Tag: Alcohol

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Casey’s Story: Celebrating Fatherhood and Recovery

Casey Steckling is a licensed social worker and addiction counselor in southwest Ohio who is passionate about working with people in recovery at Emerge Recovery. It is a treatment center as well as a trade school to help men get on track in recovery and take back their lives with a step into the trade schools leading them to job and financial security. 

He is also a person in long-term recovery for the last eighteen years, as well as a father of three children. He says:

“My children have been a grace that came directly out of my recovery, as I was ten years sober when my daughter was born. It has been possible for me to have great patience when changing diapers, dealing with tantrums, having hard conversations, and teaching them respect for life, because I’ve been living on borrowed time.” 

In Casey’s words: 

I am a person in long-term recovery for the last eighteen years, as well as a father of three. My kids would not be here if it weren’t for my recovery. I have a seven-year-old daughter, a five-year-old son, and a two-year-old daughter, and I recently lost a son at 24 weeks. 

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My kids would not be here if it weren’t for my recovery. 

My children have been a grace that came directly as a result of my choosing to get well and seek sobriety. 

I was ten years sober when my daughter was born. It has been possible for me to have great patience when changing diapers, dealing with tantrums, having hard conversations, and teaching them respect for life, because I’ve been living on borrowed time. 

I recognize I should not be here, and by proxy, neither should they. Recovery has afforded me every moment, every day, and hour I’ve been allowed to spend with them. It has also given me a perspective of peace that I pray is injected into my daily conversations and the loving care that I provide for them. I value nothing more than God, my wife, my children, and the precious time that I’ve been given because I chose to abstain. 

I’ve worked as a recovery counselor and social worker for more than a decade now, and I’ve seen countless men who are trying to reconcile with their kids. Many of those men have done difficult things, have abandoned their families, or allowed their shame to chase them away from who God created them to be. If those men cannot present as a stable and helpful force in the lives of their children, those kids may continue the unhealthy cycle of addiction. 

The most beautiful gift about my fatherhood is that it is something everyone can relate to.

They either had a dad, or wished they had (a good one). That means that when I am advocating for recovery, I always mention my fatherhood. This is a perfect picture of what society supports when they help save the life of a person-in-recovery. They (and God) have given the world the gift of my children, because they supported my recovery. 

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Take it Out of the Circle: 

Here are a series of practical applications based on Casey’s story. Share in the comments below what moves you or ideas you have, too! The circle widens when you share your recovery, wisdom, and hope. 

  • Surround yourself with other men or individuals in recovery who model the kind of life you want to live. Mentorship can be a powerful force that shares hope with us and motivates us to keep going when things get tough.
  • Set boundaries. It is simple to jump into intimate relationships, sometimes toxic ones, early in recovery. Taking time to get to know ourselves in sobriety and become the kind of people we want to be with someday can pay dividends for the future.
  • Access supports that provide family-centric and holistic support. Ensuring care and treatment for our loved ones, including children, can be a great way to involve the whole family in the recovery process.
  • Share your story. Maybe you feel moved to share your recovery story in a visible way. Make a post on social media or submit a story for the Circle of Chairs blog. Giving others hope can also help us continue on the path of health and healing.
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My Personal Recovery Story: Matt Glowiak

I’m Matt Glowiak, a loving father, husband, and man who was very fortunate to escape the clutches of addiction, which has been a common struggle for many loved ones as far back as I can remember and carries forward to this day. This is the story of how I narrowly escaped the clutches of addiction and built a life around helping others who struggle with mental health and addiction disorders. 

Beginning My Story 

Some of my earliest memories involve the mental health struggles my maternal grandmother faced. While I couldn’t make sense of them as a child, my earliest memories are polarized: either she was the funniest person in the room or the one who could become quite scary if she was in a bad mood. Regardless, I always knew I was loved. What I didn’t know, however, was what to expect each time we went over to visit. Would she welcome us with open arms, or would she slam the door and start screaming at us?

As I continued to age and mature, I started to recognize how others around her would respond. My grandfather was avoidant unless pushed to the point of confrontation. My mother would dissociate as though nothing happened. My oldest uncle would oftentimes act out in anger, screaming at her in front of everyone. My middle uncle would often show up in the most jovial mood I’ve ever seen of everyone to crash several minutes later, passed out on the floor. And my youngest uncle was the intellect who would attempt explaining to me what was happening, though I never really got it at that point. My grandmother never struggled with addiction, but her challenges ultimately led to some of her kin using to cope, with ultimately one of them dying before his time. 

On my father’s side, get-togethers were more stable, though there were many riffs in the family—so much so that I would not meet many more family members until adulthood when I personally made the choice to reach out and connect with them. My earliest talk with my father about substance abuse was around Age 15 when he told me, “Matt, there’s a difference between a beer guy and a booze guy. Don’t be the booze guy.” I didn’t really know what that meant at the time, but as I gained more life experience in college, best believe I figured it out, and in reading between the lines as well as piecing stories together over the years, I learned that many members of my father’s family also struggled with significant mental health and substance use disorders.

Then came me … As an undergraduate student at what was heralded a top party school in the early 2000s, I began experimenting with alcohol and other substances. I had a close core group of friends who I cherished dearly; however, they continued pushing the boundaries we set with use, and one by one I saw many of them drop out of school, fail out, get arrested, enter rehab, and experience a plethora of otherwise undesirable consequences that I told myself I would never experience for myself. Easier said than done, however … 

The Turning Point

Though I did not give it much thought at first, what ultimately came to scare me with my substance use during undergraduate was how much I loved the party life. Many times we were of the mentality that we would achieve a more euphoric state than the one prior. We were immortal in our early 20s, right? Of course that was wrong. 

I remember the time when I first really thought about what I was experiencing with the withdrawal and cravings and how it was at a point of barely being within my control. I could outsmart addiction, right? Then, I recalled a time when I was 14 years old. I was a star student, athlete, and member of numerous extracurricular activities. I needed to have a procedure where the physician froze warts on my feet. Gross, right? 

Well, what was even worse, which never connected until many years later, was how without even realizing what I was doing, I began abusing the liquid hydrocodone I was prescribed. Given my high tolerance for pain at the time but loving the way I felt, I skipped the morning dose and doubled down in the evening. 

This reflection and connection I had in sophomore year of undergraduate led to me feeling even more depressed than I was, as I was also failing classes (a new experience for me) and grieving a break-up with my high school girlfriend who cheated on me. I thought it would help to distance myself from my primary group a bit, begin associating with those who abstained from use of any kind, and hoped a spiritual connection to Buddhism would be enough to save me. It helped a bit in that I did have some further distance from use and cleared my head a bit; however, I always knew where the fun was and returned to it every chance I could. 

Climbing Toward Clarity

Fortunately, I wound up dating my best friend—who I had known since I was 11 and is now my wife—who, along with my other best friend, intervened with me my senior year. Best believe I was resistant at first and even did all I could to convince them to go out partying with me the same night. They held firm, stressed their point, and after that night, I never experimented with anything again. From there, I loosened the grip from the more potent substances but still found pleasure in drinking and smoking but with limits such as not using until the end of the day, during hazardous situations, et cetera as to minimize the risk of legal implications, overdose, or physical harm to self or others. 

After a couple years out of undergrad and knowing that I wanted to do something with my psychology degree, I enrolled in a mental health counseling master’s program online. My intention was to ultimately open a private practice, which I one day did. Admittedly, though graduate school was a motivating factor, it was also stressful, especially atop a 10-hour a day job that I found soul wrenching. Throughout, I would convince myself that drinking and smoking minimized my stress while making me even more insightful. In a way, it worked. At the same time, it was the wrong type of enforcement for someone teetering on a diagnosable addiction disorder. Even here, I keep my concerns in the background, as in many ways, I was achieving all the success I desired.

As I tell my clients and students now, sometimes your life’s calling finds you instead of the other way around. My masters internship wound up being at a site where I counseling court-mandated clients who received DUIs and other drug violations. After, my first full-time job as a counselor was at a methadone clinic. THAT was my wake-up call. At both my internship and the methadone clinic, client after client would give me the same excuses I gave myself for at least the past decade. There, I realized for certain that I was nothing special. I was like anyone else struggling. Further, I had the genetic predisposition. Much of what led to my clients coming to see me, I possessed as well.

They say that while in recovery one should focus on themselves only for the first year. After a year of success, focus on a plant. The next year, focus on a pet. And if all else goes well, you are ready for healthy human relationships. For me, the accountability to others really kept me in check. Though still not perfect, my entire perception and behaviors when it came to substance use changed. I had to live a better example for others, which ultimately helped myself.  

My Equilibrium and Closing Thoughts

As a youngster, I was raised with this negative view of addiction. While some of it came from my family as well as the church we attended, a lot of it came from the anti-drug campaigns they ran on TV. It appeared that most everyone addicted to drugs and alcohol was someone who didn’t care about theirself or others, had no regard for the law, and had no desire to stop. As someone who was mostly a straight-A student, in many prosocial activities, fairly popular, and from what I considered a healthy family dynamic (despite what I shared earlier); there was no way I could fall prey to addiction. Best believe, the only one I was outsmarting was myself.

Though I now have over a decade of experience as a clinician, professor, presenter, writer, advocate, and otherwise; I now know for certain that I am at risk. I hold firm boundaries, am open to constructive criticism, and continually remind myself that I am no different than anyone else struggling. The big difference is that I am fortunate to not only have woken up when I did but also having the positive support around me and now a career that keeps me accountable. 

The key to recovery, whether you are one who has gone through treatment or not (like me), it must be on the forefront of your mind to make it work. That is the key to life—being resilience while learning from your mistakes. It is true that it is not so much of what we have done or have had happen to us in the past that defines us as it is what we choose to do or not do with it. In my case, I am choosing to continue pushing forward while building my life around loving and helping other people. That is unwavering. 

Introduction to My Work and Passion for Mental Health

My work in mental health is quite diverse, as I love everything the field has to offer. I am a professor who teaches graduate level mental health and addiction counselors, a clinician who works with mental health and addictive disorders, a writer, a presenter, and perhaps most importantly, an advocate for prosocial change. While the path was not always linear, it seems as though the universe always had a way of guiding me in this direction. This is especially true when it comes to working with addictions. From my master’s internship, to the clients I worked with as a doctoral student, to my first full-time position in the field being a substance abuse counselor at a methadone clinic; the path found me. 

