What Is a “Dry Drunk”?

A “dry drunk” is someone who’s sober but still experiencing some of the emotions and behaviors caused by alcohol use. The term also describes someone who returns to an immature mindset1 after years or decades of impairment—arguably, back to how old they were when they began drinking. Other effects include irritability and impulsiveness. 

The term came about when Alcoholics Anonymous (AA) first began. AA members coined it2 as a non-negotiable stage of alcohol recovery. Later, psychiatrists and addiction specialists added their own twists to the definition, but generally agreed it’s part of recovery as a whole.

Who’s Most at Risk of Dry Drunk Syndrome?

Everyone in alcohol addiction recovery risks dry drunkenness, but it does become more likely for some specific groups.

Someone Who Never Went to Treatment

Not everyone needs professional alcohol addiction treatment, especially if their addiction isn’t severe. Or so it may feel.

Some forms of treatment, like outpatient therapy, address why/how drinking became a coping tool. Without treatment, you lose the chance to identify trauma, mental health conditions, and instill positive coping skills. Treatment can also help you process having an addiction. 

Without treatment, you risk developing dry drunk syndrome.

Someone Who Didn’t Complete Treatment

Anyone that prematurely left addiction treatment likely won’t enjoy the inner healing it can provide. You may not heal the underlying issues of addiction if you don’t finish treatment, resulting in dry drunk syndrome. 

Someone Who Had Poor Treatment

You may have gone to treatment but felt like you didn’t benefit from it. Maybe the facility wasn’t up to par, or you just couldn’t relate to their methods. Factors like that could keep you from fully engaging in treatment and experiencing healing. 

Other Nuances of Dry Drunk Syndrome 

Some symptoms of dry drunk syndrome mimic physical health issues2, like allergies and hypoglycemia. In early AA days, some members wrongly assumed more serious health conditions were simply a phase of their recovery. When those symptoms were medically addressed, they were no longer dry drunk.

So, it’s important to remember the signs and symptoms of dry drunk syndrome. That way, you can differentiate its symptoms from another health condition and get the treatment you need.

What Are The Signs of Dry Drunk Syndrome?

The signs of dry drunk syndrome2 include:

Changes in Mood 

You may feel more down, hopeless, or irritated than normal. You might also feel out of control since you can’t use your old coping tool anymore. Or, your mood could turn aggressive, and you may snap at your friends and family. 

Difficulty Concentrating

Feeling confused, disoriented, or distracted can make it hard to concentrate. Dry drunk syndrome can cause those feelings, affecting your work, school, and daily interpersonal life. 

Isolating

Feeling low, irritable, and ashamed of your feelings could lead to isolation. Or, you may want to deal with those feelings on your own, which could cause you to spend more and more time in isolation. That could mean staying in your room, overstaying at work, or becoming emotionally isolated around others. 

Engaging in Other Addictive Behaviors

You may turn to other substances1 in lieu of alcohol. These include “innocent” replacements, like caffeine, and even narcotics like cocaine. Other popular replacements include vapes and cigarettes, which contain nicotine. Excessively using nicotine or caffeine may seem better than using alcohol, but the underlying cause of addiction remains unaddressed.

Going Back to Old Bars

Despite not drinking anymore, you may feel drawn to the bars you used to go to and the social circles you were in. You may go to reconnect with old friends or another part of yourself. But doing so could tempt you into a relapse.

Habitual Lying

Hiding alcohol use and addiction usually requires lying, which can be a hard habit to break for those with dry drunk syndrome. You may find yourself lying about small or unimportant truths, creating trust issues with you and your loved ones. 

Anger And Resentment

In an attempt to avoid self-blame, rather than absolving it, you may blame others for personal errors. This could present as frequent anger outbursts, constant anger, and having a short fuse. You may also resent others for causing your addiction or contributing to it. Or, you might resent those who have gotten sober and seem perfectly happy.

Exaggerated Self-Importance

You may expect praise and positive attention for getting sober. This could lead to an exaggerated sense of self-importance, as you believe you’re owed praise. Receiving praise could then fuel that belief. Treatment can help you feel proud of your sobriety without the praise of others, which could prevent this symptom of dry drunk syndrome. 

How Is Dry Drunk Syndrome Treated?

To treat dry drunk syndrome, you and your care providers will likely return to your addiction’s root cause.  A therapist, psychologist, or addictions counselor will use various techniques to help you identify the factors that lead to addiction and find a path forward. These techniques include:

Cognitive Behavioral Therapy (CBT)

CBT helps you identify and address the thoughts and emotions behind your behaviors. For dry drunk syndrome, you’ll go back to what may have caused your addiction and how that unresolved cause still affects your present self. You and your therapist will then begin the healing process to resolve those issues and relieve you from dry drunk syndrome. 

Dialectical Behavioral Therapy (DBT)

DBT helps you accept strong emotions, navigate their effects, and learn tools for interpersonal communication. This therapy targets the emotions of dry drunk syndrome and the strong feelings that may have led to substance use in the first place. DBT usually takes place in a group setting with a classroom-like structure. You’ll learn new skills, accept your emotions, and explore ways to better yourself.

Holistic Therapies

Holistic therapies can help you navigate dry drunk syndrome by fostering your mind-body connection. Connecting deeper to yourself can open your eyes to the emotions that drove your addiction and how dry drunk syndrome continues to have those emotional effects. Holistic therapies for dry drunk syndrome include

The 12 Steps

Many of the original Alcoholics Anonymous (AA) members followed the 12 Steps to alleviate dry drunk syndrome. Those same principles still apply today. As the earlier members found relief through surrender and commitment to abstinence, so can you. Many rehabs and outpatient programs use the 12 Steps in treatment. And, you can keep going to AA meetings as long as you want, even after you leave treatment. You’re always welcome there.

Find A Support Group

12-Step groups exist worldwide. To find one near you, you can use AA’s meeting finder. You can also attend a rehab with a 12-Step focus.
To see 12-Step rehabs, you can browse our list of centers to see reviews, photos, insurance information, and more.

Fawning as a Trauma Response: Understanding Its Effects and Coping Strategies

Fawning as a trauma response is the 4th theorized response to trauma and complex PTSD (c-PTSD). As defined1, “Fawn types seek safety by merging with the wishes, needs, and demands of others” and, “fawn types avoid emotional investment and potential disappointment by barely showing themselves.”

Fawns intrinsically believe they’ll need to forfeit their desires, boundaries, and rights1 to earn a relationship with someone. Childhood trauma/c-PTSD often causes the fawning response2, though later-life traumas can too. Psychoeducation and therapy can help fawns, and treatment providers, understand and overcome this response.  

Defining Fawning as a Trauma Response

Fawning was recognized fairly recently as a trauma response, adding to the better-known Fight, Flight, and Freeze responses. Fawns often grow up in an abusive home environment3 or with narcissistic parents. Fawns adapt to trauma by adhering to others’ needs. The usual narrative goes:

If I just do what they want, am always useful, exceed their expectations, and never cause conflict, I’ll be okay.”

While that tactic may have worked when they needed it to, fawning also puts many “fawns” in the paths of narcissists, abusers, and manipulative people. Since they feel unable or scared to say no, a fawn may fall victim to these domineering personalities. 

How Fawning Differs from Other Trauma Responses

You could also react to trauma with fight, flight, or freeze responses3.

  • Fight: When something triggers you, you’ll face the threat with yelling, physical or emotional aggression, crying, or attacking the source of the danger.
  • Flight: You’ll physically or emotionally flee from the perceived threat. If you can’t do either, you may feel extremely anxious, fidgety, and hyperarousal.
  • Freeze: Perceived danger could make you freeze up and lose control of your body. You may even black out as a way to completely avoid the danger.

Fawning, in contrast, has few or no physical signs. The person fawning may seem completely fine, not triggered at all. They might think they’re fine, too. But that emotional disconnect can become another way to deal with past and ongoing trauma. 

Early Triggers Leading to Fawning

Children may adapt to emotional, physical, or sexual abuse by submitting to their abuser and aiming to please4. As children, fawns also ignore their own needs, feelings, and boundaries to appease people of authority—usually their parents. This pattern often continues into adulthood.

For example, a hungry child may hold their tongue for fear their mother will lash out if they communicate their hunger. Or, a child may push down the anger of being ignored by their parents for fear of being ridiculed. Staying quiet and outwardly unbothered then becomes the safest course of action. 

