Tag: Alcohol

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Beyond Willpower: The Disease Model of Addiction

Addiction was once viewed primarily as a moral failing. But today, it’s increasingly recognized by addiction scientists and healthcare professionals as a disease affecting the brain. The disease model offers a framework for destigmatizing addiction by understanding it as a disorder that’s no different from any other physical illness or chronic health condition.

We look at the core concepts of the disease model, how it came to be, and the controversies surrounding this perspective. We’ll explore the chronic nature of addiction and how the brain is affected by substance use, and most importantly, what the disease model means for those treating and recovering from addiction. 

What Is the Disease Model of Addiction? 

The disease model views addiction as a chronic, relapsing brain disease characterized by compulsively seeking and using substances despite harmful consequences. This model focuses on the biological and neurological factors that lead to addiction. It positions addiction as a medical condition that requires professional treatment, rather than just willpower.

Definition and Concept

According to addiction scientists, “the disease model represents a comprehensive explanatory concept that encompasses the social, psychological, spiritual, and biological dimensions of alcohol and drug dependence.”1

This model sees addiction as chronic, meaning it’s long-lasting and persistent. Addiction is a condition with a continuous course that involves periods of relapse and remission. This is similar to other chronic diseases like diabetes or heart disease, which require ongoing management.

“Relapsing” means people with addiction often return to substance use after abstaining for some time. Because addiction is cyclical, people may experience periods of sobriety followed by setbacks. This is why ongoing treatment and support are such crucial aspects of the recovery process.

Understanding Addiction as a Health Condition

Proponents of the disease model firmly believe this framework is necessary to effectively prevent and treat addiction, as well as reduce stigma. According to The Addiction Policy Forum, a nonprofit organization with a mission to eliminate addiction,

Addiction needs to be treated like a disease, and we have to follow a disease model. This has been a real area of frustration…for many of us in this field. We only have about half of the country that really understands this as a health condition.2

How the Disease Model Evolved in Addiction Science

The disease model of addiction has evolved over time.3 While earlier perspectives largely viewed addiction as a moral failing, medical perspectives on addiction became more common in the late 19th and early 20th centuries. This marked a shift toward understanding addiction as a health issue, as opposed to a character flaw. The disease model gained even more momentum in the mid-20th century with the rise of Alcoholics Anonymous (AA) and increased scientific research into the brain’s reward system.

Key Concepts of the Disease Model 

Here’s what the disease model says about the brain science behind addiction:

Brain Changes and Neurobiology

Addiction fundamentally alters brain structure and function.4 Over time, repeated substance use disrupts the brain’s reward system, which leads to compulsive drug seeking and use. Dopamine, the brain chemical responsible for pleasure and motivation, becomes overstimulated, creating an imbalance. Over time, the brain adapts to this excess of dopamine and needs more of the substance to feel the same effects. This process, combined with changes in other brain regions involved in decision-making and impulse control, is why addiction is so persistent. 

The good news is that understanding these brain changes allows healthcare professionals to develop more effective treatment approaches.

The Chronic Nature of Addiction 

Addiction is often compared to chronic conditions, like asthma or arthritis, that require ongoing management. But unlike acute illnesses with a clear beginning and end, addiction often entails periods of relapse and remission. This chronic nature highlights the need for long-term treatment and support. While personal choices might initiate substance use, the changes in brain chemistry that result from addiction can make it hard to quit without professional help. This perspective shifts the focus from moral failure to a medical condition requiring sustained care.

Genetic and Environmental Influences 

A number of genetic and environmental factors can influence the development of addiction. Genetic predisposition can make some people more vulnerable to addiction. But genetics alone don’t determine addiction; environmental factors also play a major role. Factors like early exposure to substances, peer pressure, stress, and trauma can heighten the risk of addiction, especially for someone with a preexisting genetic blueprint. 

The disease model opens up space for discussing not just how to treat addiction, but how to more effectively prevent it,5 says The Addiction Policy Forum: 

We know that most people who have an addiction—about 90% of those who have a substance use disorder—begin in adolescence. But it’s also the only disease space where our treatment system is set up for adults. So it’s the only disease in America where we wait for it to worsen before we start to treat it. We need to follow these same core precepts in how we treat diseases for how we prevent and treat substance use disorders.

Criticisms and Controversies of the Disease Model of Addiction

While the disease model has contributed to a more compassionate understanding of addiction, it’s not without its critics. 

One review of the scientific advances in addiction treatment sums up the questions surrounding the disease model6 that still linger among treatment professionals:

Although the brain disease model of addiction has yielded effective preventive measures, treatment interventions, and public health policies to address substance-use disorders, the underlying concept of substance abuse as a brain disease continues to be questioned, perhaps because the aberrant, impulsive, and compulsive behaviors that are characteristic of addiction have not been clearly tied to neurobiology.