Since graduating with my doctorate in counselor education and supervision as well as masters in mental health counseling, I have built my life around not only helping others but improving myself. I do believe this is my life’s calling, and my intention is to help everyone else I meet find and follow theirs. While I cannot say that doing what I love feels like I never work a day in my life, as you can best believe I work nonstop, I can say that I finish every day—even the tough ones—feeling fulfilled. If I can do it, I know others can, too. 

Understanding the Stigma Around Addiction

While it is true that many people are focused on their health, a lesser spoken topic is mental health. Even lesser spoken is addiction. While there is so much stigma and misunderstanding around mental health, this is even more true with addiction. People are quick to personalize external challenges (e.g. institutionalized discrimination) while seeing personal flaws in individual hardship, the truth is that all of us go through challenges at one point or another in life. 

Addiction is the disease that knows no boundaries. Any person from any demographic can fall prey to addiction at any point in life. I have seen this both personally and professionally. Doctors, lawyers, police officers, firefighters, civic leaders, moms, dads, uncles, aunts, friends, loved ones, trusted colleagues—literally anyone—can fall prey at any time. The misconceptions that surround addiction leave many viewing it as a moral deficit when it is well within one’s control, when the truth couldn’t be more opposite. 

In the spirit of “an ounce of prevention is worth a pound of cure,” there is so much more we need to be doing at a societal level to prevent addiction before it starts. A big part of the equation is speaking openly and honestly about the issue. Scare tactics and fabrications do the opposite, especially with our youth. When some uses and the only consequence is a good time, it immediately invalidates arguments aimed to discourage use. The truth is that, for many substances, they begin as an enjoyable experience for those who use, but for some who struggle to stop, the consequences become gravely catastrophic over time.  

Lessons Learned from Addressing Addiction in My Career

A lot of the work that needs to be done to combat addiction, going well beyond typical treatment protocol, is what happens beyond the couch, so-to-speak. For example, while working at the methadone clinic, where my clients were all diagnosed with opioid use disorder (many with co-occurring disorders), there was a common theme. Most every client who wound up using heroin began doing so because of prescription painkillers going wrong. Many began taking them as prescribed at first, but over time, tolerance built while withdrawal set in, and they found themselves using in increasing amounts to the point where prescribed medications were no longer enough. At this point, they were hooked.

Legislation at the time would immediately pin the fault on individuals they deemed were “doctor shopping.” While, yes, many individuals struggling with addiction do this to get their fix, it is part of the symptomology of addiction. On the other hand, prescribing physicians have access to a prescription monitoring program in which they can see every prescription, filled and unfilled, for anyone coming to see them. Where is the physician’s responsibility in this? As a medical professional who is obligated to do right by their patients, many were doing the wrong things. Accordingly, my clinic and I would attend legislative advocacy events as well as writing letters until the physicians were also held accountable.

Another issue we have is where police officers inappropriately manage mental health calls. We see this in the news all the time, and I have experienced it in my work, where individuals with significant mental health disturbances are treated like criminals instead of mentally ill individuals who need treatment. The consequences have been devastating to the point where people have been injured or even killed while being in the middle of a crisis. 

To combat this, having police social workers or counselors who can assist police officers with mental health calls can go a long way. In the community where I had my private practice, my partner and I joined local mental health coalitions where we would discuss ways to address the problem. Ultimately, the community ultimately received a $50,000 grant to pay a police social worker 1-year salary as a test-run. Fortunately, there was such a positive response that, moving forward, the position became a permanent one.

Sometimes the most seemingly complicated issues have the easiest solutions. You only know, though, by talking about it and seeing that talk into action. Many great things begin slowly but build over time. In many municipalities where physicians have become held accountable while police departments focus on mental health, we see neighboring communities ultimately follow suit. The only way to make it happen, though, is by acting. Counseling is much more than therapy but a philosophy that serves the human spirit. 

Advocating for Change: Solutions Rooted in Experience

A key part of advocacy is empowering the voices that otherwise go unheard. It is true that we live in an unjust society where many people’s needs go unmet. Even worse is how we blame them for their circumstances. Rather, we need to recognize the realities of genetic predisposition, institutionalized oppression, intergenerational trauma, environmental stressors, and otherwise. When we take a moment to hear people’s stories, we can empathize. 

Most often, we realize that those with the most undesirable of life circumstances are there because of the hand they were dealt. Even for those who, perhaps, continue making unhealthy decisions, there is a reason for it. Every person deserves a fair chance, and we have the opportunity and ability to give it to them.

Advocacy need not be a lofty thing in which all the world’s problems are resolved with the wave of a wand. Rather, it can begin with the simplest of actions. Having the conversation, writing a blog, educating yourself, asserting yourself to others, joining community activities, establishing your own organizations, volunteering time, and so much more are all steps in the right direction. Again, efforts continue to grow and build over time. 

Reflections and Call to Action: Building a Better Future

It is important to recognize how sometimes the greatest things come out of the most challenging of situations. Sometimes, it requires something horrible to happen for people to take action. While it would be more desirable for that not to be the case, unfortunately, it is. Given that there is a lot warranting our attention in the world right now, rather than become angry, depressed, or remain stuck; take the first step toward doing something.

Most everyone, whether they realize it or not, has been touched by addiction. It may be a friend, loved one, colleague, neighbor, or otherwise. These are people we love who are worth our efforts. Take a moment to think … If you were the one in a bad situation, would you not want others to act? I think the answer is a resounding “yes.” 

Currently, we are aware of what addiction is. It is a biopsychosocial disease. That is, it negatively impacts our physiology, thoughts and feelings, and interpersonal relationships. The disease is so invasive that simply stopping often feels as though one is struggling to fulfill their basic needs for survival. In some cases, it can be deadly. Rather than pass judgment, realize that no one ever wants to experience addiction. No matter how much I speak on the topic, I cannot stress this enough.

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How We Speak Matters: Undoing Stigmatizing Language: Andrew Schreier

Andrew J. Schreier is a licensed professional counselor with over twenty years of experience in substance use, mental health, gambling, and clinical supervision with extensive experience in clinical supervision, counseling, and education. He serves as the Director of Clinical Services for Community Medical Services in Wisconsin and Minnesota, overseeing treatment programs for opioid use disorder. A national speaker and host of the Talking Addiction & Recovery podcast, Andrew explores topics such as substance use, mental health, and gambling to foster meaningful change for individuals seeking care and growth and development for professionals.

The passion for this topic stems from witnessing the profound impact that stigma can have on individuals seeking help. I’ve seen how a single word—uttered carelessly or in written communication—can either empower someone or push them further into isolation. This has driven me to advocate for compassionate, person-first language in every aspect of treatment and recovery for several issues impacting millions of people.

Language is the foundation of human connection. Words can shape people and culture. It’s how we communicate thoughts, share feelings, and build relationships. But when it comes to substance use, mental health, gambling, criminal justice, and recovery, the words we use can do more than just describe; they can harm, stigmatize, or exclude.

What Is Stigma?

Stigma is a negative association with circumstance or trait that can result in discrimination against a person for a certain characteristic(s).  Stigma can also be described as internal feelings of shame or judgment from others.  Language includes words or phrases with negative labels that assign judgment.  

Stigma around addiction may come from old and inaccurate ideas or fear of things that are different or misunderstood. Today, we know that addiction is a chronic, treatable medical condition. We also know that people can recover and continue to lead healthy lives.

The Power of Language

Words matter. Language is not just a tool for communication; it shapes perceptions, influences policies, and defines how individuals are treated. Yet, in relation to substance use, mental health, gambling, and criminal justice spaces, stigmatizing language remains a persistent issue.  Examples of stigmatizing language include: 

  • Terms like “addict,” “junkie,” or “relapse” reduce people to their conditions and perpetuate shame.   
  • Many generations have grown up in a society where language such as “crazy,” “psycho,” “loony,” “nutty,” and “mentally ill” were acceptable words to describe an individual with mental health.  
  • “Pathological,” “compulsive,” “irresponsible gambler,” and “gambling addict” generally attract substantial negative stereotypes, social distancing, emotional reactions, status loss, and discrimination.
  • Designed to desensitize, terms such as “felon,” “convict,” “offender,” and “criminal” replace names and other descriptions, such as “woman,” “daughter,” “father,” “child,” or “person.” These labels compound punishment and ultimately harm by reducing people to their worst moments, fueling stigma and haunting people for years after sentences are served.

The consequences of this language are far-reaching. Stigmatizing terms discourage individuals from seeking help, fearing judgment or discrimination. Feeling stigmatized can reduce the willingness of individuals with substance use disorders to seek treatment.  Stigmatizing views of people with substance use disorders are common; this stereotyping can lead others to feel pity, fear, anger, and a desire for social distance from people with a substance use disorder.  In clinical settings, they can perpetuate bias in documentation and decision-making.  Stigmatizing language can negatively influence healthcare provider perceptions of people with substance use disorders, which can impact the care they provide.  At the community level, such language reinforces negative stereotypes, reducing public support for funding and policy changes that could expand access to treatment.

By addressing this issue, we can create a more inclusive and supportive environment for those struggling with addiction and other behavioral health challenges. Shifting to person-first language—such as “person with a substance use disorder” or “person with a gambling disorder” instead of  “substance abuser” or “gambling addict”—respects the individual’s humanity and acknowledges their capacity for recovery.

Introducing Person-Centered Language 

Person-centered language is a language that puts people first. People are so much more than their substance use disorder, mental illness, or disability. Using person-centered language is about respecting the dignity, worth, unique qualities, and strengths of every individual. 

The solution to this issue begins with awareness and education. Through my work, I’ve identified several actionable strategies that can help professionals, organizations, and communities move toward more supportive language:

  1. Adopt Person-First Language: Referring to individuals as “persons with a substance use disorder” or “persons experiencing gambling-related harm” emphasizes their humanity and potential for recovery. This small change can make a big difference in how people feel about seeking help.
  2. Eliminate Stigmatizing Terms: Words like “relapse” can be replaced with “return to use,” and “addict” with “individual in recovery.” Such shifts reduce shame and promote a more constructive dialogue.
  3. Train Professionals: Regular training for clinicians, social workers, and other providers can help them understand the impact of their words and adopt best practices for communication.
  4. Revise Documentation Practices: Clinical records should reflect person-centered care by avoiding labels and focusing on specific behaviors, needs, and strengths.
  5. Raise Public Awareness: Community education campaigns can dispel myths, challenge stereotypes, and encourage supportive attitudes toward those in recovery.

Letting Go of Stigmatizing Terms

Throughout my career, I have witnessed firsthand how stigmatizing language impacts individuals in treatment. Early in my work, I noticed how terms like “noncompliant” or “frequent flyer” in clinical documentation shaped the attitudes of treatment teams. Patients were often unfairly labeled before they even walked through the door. Recognizing this, I began advocating for changes within my teams, encouraging the use of language that focused on behaviors and needs rather than labels.