Psychological Mechanisms of Fawning

To the fawn, fawning is their only means of staying safe. They consistently sacrifice their needs and boundaries for safety, which can lead them to believe the two can’t intertwine. That belief can lead to codependency in adulthood2 and a personality change. For example, a headstrong child may grow into a demure, people-pleasing adult. 

How Fawning Changes Attachment Styles

Instead of having a secure attachment style5, a fawn will likely gravitate towards fearful-avoidant styles. These styles describe someone who has a negative model of self and others. A fawn may crave intimate relationships but feel too afraid of pain and ridicule to maintain or initiate relationships. 

Pandering and people-pleasing can prevent fawns from forming secure, mutually beneficial friendships. Others who value the fawn’s thoughts and opinions may struggle to connect with someone who “mindlessly” agrees to their every whim. In contrast, a narcissistic person would enjoy a fawn’s ongoing agreeability. 

Fawning And c-PTSD

Childhood trauma is one of the forms of complex post-traumatic stress disorder (c-PTSD). Someone with c-PTSD will have distorted beliefs2 about themself: that they’re worthless, unimportant, small, and unworthy. So, they may fawn as an outward show of their unimportance compared to the importance of their abuser—hoping this juxtaposition will spare them harm.

A fawn may continue this long enough that it becomes part of who they are. 

Effects of Fawning on Individuals

Even if you’re no longer fawning as a trauma response, it can become part of your adult personality. Fawning can make you feel unheard, used, and unimportant. You may also feel confused since you don’t have a reason to fawn or want to stand your ground, but it keeps happening anyway.  

Chronic fawning could dissolve your boundaries, identity, and self-esteem over time. You may feel only as important as you can be to someone else. Or, you may find yourself caught up with emotional abusers who exploit your people-pleasing. Neither has a positive effect on your model of self.

Fawning can also disconnect you from genuinely good people who want to satisfy your needs and make you feel seen. Someone who desires a mutual friendship or romantic relationship may feel confused by a fawn’s behavior. This could then rob you of healthy relationships throughout your life. But it doesn’t need to stay that way.

Healing And Recovery

Therapy can help you process your trauma and recognize the effects of your fawning response. You may decide on rehab for trauma, outpatient treatment, or sessions with a trauma-informed therapist. Discuss your options with your doctor or therapist to find the best fit for you.

Therapies for Trauma And The Fawn Response

Your therapist may use a combination of therapies, including eye movement desensitization and reprocessing (EMDR), cognitive behavioral therapy (CBT), and acceptance and commitment therapy (ACT) to address your trauma. 

EMDR therapists have you briefly recall your trauma while you track an object6 (like a pen) back and forth with your eyes. Some therapists use touch. Tracking the object desensitizes you to the strong emotions brought up by retelling your trauma. This can help you process the event without such painful emotions attached to it. 

CBT works by identifying and adjusting the potentially distorted thoughts7 leading to your behaviors. Using CBT, your therapist can help you identify the thoughts and emotions causing you to fawn. Then, you’ll work on adjusting your behaviors with the truth of your thoughts revealed.

ACT helps you accept painful emotions and traumas8 as an inevitable part of life and respond with flexibility and adaptability—rather than suppression. Using ACT, your therapist can help you find more productive ways to adapt to trauma by committing to the pursuit of your values and desires. For example, you may accept your fear of saying no to someone but commit to setting the boundaries that would protect your valued energy, well-being, and time. 

In therapy, you can also learn coping strategies to recognize fawning and protect yourself from its effects. 

Coping Strategies for Fawning

First, you can learn to recognize fawning. Keep these questions in mind as you determine what is/isn’t a fawning response:

  • Did saying yes or doing what the other person wanted make you angry?
  • Did saying no feel unsafe? (If you need to talk with someone, call the domestic violence hotline at 1-800-799-SAFE, or text START to 88788.)
  • Did you feel responsible for how someone reacted to something?
  • Did you adopt or agree with the values of a friend, even though you don’t actually feel that way?
  • Did you act like you agree with someone just to get them to favor you and do what you want?

How you answer those questions can queue you into your tendency to fawn. If you recognize your behaviors as fawning, you can fill a toolbox with coping strategies on your own or with your therapist. Here’s a few examples of responses to use when you feel tempted to fawn:

  1. “No, I don’t feel comfortable doing that.”
  2. “I don’t have time to take that on for you.”
  3. “I don’t have the mental space to fix this problem for you.”
  4. “No, I can’t.”
  5. “No, I can’t do that, but here’s how I can help….”
  6. “I disagree but value your opinion.”
  7. “I’m not able to do that now.”
  8. “I want to help, but I’m not the person to help you with this.”
  9. “No, I need to put my time elsewhere.”
  10. No.

They may feel scripted at first, but keep practicing responses like these to get better at expressing your genuine desires and opinions. 

Practical Solutions for Fawning

As part of AAA (Acknowledge your feelings, Acknowledge what you want to happen next, Action), you first need to acknowledge your tendency to fawn. With the help of a therapist, you can delve into what caused this response. If it’s a way to garner acceptance from others, you may discuss why you desperately need their acceptance and how you can feel just as validated and accepted without people-pleasing. 

Then, you can take responsibility for your emotions. You can do this by journaling your emotions and how you express them in the moment. Once you take responsibility for those emotions, you can move into problem-solving. 

You and your therapist can think of practical ways to address and respond to the emotions causing you to fawn, like journaling, writing out new responses, and brainstorming what you could say/do to feel safe and validated. Together, you can also learn how to validate yourself and grow your self-acceptance without needing the approval of others.  

Supportive Resources And Communities

You can attend support groups for trauma online and in person. The c-PTSD Foundation, for example, offers online support on their website. The National Alliance on Mental Illness (NAMI) has a tool for locating mental health support groups in your area. You can also search for the support groups in your area via an internet search or by contacting a mental health institute in your community. 

Or, if you want to deepen your knowledge and introspection, you can read these books about trauma and the fawning response:

You can browse Amazon, your local library, and other online bookstores for more books on trauma and the fawning response. 

Advocacy And Raising Awareness

You can advocate for yourself or someone else by learning more about the fawning response. Education can pave the way for greater understanding in both yourself and someone with limited background knowledge on trauma (and how people respond to it).

Continued awareness for fawning and other trauma responses also promotes trauma-informed care throughout different treatment settings. Your understanding of this trauma response can help others–and yourself–feel understood, valued, and validated.

The Signs of Drug Use in Teens

Drug use in teens is an increasing problem in the U.S. It’s important to recognize the signs of drug use in order to intervene and help teens struggling with addiction. Common signs of drug use in teens include changes in behavior, including mood swings, attitudes, and school performance. Additionally, physical signs can include red eyes, changes in sleep patterns, and changes in physical appearance. Finally, teens with drug addiction may show signs of financial or legal trouble, including stealing money or getting into trouble with the law.

If your child is using drugs, this recovery journey you’re about to embark on can not only help your teen, but it can also make your whole family grow closer. Getting teen treatment can set your child on the path to success. 

Signs, Symptoms, and Behaviors of Drug Use in Teens

If you know what to look for, you can discover if your teen is using drugs or drinking alcohol. Be on the lookout for these signs:

Changes in mood:

  • Irritable
  • Withdrawn
  • Unable to focus
  • Depressed or hyperactive

Changes in appearance:

  • Unkempt appearance
  • Bloodshot eyes
  • Flushed cheeks

Changes in behavior:

  • Sneaking out
  • Secretive about their phone or their whereabouts
  • Missing school or work
  • Hanging out with a new crowd of friends

How to Spot Drug Use in Teens

If you have a hunch your kid is using drugs, but you want to be sure, there are some things you can do to get a better idea of the situation:

  • Have eye contact conversations, and see if their eyes are bloodshot.
  • Smell for smoke.
  • Pay attention to their emotional state, this may be out of the norm.
  • Go through their belongings: This can be a sensitive topic. Giving your children the privacy they deserve is important, but if you are concerned about your teen’s safety and well being due to possible drug use, you may want to consider this option.

Teen Drug Use Statistics

 According to the National Institute on Drug Use, since the start of COVID-19, reported drug use has decreased1. This is likely due to school closure and social distancing (i.e. less peer pressure). Luckily, the downward trend has continued through the last couple of years; however, substance use still poses a threat.

