s extremely important to stay true to yourself, and be honest with your mental healthcare team. You might also connect with a community that defines sobriety in a particular way, which may impact how you view your own recovery process.

Total Abstinence

For some people, sobriety means total abstinence from all psychoactive substances,18 including prescribed psychiatric medication. This strict boundary may even impact the way you approach your physical health. For example, some people in recovery from opiate use refuse narcotic medications at all costs, even when they have surgery.

There is nothing inherently right or wrong about this perspective. It has become common enough that most doctors can accommodate their patients’ needs without the use of these medications. It’s not an easy path, but for many people, it’s the right one.

Harm Reduction

Not everyone commits to total abstinence. And not everyone should. Some serious mental health conditions make prescription medications an absolute necessity. For example, people with bipolar disorder may experience debilitating depression if they abstain from mood stabilizers. At the end of the day, sobriety is meant to be a path toward health, not away from it.

Even Alcoholics Anonymous takes a nuanced approach to the idea of abstinence.19 They recommend that members who require medication continue to take it, but only if they can stay accountable to themselves, their communities, and their medical teams. It’s possible to use substances safely if you’re doing so under appropriate supervision.

As cannabis use becomes more and more culturally acceptable, we are likely to learn more about the medical applications of CBD, especially as relates to recovery from substance use disorders. Because of this, it may become more widely used by people who still consider themselves to be sober.

The Risks of CBD

Despite promising research, there are still some risks associated with CBD use. Although it’s not believed to be habit-forming, it is still a cannabinoid. And many CBD products include trace amounts of THC, which can sometimes be addictive. Studies suggest that 9% of people who smoke cannabis develop a dependence on it.20 For those without substance use disorders, that may be an acceptable risk. For some people in recovery, it may be too dangerous.

If you plan to use CBD in response to a substance use disorder, proceed carefully. Make sure to talk to your treatment providers about its potential risks and benefits, and find out if it can interact with any of your other medications.

Whether or not CBD is right for you, it’s important to be fully honest with yourself, your support network, and your healthcare providers about your experience. For example, if you decide to use cannabis in response to acute panic attacks, and then find yourself using it daily, this may be a warning sign. As with any other substance, it’s best to be mindful of the emotions you associate with its use. Like many other substances, it’s possible to use CBD appropriately. It’s also possible to misuse it, or to overuse it.

Finding Balance, With or Without CBD

As cannabis use becomes less stigmatized, people are starting to question whether or not it interferes with sobriety. There’s no clear answer to this. However, the same is true for most substances. If you’re recovering from cocaine use, can you still safely drink? If you’re recovering from opiate use, should you take Prozac? These questions are complicated, and the answers may vary from person to person. During rehab and recovery, you’ll likely start to define where the line is for you.

As you think about your personal history of substance use, you’ll start to distinguish between healthy and problematic behaviors. Are there ways you’ve used substances in the past that felt sustainable? In the process of recovery, are you still capable of approaching medication in that way? If you can incorporate CBD into a genuinely healthy lifestyle, it has many benefits. However, if you’re concerned about using it unsustainably, it may not be worth the risk.

With or without the aid of CBD, there are many ways to begin recovery. Learn more about private rehab programs here.

Frequently Asked Questions About Using CBD in Recovery

Is it possible to use CBD while maintaining sobriety?

The definition of sobriety varies according to different recovery philosophies. Some people choose total abstinence from all psychoactive substances, including CBD. Others may take a harm reduction approach, considering the potential benefits of CBD for managing symptoms. It’s important to communicate openly with your healthcare team and determine what aligns with your recovery goals and personal definition of sobriety. Remember, recovery is a journey of self-discovery and finding the balance that works for you.

Are there risks associated with using CBD in recovery?

While CBD is not believed to be habit-forming, it’s still a cannabinoid and may contain trace amounts of THC. It’s essential to discuss CBD use with your treatment providers, as it may interact with other medications. Honesty with yourself, your support network, and healthcare providers is crucial in monitoring your CBD use and recognizing any warning signs of misuse or overuse.

Can CBD help with cravings and withdrawal symptoms during recovery?

CBD shows promise for alleviating addiction-related symptoms, including cravings and withdrawal, due to its impact on cannabinoid receptors in the brain. It’s shown positive effects in helping people recover from opioid, cocaine, and methamphetamine use. While CBD isn’t a standalone solution, it may be worth exploring as part of a comprehensive treatment plan. Consult with your healthcare provider to determine if CBD is a suitable option for you.

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12-Step vs. Non-12-Step Recovery: Which Is Best for You?

Rehab is designed to provide structure as you begin the process of recovery. There are countless ways to heal, and it’s important to choose a framework that meets your specific needs. While many people benefit from 12-Step rehab programs, others prefer a more holistic approach to addiction treatment.

Recent research shows that 12-Step programs have a hugely positive impact,1 and may even be “the most effective path to abstinence.” However, there is some question as to why this is true. For example, 12-Step programs offer social support,2 which is essential during recovery, but is not unique to this philosophy. At most inpatient rehab programs, you’ll be able to build community with or without following the 12 Steps.

It’s also important to note that spirituality is a component of every 12-Step program. If you’re not interested in faith-based recovery, these groups may not be right for you. Various rehab facilities offer different 12-Step groups, such as A.A. and N.A., as well as non-12-Step programs. Before choosing which residential rehab you’ll attend, it’s best to learn as much as you can about the available options.

What Is 12-Step Recovery?

Alcoholics Anonymous is the best-known 12-Step program.3 A.A. is “an international fellowship of men and women who have had a drinking problem. It is nonprofessional, self-supporting, multiracial, apolitical, and available almost everywhere. There are no age or education requirements. Membership is open to anyone who wants to do something about his or her drinking problem.”

Members of A.A. attend group meetings,4 most of which have a similar format: initial announcements are followed by a reading of the 12 Steps5 and the 12 Traditions.6 Then a member will share their story. This may be followed by a group conversation, or more structured time for other members to describe their experiences. This structure is simple but effective. As one member writes, “I always feel a little better after it’s over.”