Initially, the thought of simply removing stigmatizing words and replacing them with person-centered language appeared easy.  However, after beginning to take on that task it became more apparent at how prevalent stigmatizing language is through policies, procedures, textbooks, sources, narratives, educational materials, and awareness campaigns to name a few.  In asking people to eliminate stigmatizing language meant asking them to let go of words they have come to use on a regular basis.  

Some people used those words to describe themselves in their own recovery with lived experience. Professionals have used stigmatizing terms in how they talked not only to but about people they served. Helping professionals let go of stigmatizing language involves acknowledging past habits, understanding their impact, and actively working through a process that includes reflection, education, and practice. Here are some tips to facilitate this journey, including the idea that it might resemble a grief process:

  1. Acknowledge Past Usage Without Judgment
    1. Normalize Mistakes: Remind professionals that everyone has used stigmatizing language at some point due to societal norms, training, or common phrases.
    2. Create Safe Spaces: Foster environments where professionals can openly discuss their language habits without fear of judgment. Encourage the perspective that improvement begins with self-awareness.
  1. Understand the Emotional Attachment to Language
    1. Recognize Resistance: Letting go of familiar terms can feel uncomfortable. Professionals may associate certain languages with their identity, training, or professional experience.
    2. Embrace the Grief Process: Encourage professionals to view this shift as a form of grief. They might feel denial, anger, or sadness before accepting and embracing change. Support them by discussing these emotions openly.
  1. Educate on the Impact of Language
    1. Highlight Harmful Effects: Show how stigmatizing language perpetuates stereotypes and discourages individuals from seeking help. For example, terms like “addict” increase perceptions of personal blame, leading to worse treatment outcomes.
    2. Use Data and Stories: Share research and real-life examples demonstrating how person-first language fosters dignity and better outcomes for individuals.
  1. Provide Practical Strategies for Change
    1. Use Person-First Language: Train professionals to replace terms like “addict” with “person with a substance use disorder.” This approach focuses on the individual rather than the condition.
    2. Pause and Reflect: Encourage them to pause and consider the potential impact of their words before speaking.
    3. Use Tools and Resources: Offer quick-reference guides or charts that suggest alternatives to stigmatizing terms.
  1. Normalize Continuous Learning
    1. Reframe Learning as Growth: Remind professionals that language evolves. A commitment to lifelong learning aligns with professional ethics and improves patient care.
    2. Practice Role-Playing: Use training sessions to practice reframing conversations and identifying stigmatizing phrases.
  1. Promote Organizational Support
    1. Leadership Modeling: Encourage leaders to adopt and model inclusive language to set an example for their teams.
    2. Policy Updates: Advocate for policies and documentation practices that reflect non-stigmatizing language.
  1. Celebrate Small Wins
    1. Acknowledge progress, even if it’s incremental. Shifting language habits takes time and effort, but every step forward is meaningful and recognizing any positive change provides dignity, compassion, and respect for the people we serve.  

By normalizing the discomfort that comes with change and framing it as part of a growth process, professionals can move toward language that uplifts and empowers those they serve.  

Language as a Tool to Change

Undoing stigmatizing language is about more than changing words; it’s about transforming the culture of substance use, mental health, gambling, criminal justice, and other spaces related to people we serve. By speaking with care and intention, we can create environments where individuals feel valued, supported, and empowered to seek help.

In talking to and about individuals, the best practice and way to eliminate harm is by letting people choose how they want to be described. If you are not sure what words to use, just ask.  Avoid using language that defines someone by their condition. Use updated, accurate terminology instead of outdated terms. Avoid language that makes judgment. Describe without downplaying or becoming overly graphic. Use person-centered language that avoids seeing them as their diagnosis and instead focuses on the whole person.  

Looking ahead, I envision a future where person-first language becomes the standard in all areas of behavioral health. This includes expanding training programs, integrating these principles into policy and advocacy work, and using a multitude of platforms.  

Language has the power to heal or harm. Let’s choose to use it as a tool for connection, compassion, and change.

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The Importance of Neuroaffirming Care in Mental Health and Substance Use Treatment: Dr. Sarah Anderson

In recent discussions surrounding mental health and substance use treatment, the concept of neuroaffirming care has emerged as an essential paradigm shift. A neuroaffirming approach not only emphasizes each person’s individuality but also recognizes and respects the diverse range of neurocognitive profiles within our world. In this article, I will look into why neuroaffirming care matters, share its key ideas, explore its background, and highlight how it’s vital in mental health and substance use treatment.

Understanding Neuroaffirming Care

Neuroaffirming care is a progressive model grounded in an understanding of the diverse ways individuals think, process information, and interact with the world. It recognizes that neurocognitive differences—such as those found in individuals with autism (ASD), ADHD, dyslexia, and other learning disabilities—are not deficits or disorders to be fixed, but rather distinct variations that enrich how individuals perceive and interact with the world around them.

This perspective sees neurodiversity as an integral part of humanity, encouraging a more inclusive approach in therapeutic settings. Unlike traditional care models, which often apply a one-size-fits-all framework, neuroaffirming care tailors interventions to meet the unique needs and preferences of each individual. Traditional approaches may standardize assessments and treatments, potentially overlooking the nuances of a person’s lived experience. In contrast, neuroaffirming care acknowledges that neurodivergent individuals may process sensory information, social cues, and cognitive tasks differently, requiring interventions that are flexible and adaptive. (Chapman & Botha, 2023)

Examples of Neuroaffirming Care:

1. Inclusive Practices: Tailoring treatment plans to align with the client’s cognitive style, preferences, and personal history.

Example: A therapist working with a neurodivergent client adapts a mindfulness exercise by allowing them to focus on a sensory object, such as holding a stress ball or rubbing a textured fabric, instead of expecting them to sit still with their eyes closed, which might feel overwhelming or inaccessible.

2. Respecting Autonomy: Allowing clients to make informed choices about their treatment and respecting those decisions, even when they differ from standardized protocols.

Example: A client with ADHD requests shorter therapy sessions to maintain focus. Rather than insisting on traditional 50-minute sessions, the therapist offers 25-minute sessions and gradually builds toward longer durations as the client feels ready.

Examples of Non-Neuroaffirming Care:

1. Rigid Protocols: Applying standardized treatment methods that do not consider a client’s neurodivergent traits, potentially leading to frustration and disengagement.

Example: Forcing a neurodivergent client to participate in a large group therapy session despite their expressed discomfort in group settings, leading them to withdraw or avoid further sessions.

2. Invalidating Experiences: Dismissing or questioning the lived experiences of neurodivergent individuals, failing to recognize and honor their reality.

Example: A therapist tells a client with sensory sensitivities that their discomfort with bright lights in the therapy room is “just in their head” instead of addressing the environmental trigger.

Statistics on Neurodivergence in Mental Health Treatment

Neurodivergent individuals often encounter significant barriers in accessing effective mental health and substance use treatment. Research indicates that approximately 73% to 81% of adults with autism have at least one co-occurring psychiatric disorder (Buck et al., 2014; Madhavan, & Sambamoorthi, 2016). Additionally, substance use disorder rates are disproportionately higher among neurodivergent individuals. Research indicates that about 50% of individuals with substance use disorders also have ADHD, and people diagnosed with ADHD are six times more likely to face challenges related to substance use (Davis et al., 2015). This statistic emphasizes the need for tailored interventions that specifically address these challenges and underscore the importance of implementing neuroaffirming care. 

While neuroaffirming care is gaining recognition, its adoption in mental health settings varies widely. Some progressive clinics and therapists are beginning to embrace neuroaffirming approaches, especially in environments that prioritize inclusivity and holistic care. However, many traditional mental health settings still rely on standard practices that may not adequately account for neurodiversity and its implications in treatment. Neuroaffirming care is more likely to be found in specialized settings, such as those focusing on developmental disorders, community mental health programs that emphasize inclusivity, and practices run by clinicians who are informed about neurodiversity principles. In contrast, more traditional settings may struggle to integrate these principles into their practices, resulting in ongoing gaps in care for neurodivergent individuals. This inconsistency in the availability of neuroaffirming care further emphasizes the need for systemic changes in mental health and substance use treatment approaches.

Historical Context of Neuroaffirming Care

The emergence of neuroaffirming care can be traced back to the neurodiversity movement, which gained momentum in the late 1990s and early 2000s (Chapman & Botha, 2023). Advocates began challenging the traditional medical model that treated neurological differences solely as deficits or disorders. Instead, they promoted the idea that neurodiversity is a natural variation of human cognition, deserving of respect and understanding. For instance, the neurodiversity movement challenged stereotypes surrounding autism, emphasizing the strengths and unique perspectives that autistic individuals bring to the table, such as innovative problem-solving and attention to detail. This paradigm shift inspired mental health professionals to rethink their approaches, focusing on affirming and accommodating differences rather than attempting to “fix” them.

Neuroaffirming Interventions in Mental Health

Neuroaffirming interventions in mental health can vary widely but generally aim to create a supportive environment that is responsive to the specific cognitive and emotional needs of neurodivergent individuals.

1. Cognitive Behavioral Therapy (CBT) Adaptations

Traditional CBT can be adjusted to incorporate the client’s unique thought processes and emotional responses, making it relevant to their experiences.

Example: A neurodivergent client with autism might struggle with abstract concepts like “challenging negative thoughts.” The therapist adapts CBT by using concrete, visual tools, such as a thought diary with emojis or a color-coded chart, to help the client identify and manage their emotions in a structured way.

In contrast, a non-neuroaffirming approach might involve using overly abstract CBT techniques that leave the client feeling confused and unsupported, causing disengagement.

2. Mindfulness Practices

Mindfulness can be tailored to fit different sensory preferences, allowing clients to engage in exercises in ways that feel comfortable.

Example: A client with sensory sensitivities may find traditional deep-breathing exercises difficult due to the focus on internal bodily sensations. Instead, the therapist encourages them to practice mindfulness by listening to calming music or focusing on a weighted blanket’s pressure.

Non-neuroaffirming practices might force clients to adhere to rigid mindfulness techniques that increase their anxiety, such as insisting on silent meditation in a setting that feels overstimulating.

3. Strength-Based Approaches

Focusing on the individual’s strengths rather than their challenges fosters a sense of empowerment and self-efficacy.

Example: A therapist working with a neurodivergent teenager emphasizes their talent for drawing as a tool for emotional expression and problem-solving, integrating art therapy into their sessions.