The Most Commonly Used Drugs Amongst Teens

The most commonly used drugs reported in 2022 were nicotine/vaping, cannabis/marijuana, and alcohol. (Keep in mind that these are only the reported statistics. More teens likely use these substances and just don’t report it.)

  • 20.5% of 10th graders vaped
  • 19.5% of 10th graders ingested cannabis
  • 15.2% – 31.3% of 10th graders drank alcohol

While this downward trend provides some hope, research findings show dramatic and rising death rates in youth between the ages of 14-18. 

Also, it’s important to know that fentanyl, amongst other dangerous players, has contaminated the U.S. and worldwide drug supply2. This substance is extremely potent, meaning even the tiniest drop can make the user overdose. Fentanyl could be found in drugs like cocaine, MDMA (ecstasy), and heroin because it’s cheaper to cut these drugs with fentanyl than sell the pure substance.

Educating yourself on these dangers, and knowing how to help your child, is crucial for prevention, awareness, and recovery if/when needed.

Reasons Why Teens Use Drugs

Each teen has their reasons for using drugs. Here are some common factors that can push them to experiment.

  1. Peer Pressure: Being a teenager is hard, and they just want to fit in with their peers. If their best friend, or someone they admire, offers them drugs or alcohol, they’ll likely take it to feel accepted. 
  2. Media: TV shows, movies, and especially social media nowadays can show drug use as glamorous, normal, or fun. This can appeal to impressionable teens.
  3. Self-Medication: Mental health issues start to pop up around adolescence, and some teens may see the escape of drugs as a way to avoid these complex feelings.
  4. Experimentation: Teens are curious and ready to try new things, especially as they start to gain some freedom.
  5. To Feel Grown Up: Wanting to be a grownup and assert their independence can lead them to drinking or doing drugs.

Find Help for Teen Drug Use

So you’ve had the conversation with your teen about their drug or alcohol use. Now is the time to start gathering resources on how to help them.

  1. Gather Information: Begin by browsing programs for teens. Think through what you want to get out of this experience—for your child and your family. You may want to look for gender-specific care. These programs address hardships that boys and girls uniquely experience by giving them tools to face uncomfortable emotions and experiences. Gender-specific care also helps them focus on treatment without distractions. 
  1. Engage in Family Therapy: Family therapy will likely be an important part of the recovery process, for your teen and your whole family. Addiction education for loved ones is usually offered with this, as well. This gives clarity on your teen’s journey with substances and recovery. So when your child comes home after treatment, everyone will have the skills they need to maintain a healthy recovery environment.
  1. Be Supportive: Most importantly, be a rock for your child. They’re likely going through a confusing time, so having your support will make this process easier and improve their chances of success.
  1. Make Sure You Have Support: Give yourself grace through this journey. Helping your child through addiction recovery can be emotionally draining. You will have support from medical professionals, but other family members or friends can also provide support in this process. 

4A. Remember to prioritize your own self-care. Engage in activities that bring you joy and practice stress-reducing techniques.
As your kids grow older and start making their own decisions, you can act as a compassionate guide and lead by example. What you do from here on out is what matters most. A bright future awaits for your child with the right teen treatment.

find help for teen drug use

What Is The Most Addictive Drug?

The most addictive drug varies from person to person. Some genetic mutations make certain drugs more addictive than others. Or, you might find yourself drawn to a seemingly “less addictive” drug, like nicotine, that feels just as powerful as a narcotic. 

With that said, scientists have narrowed down a few of the top addictive drugs. Their addictive potential comes from reactions, communications, and changes in the brain. 

But for each addictive drug, you have resources for recovery. You can speak with your care team to decide which route of treatment works best for you—like going to rehab. 

Heroin

Heroin comes from certain poppy plants. As an opioid, heroin is highly addictive and can change the structure of your brain1 over time. It usually comes from South America. Dealers often cut heroin with starches, sugars, or sedatives—some of which can have unpredictable and unwanted effects. 

Pure heroin looks like a white powder and tastes bitter. Impure heroin is called “black tar” for its sticky feel and dark color (from impurities). 

You can snort powdered heroin or smoke it. For black tar heroin, you can inject it into your veins or muscles once it’s been dissolved and diluted.

Heroin absorbs into mucous membranes in your nose and lungs—or, if you inject it intravenously, it dissolves directly into your bloodstream. 

Once ingested, heroin bonds to mu-opioid receptors in your brain and activates them2, which turns off GABAergic neurons. GABAergic neurons keep dopamine from rushing along your reward circuit. Once the opioid receptor turns GABAergic neurons off, dopamine runs free, which causes a rush of euphoria and a strong sense of general well-being. 

Activating the reward system like this tells your brain opioids are about as great as it gets. Add in the distressing withdrawal symptoms, and getting more can feel like an urgent need. And as you keep taking heroin, you’ll need higher doses to feel the same high as your first time2—which means you’ve built up a tolerance. 

Much of heroin’s danger lies in this rapid high-low pendulum swing.  Soon, you might need high doses to keep from feeling sick. Trying to chase your first high, you might accidentally overdose. 

Taking too much could cause your breathing to slow to null3. You might also feel constipated, nauseous, and extremely itchy. Long-term use can knock your neuronal and hormonal systems off balance4—sometimes permanently. 

Alcohol

As a depressant, alcohol suppresses the central nervous system. And, alcohol is both socially accepted and easy to get—a tricky combination. Alcohol causes a sense of happiness and well-being5, which activates your brain’s reward system. It sees alcohol as medicine and, eventually, as something you inherently need to survive. 

Because of its addictive nature and easy access, alcohol is one of the most dangerous substances to abuse6. Over half the visits to emergency rooms have something to do with alcohol. It’s also one of the 2 most-used substances, the other being nicotine. 

Different alcoholic drinks have different levels, or percentages, of alcohol. For example, an alcoholic seltzer drink is usually 5-8% alcohol; in something like vodka, the rate goes up to 40%. 

As with illicit drugs, you can build a tolerance to alcohol. So, you might need to add a splash of vodka to your seltzer or have an extra glass of wine to feel how you’re used to feeling on alcohol. The longer this continues, the more you’ll need to drink. 

Withdrawals include insomnia, anxiety, tremors, and seizures. For many, safely detoxing from alcohol requires medical supervision. 

Nicotine

Nicotine, like many other drugs, causes a release of dopamine7. But with nicotine, the rush isn’t quite as intense as something like heroin. Nicotine has such addictive power because of its repetitive nature7 and because you can use it with other activities (and substances). 

Smoking a cigarette or vaping can enhance the pleasure of other activities7, like watching a movie, partying, having a cup of coffee, or listening to music. Even though nicotine only adds to these activities, your brain still associates it as the source of joy in those situations. And so, you learn to keep smoking, subconsciously chasing satisfaction.

What used to be fun and motivating might seem boring or too mundane without the added boost from nicotine, so stopping can be challenging7. You might even feel like nothing’s enjoyable without smoking. That’s because nicotine represses your natural dopamine-release functions, and once they’ve been suppressed for so long, it can take time for your brain to adjust and provide its own. 

Though unpleasant, nicotine withdrawals won’t hurt you8. You may have a bad headache and experience cravings. You might also feel more anxious and hungry. But all withdrawal symptoms pass with time. 

Benzodiazepines

Benzodiazepines, or benzos, subdue the central nervous system. They’re usually prescribed to help with anxiety, panic disorders, and insomnia9 for their calming, sedative effects. But benzos can also be highly addictive.

Some benzodiazepines can cause dependence faster than others. But usually, people use them with another drug9 to balance or complement other effects. Alcohol and benzos, for example, produce an enhanced calm but can dangerously suppress the central nervous system.

The benzodiazepine Rohypnol, AKA roofies, acts as a powerful sedative. Some misuse benzos like Rohypnol against others. But usually, benzodiazepines appeal for their countering effects against opioids and for self-sedation.

Benzodiazepine withdrawals9 can feel extremely uncomfortable. You could experience nightmares, anxiety, insomnia, psychosis, hyperpyrexia (extremely high fever), and convulsions. For those reasons, detoxing under medical supervision is a safer option. 

Methamphetamines

Doctors may prescribe the psychostimulant methamphetamine, or metamfetamine, to treat attention deficit hyperactivity disorder (ADHD)10. In healthy doses (for those who need it), methamphetamine’s effects resemble the brain’s fight-or-flight response10. This response  increases energy, alertness, and focus. But it’s also a drug of abuse with a high potential for addiction.