Many 12-Step groups follow similar formats, such as Narcotics Anonymous, Cocaine Anonymous, Marijuana Anonymous, and Al-Anon, which is intended for people who love someone who struggles with substance misuse. These groups define the 12 Steps slightly differently, but all share a similar philosophy.

The 12 Steps

The 12 Steps are a list of actions that group members undertake during the process of recovery. In this process, members normally begin by admitting they have a problem. Then, you’ll connect to a higher power, sometimes called “God as we understand him.”7 Although 12-Step groups are historically rooted in Christianity, they welcome people of all faiths, including people who don’t ascribe to a specific religion. Nevertheless, the spiritual aspect of this philosophy isn’t right for everyone.

In the process of connecting with a higher power, members then make “a searching and fearless moral inventory”8 of themselves and their lives. This ruthless honesty lays the groundwork for the great changes that come with recovery. By admitting your struggles to yourself, to another person, and to your version of a spiritual source, you may come to a new understanding of your emotional experience.

In Step 9, participants seek to make amends9 to any people they may have hurt, “except when to do so would injure them or others.” Through this process, members begin to consider the effects their actions have on their communities. There is a difference between intent and impact. As you learn more about yourself, you’ll also learn how to meet your needs in a healthy way, while participating in a supportive community.

One goal of the 12 Steps is to achieve a spiritual awakening. Step 12 refers to this directly: “Having had a spiritual awakening as the result of these steps,10 we tried to carry this message to alcoholics, and to practice these principles in all our affairs.” Members are encouraged to meditate, pray, and cultivate an ongoing spiritual practice.

In these groups, you’ll be encouraged to “work the steps” throughout the process of recovery. As you encounter new challenges, you may return to the steps again and again, not always in numerical order. In stressful times, these strategies can help you focus on your goals, avoid relapse, and make the healthiest choices available. The 12 Steps are more than a checklist; they can become a way of life. However, the steps themselves are just one component of recovery. The social aspect of 12-Step groups is also an essential part of the process.

Social Support in 12-Step Programs

Experts agree that social support—or a lack thereof—has an extremely significant impact on people with substance use disorders.11 Some researchers have even postulated that “opioid addiction serves as a substitute for social attachment.” In one study, a subgroup of substance users exhibited “severe negative affect and intense craving” when exposed to perceived social rejection.

This evidence suggests that without community, people in recovery may be especially vulnerable to cravings. Whether or not those cravings lead to relapse, one thing is clear: strong interpersonal relationships are an important part of healing. Because 12-Step groups include a built-in community of people on a similar journey, they may help members get the support they need. Programs like A.A. even encourage members to become sponsors,12 actively supporting people at earlier points in the healing process.

In most residential rehabs, you’ll be in a cohort of people who share some of your life experiences. If your program is based on the 12 Steps, you’ll have even more structured opportunities to give and receive peer-to-peer support. For example, the program at Genesis House is firmly rooted in this philosophy. They treat substance misuse as “a three-fold disease: spiritual, physical, and emotional.” Residents are introduced to the 12 Steps as soon as they arrive. They continue to engage with the steps in individual therapy, and in the evenings they “are transported to local AA/NA meetings…where they will network with others in recovery and learn more about how to stay sober.”

What Is Non-12-Step Recovery?

Although 12-Step groups are extremely valuable for some, they’re not the only way to get community support. One study found that “social networks that support recovery lead to enhanced treatment outcomes and sobriety13 regardless if this support stems from family, peer groups, or 12-Step programs.”

Non-12-Step programs are ideal for people who don’t ascribe to a spiritual practice, or those who simply want a different kind of structure. There are countless approaches to recovery from substance misuse, such as evidence-based treatment, individualized treatment, and experiential therapy. And even without faith in a higher power, it’s possible to heal in a holistic way.

For example, The Holistic Sanctuary in Baja California is a rehab facility with a “natural holistic healing program.” Clients do yoga, receive daily massages, and eat an organic diet. This approach “involves healing the patient’s spiritual health through meditation, catering to their physical health through exercise, and improving their psychological wellbeing through counseling.”

There are as many ways to heal as there are people with substance use disorders. Many clients benefit from a combination approach, attending 12-Step groups while also participating in different therapeutic modalities.

“In the same way that medicines and psychotherapy can go together, AA and 12-Step can go together with in-depth psychotherapy and medications when indicated.”

– Dr. Thomas Gazda, Medical Doctor, Soberman’s Estate

Finding the Right Approach to Treatment

If you’re not sure whether 12-Step treatment is the right fit, you can talk to the admissions team at a rehab center to learn more. These questions may help you find out whether a program aligns with your specific goals for recovery:

  • In this program, is attendance of 12-Step groups mandatory?
  • How much time will I spend in individual therapy, compared to time spent in groups?
  • Do all your one-on-one 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 and/or 12-Step meetings after they complete inpatient rehab?

If at all possible, it’s best to know the answers to these questions before you begin residential treatment. The more information you have, the better you can plan for life during and after rehab.

Attending 12-Step Groups After Rehab

​​By design, 12-Step programs are extremely accessible. They’re free, they take place internationally, and they’re open to people at every stage of recovery. A.A., in particular, offers both open and closed meetings.14 Open meetings are available to anyone, including friends and loved ones of alcoholics, who do not have substance use disorders themselves. Closed meetings are only open to people who have substance use disorders, or those who believe that they might and want to learn more.

This accessibility can be especially important for people who have recently completed rehab. When you first graduate from a residential program, you may be in a vulnerable emotional state. Rehab is only the first chapter of a much longer healing process. When you arrive home afterward, you’ll begin establishing new routines, returning to some parts of your life, and letting go of others. Attending group meetings can help you stay grounded while encouraging you to form new relationships with people who live nearby.

A Step in the Right Direction

Whether or not 12-Step recovery is right for you, there’s a great deal to learn from this philosophy. For example, the process of healing from substance misuse is not a solitary one. There are certain aspects of recovery that must be your responsibility, but no one lives in a vacuum. By connecting with the people around you and finding peers who have survived similar struggles, you can learn a great deal about what it means to live a healthy life.