Conversely, non-neuroaffirming practices might focus solely on deficits, such as repeatedly pointing out the client’s difficulties with time management, without offering constructive solutions.

Neuroaffirming Care in Substance Use Treatment

Substance use treatment, much like mental health treatment, benefits immensely from a neuroaffirming approach. Individuals with neurodivergent traits may face unique challenges in recovery, including heightened sensitivity to triggers, social cues, and emotional stimuli.

1. Individualized Treatment Plans

Tailoring recovery programs to the cognitive and emotional profile of clients enhances engagement and success rates.

Example: A client with ADHD might struggle with rigid schedules in traditional 12-step programs. A neuroaffirming approach would offer flexible scheduling options or introduce apps for task management to support the client’s executive functioning challenges.

2. Peer Support Alternatives

Creating support networks that resonate with neurodivergent individuals allows them to share their experiences in a safe space.

Example: A recovery program sets up a small, sensory-friendly peer support group for neurodivergent clients, ensuring the environment is free of harsh lighting and loud noises to accommodate sensory sensitivities.

Non-neuroaffirming practices might involve placing neurodivergent clients in large, overstimulating group settings without addressing their needs, potentially driving them away from recovery efforts.

Providing Neuroaffirming Care as a Mental Health Occupational Therapist

As a mental health occupational therapist, I prioritize neuroaffirming care in my practice by actively incorporating the principles of this approach into my therapeutic relationships. This commitment not only fosters a sense of safety and respect but also empowers clients to take an active role in their healing journey.

1. Personalized Assessments:

   In my practice, I conduct thorough and personalized assessments that go beyond standardized tools. For example, I might observe a client’s sensory responses in various environments, such as noting whether fluorescent lighting in the office causes discomfort. These observations inform the design of therapy sessions and treatment goals. Additionally, I encourage clients to share their preferences and experiences, allowing for a more nuanced understanding of their unique needs and challenges.

2. Flexible Therapy Sessions:

   Recognizing that each client has different sensory sensitivities and processing styles, I ensure that my therapy sessions are flexible. For a client with sensory sensitivities, I might introduce noise-canceling headphones or provide breaks during sessions to prevent overstimulation. This adaptability allows clients to engage more comfortably and effectively in their therapy, promoting a collaborative and supportive atmosphere.

3. Collaborative Goal Setting:

   Collaboration is at the heart of my practice. When a client expresses frustration with meeting deadlines, for instance, we work together to create achievable and meaningful goals. By implementing strategies like time-blocking, the client feels ownership and agency in their progress. I emphasize that all goals are client-driven; I will never set goals that clients do not choose for themselves. This process not only fosters a sense of empowerment but also enhances motivation and commitment to the therapeutic process.

4. Creating Safe Spaces:

   A significant aspect of neuroaffirming care involves creating safe and comfortable environments. I maintain a quiet, visually calming therapy room with sensory tools like weighted blankets, fidget toys, and dimmable lights. Clients are encouraged to customize their space and choose the tools that make them feel secure and comfortable. This environment reflects a respect for their individual needs and enhances their ability to focus and engage.

5. Ongoing Feedback:

   I prioritize ongoing feedback throughout our therapeutic relationship. Regularly asking clients how they feel about the therapy process and the strategies we employ allows me to adjust approaches as needed. For example, if a client feels overwhelmed by a particular technique, we can quickly shift to a different method that aligns better with their preferences. This responsiveness is a core component of neuroaffirming care, ensuring that each client feels heard and validated.

Conclusion

Neuroaffirming care represents a critical advancement in mental health and substance use treatment paradigms, offering a more personalized and respectful approach to care that takes into account the diverse neurocognitive profiles of individuals. Specific, practical interventions—such as adapting CBT, tailoring mindfulness, and creating sensory-friendly environments—illustrate how this approach can transform the therapeutic experience for neurodivergent individuals.

With increasing awareness and acknowledgment of neurodiversity, the mental health field must continue to evolve by embracing neuroaffirming principles. In doing so, we can enhance access to treatment and support for neurodivergent individuals, ultimately contributing to their overall wellbeing and quality of life.

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Navigating the Holidays: Essential Tips for Those in Early Substance Use Recovery: Dr. Sarah Anderson

The holidays are just around the corner, and while some people love this time of year, many feel anxious, overwhelmed, and even dread it. For those newly in substance use recovery or supporting a loved one in recovery, this season can bring added challenges. As a mental health occupational therapist, I work with many clients who feel stressed and overwhelmed this time of year. From increased family obligations to events with alcohol to overbooked schedules, it’s easy to feel overwhelmed. While setting boundaries with others and yourself can be difficult, maintaining balance is essential.

If you’re looking for practical strategies on maintaining your sobriety or supporting a loved one in their recovery, keep reading! I’ve compiled a few tips to help you find peace and maybe even enjoy the season.

Beware of Over Scheduling

Overcommitting is a top reason people feel overwhelmed during the holidays. If you have felt overstimulated and drained in past holiday seasons, try to prioritize which events you want to attend. Aim for no more than one gathering per weekend—many find even that can be too much. Everyone has a unique social and sensory stimulation threshold, so tune into what feels manageable for you. If you’re concerned about letting others down, here are some phrases that can help:

  • “Thank you so much for the invitation. I won’t be able to attend this year due to a scheduling conflict. Still, I’d love to stay connected and appreciate the invitation.”
  • “Thank you for thinking of me. Right now, I’m focusing on managing my schedule carefully, so I won’t be able to join this year. Still, I would love to do so during the next holiday season.”

Letting those close to you know that you’re intentionally avoiding overscheduling can also help set expectations.

Prioritize People Who Make You Feel Safe

If you’re facing challenges with your mental health or are new to recovery, focus on spending time with people who make you feel safe and supported. You don’t need the added stress of putting on a brave face for people who don’t honor where you’re at. Research has shown that negative social support can hinder sustained recovery (Kitzinger et al., 2023). So, while social connection is powerful for optimizing mental health, it’s crucial that this connection feels safe and genuine. I work with many clients who struggle with people-pleasing, and the thought of disappointing others can be distressing. Setting boundaries can be empowering and is one of the best skills you can develop to protect your recovery and mental health, especially during the holidays.

Stick to Your Routines

The holidays don’t mean abandoning your routines. Routines offer structure, keep you grounded, and help ensure you’re prioritizing yourself. You may need to leave a party early or decline an invitation if it conflicts with a self-care activity. Kitzinger et al. (2023) found that people in early recovery identified the consistency of structured routines to be a key factor in helping them maintain sobriety. If you’re in recovery, continue attending your meetings and staying connected with those who keep you accountable. Routines help reinforce your commitment to your health, especially during times that feel unpredictable.

Prioritize Sleep

Sleep is, in my opinion, the most important occupation within occupational therapies (OT’s) nine recognized areas. When you’re sleep-deprived, every other part of your life suffers. Lack of sleep can significantly impact mood, increase anxiety, and make managing stress harder. Additionally, poor sleep quality has been identified as a risk factor for relapse (Kitzinger et al., 2023). It is essential to prioritize rest, as it’s foundational for maintaining balance in this demanding season. Here are some strategies to ensure that you are getting adequate sleep this holiday season:

  1. Pick a bedtime and stick to it.
  2. Have some set phrases that you can use to get out of late-night events. 
  3. Stick to the sleep routine you’ve developed. I know it can be tempting to stay up late and get lost in a holiday movie, but I promise you will thank yourself tomorrow if you avoid screen time and get to bed on time. 
  4. If it feels hard to assert these boundaries with yourself and others, have some incentives and rewards handy. One of my personal favorites is investing in a new set of warm, cozy sheets or pajamas. Not only does this enhance your bedtime experience, but choosing fabrics that feel good on your skin also caters to your sensory needs, making it easier to prioritize rest.

Prioritize Healthy Leisure Activities & Limit Social Media

You read that right: put down the phone and stay present. It’s easy to get swept up in social media, but I want you to reflect on this– does it ever leave you feeling better? The holidays often bring a flood of curated, perfect-looking moments, making it hard not to compare. But remember—what you see is often far from the full picture. Instead, invest your time in activities that genuinely bring you joy and fulfillment. Baking cookies alone or with people you love who bring you joy is a great way to enjoy the holidays and fill time. Explore and rediscover games that you once loved. Games are a great way to spend time with others, and they help to fill time in a meaningful and healthy way. Curl up on the couch with a great book and a soft, cozy blanket. If you really want to get into the holiday mood, light a holiday-scented candle and play a little instrumental music in the background. Active living is central to recovery (Iwasaki, 2010). By structuring your time and prioritizing meaningful, screen-free activities, you can stay the course on your journey to wellness.

Identify High-Risk Situations in Advance & Create a Sober-Sensory Kit

It is important to understand your triggers that potentially can lead to relapse. Triggers can be anything from specific environments to specific people to various smells or memories. Having an awareness of what may be a trigger can help you either avoid them or have a plan in place as to what you need to do to maintain your sobriety. You have likely already done this with your therapist, sponsor, or someone else in your life. Your plan may include attending an AA meeting, calling your sponsors, or meeting with a trusted friend. Creating a sober-sensory kit can be another tool that you incorporate into your plan to help reduce relapse. Sensory kits, in general, are tools that help to promote grounding and regulation. Think about things you can eat, smell, touch, hear, and see that bring you peace. Here are some ideas of what you can pack in your sensory kit based on each of your senses:

  • Smell: Pack lotions with soothing fragrances or essential oils that are known for their calming properties. For example, lavender and chamomile are widely recognized for their ability to promote relaxation and reduce anxiety. A study by Seo (2009) found that pleasant scents, particularly essential oils, can enhance mood and reduce stress.
  • Touch: Choose lotions with textures that you enjoy—whether they are smooth or contain exfoliants. Pick one that feels nice on your skin. Always include a fidget, or focus tool, in your sensory pack. There are many different types, so I encourage you to explore various options to find the one that works best for you. Some people prefer soft, squishy fidgets, while others enjoy spiky fidget rings. There’s even the option to have fidgets that double as jewelry. Fidgets help relieve anxiety by providing a means of self-soothing while also releasing neurotransmitters that enhance focus and reduce cognitive load (Persia, 2023).
  • Hearing: Create a variety of playlists. Explore various genres of music to find the right fit. Remember, the goal with your music is to regulate your nervous system, not increase arousal. Many people enjoy instrumental jazz, low-fi, and classical music. Always make sure to pack some earbuds or headphones, that way, if you find yourself feeling overstimulated, you can easily put them on and find a sense of calm.
  • Taste: Make sure to include some candies in your kit! Both sweet and sour can help you feel grounded and ease anxiety. Sour candies, in particular, can act as little panic busters— the intense taste can redirect your focus and provide a grounding experience. Chewing gum is another great option to put in your kit. The repetitive motion of chewing not only gives you some sensory input but also has the potential to help regulate your nervous system and lower stress levels. Eating can also stimulate the vagus nerve, which plays a vital role in calming the body and promoting a sense of relaxation and well-being (Breit et al., 2018).
  • Sight: In my opinion, sight is the most challenging sense to pack because it’s harder to find items that are small enough to fit in a compact kit. One of my go-to strategies for reducing anxiety or stress is to take a quick break outside. Simply taking a look at nature can be immediately calming. Really observe what you see and take note of the unique visual qualities of the environment, such as the trees and their leaves, the sky, the grass, and more. What you see can greatly influence your emotional state, so it’s important to engage this sense if you start to feel overwhelmed. Items that you can pack to help stimulate your visual sense and provide a sense of grounding include adult coloring books, which feature intricate designs that require concentration. Liquid motion bubblers can be soothing to watch, as can fidget spinners or cubes.