Methamphetamine looks like a white powder11 or crystal-like rocks. It’s relatively easy to make and cheap to buy. Many pseudo-scientists make methamphetamine in discreet labs, usually hidden off the beaten path.  But most meth comes from larger labs in Mexico and overseas countries. 

Methamphetamine releases dopamine, serotonin, and norepinephrine10, which contribute to pleasure, satisfaction, and alertness. Using methamphetamine for pleasure can cause binges, since the desired effects only last a few minutes. And because meth is one of the cheaper stimulants and easy to get, feeding the binges might not seem like a problem. 

But, as with other drugs, your brain changes with repeated doses. You might build up a tolerance12, prompting higher doses. Your brain may also stop producing dopamine and serotonin on its own. 

Methamphetamine withdrawals12 can cause cravings, depression, anxiety, violent behavior, confusion, insomnia, hallucinations, delusions, and psychosis. 

Cocaine

Cocaine is another highly addictive stimulant13. It’s also one of the most common illicit drugs14 in America. 

Cocaine prevents the reuptake of dopamine14, meaning dopamine stacks up on dopamine receptors. This sends an intense rush of pleasure and stimulates the entire reward pathway15, causing your brain to see cocaine use as intrinsically rewarding. Even the sights, sounds, and places associated with cocaine use can trigger the need for a dose. 

As with many other drugs, you can become used to the effects of cocaine, or “tolerant”. You’ll need more and more to feel the same high as your first time. This puts you at risk for an overdose. New dangers also lie in adding vermisol to cocaine15, which is used as a cutting agent. Sometimes, fentanyl even makes its way in. 

The withdrawals from cocaine16 include insomnia, tremors, cravings, and hyperactivity. 

Crack Cocaine

Crack cocaine is a smokeable version of regular cocaine17. So it’s also a stimulant, and addictive, but even more potent due to how it’s ingested. Before it’s smoked, crack cocaine looks like small rocks or crystals. 

The membranes in your lungs absorb crack cocaine18 easily and quickly, resulting in an almost immediate high. The high goes away faster than powder or liquid cocaine, which could prompt a binge—smoking until you run out of crack or money.  

The reinforcing action is even more powerful in crack cocaine17. Your brain thinks it’s a good idea to keep having more more often, trying to realize the pleasure it knows crack can give.

Barbiturates

Similar to benzodiazepines, barbiturates are a depressant19 generally used for anxiety, headaches, seizure prevention, and insomnia. Those who misuse this prescribed medication usually do to counter the effects of other drugs—typically stimulants like cocaine.

You can take barbiturates as a pill or liquid. Barbiturates make you feel sleepy, relaxed, and at ease19. They can also impair your memory and judgment, and make you irritable. You might also feel paranoid and suicidal.  

Overdosing on barbiturates19 causes your heart rate to rise, your breathing to slow, and your body temperature to lower. Overdoses can also cause comas and death.  

Methadone

Doctors prescribe methadone, a synthetic opioid20, to treat opioid use disorders (OUDs). It relieves cravings, reduces withdrawal symptoms, and doesn’t provide the same “rush” of euphoria as other opioids. At the correct dosage, these factors make methadone a valuable treatment element20 for OUDs. 

Part of what makes methadone maintenance treatment (MMT) effective is the low risk for addiction. And, in MMT, you don’t have to share needles or risk taking heroin, cocaine, etc., of unknown purity20. Doctor oversight adds another element of safety. 

But methadone does have an addictive element. The usual dose for OUD management ranges from 60+mgs20. Sometimes, patients in treatment buy extra doses from others or hoard doses to eventually get a euphoric effect from methadone. 

Taking too much methadone can cause dangerous effects, especially if you’re on other medications. Signs and symptoms of an overdose20 include dizziness, slurred speech, unconsciousness, slow pulse, shallow breathing, tiny pupils, and frothing at the mouth. 

Naloxone reverses the overdose effects of methadone20, as it does with other opioids. 

Marijuana

Marijuana, or weed, comes from the marijuana plant. Its addictive psychoactive properties lie in the THC21 (delta-9-tetrahydrocannabinol) in marijuana. You can ingest marijuana in many ways21—smoking the leaves, drinking it in tea, eating foods with weed, and smoking concentrated weed in the form of a sticky resin.

Weed produces a sense of relaxation22 and a milder feeling of euphoria. Weed can also make you pretty hungry (or, give you the munchies) and laugh easily. You’ll experience these effects right away if you smoke weed. 

Eating it slows the onset by a half hour or more, which could prompt you to redose, thinking it’s not working. Taking too much can cause anxiety, fear, paranoia, and panic22—the opposite of what weed usually feels like. Extremely high doses can even cause acute psychosis.  

Marijuana activates the reward system23 in your brain, causing a flood of dopamine to course along your reward pathway. After continued use, your brain teaches you to keep having weed as a way to feel reward and satisfaction. Continued usage can also impair your memory, learning abilities, and balance23.

Starting weed at a young age leads to a higher risk of addiction24. But anyone at any age can find themselves addicted, meaning they’d feel withdrawal symptoms and be completely unable to stop—even when they know they should. In states that don’t monitor distribution, the potency of THC continues to rise too. This creates consequences scientists and health professionals haven’t fully realized yet. 

But for each substance and its potential for addiction, you have opportunities to recover. 

Find Effective Drug Addiction Treatment Near You

The most addictive drug could vary widely from person to person. While one person might struggle to stop smoking cigarettes, someone else might not feel able to stop drinking—but drinking isn’t a problem for the first one. 

Fortunately, treatment for drug addiction caters to this variance. You can get the care you need at a residential rehab, outpatient facility, or detox unit. Your care team can help you decide which type and level of care will best meet your needs. 
To see a comprehensive collection of rehab facilities, you can browse our list of drug addiction rehabs to see photos, prices, reviews, insurance information, and more.

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

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

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

How to Spot Cocaine Use

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

Physical Signs

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

Emotional And Mental Signs

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

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

Slang Names for Cocaine

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

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

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

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

What Is Cocaine?

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

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

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

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

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

Is There a Difference Between Cocaine and Crack?

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

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

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

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

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

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

The Effects of Cocaine Use

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

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

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

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

What Is Cocaine Cut With?

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

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

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

Cocaine Mixtures

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

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

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

Treatment for Cocaine Addiction

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

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

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

Therapy for Addiction

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

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

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

The 12 Steps

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

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

Aftercare

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

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

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

Find Power Through Recovery

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

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


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

How to Spot High Functioning Depression: Signs and Treatment

High functioning depression can look like appearing okay to friends and family, while really you’re struggling on the inside. There are a lot of misconceptions about what depression looks like. But depression actually comes in many different forms and levels of intensity. Sometimes, symptoms can be hard to identify.

Seeking help can be daunting, but you are strong enough to begin healing. You can get treatment for high functioning depression to start living to your fullest potential.

What Is High Functioning Depression?

High functioning depression is a subtype of depression in which individuals experience symptoms of depression but can maintain their daily functioning, such as going to work or school, socializing, and completing daily tasks. It is characterized by a relatively high level of functional status, low depression scores, and little agitation.

High functioning depression can be challenging  to spot, so it’s important to recognize the symptoms you’re experiencing. This disorder usually has milder symptoms of major depression1. And it can be caused by a combination of genetic factors2 and other life experiences.

Despite feeling the opposite, putting on a happy face may seem like a good way to cope with depression at first. But ignoring the signs that you might be depressed can make it worse. High functioning looks different for everyone. Sometimes it seems like a way to protect yourself from uncomfortable feelings, and sometimes it looks like wearing a mask and pretending to be happy when you are not.

While your high functioning depression might feel manageable now, it could snowball into something more harmful. But co-occurring disorders like anxiety, major depressive disorder, and insomnia can also be an issue as a result of the depression3. And if you’ve experienced these feelings for 2+ years, you may have persistent depressive disorder (PDD), or dysthymia4

Signs of High Functioning Depression

If you think you have high functioning depression, it’s essential to talk to a licensed clinician who can diagnose you; however, here are some of the symptoms that you can identify4

  • Low self-esteem
  • Changes in sleep habits 
  • Changes in appetite 
  • Internalized distress
  • Difficulty concentrating
  • Trouble making decisions
  • Feelings of sadness and hopelessness
  • High achievement orientation
  • Difficulty seeking help

These symptoms can have damaging and long lasting effects. Sometimes, high functioning depression can cause more harm than acute major depression5. But there are resources and tools available. You can stop the cycle and step into a more fulfilling, positive lifestyle by seeking professional help for your high functioning depression. 