Like any other healing process, the 12 Steps can be a-linear. As you begin recovery, be patient with yourself. There are some lessons you may have to learn more than once, in new contexts or at different times of your life. That type of repetition is normal and even healthy. As you continue to change and grow, it can be helpful to ground yourself with a list of goals or strategies that you’d like to focus on throughout recovery. There may be 12 of them, or 2, or 37. The important thing is to find a way of healing that aligns with your unique values.

To continue exploring various treatment philosophies, you can learn more about rehabs that offer 12-Step programs and non-12-Step treatment.

Frequently Asked Questions About 12-Step vs. Non-12-Step Rehab

What’s the difference between 12-Step and non-12-Step rehab programs?

12-Step rehab programs, like Alcoholics Anonymous (A.A.), follow a structured framework involving admitting a problem, connecting to a higher power, making amends, and achieving a spiritual awakening. Non-12-Step programs offer alternative approaches to recovery, focusing on evidence-based treatments, holistic healing, and individualized therapy.

Are 12-Step groups mandatory in all rehab programs?

The attendance of 12-Step groups varies at different rehabs. Some programs make it mandatory, while others offer a choice between 12-Step and non-12-Step options. It’s important to inquire with the rehab you’re considering about their specific approach to ensure it aligns with your preferences and goals for recovery.

Can non-religious people participate in 12-Step programs?

Yes, 12-Step programs welcome people of all faiths and those who don’t ascribe to a specific religion. While spirituality is a component, it’s not limited to a particular faith. These programs encourage participants to connect with a higher power as they understand it, which can be interpreted in a way that aligns with personal beliefs or values.

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Is Telehealth Effective for Substance Use Disorders?

Many people hesitate to start rehab because residential treatment programs feel inaccessible. Fortunately, they’re not the only option. More and more rehab programs now offer treatment via telehealth.

The popularity of telemedicine1 has skyrocketed in the past few years. It’s clear to see why this type of treatment became important in 2020: online appointments allow people in recovery to get the care they need, without taking unnecessary risks. Online treatment programs also limit the number of people on-site at a rehab facility, protecting both staff and clients.

However, online mental health treatment isn’t just for times of quarantine. Even before COVID-19 made social distancing a primary concern, “telehealth initiatives provided a platform to combat the shortcomings of cost, quality, and access ingrained in American health care.”2 Online therapy is a vital component of accessibility. Oftentimes, those who most need treatment also have the hardest time traveling to see a healthcare provider. For these clients, telemedicine makes it possible for them to get much-needed care.

What Is Telehealth?

Telehealth, or online medical care, is an especially valuable resource for vulnerable populations. Substance use disorders can affect anyone, including elderly and immunocompromised clients, those with mobility issues, and people whose schedules make in-person therapy impossible. For example, a CEO or high-level executive might be able to take an hour-long break for a therapy session, but unable to take 3 hours off so they can commute to and from the office.

When you think of online addiction treatment, you may imagine something like a Zoom call, with the client and provider talking through a screen. That’s certainly a big part of telemedicine, and most talk therapy sessions do fall into this category. But there’s much more to online healthcare than video chat.

Telemedicine can include any type of online health management.3 For example, you might track your daily caloric intake through an app and share it with your nutritionist, or you might communicate with your psychiatrist via email. Many patients opt in to text message reminders about upcoming appointments. All of these fall under the umbrella of online healthcare.

Is Your Privacy Protected During Online Therapy?

Many clients are rightfully concerned with their privacy, and the confidentiality of the therapy they receive. And of course, any kind of online communication has an inherent security risk. A hacker is unlikely to get their hands on any information you share in person, behind closed doors, with no recording devices in the vicinity. Thankfully, several regulations control the privacy of clients’ health history.

Most of the time, healthcare providers are legally obligated to protect any client data obtained during treatment, whether that treatment occurs online or in person. However, some of these rules have changed since the pandemic. In the U.S., for example, the government has allowed more flexibility to healthcare providers who are moving their practices online. In some cases, lawmakers may be more lenient regarding HIPAA regulations for telehealth.4 This is intended to make virtual treatment accessible for clients whose providers may not have been set up for online healthcare prior to COVID. It gives doctors and counselors a little more leeway, so they don’t have to stop seeing patients entirely while they learn how to use various online platforms.

It’s likely that these regulations will change over time, as we continue to adjust to this new era. Clients engaged in online addiction treatment programs should stay apprised of this. Ideally, you’ll check in with your providers on a regular basis to make sure that their specific practices meet your needs for confidentiality.

Feeling safe with your therapist is paramount; a lack of trust will almost certainly interfere with your recovery. Step one, as always, is to find the right type of treatment and the right provider for you. After that, there are still a number of factors to consider as you decide if telemedicine is a good fit.

Pros and Cons of Online Rehab

Like any other form of communication, online rehab has its pros and cons—it’s certainly not appropriate for everyone. However, the very act of considering online therapy is an opportunity for you to evaluate your own priorities. By deciding whether online therapy is right for you, you’ll likely learn more about what you need out of any treatment program.

Advantages of Remote Therapy Sessions

Accessibility

Online therapy is one of the most accessible forms of healthcare. All you need is an internet connection and a computer, tablet, or even a phone. You’ll be able to contact your medical team from home, from the office, or from the other side of the world. You won’t have to cancel appointments if you’re sick, or if the weather is bad. It also allows for more flexible scheduling, because it completely eliminates travel time.

Accountability

Some clients, especially those who are new to recovery, may struggle to make and keep their appointments. This can be especially true if in outpatient treatment. If your appointments happen virtually, you’ll have fewer excuses to cancel. If you forget an appointment, some therapists will call or text you a reminder. Then, instead of having to reschedule or pay for unused time, you’ll be able to hop on the call within just a few minutes.

Group Dynamics

Online mental health treatment makes it possible for clients to engage in group therapy with people who are physically distant. Clinical Director Brenna Gonzalez explains how The Hope House Scottsdale uses technological tools for long-distance family therapy:

“The theatre room is equipped with telehealth equipment, so we can include family members in a client’s treatment program. Returning home to family support is really important, so it’s key to ensure family members understand what’s going on with their loved ones during treatment.”

Hope House Scottsdale movie theatre
The Hope House in Scottsdale, Arizona has an on-site theatre room fitted with telehealth equipment.