Leaning into your senses and creating a sensory pack can quickly help you feel grounded if you’re feeling stressed, anxious, or triggered. By incorporating items that engage a variety of senses—such as soothing scents, fidgets, or calming music—you can help regulate your nervous system. With the hustle and bustle of the holidays, the best part is that these sensory packs are portable and easy to use. You can take them anywhere!

Putting it All Together 

This holiday season, make your recovery a priority by implementing practical strategies to help maintain balance amid the chaos. Avoid the trap of overscheduling by intentionally selecting events that bring you a sense of safety and support. Surround yourself with uplifting people who bolster your resilience. Sticking to routines—like getting enough sleep—is essential for your wellbeing. These habits empower you and lower the risk of relapse. Remember, prioritizing your recovery doesn’t mean you have to miss out on fun; it’s all about finding the right balance! Seize this wonderful opportunity to cultivate joy and connect with loved ones while also caring for your mental health.

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Rehab for The Holidays: Give Yourself And Your Loved Ones The Gift of Recovery

Disclaimer: We appreciate the contribution of the author who wrote this article. The opinions and views expressed are uniquely the author’s and add valuable perspectives to Recovery.com. Enjoy!

This was going to be the year you beat addiction. This was going to be the year you rediscovered life. Yet here we are entering the holidays and it hasn’t quite worked out that way. You could say, “Oh well, I’ll get sober in January.” 

Isn’t that what you said last year? How about a new approach? Why not this year you give yourself and your family the best gift of all: recovery! The gift that keeps on giving year after year with compounded interest! 

How about this year you spend the holidays in treatment so next year, and all the years after that, can be what you wanted this year to be? 

Overcoming Excuses With Reasons to Hope

The excuses we make for not starting our recovery journey during the holidays mimic the same self-defeating tactics we use all year; they just seem to have more clout between the turkey and Deck the Halls. But really, it’s just the same old Grinch who wants to steal another Christmas. 

Going to rehab and pursuing recovery always comes with challenges, regardless of the time of year or season. But this year can be different! Here are some reasons why rehab for the holidays is a great gift idea, despite the challenges.

Top 4 Oppositions to Treatment And Reasons to Go Anyway

Reason #1

“I have to be home with my family for the holidays!” 

This might be the biggest barrier when thinking about holiday rehab. Think about past holidays, maybe even last year, and ask yourself how that worked out. We get caught up in the greeting card sentiment about this time of year, but for those with an alcohol or drug addiction, the dreamy emotion quickly becomes a nightmare of stress, conflict, and embarrassment. 

Spending time in treatment means you can really be “home for the holidays” in the future, giving yourself drama-free celebrations to look forward to all year long. 

Reason #2

“I can’t be away from my job or school.” 

Many businesses slow down this time of year and schools have long breaks. While other times of the year your absence would be obvious, during the holidays people won’t even question you taking time off. This makes the holidays one of the best time for treatment. Your boss, customers, or teachers likely recognize the impact of your addiction and would welcome this effort to start the New Year in recovery.

Reason #3

“I can’t afford treatment during the holidays.” 

The end of the year may actually be the best time financially, since you may have already met your insurance deductibles. With many policies, January means a whole new “out-of-pocket” expense. This can affect the total coverage an insurance company will pay.

Reason #4

“It would be selfish to go into treatment during the holidays.” 

Self-care and selfishness are not the same. Getting treatment is the opposite of selfish. Investing in yourself so you can be a better father, mother, spouse, son, or daughter is not selfish. It’s an investment in you!

Don’t put this off for next year; make next year what you want it to be–all it’s meant to be–by entering treatment during the holidays. Recovery is a lifelong journey that can’t be postponed without consequences. Give yourself and your family the best gift of all this holiday season: recovery.
You can browse treatment facilities on Recovery.com to find the best fit for you. Check out our podcast to learn more about recovery and gain insights from experts.

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The Dangers of Mixing Alcohol With Other Drugs

Mixing alcohol with other drugs might be a common occurrence for those who do both regularly, but most people don’t realize how dangerous this practice is. Whether combined with prescription medications, over-the-counter remedies, or recreational drugs, alcohol can amplify or interfere with the effects of these substances, setting the stage for dangerous reactions. And over time, using any combination of substances can damage your physical, mental, and emotional health. Understanding the risks involved is the first step toward staying safe.

Here’s what you should know about mixing alcohol with other substances:

What Happens When You Combine Alcohol With Drugs?

Mixing drugs with alcohol can be risky because it creates interactions that are hard to predict. Sometimes, alcohol makes a drug more powerful; other times, it weakens the effects. Either way, these combinations can cause serious health issues like heart problems, liver damage, or even overdose. The CDC warns:

If you drink alcohol while using other drugs, the effects may be stronger and more deadly than using either one alone…It can be dangerous to use two or more drugs at the same time, or within a short time of each other.

Here’s what you need to know about how different types of substances interact with alcohol.

Alcohol and Prescription Medications

Prescription drugs are carefully calibrated to provide specific therapeutic effects, but drinking alcohol while taking these drugs can throw off that balance.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “Alcohol and medications have the potential to interact1 in three main ways:”

  1. Alcohol can change how your body processes a medication, either speeding it up or slowing it down. That can make the level of medication in your bloodstream higher or lower than intended.
  2. Some medications can affect how your body absorbs and processes alcohol, which might result in higher blood alcohol levels and other unwanted effects.
  3. Alcohol can also influence how a medication works in your body, making it either more or less effective than it should be.

Opioids

Combining alcohol with opioids (like oxycodone or hydrocodone) slows your breathing and lowers your blood pressure to dangerous levels. Both substances relax your central nervous system, and together, they can lead to overdose. The CDC warns,

Drinking alcohol at the same time or within a few hours of using other drugs like opioids or benzodiazepines2 can cause serious harm. It can make it hard to breathe, which can damage your brain and other organs. This can also lead to early death.

Antidepressants

Drinking alcohol while on antidepressants, like SSRIs or tricyclics, can reduce how well the medication works. It may also increase side effects like dizziness, drowsiness, or worsening depression. It can also increase suicide risk. One 2018 study found that “in patients being treated for depression, even low levels of drinking may be problematic because alcohol may reduce antidepressant response3 and decrease patient adherence while promoting impulsivity, all of which may potentiate suicide risk.” 

Alcohol has other adverse effects for people taking antidepressants:

  • Dangerous blood pressure spikes: Some antidepressants, like tranylcypromine (Parnate) and phenelzine (Nardil), can cause dangerously high blood pressure when combined with drinks that are rich in tyramine, like beer and red wine.
  • Increased seizure risk: Bupropion (Wellbutrin) lowers the seizure threshold, and alcohol can raise this risk even further.
  • Higher risk of liver damage: Duloxetine (Cymbalta) may contribute to liver damage.  Mixing it with alcohol can increase the chances of liver toxicity.
  • Fatal overdose risk: Combining alcohol with venlafaxine (Effexor) can significantly increase the risk of fatal alcohol overdose.

Sedatives and Benzodiazepines

Alcohol intensifies the sedating effects of drugs like Valium or Xanax. This can impair your memory and coordination, increasing the risk of accidents and even respiratory failure. Like opioids, mixing benzos with alcohol also increases the risk of fatal overdose: 

Any combination of alcohol, opioids, and benzodiazepines is particularly dangerous because they may have synergistic rather than additive effects on brain circuits involved in vital physiological functions.

Alcohol is involved in about 20% of benzodiazepine-related overdose deaths.4 

Alcohol also amplifies the side effects of certain insomnia medications,5 increasing the risk of accidents related to impaired motor function, memory loss, and sleepwalking. 

Even medications prescribed for non-mental health conditions, such as blood pressure drugs, can interact with alcohol. Alcohol can counteract the medication’s effects, raising your blood pressure and increasing the risk of heart problems.

If you have questions about drinking while taking your medication, you can check for warnings on the label or look up the drug in DailyMed, a resource from the National Library of Medicine. 

Alcohol and Over-the-Counter Medications

Over-the-counter (OTC) medications can also cause problems when combined with alcohol.

Cold and Allergy Remedies

Many OTC cold and allergy medications contain antihistamines, which make you drowsy. Alcohol can make that drowsiness worse, affecting your ability to focus or drive.

Pain Relievers

Alcohol and acetaminophen (like Tylenol) can put a lot of strain on your liver. And combining alcohol with NSAIDs, like ibuprofen, can irritate your stomach and increase the risk of ulcers or bleeding.

Cough Syrups

Some cough syrups already contain small amounts of alcohol. Adding more alcohol on top of that can amplify drowsiness and impair your motor skills.

Alcohol can also interact with OTC medications that are commonly used to treat a wide range of symptoms:

  • Allergies
  • Cough
  • Cold and flu
  • Arthritis
  • ADHD
  • Diabetes
  • Heartburn
  • Muscle pain

…and more.

Always read the labels of your medications carefully, and avoid drinking alcohol while taking them unless explicitly approved by your doctor.

Alcohol and Recreational Drugs

Mixing alcohol with illicit drugs is especially unpredictable. Each combination affects the body differently, and the risks can be severe.