Healing from the Inside Out: Treatment for High Functioning Depression

Acknowledging that you may have high functioning depression, and facing those negative feelings, is a vital first step in your journey toward healing. Getting a diagnosis and the right care can then get you to feel like the real you again.

Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOs) can help manage your symptoms. However, medications are even more effective when combined with other therapies5

Talk Therapy

Cognitive behavioral therapy (CBT) is proven to be one of the best treatments for depression6. This therapy helps you identify unhelpful thought patterns that might contribute to your high functioning depression. Then, you’ll learn how to replace those negative thoughts with positive ones. Once you build out these new ways of thinking, your emotions will likely become more manageable. And you’ll learn habits to overcome any new challenges that arise in the future.

Cognitive behavioral analysis system of psychotherapy (CBASP) is a therapy designed specifically for persistent depression7. CBASP helps you create a clear, step-by-step action plan to tackle your issues. You’ll learn how to develop constructive, positive habits. And you’ll focus on your actions’ impact on yourself and others. This, in turn, motivates you to maintain a positive lifestyle.  

Holistic Therapies

Healing requires looking at the whole “you.” And healthy lifestyle changes can enhance treatment for depression5. There are a few different holistic practices that you can incorporate into your recovery to heal your mind, body, and spirit.

Yoga builds physical and mental strength, which makes it an effective treatment for depression8. Yoga can provide community and a sense of belonging, and depression-related themes can be shared in classes. You’ll work through breathing exercises, learn resilience in different poses, and practice mindfulness. And you can do it from anywhere and on your schedule. 

Meditation and mindfulness are another instrumental way to treat depression. In fact, data shows that mindfulness-based training is as effective as other talk therapies for depression treatment8. These practices draw your attention to the present moment and your surroundings. By incorporating mindfulness into your daily routine, you can become more aware of your emotions. And in time, you can better manage your feelings and choose to seek the positive. 

How to Support Someone with High Functioning Depression

If you think someone you love is experiencing high functioning depression, providing a listening ear and complete understanding can go a long way. While you can be a support system for the person you love, encouraging them to get professional treatment is the best way to help them heal. You can be their rock, guide them through the process, and be patient as experts help your loved one work through their depression. 

Learning to Live Fearlessly

Coming face-to-face with your depression can be scary. But by confronting what’s holding you back, you can set yourself free. Tap into your resilience by seeking help for your high functioning depression

Change happens in small steps. Here are 6 things you can start doing today to live fearlessly: 

  1. Seek professional help
  2. Challenge negative thoughts
  3. Practice self-care
  4. Reach out for support from friends and family–remember reaching for help is a good thing
  5. Make manageable changes (i.e. daily routine, new hobby)
  6. Set goals for yourself

Understanding the Link Between Addiction and Schizophrenia

Drug addiction and schizophrenia can feel pretty similar. And if you have both, it might be hard to tell where one condition ends and the other begins. Learning about that dynamic is a key part of recovery. That knowledge can empower you to find the right type of treatment for schizophrenia and substance abuse.

Does Drug Addiction Cause Schizophrenia?

In short: no, taking drugs won’t give you schizophrenia. But addiction and schizophrenia have similar causes—and similar symptoms. The same factors that make you vulnerable to one can also make you vulnerable to the other.

If you have schizophrenia, drug use can trigger your symptoms. And depending on what drug you’re taking, being high can even feel like psychosis. That’s because both drug use and schizophrenia tamper with your brain’s reward system. Here’s why.

The Similar Brain Chemistry of Schizophrenia and Addiction

Taking any drug has an impact on your brain’s reward system. And it doesn’t matter what the drug’s actual effects are. The very act of getting high increases your levels of dopamine, a neurotransmitter. So when you take drugs, you feel a sense of reward.

Over time, you’ll need more and more of a drug to achieve that feeling. Reward might be replaced with relief. And as your tolerance goes up, you’ll likely develop a more severe addiction.

Even if you never take drugs, schizophrenia still disrupts your reward system.  In some people, it decreases baseline levels of dopamine. Or, it can make you hypersensitive to dopamine, so doing drugs feels like an even bigger reward. And if you’re taking drugs that reduce the symptoms of schizophrenia, addiction is even more likely.

Self-Medicating to Manage Schizophrenia

While addiction is unhealthy, it often begins as a coping mechanism. You might feel like drug use helps you control the symptoms of schizophrenia. And, in some cases, that might even be true. For example, nicotine reduces psychotic symptoms. But that doesn’t mean cigarettes are good for you.

In the long term, addiction continues to destabilize your reward system. Because of this, ongoing drug use can exacerbate your schizophrenia symptoms. This complicates the process of recovery.

Treatment for Both Schizophrenia and Addiction

Quitting drugs isn’t a cure for schizophrenia. But for some people, it’s an important first step toward healing. And because of the overlap between addiction and schizophrenia, many of the same treatments might help with all your symptoms.

If you’re recovering from both these conditions, you might benefit from treatment for co-occurring disorders. Within that framework, there are several specific therapies that can help.

Motivational Interviewing

Motivational interviewing (MI) helps patients with schizophrenia commit to ongoing treatment. It’s an especially effective treatment for people with both addiction and psychosis.

MI isn’t technically a type of therapy. Instead, it’s a conversation style that many different clinicians apply to treatment. Therapists, doctors, nurses, and others can all use this approach. During MI, they’ll use active listening, pointed questions, and other techniques. This can help you find your personal spark of motivation to heal.

Contingency Management

For patients with both schizophrenia and addiction, contingency Management (CM) can make recovery more likely. This approach rewards your participation in treatment. For example, you might get a gift card, voucher, or even cash for going to a therapy session. You and your care team will write and honor a treatment contract, defining prizes for each activity. In most cases, the value of your rewards will go up over time. For many people, this agreement motivates positive changes.

Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) was originally developed to treat borderline personality disorder. Today, it has many additional uses. For example, DBT can help patients with schizophrenia, addiction, and other mental health conditions.

Sessions of DBT can feel more like classes than therapy. You’ll meet with a group, go through a workbook, and even do homework. You might also have 1:1 sessions with your therapist. Patients learn practical skills in 4 modules: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. These coping strategies can empower you to live a healthier life.

Cognitive Behavioral Therapy

Like DBT, cognitive behavioral therapy (CBT) focuses on practical coping skills. CBT helps patients with addiction and schizophrenia manage their symptoms without drug use.

Instead of trying to change your feelings, CBT shows you new ways to respond. Future episodes of psychosis might always trigger drug cravings. But you’ll learn how to accept that feeling and move on, instead of falling back into addiction.

Specialized Care in Rehab

Schizophrenia is often a lifelong condition. Instead of “fixing” all of your symptoms, treatment empowers you to manage them. These strategies are far more sustainable than addiction. And in an effective rehab program, you can heal from both at the same time.

Browse rehabs that treat schizophrenia to see locations, photos, reviews, and more.

Reviewed by Rajnandini Rathod

How to Identify & Treat Gambling Addiction

Gambling is often seen as harmless fun, and many people are able to do it from time to time without developing an addiction. This makes it difficult for some people to realize when it’s becoming a problem.

Unfortunately, few people who struggle with gambling addiction get the help they need. In fact, many people are unaware that there is rehab available for gambling. But the truth is that there are plenty of effective programs available for treating gambling addiction. Let’s take a look at how this addiction develops, what encourages many people to quit, and how you can find support to do the same.

Spotting Problem Gambling

Gambling can include activities such as buying lottery tickets, playing slot machines at a casino, betting at races, hosting poker nights with friends, and more. While these activities aren’t necessarily problematic in and of themselves, they’re considered a gambling disorder ((Menchon, J. M., Mestre-Bach, G., Steward, T., Fernández-Aranda, F., & Jiménez-Murcia, S. (2018). An overview of gambling disorder: From treatment approaches to risk factors. F1000Research, 7, 434. https://doi.org/10.12688/f1000research.12784.1)) when they include “recurrent, maladaptive gambling behavior that results in clinically significant distress.”