Continuity of Care

Virtual therapy appointments often allow you to stay in contact with the same treatment team even when you move from one location to another. This is especially important for clients who travel to residential rehab in another state or country, and want to proceed to an aftercare program at the same rehab center when they return home.

At some rehabs, online treatment is a routine component of aftercare. Ryan Soave, the Director of Program Development at All Points North Lodge, describes the role telehealth plays in their continuing care:

“In our full continuum of care, people come out of detox into our residential facility, then they step down to the partial hospitalization program, all the way through into intensive outpatient and the telehealth program.”

Not every rehab facility offers this. Some programs may suggest you engage in online aftercare with the same facility, but a different medical team. If you live in the U.S. and travel to another state for rehab this can get especially complicated, as the U.S. has strict laws governing therapy for out-of-state clients.5 Make sure to learn what your options are before you begin inpatient therapy, so you’ll know what to expect going forward.

Potential Drawbacks of Attending Addiction and Mental Treatment Virtually

Limited Physical Care

Virtual therapy can address many serious issues, and may be appropriate for some physical exams. However, it has noteworthy limitations when it comes to physical care, especially in the treatment of substance use disorders. For example, it’s not an effective way to perform medical detox. That process should be closely supervised by an in-person team of doctors and nurses.

Even clients who have already completed detox may still benefit from in-person care. One major drawback of online treatment is that online appointments don’t allow doctors to monitor your vital signs or perform daily drug testing.6 This aspect of accountability can be very important for people who are new to treatment, and losing access to it can severely impact the recovery process.

Confidentiality

Although providers are ethically obligated to protect their clients’ data, breaches can and do occur. In telehealth appointments, you may be responsible for some aspects of online security.7 Your device or your home network may not be entirely secure, even if your therapist’s data is.

Lack of Experiential Therapy

Online therapy is an effective way to talk to a therapist or other provider. However, there are many powerful and effective types of therapy that can only happen in person. During on-site or inpatient treatment, you may have access to art therapy, group activities, and even massage or acupuncture. Experiential therapy can greatly benefit your physical and mental health. These opportunities invite clients to learn about healthy social dynamics while creating happy memories. And it’s just not possible to go whitewater rafting via video chat!

Online Rehab Programs Can Be a Great Fit for Some Circumstances

Because of its physical limitations, some clients may benefit from telemedicine as part of a combination approach to recovery. You may choose to see some providers online and others in person. You may plan to maintain long-distance therapeutic relationships after complete inpatient treatment. If you’re interested in online therapy, be sure to talk to your medical team and ask whether they think it might be right for you.

Before you begin this type of online treatment, take some time to understand your own interest in it. Recovery is a time to reconnect with yourself and to start building healthy relationships. For some people, virtual treatment programs are appealing mostly because it allows you to stay in isolation. If that’s true for you, it might not be the best fit.

If you have other concerns—such as physical health issues, scheduling, or various forms of accessibility—don’t let the perfect be the enemy of the good. For many people, online appointments are the only way to access high-quality care. If in-person treatment just isn’t an option for you, telehealth may make it possible for you to begin recovery.

View and connect with rehabs that offer online services to find out if this format is a good fit for you.

Frequently Asked Questions About Virtual Addiction Treatment

Is telehealth effective for substance use disorders?

Telehealth is an effective option for addiction treatment, providing accessible and convenient care via online platforms. It offers a safe and private way to receive therapy, making it especially beneficial for vulnerable populations and those facing travel constraints.

Is privacy protected during online therapy?

Online therapy ensures privacy through legal obligations and regulations, and most healthcare providers strive to maintain confidentiality. Clients should stay updated on specific practices and communicate their concerns to their therapists to ensure their privacy needs are met.

What are the pros and cons of online rehab?

Online rehab has advantages such as accessibility, accountability, group dynamics, and continuity of care. However, it has limitations in physical care, potential confidentiality risks, and the lack of certain experiential therapies. Assessing personal priorities and consulting with your treatment team can help determine if online treatment is a suitable choice.
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Understanding the Role of Sober Coaches in Addiction Recovery 

The transition from an addiction treatment program to daily life is a fundamental step in the recovery journey. Many people can feel overwhelmed and isolated during this time. These feelings are normal—you’re navigating new territory and adjusting to a new lifestyle.

To make the adjustment period more manageable, some luxury treatment centers will set you up with a support system as part of their continuing care program. Another way to bolster your support network is with a sober coach, also known as a recovery coach. Many sober coaches are affiliated with rehab centers or hospitals. However, some work with free-standing organizations, or as private practitioners. 

Sober coaches can help you feel less isolated, hold you accountable and offer advice and guidance to ensure sustainable recovery as you return to life outside treatment. 

A sober coach may be a good option if you want a more hands-on relationship with a non-clinical professional who can guide you through this particularly sensitive stage. Keep in mind that a sober coach is not a replacement for other parts of your continuing care program. Rather, they supplement aspects of continuing care and offer support that some people may need for long-term recovery. 

Since sober coaching is a relatively new position in addiction treatment, we explore how their role is defined and ways in which they can support your recovery. 

What Is a Sober Coach?

The recovery journey doesn’t stop when a rehab program ends. In more recent years, we’ve seen a rise in new peer-based recovery support services1 that has stemmed from the need to provide people with extra support as they transition from a formal treatment program into their natural environment. A growing number of peer-based recovery support services and new roles have been designed to assist people during that transition period and help them maintain long-term sobriety. One of those roles is a sober coach.

Sober coaches can have many different titles, including recovery coach, recovery manager, recovery mentor, recovery guide and more. Their role remains the same: to provide someone with “non-clinical assistance to support long-term recovery from substance use disorders.”2

Unlike clinical professionals, sober coaches don’t need to have formally acquired credentials. Instead, sober coaches draw on experiential knowledge and expertise3 to help clients achieve and maintain lasting sobriety. Their knowledge generally comes from their own addiction recovery experiences or from helping others recover. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), a sober coach offers supportive assistance, rather than directives.4 They can help with a number of recovery-related issues: 

  • Setting recovery goals
  • Developing recovery action plans 
  • Finding new peers
  • Improving job skills
  • Exploring new hobbies and things to do in your spare time 
  • Finding sober housing 
villa paradiso sober coaching
Villa Paradiso Rehab in Marbella, Spain offers aftercare recovery coaching.