Marijuana

Alcohol and marijuana are often used simultaneously. But using alcohol and marijuana together can intensify the relaxing effects of both, which might impair your coordination and judgment. It can also make you feel nauseous or dizzy. Interestingly, research shows that some people tend to drink more when they use marijuana.6 

Cannabis can also heighten the risk of car accidents7 due to its effects that impair your ability to drive: 

  • Slowed reaction time
  • Loss of coordination and problem-solving skills
  • Distorted perception of time, distance, and speed

Cocaine

When alcohol and cocaine mix, your liver creates a toxic substance called cocaethylene. The “only known instance where a new psychoactive substance is formed entirely within the body,” cocaethylene lasts longer and has more intense effects than cocaine.8 As the substance increases your heart rate and blood pressure, it raises the risk of heart attack or stroke.

Ecstasy (MDMA)

In most spaces where people use ecstasy, alcohol is also involved. Mixing alcohol and MDMA dehydrates your body and puts strain on your organs, which increases the chances of heatstroke or even organ failure. It can also cause confusion or anxiety.

Heroin

As with other opioids, drinking alcohol amplifies heroin’s depressive effects on the nervous system. This can cause a number of adverse reactions:

  • Slowed breathing 
  • Loss of consciousness
  • A high risk of fatal overdose

Substance use can lead to high-risk behaviors that have serious consequences. According to the CDC, 

Using alcohol together with other drugs can increase your risk of overdose; injury; violence; sex without protection, which can lead to sexually transmitted infections, HIV, or unplanned pregnancy; chronic disease; and alcohol or other substance use disorders.

Adapting to one substance can also affect your tolerance for another. Learn more about cross-tolerance here. 

Signs of Dangerous Interactions When Mixing Alcohol With Other Drugs

It’s not always easy to tell when a drug and alcohol combination has taken a turn for the worse—but certain symptoms can be red flags.

Physical Symptoms

Keep an eye out for physical warning signs like:

  • Extreme drowsiness or dizziness
  • Nausea or vomiting
  • Slurred speech or trouble walking
  • Slow or irregular breathing
  • Chest pain or a racing heart
  • Seizures or unconsciousness

If you or someone else experiences these symptoms, it’s important to get medical help immediately.

Behavioral Symptoms

Behavioral changes can also indicate a harmful interaction between alcohol and other substances. Watch for these warning signs:

  • Confusion or memory lapses
  • Unusual aggression or irritability
  • Paranoia or hallucinations
  • Risky or reckless behavior
  • Difficulty concentrating or staying awake

Behavioral changes may not always be immediately noticeable, but they often signal a serious issue that requires intervention.

What to Do if You or Someone You Know Is Experiencing a Negative Reaction

If someone is experiencing a negative reaction after mixing alcohol with other drugs, taking quick action can save lives.

  1. Call 911 immediately. If someone loses consciousness, has trouble breathing, or shows other severe symptoms, contact emergency services. Be honest with the responders about what substances they took.
  2. Stay with the person. Keep them awake and monitor their breathing. Turn them onto their side to stop them from choking if they vomit.
  3. Avoid self-treatment. Don’t try to manage severe symptoms on your own or rely on home remedies. Medical professionals are trained to handle dangerous drug interactions.
  4. Plan for long-term support. If the situation isn’t immediately life-threatening but indicates a pattern of misuse, consider contacting a treatment center or addiction specialist for help.

Find a Supportive Drug Rehab Program

Mixing alcohol with other drugs can have life-altering consequences. From intensifying side effects to increasing the risk of overdose, these combinations are far more dangerous than many people realize. Understanding the risks and recognizing the signs of harmful interactions can prevent serious complications and even save lives.

Mixing drugs with alcohol isn’t just dangerous—it can be a sign of substance use disorder. If you’re struggling with these behaviors, intervening early can put you on the path to recovery before the problem gets worse. Comprehensive addiction treatment programs provide medical care, therapy, and ongoing support to help you overcome addiction safely and effectively.

If you’re concerned about your alcohol and drug use, the best time to reach out for help is now. Search for rehab programs by location, price range, facilities, and more, and talk to a support specialist directly today.

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Affirmations and Self-Love: Building Mental Strength and Sobriety One Positive Thought at a Time: Andrea Mora

Hello again! It’s your friendly neighborhood mental health and substance abuse recovery advocate! I hope you found my last article helpful, enjoyable, and perhaps even motivating. That was the intended purpose, so thank you if you found value in it. I write these articles to show there is hope, help, resources, and everyday things you can do to work towards and maintain your sobriety and your mental stability. One of the best things I do for myself is practicing affirmation and self-love. After all, who better is there to inspire us than…ourselves, right? There are many ways we can practice self-love, and while I’m going to share some of those with you, it is important to remember that these are not the only options. Get creative figure out what would work best for you by listening to your thoughts and needs. What may inspire me may not be the inspiration for you, and that is ok! 

As you may remember, in my last article, I mentioned I am 6.5 years sober from alcohol and right around 6 years stable with my mental illness of Bipolar Disorder Type I. I have had a few breakthrough episodes during these 6 years, mental illness-related, and some of my other mental illness diagnoses rear their ugly heads frequently, but I have never broken sobriety. Does that mean it is easy, HEL—HECK NO! (not sure if I can swear in here, but my mouth is like that of a sailor with scurvy, so I best check. You’d get more flavor that way 😊) But, I digress. 

Each illness I live with brings its own sets of challenges as I move throughout the day, weeks, months and years. But something that has helped me along the way is practicing self-love. I do this in many ways, but a big one for me is affirmations. Before I dive right into affirmations, I’m sure we all have our own definitions of what mental illness and addiction/substance abuse are to us, but some common factors go into these. 

Mental illness and substance abuse often share common underlying factors, which can make these conditions interrelated and challenging to treat separately. One significant factor is genetics, as both mental health disorders and addiction have hereditary components. If a person has a family history of depression, anxiety, schizophrenia, or addiction, they are at an increased risk of developing these issues themselves. Genetics can influence how people respond to stress, how their brains process rewards, and even how susceptible they are to addictive substances. This genetic vulnerability can create a predisposition that, when combined with other factors, may lead to both mental illness and substance abuse.

Another shared factor is environmental stress. Trauma, abuse, and adverse life events are major contributors to both mental illness and substance use disorders. People experiencing chronic stress from poverty, relationship issues, or personal loss might turn to substances as a way of coping with overwhelming emotions or negative thoughts. Additionally, social environments that normalize or encourage drug and alcohol use can make substance abuse a more likely coping mechanism for those with underlying mental health issues. Environmental factors like these don’t cause mental illness or addiction on their own but can trigger or intensify these conditions in people who may already be vulnerable.

Biology also plays a role, particularly in how the brain’s reward and stress pathways are affected by both mental illness and addiction. Both conditions impact neurotransmitters like dopamine and serotonin, which regulate mood and feelings of pleasure. For instance, people with depression may use substances to artificially elevate their mood, while those with anxiety may turn to drugs to alleviate symptoms temporarily. Unfortunately, this self-medication cycle often worsens both the addiction and the underlying mental health disorder, leading to a cycle that is difficult to break. The overlapping brain chemistry changes can make it challenging to address one issue without addressing the other, which is why integrated treatment for co-occurring disorders is often necessary for long-term recovery.

When we think of this, especially the long-term recovery portion of recovery, it can seem overwhelming and scary, with feelings of not knowing where to start. From my own experiences, the most important thing is to just start. One small thing, if looking at a big picture causes you distress, will help in some way. Will it “fix” you? Absolutely not, but will it help you in that moment? There are great odds it will. Like I mentioned before, let’s talk about affirmations.

Affirmations are positive statements or phrases that you repeat yourself to reinforce positive thinking and self-belief. These statements are usually framed in the present tense and focus on personal strengths, goals, or aspirations. For example, someone might say, “I am strong and resilient,” or “I deserve happiness and success.” Or one of my personal favorites “I deserve to treat myself to coffee and chocolate”. The purpose of affirmations is to shift one’s mindset, helping to replace negative self-talk and limiting beliefs with more empowering, constructive thoughts.

The practice of using affirmations is rooted in the idea that our thoughts and beliefs shape our emotions and actions. By consistently repeating positive affirmations, we can influence our subconscious mind, making it easier to adopt a more optimistic perspective. This can be particularly helpful for managing stress, building confidence, and improving overall mental well-being. When practiced regularly, affirmations can help reframe how you view yourself and your potential, which promotes a sense of self-worth and motivation.

While affirmations alone aren’t a cure-all, they are often used as a tool in combination with other self-help strategies like mindfulness, therapy, or goal-setting. Many people find that using affirmations as part of a daily routine — whether saying them aloud, writing them down, or visualizing them — can help reinforce a positive outlook. Over time, affirmations can help create lasting changes in mindset, aiding people in overcoming self-doubt, staying focused on their goals, and cultivating a more positive relationship yourself.

For myself, I love to write affirmations on Post-it notes and stick them around my computer monitor. I have different ones for different moods and positive needs and read the one I feel I need to read at that moment. By thinking it, or reading it out loud, I get the same benefit from it. That is, I know I’m a baddie with an attie and I can control my reaction to things, even when I can’t control the situation. (And just like that, I have an affirmation!) I can fill my cup up with love for myself, and it is almost giving myself permission to think, feel or act in a helpful way regardless of the challenge in front of me. 

You are your best weapon and your own worst enemy. Let’s try to use our powers for good, not evil, and bring out something in yourself that may change your mood, your day, month, or even your lifetime. The messages we send to ourselves have such power, and with great power comes great responsibility. The responsibility to ourselves, our hearts, our minds and our mental well-being. If you take one thing from this article, take this: Write yourself one, just ONE affirmation, and read it daily. You’ll find your mind shifts with the kindness you give yourself permission to feel. You can do it, and I believe in you! So…believe in yourself too, you baddie!

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Attention Deficit Hyperactivity Disorder (ADHD) and Substance Use Disorders: Dr. Sarah Anderson

There is a strong relationship between Attention Deficit Hyperactivity Disorder (ADHD) and substance use disorders. Research indicates that up to 50% of individuals with a substance use disorder also have an ADHD diagnosis, and those with ADHD are estimated to be six times more likely to struggle with substance abuse compared to those without the diagnosis (Davis et al., 2015). So, what accounts for this connection? 

Some evidence points to personality traits associated with ADHD that may predispose individuals to substance use. Other research has examined differences in the dopamine reward pathway between those with and without ADHD. The impulsivity and self-regulation challenges linked to ADHD, along with difficulties in executive functioning, is another factor that potentially increases the risk of substance use. 

Although we may not be able to alter inherent personality traits or easily address the complexities of the dopamine system, therapy can play a vital role in supporting and enhancing executive functioning skills.