About 0.5% of Americans experience gambling problems, ((Substance Abuse and Mental Health Services Administration. (2014). Gambling Problems: An Introduction for Behavioral Health Services Providers. Advisory, Volume 13, Issue 1. Retrieved from https://158bvz3v7mohkq9oid5904e0-wpengine.netdna-ssl.com/wp-content/uploads/2014/04/Gambling-Addiction-An-Introduction-for-Behavioral-Health-Providers-SAMHSA-2014.pdf)) according to data from national surveys. However, studies have shown that only 10% of people with a gambling addiction ever seek help, with financial issues being the most common motivation. And often when people do get into treatment, they do so for other symptoms such as insomnia or depression, which they may or may not realize are related.

Treatment Methods for Gambling Addiction

Although medication can be used to treat this condition, studies have shown that cognitive behavioral therapy (CBT) is a much more effective treatment option for gambling addiction. ((Menchon, J. M., Mestre-Bach, G., Steward, T., Fernández-Aranda, F., & Jiménez-Murcia, S. (2018). An overview of gambling disorder: From treatment approaches to risk factors. F1000Research, 7, 434. https://doi.org/10.12688/f1000research.12784.1)) Other talk therapies are also proven to work well, and can provide both short- and long-term benefits.

However, more research needs to be done in order to fully determine the most effective treatment for gambling disorders. Additionally, every person’s situation is unique, and each treatment plan needs to be tailored to their needs, especially if co-occurring disorders are a concern.

Cognitive Behavioral Therapy (CBT)

Research shows that CBT is extremely successful in treating gambling addictions. ((Menchon, J. M., Mestre-Bach, G., Steward, T., Fernández-Aranda, F., & Jiménez-Murcia, S. (2018). An overview of gambling disorder: From treatment approaches to risk factors. F1000Research, 7, 434. https://doi.org/10.12688/f1000research.12784.1)) This psychotherapy aims to change negative and dysfunctional thoughts and behaviors by replacing them with positive ones. When used to treat gambling addiction, this involves “identifying and changing cognitive distortions about gambling, reinforcing nongambling behaviors, and recognizing positive and negative consequences.” This helps people with a gambling disorder understand that the long-term negative effects, such as debt, legal issues, and damaged relationships, outweigh the short-term benefits.

Relapse prevention planning is often used in combination with CBT. In this technique, the patient is taught to recognize and either avoid or navigate situations that could lead to relapse. Someone with a gambling disorder may learn that these include locations like casinos, negative feelings such as anger or depression, and other stressors like work or family issues.

Therapy sessions held online or over the phone are another option that can provide flexibility, anonymity, and confidentiality.

Motivational Interviewing (MI)

This technique has shown a lot of promise as an effective approach to treating gambling addiction. ((Menchon, J. M., Mestre-Bach, G., Steward, T., Fernández-Aranda, F., & Jiménez-Murcia, S. (2018). An overview of gambling disorder: From treatment approaches to risk factors. F1000Research, 7, 434. https://doi.org/10.12688/f1000research.12784.1)) During this approach, a trained therapist works with patients to help them determine why it’s so hard to change their behavior. Normative feedback, which has patients compare their gambling behavior to that of the general population to help them see their maladaptive behavior, is a core part of this approach.

Research shows that motivational interviewing is associated with less gambling, as well as psychosocial improvements and a better overall quality of life. Some studies show that just 15 minutes of MI can be even more successful in treating a gambling disorder ((Yau, Y. H. C., & Potenza, M. N. (2015). Gambling disorder and other behavioral addictions: Recognition and treatment. Harvard Review of Psychiatry, 23(2), 134–146. https://doi.org/10.1097/HRP.0000000000000051)) than longer and more intensive treatment methods.

Medication

At this time, the FDA has not approved any medications for gambling disorder treatment. ((Menchon, J. M., Mestre-Bach, G., Steward, T., Fernández-Aranda, F., & Jiménez-Murcia, S. (2018). An overview of gambling disorder: From treatment approaches to risk factors. F1000Research, 7, 434. https://doi.org/10.12688/f1000research.12784.1)) Research is taking place but nothing has been proven yet, although one study showed that 2 antidepressant drugs, paroxetine and fluvoxamine, were significantly superior to the placebo in treating people with a gambling addiction.

The opioid antagonists naltrexone and nalmefene have also shown promising results, but further studies are needed to determine if they’re effective for everyone.

Family Involvement

Involving family members in the recovery process shows very positive outcomes for those struggling with addiction. If it’s important to you to include loved ones in your recovery journey, you can look for a rehab that offers family involvement. Many treatment centers offer family therapy (either remote or in-person) and on-site family programming as part of their residential care.

Alternative Treatment Approaches

Mindfulness is another treatment that has positive effects for those recovering from gambling addiction. ((Menchon, J. M., Mestre-Bach, G., Steward, T., Fernández-Aranda, F., & Jiménez-Murcia, S. (2018). An overview of gambling disorder: From treatment approaches to risk factors. F1000Research, 7, 434. https://doi.org/10.12688/f1000research.12784.1)) This technique is shown to minimize levels of severity, abstinence, and craving in people with gambling disorders, as well as improving quality of life and mental and emotional states.

Gamblers Anonymous (GA) is a support group ((Gamblers anonymous. (n.d.). Retrieved from https://www.gamblersanonymous.org/ga/)) for people in recovery from this addiction. Members go through a 12-Step program (similar to Alcoholics Anonymous) and choose a sponsor to support them along the way. If you attend a 12-Step rehab, you may attend GA meetings as part of your residential treatment program. Many people choose to attend support groups, 12-Step or otherwise, as part of their continuing care plan for ongoing recovery.

You may also choose to sign up for a self-exclusion program to prevent you from gambling ((Substance Abuse and Mental Health Services Administration. (2014). Gambling Problems: An Introduction for Behavioral Health Services Providers. Advisory, Volume 13, Issue 1. Retrieved from https://158bvz3v7mohkq9oid5904e0-wpengine.netdna-ssl.com/wp-content/uploads/2014/04/Gambling-Addiction-An-Introduction-for-Behavioral-Health-Providers-SAMHSA-2014.pdf)) in the future. Studies show that this approach reduces the amount of gambling in people with gambling disorders. Once you sign up, you’ll be prohibited from gambling for a certain period of time, chosen by you﹘even for life if you choose. If you gamble during your banned period, you will be asked to leave, need to return any money won, and may even be charged for trespassing. You can perform a quick online search to see if your state offers an initiative like this.

Risk Factors for Gambling Addiction

There are several risk factors for gambling addiction, ((Menchon, J. M., Mestre-Bach, G., Steward, T., Fernández-Aranda, F., & Jiménez-Murcia, S. (2018). An overview of gambling disorder: From treatment approaches to risk factors. F1000Research, 7, 434. https://doi.org/10.12688/f1000research.12784.1)) including demographic and psychological ones.

Adolescents are especially vulnerable and much more likely to develop a gambling addiction than older adults. Impulsivity is a common factor in all addictions, and gambling disorder is no exception. Other psychological factors associated with gambling problems are harm avoidance, low self-directedness, difficulty making decisions and planning, and sensation-seeking behaviors. Gambling disorders may also develop as a coping mechanism ((Yau, Y. H. C., & Potenza, M. N. (2015). Gambling disorder and other behavioral addictions: Recognition and treatment. Harvard Review of Psychiatry, 23(2), 134–146. https://doi.org/10.1097/HRP.0000000000000051)) for mood and anxiety disorders.

Among older adults, men have a higher chance of developing a gambling problem than other genders, as well as ethnic minorities, people with lower income and socioeconomic status, lower education levels, and unmarried status. One study found that most adults with this addiction use gambling to alleviate boredom or their inability to do an activity they previously enjoyed.

Why People Decide to Stop Gambling

Financial Problems

The extreme financial consequences of gambling addiction make it particularly insidious, because these can spill over into so many other areas of life. If you’re considering getting help for gambling-related problems, you may have already experienced some of the following:

  • Unpaid bills
  • Maxed out credit cards
  • Damaged credit score
  • Struggling with money despite having an adequate income
  • Continually borrowing money from family and friends
  • Refinancing assets or depleting investment accounts
  • Getting trapped in additional debt cycles with high-interest loans, etc.
  • Home foreclosure or property repossession

These monetary consequences of problem gambling ((Financial consequences. (n.d.). Nevada Council on Problem Gambling. Retrieved from https://www.nevadacouncil.org/understanding-problem-gambling/impact-consequences/financial-consequences/)) can also strain relationships with partners, family, and friends.