Generally, a sober or recovery coach offers the four following types of support: 

Emotional Support

Emotional support includes anything that addresses your emotional concerns. This could range from inspirational coaching to empathetic listening and encouragement. 

Informational Support

Sober coaches can connect you with resources and information that benefit your recovery, like learning a new life skill or developing new coping strategies for dealing with challenges. 

Instrumental Support

This includes assistance with concrete, practical tasks like finding housing and employment.

Affiliational Support

A sober coach can help you connect with  others who can bolster your recovery journey. This might take place through events,activities, or online or in-person communities. 

The Difference Between Sober Coaches and Sober Companions

There are several roles that involve helping people maintain long-term recovery beyond inpatient rehab. It’s important to clarify the distinction between them, to ensure you look for the right type of guidance. 

A common misunderstanding is that sober coaches are like sober companions. However, their roles are markedly distinct. 

Sober Coaches (or Recovery Coaches)

A sober coach is a hired, non-clinical professional who supports your long-term recovery from substance use disorders. Most have been through recovery themselves and are trained on how to help others through the journey. Sessions with your recovery coach occur on a regular basis and are held via phone, online or even onsite at your treatment center. 

Sober Companions

A sober companion is generally more involved in your daily life than a sober coach. They will accompany you throughout your day as necessary, to ensure you have the support and accountability you may need to prevent a relapse.

noosa confidential sober coaching
Noosa Confidential in Queensland, Australia offers sober coaching as part of the aftercare portion of their programming.

Who Are Sober Coaches a Good Fit For? 

Sober coaches offer support through various stages of the recovery journey.5 

A sober coach could be a good fit for you if you don’t have a strong support network, live in an environment with many triggers, or need additional help with daily life. Some people can benefit from having a sober coach in more than one stage of their recovery journey. 

The Pre-Decision Stage

Before you make a decision to enter residential treatment, a sober coach can help you take this big step. They can ensure you feel less isolated through the process and assist with finding a rehab that suits your needs. Once you’ve found a program, they can guide you through the entry process. 

During Treatment

A sober coach who supports you during a rehab program takes on a slightly different role. They are an advocate and will help you foster life skills for lasting sobriety. For example, Hope Rehab Center in Thailand has a treatment model that includes exposure therapy, wherein clients are taken on excursions to experience the outside world. Their on-site sober coach supports you during these encounters to help you handle real emotions that may come up during life after rehab. 

Aftercare

A number of luxury addiction treatment centers across the globe offer sober coaching as part of their aftercare program. Oftentimes, sober coaches that work with rehab centers reflect the same level of care, support and privacy your addiction treatment program offers. 

In Europe, both Villa Paradiso Rehab in Marbella, Spain and Tabula Rasa Retreat in Portugal have aftercare recovery coaches. 

Australia has a number of treatment programs with sober coaches as part of their aftercare, including Noosa Confidential in Sunshine Coast and The Banyans in Brisbane. 

The United States has plenty of options across the country. For example, Oceanside Malibu in California, JourneyPure in Tennessee, Blue Ridge Mountain in Georgia and The Sanctuary at Sedona in Arizona all offer recovery coaching as part of their aftercare programs. 

It’s important to keep in mind that while sober coaches offer valuable support and life skills for sobriety, they should not replace the care you’ll receive from healthcare professionals and therapists during primary treatment and aftercare. 

The Difference Between Sober Coaches and Other Addiction Treatment Professionals

Sober coaches are relatively new in addiction treatment and can perform many different roles in someone’s recovery,6 which sometimes leads to role ambiguity. 

The public still holds some confusion about the responsibilities of sober coaches compared to other addiction treatment professionals. However, there are established differences as outlined in the Great Lakes Addiction Technology Transfer Center’s guidelines for ethical peer-based recovery support.7 It’s important to understand these distinctions to make sure you’re looking for the right professional for your needs. 

Sober coaches are not healthcare professionals. 

Unlike doctors, nurses, or psychiatrists, most recovery coaches don’t have medical degrees. Their role is never to diagnose you or provide you with medical advice or care. 

Instead, a sober coach helps you remove potential roadblocks that might prevent you from seeing a medical professional. For example, they can help you find the right medical professional, or drive you to your appointment. 

Sober coaches are not social workers or addiction counselors. 

Unlike social workers and addiction counselors, sober coaches take on a more informal role and aren’t required to have a degree in social work or formal credentials in counseling. 

Whereas addiction counselors are discouraged from self-disclosure, or using their personal experience to connect with clients, sober coaches are encouraged to share their personal experiences with you. They act as your confidant. 

If you need professional help from a social worker or an addictions counselor, your sober coach will help you get in touch with them.

Sober coaches are not sponsors. 

Unlike with sponsors, you and your sober coach don’t uphold each other’s sobriety.  Some sober coaches haven’t struggled with addiction before, but are there to support you, especially during sensitive transition periods. 

A relationship with a sober coach is more like that of a mentor and a mentee, or a personal trainer with their client.

oceanside malibu sober coaching
Oceanside Malibu in Malibu, California offers recovery coaching as part of their aftercare program.

How to Find the Right Sober Coach for You

Most sober coaches work in affiliation with recovery centers and hospitals. However, some work with free-standing organizations or as private practitioners.  

Since sober coaches don’t need to have formally acquired credentials, it’s important to take extra precautions when searching for one, especially if you plan to look outside of your rehab program. 

If you’re unsure where to start, you could ask recovery centers during an initial phone call if they have any referrals for reputable sober coaches. If you’re already seeing a therapist, you could ask if they have  any recommendations for you.  

How to Search for Rehab Center-Affiliated Sober Coaches

1. Check the addiction treatment center’s reputation and credibility.
Doing this as the first step gives you a good idea of the level of expertise a rehab center would expect from its employees and affiliates.

Reputation Check

Read through the rehab center’s online review. You can also ask around to see if they’re in good standing with other healthcare providers or treatment facilities.