Executive Functioning and Its Role in Recovery 

Executive functioning encompasses the cognitive processes necessary for planning, organizing tasks, following through, and achieving long-term goals. Additionally, executive functioning skills are needed to maintain a job, live independently, and successfully engage in one’s daily life. Executive dysfunction can pose barriers to recovery. Individuals with executive dysfunction experience challenges in organizing their environment, accurately remembering facts/dates/appointments, and completing tasks (Barkley, 2015). 

Additionally, the inability to manage impulses, initiate tasks, and self-regulate can result in significant stress and hinder one’s ability to manage life independently, which may lead to relapse (Mannuzza et al., 2008).  Therefore, when it comes to designing a path for sustainable recovery, individuals struggling with both ADHD and substance use disorders must engage in therapy that focuses on building executive functioning skills.

Occupational Therapy, Executive Functioning & Substance Use Recovery 

As an occupational therapist specializing in mental health and substance use recovery, my role differs from that of other mental health therapists. My primary focus is on supporting the development of independent living skills, which includes a range of activities such as household management, job responsibilities, driving, grocery shopping, cooking, and budgeting. Executive functioning plays a crucial role in a person’s ability to live independently; I believe it is one of the most important skills necessary for successful independent living. Currently, I work at a mental health and substance use recovery center. Many of the clients I work with have difficulties maintaining employment, keeping their environment organized and clean, consistently taking their medications, engaging in basic self-care activities, managing their emotions, handling their finances, and structuring their time. I can confidently say, based on client reports, that the vast majority of clients I’ve worked with experienced challenges with executive functioning prior to their substance use. Furthermore, many clients who sought treatment before arriving at the center have mentioned that issues related to executive dysfunction, such as boredom—which is closely associated with difficulties in task initiation and time management—function as triggers for relapse.

Therefore, to ensure they can maintain their recovery, it is essential that we focus on fostering the development of their executive functioning skills.

Key Areas of Executive Functioning

Understanding the relationship between ADHD, substance use disorders, and long-term recovery requires an exploration of the key components of executive functioning that are often affected in individuals facing these co-occurring diagnoses. Below, I break down each of these areas, highlighting their impact on recovery and strategies that can help enhance these skills for improved outcomes.

Planning and Prioritizing

Individuals with ADHD often face challenges with planning and prioritizing, which can lead to difficulties in breaking tasks into manageable steps and organizing their responsibilities. Clients I have worked with who struggle with these skills often have trouble paying bills on time, cooking, grocery shopping, and arriving at work punctually. Additionally, they may find it difficult to balance their time between work, family, friends, and other responsibilities. 

Challenges with planning and prioritizing can pose significant issues in early recovery, as many individuals who are newly discharged are tasked with managing new responsibilities, including completing step work, regularly attending meetings, and independently handling everyday life activities. Effective strategies to assist clients in these areas include the use of planners or digital calendar tools, which help establish a structured framework for daily activities (Cole et al., 2024). Other strategies such as time-blocking and creating actionable task lists can further enhance the ability to stay organized. 

The Eisenhower Matrix is an incredibly useful tool for prioritizing tasks, as it allows individuals to categorize their responsibilities based on urgency and importance (Jyothi & Parkavi, 2016). The matrix divides tasks into four quadrants: 

  1. Urgent and Important: Tasks that require immediate attention and are critical to achieving goals. These should be done right away. 
  2. Important but Not Urgent: Tasks that are essential for long-term goals but do not require immediate action. These should be scheduled for later. 
  3. Urgent but Not Important: Tasks that require immediate attention but are not necessarily tied to your personal objectives. These can often be delegated to others. 
  4. Neither Urgent nor Important: Tasks that have little significance; these should be minimized or eliminated from your to-do list. 

Using the Eisenhower Matrix can help individuals visualize their tasks and prioritize effectively, ensuring they focus their time and energy on what truly matters. 

Organization:

Organization directly impacts a person’s ability to manage various aspects of daily life. Effective organization helps individuals create a structured environment, prioritize tasks, and manage important responsibilities, including appointments, medication schedules, and personal commitments. For those recovering from substance use, the ability to stay organized can significantly reduce feelings of overwhelm and stress, which are often triggers for relapse (Kitzinger et al., 2023). 

When I work with clients, I help them create systems to declutter their living spaces, use visual reminders, and implement paper or digital organizers to keep track of their tasks. I also support them in developing personalized routines that foster consistency and accountability, which ultimately empowers them to manage their recovery journey more successfully.

Task Initiation

A common hurdle for clients with ADHD is difficulty in starting tasks, which often leads to procrastination and avoidance, further exacerbating feelings of anxiety and overwhelm. Two of my favorite methods to use with clients are the “5-minute rule” and the “Pomodoro Technique,” as they encourage them to work on tasks in smaller, more manageable time intervals. 

The Pomodoro Technique, in particular, involves breaking work into 25-minute focused intervals, known as “Pomodoros,” followed by a 5-minute break (Biwer et al., 2023). After completing four Pomodoros, clients take a longer break of 15 to 30 minutes. This method not only makes tasks feel more manageable but also helps sustain attention and reduce distractions. By creating a structured approach to work, the Pomodoro Technique allows clients to cultivate a rhythm that can enhance productivity and concentration. 

Additionally, this technique promotes a sense of accomplishment as clients complete each interval, reinforcing positive behavior and making it easier to tackle larger tasks over time. The regular breaks also provide opportunities for clients to engage in self-care or relaxation, further reducing feelings of stress and anxiety that can often hinder their progress (Gnanavel et al., 2019). Implementing the Pomodoro Technique can be a powerful tool for fostering time management skills and improving overall task initiation. 

Impulsivity Control

Enhancing impulse control, particularly when it comes to making unhealthy choices during times of distress or dysregulation, is essential for recovery. Interventions aimed at improving impulse control involve teaching clients mindfulness techniques to help them pause and reflect before acting on their impulses (Zylowska et al., 2008). Incorporating games and activities that promote impulse control, such as Jenga and Simon, can also significantly aid in fostering self-regulation. Lastly, cognitive-behavioral strategies can be utilized to help clients identify and challenge the thought patterns that contribute to impulsive decisions. 

Emotional Regulation

Improving emotional regulation is crucial for reducing ADHD symptoms and minimizing substance use behaviors. Difficulty in managing emotions effectively can result in increased stress, strained relationships, and other life challenges, all of which can potentially contribute to relapse. Teaching clients techniques like sensory modulation strategies, deep breathing exercises, and coping skills can empower them to manage their emotions more effectively. Incorporating expressive arts, such as drawing or painting, or physical activities, such as exercise, can also serve as healthy outlets for emotions (Hasegawa et al., 2017).

Working Memory 

Deficits in working memory significantly affect a person’s ability to engage in daily life. Difficulties in short-term memory can lead to issues such as forgetting important appointments, mismanaging medication schedules, or failing to recall coping strategies during stressful situations, all of which can increase the risk of relapse. To address this area, therapists implement memory aids, such as written reminders or digital apps, that assist in retaining important information and instructions. Training in mnemonic devices and visualization techniques can also enhance memory recall (Martin & Marsh, 2009). 

Additionally, engaging in mindfulness practices has been shown to enhance short-term memory. Research indicates that mindfulness can improve cognitive functions, including memory retention and recall abilities, by promoting focused attention and reducing distractions (Zeidan et al., 2010; Killingsworth & Gilbert, 2010).

Self-Monitoring 

Self-monitoring skills are important because they help individuals notice how they are doing and make changes to their behavior when needed. Clients often benefit from learning how to evaluate their performance on tasks and reflect on their emotions and thoughts throughout the process. Journaling or using mobile apps can facilitate self-reflection by allowing individuals to document their thoughts, feelings, and experiences regularly. 

For example, someone might use a journal to reflect on their daily challenges and successes, helping them identify patterns in their behavior over time. Similarly, mood tracking apps can encourage clients to log their emotions throughout the day, providing insights into triggers for anxiety or stress. This process of self-reflection can lead to more effective self-regulation, as they become more aware of their emotional responses and can devise strategies to manage them (Barkley, 2015).

Comprehensive Assessment and Goal Setting

To help clients enhance their executive functioning skills, the process begins with a thorough assessment aimed at identifying both strengths and weaknesses. This assessment is crucial, as it not only reveals specific executive functioning deficits but also ensures that the interventions used are relevant and effective. Without a comprehensive evaluation, important areas of need may go unrecognized, resulting in interventions that do not adequately address the client’s deficits. Standardized tools, interviews, and observations provide valuable insight into how these limitations impact daily life engagement. Once the assessment is complete, establishing goals collaboratively is essential. This process empowers clients to choose goals that are meaningful to them, fostering a sense of ownership in their recovery journey. 

By creating a collaborative environment, clients are more likely to make significant progress. This tailored approach not only addresses specific challenges associated with ADHD and substance use disorders but also promotes a greater sense of agency and self-efficacy. When clients feel that their needs are understood and prioritized from the start, they are better equipped to engage in the therapeutic process and achieve lasting change.

Key Points

The significant connection between ADHD and substance use disorders presents unique challenges that require a comprehensive approach to support sustainable recovery. Addressing executive functioning skills — such as organization, time management, impulse control, and emotional regulation — is essential for individuals with these dual diagnoses. By focusing on enhancing these skills, individuals in recovery can learn how to manage their daily lives more effectively and navigate the complexities associated with both ADHD and substance use.

Recognizing the specific needs of individuals with this dual diagnosis is crucial for developing effective treatment strategies. Tailored interventions that target executive functioning can lead to improved recovery outcomes and a better overall quality of life. A holistic focus on these skills not only helps individuals address the symptoms of ADHD but also empowers them to take control of their lives, establish meaningful goals, and create a sustainable path toward lasting recovery.

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Beyond the 12 Steps: Alternative Paths to Recovery for Young Adults: Megan Cornish

Disclaimer: The views and opinions expressed in these contributions are those of the individual authors and do not necessarily reflect the views of Recovery.com.

In 1935, Bill Wilson and Bob Smith were both fighting to keep their alcoholism in check while juggling demanding jobs. When they met and began to talk about their battles, they recognized a truth that would become the foundation of the recovery community in the United States: staying sober is a whole lot easier when you’re not doing it alone. By 1950, Alcoholics Anonymous (the group Bill and Bob started, also known as AA) had already helped more than 100,000 people find their way to recovery.

AA struck a chord in early 20th-century America. Its manual, called “The Big Book” by members, laid out 12 steps to guide people through recovery. The approach fit right in with the era’s thinking around addiction, spirituality, and self-care.