Relationship Problems

All that additional stress can lead to significant problems at home—which is why gambling disorder is associated with higher rates of divorce ((Svensson, J., Romild, U., & Shepherdson, E. (2013). The concerned significant others of people with gambling problems in a national representative sample in Sweden – a 1 year follow-up study. BMC Public Health, 13, 1087. https://doi.org/10.1186/1471-2458-13-1087)) and domestic violence. ((Dowling, N. A., Ewin, C., Youssef, G. J., Merkouris, S. S., Suomi, A., Thomas, S. A., & Jackson, A. C. (n.d.). Problem gambling and family violence: Findings from a population-representative study. Journal of Behavioral Addictions, 7(3), 806–813. https://doi.org/10.1556/2006.7.2018.74)) Family members may also develop depression or anxiety, or use substances to cope.

Legal Problems

It’s also common for people with a gambling disorder to have legal problems. One study found that about 25% of people with a gambling disorder had done something illegal related to gambling, ((Problem gambling and the criminal justice system. (2013). Victorian Responsible Gambling Foundation. https://responsiblegambling.vic.gov.au/documents/131/Problem-Gambling-Criminal-Justice.pdf)) including stealing, writing bad checks, and using unauthorized credit cards.

Drugs, Alcohol, and Gambling Addictions

Gambling disorders often co-occur with substance use disorders ((Barnes, G. M., Welte, J. W., Tidwell, M.-C. O., & Hoffman, J. H. (2015). Gambling and substance use: Co-occurrence among adults in a recent general population study in the united states. International Gambling Studies, 15(1), 55–71. https://doi.org/10.1080/14459795.2014.990396)) and other behavioral health issues. Gambling and substance use disorders share certain behavioral traits, including loss of control, cravings, tolerance, and withdrawal. (In the case of gambling addiction, “tolerance” refers to the need to risk more money to feel the same thrill.)

Alcohol is often easily available in casinos and other gambling environments. And as the consequences of the addiction (like financial loss and relationship problems) progress, substances can be a way to cope. In turn, alcohol and drug use encourage impulsive behavior—which makes it even harder to stop problem gambling.

Choosing the Best Gambling Rehab Center

If you’re struggling with financial or family problems due to gambling, life can feel out of control. But the good news is that there’s plenty of support available from professionals with experience treating people in your very situation. And so many people who worked through the challenges of gambling addiction recovery are now living happy, healthy, and fulfilled lives.

Choosing a few addiction treatment programs that seem like a good fit for you and getting further information from their admissions staff is a great place to start.

See our directory of gambling rehabs to further explore your options and see program information, specializations, staff qualifications, and more.

Reviewed by Lisa Misquith

Recognizing the Signs of Addiction to Prescription Pain Relievers

It can be hard to recognize the signs of a substance use disorder. That’s especially true for patients who overuse prescription medications. Even if you started taking a drug for medical reasons, it’s still possible to misuse it. Because of this, many patients struggle to admit that they need to go to rehab for an addiction to prescription pain relievers.

If you regularly use any type of pain medication, especially a narcotic, you should learn about the symptoms of addiction. By paying attention to these signs, you can stay in touch with your own relationship with your prescriptions. That way, you’ll be ready to get help if and when you need it.

Defining Addiction

Experts at the American Society of Addiction Medicine define addiction as “treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”

In layman’s terms: people with substance use disorders continue to take drugs even when those drugs have a negative impact on their lives. However, there is a difference between having physical dependence on a medication, vs having a substance use disorder. ((Abuse, N. I. on D. (–). Is there a difference between physical dependence and addiction? National Institute on Drug Abuse. https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence-addiction))

Physical Dependence

Many people depend on medications for their health. For example, a person with severe diabetes may depend on insulin in order to regulate their blood sugar. If a medication clearly and consistently improves your quality of life, its use does not qualify as addiction.

However, the line between physical dependence and substance abuse is blurry at best. You don’t misuse a substance because it makes your life worse. At first, you’ll probably have reason to believe it helps. And even in the throes of substance abuse, dangerous drugs may still provide some positive effects. For example, a prescribed narcotic may continue to relieve your back pain, even while it wreaks havoc on your relationships.

Substance Use Disorders

People who struggle with substance misuse often display signs of “compulsive drug use despite harmful consequences.” These consequences of addiction ((Abuse, N. I. on D. (–). Addiction and health. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/addiction-health)) may include mental health issues, such as depression and anxiety, and physical ailments, such as cardiac arrest, dental problems, and cancer. Drug use can also damage interpersonal relationships and interfere with your career.

This condition may or may not include chemical dependence. If it does, then it’s often essential for patients to undergo supervised medical detox, rather than attempting to stop using a drug by themselves. The physical side effects of detox can be especially dangerous for people with an addiction to opioids, including prescription pain relievers.

Signs and Symptoms of Addiction to Prescription Painkillers

Opioids are widely prescribed to treat chronic pain. ((Rosenblum, A., Marsch, L. A., Joseph, H., & Portenoy, R. K. (2008). Opioids and the treatment of chronic pain: controversies, current status, and future directions. Experimental and clinical psychopharmacology, 16(5), 405–416. https://doi.org/10.1037/a0013628)) These medications “play a unique role in society. They are widely feared compounds, which are associated with abuse, addiction and the dire consequences of diversion; they are also essential medications, the most effective drugs for the relief of pain and suffering.”

It’s difficult for many people, including patients and medical professionals, to immediately recognize the difference between addictive behavior and the appropriate use of pain medications. If you’re concerned about potentially misusing opiates, you can look out for the following signs and symptoms:

Using Prescription Painkillers When You’re Not in Physical Pain

Opiates should be prescribed to treat physical pain. If you find yourself compelled to continue taking them even when you have no physical symptoms, you may be at risk for a substance use disorder.

It’s also possible to treat some types of pain with non-addictive medications. For example, a minor headache might be better treated with an over-the-counter anti-inflammatory, like aspirin or ibuprofen. If you find yourself medicating minor ailments with powerful drugs, this can also be a warning sign.

Using Painkillers for Emotional Reasons

There are significant similarities between physical and emotional pain. ((Sturgeon, J. A., & Zautra, A. J. (2016). Social pain and physical pain: Shared paths to resilience. Pain Management, 6(1), 63–74. https://doi.org/10.2217/pmt.15.56)) Because of this, it may be hard to differentiate between your own physical and psychological reasons for using a drug. However, you may notice the urge to use medication when you’re experiencing overwhelming emotions. If you find yourself taking prescription painkillers to deal with your mental state, you may have a problem with drug abuse.

Obsessive Thinking

Patients with substance use disorders may spend a disproportionate amount of time thinking about using drugs. This may include thinking about when you’ll next take a pain pill, how you’ll refill your prescription, or whether anyone else has noticed how often you take opioid medications.

There’s a difference between planning around your medication and obsessing over your access to drugs. For example, it can be perfectly healthy to plan to take a pain pill before bed so that you won’t have to drive while intoxicated. On the other hand, if you spend all day, every day, looking forward to your nightly dose, you may have reason to be concerned.

Changing Sleep Patterns

Most mental health conditions, including substance use disorders, can disrupt sleep patterns. ((Abuse, N. I. on D. (2020, March 9). Connections between sleep and substance use disorders. National Institute on Drug Abuse. https://nida.nih.gov/about-nida/noras-blog/2020/03/connections-between-sleep-substance-use-disorders)) Opioids, in particular, “can produce profound sleepiness, but they also can disrupt sleep.” Exhaustion, insomnia, and disrupted sleep may all be signs of opiate misuse.

Because so many different stimuli can affect sleep, pay attention to what’s going on in your life when your sleep patterns change. If you’re going through a particularly stressful time, or you just got a new mattress, you may not have a cause for concern. However, if your sleep patterns change in tandem with your narcotic use, then substance abuse may be the cause.

Negative Physical Effects

Prescription drugs are intended to improve your quality of life and your physical well-being. If any prescription has more negative effects on your body than positive ones, you should talk to your doctor about discontinuing its use. However, if you have a substance use disorder, you may be tempted to ignore side effects in order to keep using the drug.

The side effects of prescription opioids include, but are not limited to, drowsiness, constipation, itching, sweating, and a decreased libido. Drug use may also change your behaviors in a way that causes negative physical health effects. For example, you might spend less time exercising, or put less effort into personal hygiene.