Accreditation Check

In the U.S., there are two national organizations that accredit treatment providers. These include the Joint Commission and Commission on Accreditation of Rehabilitation Facilities (CARF). While rehabs might showcase accreditation logos on their website, you should check directly with the accrediting body.

2. Ask the addiction treatment center for sober coach options.
After you’ve found a reputable rehab center you trust, ask them for referrals of sober coaches. Usually, you would have gone through an initial phone call with an admissions specialist first. They’ll ask general background questions, including questions about your medical history, substance use history and family history. 

Once they have a better understanding of your situation, they will give recommendations for different sober coaches. You can compare their backgrounds and even go through an initial phone call with them to find a sober coach that best matches your needs. 

How to Search for a Private Sober Coach

If your addiction treatment program doesn’t offer sober coaching, you can hire a private sober coach to help you at any point in your recovery journey. Much like rehab centers, there are certain markers you should look out for to ensure you hire a credible, reputable sober coach who matches your needs. 

1. Ask people you trust.

You can start your search by asking people you trust if they have any recommendations for sober coaches. This could be your therapist, psychiatrist or even your doctor. 

2. Check the sober coach’s reputation, accreditations and affiliations.

Important to note: there’s no professional, independent governing body that offers accreditations to sober coaches.

Many private sober coaches have a website. It’s recommended to look through them and use these indicators to check whether the sober coach is reputable and has the level of expertise you’re looking for:

  • Online reviews—These give you a general idea of a private sober coach’s reputation.
  • Feedback—Reach out to people who have used that sober coach’s service and ask for their feedback. 
  • Relevant qualifications—Some credentials to look out for include psychiatric, medical, or social work accreditations or degrees. Keep in mind that if a sober coach doesn’t have the degrees listed above, it doesn’t necessarily mean they’re not qualified.
  • Work experience—Check a sober coach’s work background to see how many years they’ve been a practicing coach and if they have experience with others in similar situations as yours. 
  • Affiliation with treatment centers or hospitals—Check the qualifications of the centers they’ve partnered with to give yourself an idea of their credibility and professionalism.   

Sober Coaches Offer the Extra Support Many People Need for Long-Term Recovery

Adjusting to life after rehab can feel like a difficult prospect. As you journey to create a healthy, substance-free lifestyle, there are resources and tools you can turn to that help make the adjustment easier. 

For many people, sober coaches are a pillar to lean on and offer invaluable support they need for long-term recovery. The relationship is often grounded in trust, health and wellness, which is why finding the right person is so important. 

Many established rehabs either have referrals for sober coaches or have sober coaching as part of their program. To get your search started, browse our collection of rehabs that offer sober coaching.

Frequently Asked Questions About Sober Coaches

What is a sober coach?

A sober coach, also known as a recovery coach, provides supportive assistance to people in long-term recovery. They supplement other aspects of continuing care and can help with setting recovery goals, developing action plans, finding new peers, improving job skills, exploring new hobbies, and finding sober housing.

What’s the difference between sober coaches and sober companions?

A sober coach is a non-clinical professional who supports long-term addiction recovery. They provide regular assistance through phone, online, or in-person sessions. A sober companion, on the other hand, is more involved in a client’s daily life, providing support and accountability to prevent relapse and accompanying them throughout the day as needed.

How can I find a sober coach?

To find a sober coach, follow these steps: 1. Check the reputation and credibility of the addiction treatment center you are associated with. 2. Ask the treatment center for referrals of sober coaches. Compare their backgrounds and have an initial phone call with them to find a match. 3. If your treatment program doesn’t offer sober coaching, you can hire a private sober coach. Ask trusted professionals like therapists or doctors for recommendations and check their reputation, qualifications, work experience, and affiliations with treatment centers or hospitals.

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Ibogaine Treatment for Substance Use Disorders

gabon scenery

When you first enter recovery, it can be daunting to consider the road ahead. Especially after addiction, which sometimes offers instant gratification, you may be concerned about the slow rhythm of sustainable change. Some clients find it helpful to kickstart this process using ibogaine-assisted therapy.

Ibogaine is an alternative medicine, often administered in a short-term retreat setting. While it’s not readily available in the U.S., clients can travel to treatment centers around the world to seek it out. If ibogaine is right for you, it could certainly worth the trip. This experience is extremely different from most other forms of treatment.

What Is Ibogaine?

Ibogaine is a naturally occurring psychoactive alkaloid, found in the West African iboga shrub. In small doses, it’s a mild stimulant. In large doses, it can produce a dreamlike psychoactive state. This medicine has a long history, and has historically been used in healing and initiation ceremonies by members of the Bwiti religion.

The Multidisciplinary Association for Psychedelic Studies (MAPS) is exploring ibogaine as a potential treatment for substance use disorders, especially opiate addiction. According to their experts, “People with problematic substance use have found that larger doses of ibogaine can significantly reduce withdrawal from opiates1 and temporarily eliminate substance-related cravings.”

Experts found that ibogaine can have both psychological and physiological benefits. It’s sometimes administered at the beginning of a client’s detox process, because it “diminishes opioid withdrawal symptoms and reduces drug cravings.”2 Research suggests that ibogaine and its analogs “potently promote neuronal growth,” and produce “antidepressant-like behavioural responses.” Because of this, its effects may be beneficial for clients with a variety of mental health diagnoses.

The Uses of Ibogaine

This versatile treatment is especially useful for clients at the beginning of their recovery process. According to Álvaro de Ferranti, Founder of Tabula Rasa Retreat,

“It is not necessary to detox off drugs before an ibogaine treatment, particularly heroin…Ibogaine does take away heroin withdrawals instantly.”

It’s important to note, however, that clients detoxing from alcohol or benzodiazepines should taper off before beginning this treatment. Make sure to talk to your team of providers about your medical history, in order to avoid any serious side effects.

In addition to opiates, ibogaine is “also known to arrest cravings and addictions to stimulants such as crack cocaine and meth,” Ferranti continues. “It can also help people with dual disorders, mental disorders, and people who simply want to enhance their life spiritually and find answers and come back to self-love.” In particular, research supports the use of ibogaine for certain mental health concerns.

Opioid Addiction

In the Western world, this treatment is best known for its effect on recovery from opiate addiction. It alleviates most withdrawal symptoms, making detox faster and less uncomfortable. Clients also experience long-term benefits.