AA was built on a framework that included:

  • A primarily spiritual worldview
  • A focus on alcohol as the substance of choice
  • The belief that the ability to get and stay sober could only be found through a higher power
  • Strategies that were tested out and established by predominantly (white) men
  • An abstinence-only approach, with absolutely no substance use allowed

There’s a reason AA’s so popular. Research shows that, for many people, it works. In fact, AA’s 12 step program was found to be 60% more effective than other interventions for helping people get into recovery from alcoholism.

90 years have passed since Bill and Bob founded AA, and while it’s still easier to stay sober with help, a lot has changed. The old model tends to resonate with the older generations, who identify with the framework that AA was built on. But there are a lot of people—especially young people—looking for recovery resources who might not connect with AA’s traditional (and, at times, inflexible) views on recovery. And though it’s hard to find a non-12-step based recovery program, they do exist—it’s just a matter of figuring out where to look for what will work for you.

Recovery Support, But for Young Adults

YPR- Young People in Recovery

If you walk into a typical 12 step meeting, you’ll probably find people of all ages, but you might also notice that the average veers towards the older generation. Possibly that’s because it takes time to realize you need support to stay sober, and the young people who make their way to 12 step meetings are ahead of their peers. No matter what the reason, there can be a certain energy in AA meetings: stories full of hard-earned wisdom, decades-long battles, and the kind of insight that only time can give.

This wisdom is something young people in recovery need—but sometimes, they need support from people their own age, too. 

Young People in Recovery (YPR) is a non-profit that’s trying to offer exactly that. YPR gets that young adults (under the age of 30) in recovery are facing unique pressures: navigating college life, launching careers, building relationships—all while managing sobriety in a world where social media, parties, and stress are ever-present. 

YPR offers local chapters, life-skills workshops, advocacy projects, and social events, and welcomes all recovery pathways, including people in 12-step programs. They try to create a space where young people can connect with people their age who understand the here-and-now challenges they’re struggling with.

Recovery Support, But Not for Alcohol

SMART Recovery

Not everyone battling addiction is fighting alcohol. Maybe it’s opioids, stimulants, or even behaviors like gambling or overeating. And while many people struggling with other addictions find AA to be helpful, others don’t—and that’s okay.

SMART Recovery stands for Self-Management and Recovery Training, and it focuses on giving struggling people practical tools and strategies to overcome addiction. SMART emphasizes personal responsibility and secular principles, and it draws on ideas from cognitive-behavioral therapy and motivational interviewing to address any type of addiction.

Instead of 12-Steps, SMART Recovery uses a 4-Point Program:

  1. Building and Maintaining Motivation: Helping you identify and keep sight of your personal reasons for change.
  2. Coping with Urges: Teaching strategies to manage cravings and avoid relapse.
  3. Managing Thoughts, Feelings, and Behaviors: Using cognitive techniques to tackle unhelpful thinking patterns.
  4. Living a Balanced Life: Encouraging you to set goals and create a fulfilling, healthy lifestyle.

Now, while SMART Recovery is gaining popularity and has helped many people, it’s worth noting that there’s not as much research on its effectiveness compared to programs like AA. Early studies are promising, but more comprehensive research is needed to fully understand how well it works across different populations.

But if you’re looking for a recovery program that isn’t specific to alcohol, SMART Recovery might be worth checking out.

Recovery Support, But Not Religious

In 1935, faith and religion played a huge role in the day-to-day lives of most people. It’s estimated that as many as two out of every three people identified as religious by the 1950s. Today, that number is much lower—less than half—with one in three people identifying as “spiritual, but not religious.”

The move towards non-religious-affiliations is most noticeable with younger generations. According to research conducted by the Pew Research Center, only around four in ten millennials reported religion as being “very important” to them, compared to just 60% of Baby Boomers. Many young adults describe themselves as “spiritual but not religious,” or they don’t identify with any spirituality at all.

Alcoholics Anonymous, which is religious by nature, won’t work for someone who doesn’t believe in a “higher power.” And although AA has widened its definition of a “higher power” to include anything that gives you strength—even if it’s not a traditional deity—that concept still doesn’t resonate with everyone.

If you’re among those who feel like you might need recovery support without the religious or spiritual framework, there are a few options for you.

Secular Organizations for Sobriety (SOS)

The Secular Organizations for Sobriety (SOS), also known as “Save Our Selves”, promotes a non-religious path to sobriety. It was founded in 1985 by James Christopher, who felt that the spiritual focus of traditional programs like AA didn’t fit with his beliefs.

Here’s what’s different about SOS:

  • Secular: SOS doesn’t invoke any higher power. Instead, there’s a focus on self-reliance and confidence in your ability to change.
  • Self-Empowerment: SOS believes you’re in charge of your own recovery journey, so they try to support you in taking control of your life and making conscious decisions to stay sober.
  • Community Support: SOS meetings still provide peer support—they give space to share experiences and strategies without religious or spiritual discussions. 

One thing to keep in mind is that SOS isn’t as widespread as some other programs, so finding a local meeting might require a bit of searching. But they do offer online resources and support groups, which can let you access SOS even if there’s no chapter near you.

LifeRing Secular Recovery

LifeRing is another option if you’re looking for a secular approach to recovery. Like SOS, LifeRing was established as an alternative to religion-focused recovery programs. It also grew out of a demand for more flexible approaches that didn’t prescribe strict guidelines for recovery.

As a recovery program, LifeRing:

  • Empowers Your “Sober Self”: LifeRing operates on the idea that within each person struggling with addiction, there’s a “sober self” and an “addict self.” The goal is to strengthen your sober self through positive support and self-empowerment so that it can overcome the addict self.
  • Offers Flexibility: There are no prescribed steps to follow. Instead, LifeRing encourages you to develop your own recovery plan. Their motto is “Empower Your Own Recovery.”
  • Focuses on the Present: Meetings center around what’s going on in your life right now. Participants talk about their current challenges and successes, supporting each other but not dwelling on labels or past mistakes.
  • Keeps It Secular: LifeRing maintains a strictly secular approach. There’s no discussion of a higher power or spiritual aspects, keeping it a comfortable space for those who prefer to keep religion out of their recovery journey.

While LifeRing isn’t as widely known as some other programs, it’s gaining popularity, especially among young adults who are looking for recovery support that’s personalized to them and non-religious. As with other alternative recovery programs, there’s less research on its effectiveness compared to AA, but that doesn’t mean that you won’t find it to be valuable on your path to sobriety.

Recovery Support, But Not Centered on Men’s Experiences

AA was created by men. That’s not to say it hasn’t helped women—it has, by the thousands—but women didn’t even attend AA until after the Big Book was written. 

The experiences, challenges, and societal expectations faced by women can be really different.

Women for Sobriety (WFS)

Dr. Jean Kirkpatrick wanted to get sober, but found that AA didn’t help her—- at least, not in the ways she needed as a woman battling alcoholism. After discovering and defining the strategies and principles that actually did help her achieve sobriety, she established Women for Sobriety in 1975. 

WFS is all about:

  • Positive Affirmations Instead of Steps: WFS is built around 13 Acceptance Statements that support emotional and spiritual growth. The statements are about building self-esteem, reducing guilt, and getting healthy.
  • Holistic Healing: WFS views addiction as about more than just the substance—it also involves a persons’ emotions, relationships, and self-worth. As a result, the program stresses that women in recovery need to nurture all aspects of their lives.
  • Empowerment Rather Than Powerlessness: Instead of admitting powerlessness over addiction (like AA calls for), WFS encourages you to recognize your strength and capability to change your life.
  • Peer Support: Meetings provide a space where women can share openly with each other without fear of judgment.

WFS offers both in-person and online meetings, which is awesome if you’re balancing a busy schedule or prefer connecting from the comfort of your home. Plus, it’s secular, so there’s no religious component unless you want there to be.

She Recovers

She Recovers was founded by Dawn Nickel and Taryn Strong, a mother/daughter duo. Like WFS, She Recovers is specifically built for women, but they use tools like yoga, meditation, and mindfulness to bolster their recovery program. Plus, it tackles issues like mental health, trauma, and stress. 

The She Recovers approach centers on:

  • Integrative Approaches: She Recovers embraces all pathways to recovery. Whether a woman is into 12-step programs, yoga, therapy, or something entirely different, they’re welcome.
  • Connection is Key: The program is big on the power of connection and community. They offer retreats, workshops, coaching programs, and a strong online presence so that there’s always a way to connect with other women on similar journeys.
  • Self-Care and Wellness: She Recovers encourages practices like yoga, meditation, and mindfulness as tools for healing. 
  • For All Women: The community welcomes all self-identified women and non-binary individuals more comfortable in a women-centered space. 

She Recovers also offers a directory of Certified Recovery Professionals whose training and work align with She Recovers principles. Women pursuing recovery can find coaches, yoga instructors, dance facilitators, and other healthcare professionals that can support their pursuit of sobriety.

Recovery Support, But Not Abstinence-Focused

You don’t have to be an addict to want to change your relationship with substances. Alcoholics Anonymous has a hardline approach to recovery- if you’re an addict, you need to stop using all substances, period. But not all people feel like they need that- and not all recovery programs require complete abstinence, either.

Moderation Management (MM)

Audrey Kishline founded MM in 1994. She wanted to help people who wanted to reduce drinking to healthier levels rather than quit entirely. According to MM, problem drinking exists on a spectrum, and not everyone needs (or wants to commit to) lifelong abstinence.

The key features of MM include:

  • Personal Responsibility: MM encourages you to take control of your drinking habits by setting and sticking to your own moderation goals.
  • Tools: The program provides strategies for cutting back, like tracking your drinks, setting limits, and planning alcohol-free days.
  • Supportive Community: MM offers meetings—both in-person and online—where members share experiences, challenges, and successes in a non-judgmental environment.
  • Step-by-Step Approach: MM recommends a 30-day period of no drinking to help you reset and evaluate your habits before moving into moderation.

MM isn’t right for everyone. If you have a severe alcohol dependence or a history of failed attempts at moderation, you might benefit more from abstinence-focused programs or professional treatment. 

Finding What Works for You

At first glance, the recovery world seems very 12-Step centric. Young people especially might not vibe with the traditional framework of AA, since the spiritual emphasis, the abstinence-only approach, and the fact that it was developed nearly a century ago by and for men can make it seem out of touch.

But the good news is that there are many ways to get to recovery.

If you’ve tried AA and know that it’s not what you need to get (and stay) sober, remember you’re not alone—after all, what works for a friend might not be what works for you. There are other communities available to help you. Don’t be afraid to explore your options, remember that recovery isn’t a straight line, and keep pushing to find the path that leads from where you are to a happier, healthier life.