Negative Psychological Effects

Although painkillers may relieve emotional symptoms in the very short term (e.g., while you’re high), data suggests that prolonged opioid use may increase the risk of depression. ((Scherrer, J. F., Salas, J., Copeland, L. A., Stock, E. M., Ahmedani, B. K., Sullivan, M. D., Burroughs, T., Schneider, F. D., Bucholz, K. K., & Lustman, P. J. (2016). Prescription opioid duration, dose, and increased risk of depression in 3 large patient populations. The Annals of Family Medicine, 14(1), 54–62. https://doi.org/10.1370/afm.1885))

If you find that your baseline emotional state has changed since you started taking a certain drug, it’s important to talk to your doctor. Whether or not you have a substance disorder, this is a serious side effect that requires medical attention.

Negative Interpersonal Consequences

Substance use disorders can undermine your ability to keep commitments. If you find yourself arriving late for plans, or skipping social functions entirely in order to use a drug instead, it may be an early warning sign of a serious addiction.

Addiction can also impact the quality of your relationships. The people around you may comment that your personality has changed, or you may lose interest in doing things you used to enjoy. Pay special attention to any activities you stop or avoid doing because you can only do them while you’re sober. If you’re prioritizing drug use over meaningful social interactions, it might be time to get help.

Risk-Taking Behaviors

Unusual risk-taking behavior is another symptom of addiction. ((Addiction: Symptoms, effects, and what to look for. (2018, October 26). https://www.medicalnewstoday.com/articles/323459)) For example, you may start habitually driving while intoxicated, missing work because of drug use, or showing up to important family functions while you’re high.

If you have trouble accessing a particular drug, you may also take risks in order to obtain it. Specifically, patients may trade sex or steal “for illicit drugs, drug money, or the drugs themselves.”

Increased Tolerance

As you develop a substance use disorder, your tolerance to the effects of a particular drug may increase. Patients often find themselves taking higher doses of a drug in order to achieve the same effect.

With any drug, but especially with opiates, this pattern can be extremely dangerous. Because opiates inhibit breathing, overdose can be fatal. Pay close attention to how much of a drug you use on a daily basis. Contact your doctor before changing your dosage, especially if you feel the need to increase it.

Treating Addiction to Prescription Pain Relievers

There’s one silver lining to the opiate epidemic: because it’s so widespread and well-documented, many rehab facilities offer treatment for this substance use disorder. Depending on your specific symptoms, and your other underlying health conditions, you may be a candidate for a number of different programs.

Detox

Detox from opiate use disorder should take place under strict medical supervision. Withdrawal symptoms can be very serious, or even fatal. However, they tend to resolve within a matter of days. Many patients benefit from residential treatment during this transitional period. While you’re in a detox program, you can work with your team of providers to decide on next steps.

Inpatient Treatment

Some patients choose to attend residential rehab after detoxing from prescription pain relievers. These programs offer a variety of treatments, including talk therapy, cognitive behavior therapy, medication-assisted therapy, behavioral therapy, and life skills coaching.

Inpatient treatment programs may last anywhere from several weeks to several months. There are residential rehabs all over the world, with a wide variety of approaches to treatment. No matter how unique your needs are, you’ll likely be able to find a program that can accommodate them.

Outpatient Treatment

Once you achieve a certain level of stability, your providers may recommend that you return home while undergoing outpatient treatment. Some programs still provide daily outpatient therapy or group sessions, while others will ask you to come in once or twice a week to receive treatment.

In an outpatient program, you may continue to engage in a number of different therapies. For example, you may see a talk therapist, take non-addictive medications, and/or attend support groups for people with substance use disorders.

Support Groups

There are numerous support groups for people with a history of addiction. You can choose between them based on your personal goals and values. For example, patients with a strong sense of faith may find meaning in 12-Step groups like Narcotics Anonymous. Others may prefer a non-12-Step program, like SMART recovery.

Long-Term Recovery From Opiate Use Disorder

Healing from any substance use disorder, including the misuse of prescription painkillers, can be a lifelong process. If you began taking a drug in order to manage another health issue, you may need to explore alternative treatments with your primary care physician. If you continue to have chronic physical pain, you may benefit from ongoing cognitive behavioral therapy, or a prescription for non-addictive pain medication.

Remember that this is an extremely personal process, and the road to recovery often involves ups and downs. Be patient with yourself. As challenging as recovery can be, it’s absolutely possible. With the right support, you can live a healthy and meaningful life without the need for opioids.

If you think you may be misusing prescription pain relievers and want to find support, you can learn more about rehabs for opioid addiction treatment here.

How Do I Know If I Have a Drug Problem

A person may know they have a drug problem if they have become dependent on a drug and feel like the drug is needed for functioning. Another way an individual can tell if their drug use is causing a problem is if they are experiencing negative consequences in their home, work, or personal relationships.

When Does Using Drugs Become a Problem?

Drug usage in someone’s life becomes a problem when it negatively affects an individual’s mental, emotional, and physical health. This may manifest as an addiction, withdrawal symptoms, illegal activity, or other negative consequences in their life or the lives of family and friends.

Drugs can also become a problem in someone’s life when they depend on the drug for achieving personal fulfillment at the expense of themselves and/or others.

DSM-V and ICD-10 Criteria for Substance Use Disorders

The table below features the DSM-V and ICD-10 which can be used as a guide to determine if drug usage may be a problem in your life or your loved ones life.

This table is not to be used for a self-diagnosis. Please seek help from a mental health professional for a real diagnosis if you feel like you or your loved one may be experiencing a drug problem.

DSM-V ICD-10
The presence of at least 2 of the symptoms in the chart below indicates an individual may have a Substance Use Disorder. The severity is defined as: Mild: 2-3 symptoms, Moderate 4-5 symptoms, and Severe 6+ symptoms. The presence of 3 or more of the following should be present together for at least 1 month, or repeatedly during a 1 year period.
In the past year, have you? Have you had?
Had times when you ended up taking the substance more, or longer, than you intended? A strong desire or sense of compulsion to take the psychoactive substance?
More than once wanted to cut down or stop taking the substance, or tried to, but couldn’t? Difficulties in controlling substance-taking behavior in terms of its onset, termination, or levels of use?
Spent a lot of time taking the substance? Or being sick or getting over other aftereffects? A physiological withdrawal state when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms?
Wanted the substance so badly you couldn’t think of anything else? Evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses?
Found that taking the substance interfered with taking care of your home or family? Or caused job troubles? Or school problems? Progressive neglect of alternative pleasures or interests because of psychoactive substance use?
Continued to take the substance even though it was causing trouble with your family or friends?
Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to take the substance?
More than once gotten into situations while or after taking the substance that increase your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area?)
Continued to take the substance even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
Had to take more of the substance much more than you once did to get the effect you want? Or found that your usual drug dose had much less effect than before?
Found that when the effects of drugs were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating or racing heart?

DSM-V contains a list of criteria that helps determine if an individual may have a Substance Use Disorder. The DSM-V is the Diagnostic and Statistical Manual of Mental Disorders developed by the American Psychiatric Association in 1952. As research and data continues, the APA updates the DSM with current information which is why there is the letter V for the 5th edition.

ICD-10 contains a  list of criteria that helps determine if an individual may have a Substance Use Disorder. The ICD-10 is the International Classification of Diseases developed by the United States National Center for Health Statistics (NCHS) in 1893. As research and data continues, the APA reviews and updates the ICD with current information which is why there is the number 10 for the 10th revision.

How Can You Find Out?

Many will say if you’re questioning, then that means you have a drug problem and should seek help. Here are a few other ways you can find out if you have a drug problem.

Talk to Your Primary Care Physician

Talk to your primary care physician about your drug use and be honest. They can conduct an assessment and refer you to another health professional or level of care if needed.

Get an Assessment with a Mental Health Professional

The best and recommended way to know if you have a drug problem is to get an assessment with a mental health professional. Since they’re experts, they’ll be able to assess the severity of a substance use disorder and recommend the level of treatment you need. You can talk to your GP about a mental health assessment or find other providers who can give one.

Try Minimizing or Stopping Drugs

Note: this is not safe if you consistently take drugs, as drug withdrawal can be life-threatening. If you have not become dependent on drugs though and think you may have a problem, see if you can go without the drug or significantly reduce your drug intake. Does it cause anxiety? Are you struggling to stop?

Take an Online Quiz

Here are a few common online quizzes regarding drugs. The general quizzes below are not meant to be a diagnosis, but more of a spectrum guide of your drug usage.