In one study, conducted by MAPS, “Results showed the most improvement in drug use at one month with 50% of participants reporting no opioid use during the previous 30 days. Ibogaine was associated with substantial reductions in opioid withdrawal symptoms3 and drug use in participants and may provide a useful prototype for development of innovative pharmacotherapy of addiction.”

Cocaine and Stimulant Addiction

According to the team of providers at Iboga Quest in Mexico, “cocaine addiction appears to respond very well to ibogaine treatment4 when coupled with proper preparation and after-care.” This finding is aligned with preliminary data from formal research.

In one retrospective study, subjects who had been treated for “cocaine dependence,5 almost none of whom used opioids, reported a median relapse-free interval of 5.5 months following single doses of ibogaine.” Ibogaine’s influence on the risk of relapse may be caused by its other psychological benefits.

Another study, which specifically focused on people in recovery from cocaine addiction, found that clients “patients benefited from the treatment in all the secondary outcomes, reporting decreases in craving and improvements in personal relationships, quality of life, and self-efficacy, thus supporting existing notions that treatments combining ibogaine and psychotherapy do have a therapeutic potential in the treatment of substance use disorders.”6

PTSD

Many people in recovery present with co-occurring disorders, meaning that they have both substance use disorders and additional mental health diagnoses. In particular, it’s quite common for clients to have PTSD. This condition has a complex relationship with substances. Some clients turn to substances in order to self-medicate its symptoms, and others develop PTSD due to experiences they have while using substances.

Ibogaine is shown to have a positive impact on PTSD patients.7 One study, conducted with military veterans, found that treatment “may offer a rapid and robust, and well-tolerated, treatment option for those suffering from a variety of psychiatric and cognitive symptoms,” and specifically for symptoms related to trauma.

Depression

Promising research is currently being done into ibogaine as a treatment for depression. Scientists began by creating an analog of ibogaine,8 intended to have similar effects. This medicine, called tabernanthalog (or TBG), “appears to relieve depression and addiction symptoms without producing hallucinations or other dangerous side effects.”

Although much more research is needed into the effects of TBG, some healthcare providers already support success using ibogaine to treat depression. According to the team at Tabula Rasa Retreat, “ibogaine can lead to an increase in serotonin levels in the brain, leading to a sense of wellbeing and possibility after a difficult period.” Their program caters to people with substance use disorders, depression, PTSD, and a wide variety of other mental health concerns.

The Experience of Ibogaine

Ibogaine is available at treatment centers around the world, although not in the U.S. Just like any other type of rehab, each of these facilities has its own distinct philosophy. Choose an environment that suits your specific needs.

Whatever the atmosphere of the facility, it’s important to carefully prepare for this experience. If you’ve been using certain substances—such as alcohol—you may need to detox prior to treatment. For others, this may not be required. Make sure to talk to your medical doctor and to the staff at your treatment center about the safest way to proceed.

Ibogaine induces a psychedelic experience. During the session itself, you may find yourself in a dreamlike state for up to 72 hours. Clients often report revisiting traumatic events from the past, and gaining new insight into their least healthy behavioral patterns.

As you slowly emerge from this state, you will likely experience immediate and significant differences. Rich, a client at Iboga Quest, had previously undergone detox, and later decided to try ibogaine after a relapse. Comparing these 2 experiences, he told interviewers, “With iboga, or ibogaine, it’s like hitting the reset button…I would say I still had symptoms, but they were significantly less—maybe 20-30% of what you’d normally have.”

Ibogaine also transformed his experience of shame. Prior to treatment, he struggled to accept himself, and was haunted by past mistakes. In an ibogaine-induced dream state, he envisioned a human body with empty spaces inside it, which he’d been trying to fill by using substances. As he explored these images, he learned the value of accepting himself just as he is.

“I always thought that acceptance was almost like admitting defeat. And [ibogaine] showed me that I didn’t have to necessarily like these aspects of myself; it wasn’t asking me to do that. But I had to accept them…these are things that happened…and even if they’re aspects of myself that were true at some point, they don’t have to remain true. And accepting them doesn’t mean that they remain true forevermore. In fact, accepting them puts you in a really great position to be able to change those aspects of yourself that you don’t like. And so that was my major teaching, really.”

The Long-Term Effects of Ibogaine

Unlike some other psychedelic medicines, ibogaine can have a lasting effect on mental health.9 In fact, researchers believe that it can “modify addiction-related neural circuitry through the activation of neurotrophic factor signalling.” This has important implications for its use in the long-term recovery process.

Despite its rapidly apparent benefits, however, ibogaine is not a miracle cure for substance use disorders. Experts at Tabula Rasa Retreat have defined 4 distinct phases of ibogaine treatment:10

  • In Phase 1, patients ingest ibogaine and experience a dreamlike state. You’ll likely spend this portion of treatment in bed, and under medical supervision.
  • During Phase 2, you’ll be fully conscious and aware, but may be hypersensitive and overwhelmed by recent epiphanies.
  • Phase 3 “begins abruptly and lasts for around 3 months. This phase is known as Temporary Freedom.” During this time, clients report decreased cravings and a lower sensitivity to triggers. It’s extremely important to remember that this, too, is just one phase of treatment. Clients should have a clear plan for aftercare in order to take advantage of this time.
  • Phase 4 is also known as the “Return to Earth.” At this point, clients often see an increase in their emotional sensitivity, and may be susceptible to relapse.

Researchers have determined that ibogaine “is not a cure for addiction.11 Instead, it merely interrupts addiction.” There is a great vulnerability associated with Phase 4 of treatment. No matter how relieved you may feel in Phase 3, it’s extremely important to prepare for your long-term recovery. If at all possible, it’s best to make plans for aftercare before you begin treatment. This may guard against the impulse to return to your old life too quickly.

Some clients begin recovery with ibogaine, and then go on to attend a more traditional rehab program. You might also consider joining an intensive outpatient program (or IOP), meeting with a support group, or simply seeing a talk therapist who specializes in substance use disorders. However you choose to proceed, make sure you’re prepared for the next phase of the healing process.

Beginning Recovery With Ibogaine

Although more research is needed, ibogaine is a very promising treatment. Whether you’re healing from substance addiction, trauma, or another mental health diagnosis, it may be a good place to start moving forward. However, like any other medication, this medicine is not appropriate for all clients. It has some notable health risks,12 and may cause unwanted physical side effects. Make sure you consult with a medical professional in advance, to ensure it’s a safe method for you.

Remember that while recovery can start with ibogaine, it’s just the first step in a lifelong process. It’s best to combine this medicine with other, evidence-based therapies, which may include rehab, medical care, talk therapy, or other options. Ibogaine can be a powerful element of your healing process, and may make it easier for you to move toward a healthier lifestyle. But this experience is no replacement for the slow, careful cultivation of sustainable behaviors.

If you’d like to learn more about this therapy, see rehabs offering ibogaine-assisted treatment.

Frequently Asked Questions About Ibogaine Therapy

What is ibogaine treatment for substance use disorders?

Ibogaine treatment is a unique approach to treating substance use disorders that involves the use of the iboga plant. It’s believed that ibogaine can help people heal from addiction by providing a deep psychological and spiritual experience that helps them confront its root causes.

Is ibogaine treatment safe?

While ibogaine treatment shows promise in treating addiction, it’s not without risks. It’s important to seek treatment at a licensed and reputable facility with trained medical staff who monitor patients and provide appropriate care.

What types of addiction can be treated with ibogaine?

Ibogaine treatment is used to treat a range of conditions, including addiction to opioids, alcohol, cocaine, and meth. However, it may not be suitable for everyone and should only be used under the guidance of trained medical professionals in a controlled and supervised setting.

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Non-12-Step: A Different Take on Addiction Treatment

12-Step programs have been a popular component of addiction recovery for the past 80 years. There are over 123,000 Alcoholics Anonymous chapters around the world, and introducing yourself in front of a group of A.A. meeting attendees has become virtually synonymous with sobriety. But since its inception in the 1930s, a number of other models of addiction recovery have become available—many of which are secular, evidence-based, holistic or otherwise offer a completely different approach to treatment. If you don’t resonate with the 12-Step approach, you may find other alternatives more appealing.

Common Non-12-Step Therapies

Motivational Enhancement Therapy (MET)

Motivational enhancement therapy1 is designed to encourage internal change. It’s a time-limited intervention that typically involves a handful of sessions. The first session usually opens with an assessment and from there, a therapist advises on coping strategies for high-pressure situations. Your progress is tracked throughout the subsequent sessions. This approach uses motivational interviewing techniques to inspire change, and sometimes involves loved ones in treatment.

Biomedical or Medication-Assisted Therapy

This approach takes a logic-based view of addiction as something “broken” that can be fixed. According to clinicians who use pharmacotherapies, medications can be used to correct chemical imbalances in the brain that may make certain people more susceptible to addiction. One example of this would be Naltrexone, which prevents opioid users from feeling the drug’s narcotic effects to help them taper off it. Antidepressants may be given for co-occurring depression, lowering its tendency to exacerbate an addiction. Medications are often used in conjunction with other approaches, like talk therapy.

Neurofeedback Therapy

Neurofeedback therapy is a non-invasive treatment which involves monitoring the activity of the central nervous system. It’s based on the understanding that the brain can self-regulate. By using EEG sensors to monitor brainwave activity and rewarding the brain for calming itself, neurofeedback therapy “rewires” the neural pathways created during substance abuse, essentially training the brain and nervous system to remain in a calmer state. This approach encourages higher-frequency brain waves, which helps improve mood, focus and energy levels.

acupuncture

Holistic and Alternative Therapies

Holistic therapies are designed to complement and enhance conventional therapies like cognitive behavioral therapy by uplifting your overall state. This may make you more receptive to other aspects of your treatment regimen. They’re designed to enhance your health and entire wellbeing using methods like mindfulness, spirituality, and energy work. In rehab, holistic approaches see addiction as a symptom of broader mental, physical and spiritual unwellness and aim to treat the effects of addiction on those aspects of self. Holistic therapies used to treat addiction come in a variety of forms like massage, yoga and reiki.

Considering a Non-12-Step Program

The 12 Steps work great for some people, but they aren’t the only path to recovery. Certain questions can help guide you on whether a non-12-Step program might be a better fit.

Have you already tried the 12 Steps? If you’ve gone to 12-Step meetings many times before or 12-Step based programs and experienced recurring relapse, it may be time to try something else. Keep in mind that relapse is often part of the recovery process—if you felt momentum with the 12 Steps, then it may be best to stick with it.

book

Are you concerned about co-occurring disorders? The 12 Steps alone is unlikely to fully address trauma, depression, anxiety, and other mental health concerns that may co-occur with addiction. Many rehabs use the 12 Steps alongside other methods. It’s good to check if a rehab center specializes in co-occurring disorders—these are highly complex and require sophisticated treatment.

Explore Non-12-Step Rehab Centers

While the 12 Steps are widely used in rehabs worldwide, you can find many centers that take a vastly different approach to addiction treatment. In fact, many rehabs employ the most innovative treatment methods and specialty programs available. If the 12 Steps didn’t work for you, it may be worth looking into rehab programs with different treatment philosophies. To help with your search, our comprehensive list of non-12-Step rehabs lets you filter by price, amenities, insurance accepted, and more.

Frequently Asked Questions About Non-12-Step Rehabs

What is a non-12-Step rehab?

A non-12-Step rehab doesn’t follow the 12 Steps: a guideline to recovery that involves following designated rules. Non-12-Step rehabs use different models of addiction recovery, such as evidence-based, secular, holistic, and more.

What’s an alternative to 12-Step groups?

Non-12-Step groups provide sober community and emotional support, without following 12-Step principles: 

• SMART Recovery
• LifeRing Secular Recovery
• Secular Organizations for Sobriety (S.O.S.)
• Women for Sobriety
• Moderation Management

… and more.

Do non-12-Step programs work?

Addiction is treatable, and plenty of people find success through non-12-Step programs, like holistic rehabs. If you don’t resonate with the 12-Step approach, it may be beneficial to look into alternatives. There are many pathways to recovery; what works for one person may not work for another.