While addiction undoubtedly affects brain function, and this understanding has widespread impacts on the treatment approaches of today, “social environments, developmental stages, and genetics are [also] intimately linked to and influence vulnerability and recovery.”

It’s also worth considering that other approaches can be equally effective for people in recovery, depending on how well they align with their existing belief systems.

Alternative Models 

While the disease model has helped advance addiction research and treatment, it’s not universally accepted in the behavioral health community. Some argue that it overemphasizes biological factors and downplays the role of environmental influences. Alternative models, such as the biopsychosocial model, propose a more holistic view of addiction that looks at the interaction between biological, psychological, and social factors. The choice model,7 on the other hand, believes addictive behaviors are voluntary and that recovery is a matter of willpower and personal responsibility. 

Interestingly, one analysis of the disease vs. choice models of addiction found that there’s room for both views within the addiction treatment space, and that what’s most important is that people in recovery receive clear messages about their path forward: 

On one side, treatment providers with strong beliefs in either model are more likely to send a clear and unambiguous message to clients about what addiction is and what it is not. Defining the problem and giving clients clear direction as to what they should do and expect in the short and long term should enhance clients’ perceived self-efficacy and optimism for change.

The same study also notes that “a common criticism of the disease–choice debate is that absolute truths about addiction are irrelevant so long as people do ‘recover,’” and that “the success of treatment may therefore depend on the degree of congruence between treatment providers’ and clients’ beliefs about addiction.”

There’s no one formula for recovery. At the end of the day, it’s about finding what works for you—and that includes finding an addiction treatment program that resonates with your personal framework.

Societal and Stigma Issues 

At the time it rose to popularity, the disease model offered a more compassionate view of addiction by framing those in recovery as needing help with a health condition, rather than being to blame for their drug-seeking behavior. 

But some argue that framing addiction solely as a disease can reinforce stigma by suggesting there’s something fundamentally wrong with people who struggle with addiction. Others warn that the disease model might oversimplify the complexity of addiction’s biological, psychological, and social aspects. 

It’s worth noting that personal choice isn’t the only alternative to the disease model. One study on addiction and moralization finds that “nondisease models of addiction do not necessarily involve moralization.8 Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction.”

Ultimately, the recovery space has room for multiple perspectives. Effectively treating addiction means balancing the medical perspective with other factors that affect health.

Disease Model-Based Treatment Approaches

Medical Treatment Approaches

The addiction disease model has significantly influenced treatment approaches. It paved the way, for example, for the use of medication to treat addiction. “The disease model views addiction as a physiological disease9 with specified symptoms and course,” says psychologist and Professor of Clinical Psychology Arthur W. Blume. “[it’s] a biomedical model that understands addiction as a physiological pathology that requires medical or pharmacological interventions.” Today, medication-assisted treatment is commonly used to address opioid addiction and other substance dependencies.

Medications help countless people in recovery manage withdrawal symptoms, reduce cravings, and prevent relapse. Opioid use disorder, for example, is often treated with medications like methadone or buprenorphine. These treatments—especially when combined with behavioral therapies—can be life-changing for the people who use them to support their recovery. Ongoing research continues to explore new medical treatments that target specific brain mechanisms involved in addiction.10

Behavioral Interventions 

Behavioral therapies often form the basis of professional addiction treatment. 

These interventions, sometimes combined with medication, offer a comprehensive approach to address the challenges of addiction and support patients’ journeys toward lifelong recovery.

Support and Management Strategies 

Viewing addiction as a chronic condition stresses the importance of long-term support and management strategies. Similar to managing other chronic diseases, people in recovery require ongoing care and progress tracking: 

  • Adhering to treatment plans
  • Checking in regularly with treatment providers
  • Participating in support groups
  • Making lifestyle changes that support sustained recovery

For those who have co-occurring mental health disorders, it’s also essential to address these simultaneously, ideally via specialized care. Family involvement and other social support systems also play an important role in creating a positive environment that supports long-term recovery.

Find Support for Addiction

Understanding the true nature of addiction—no matter what conclusions you draw—can paint a clearer picture of your situation that illuminates your path forward. While overcoming addiction is a challenge, recovery is entirely possible, and plenty of resources exist to help you make this rewarding life change. Search for addiction treatment centers and filter by location, specializations, amenities, and more to find the right program for you.

Frequently Asked Questions About the Disease Model of Addiction

Is addiction a disease?

Yes, the disease model views addiction as a chronic brain disease. This perspective sees addiction as a health condition and challenges the stigma surrounding addiction as a moral failing. It supports seeking professional treatment and long-term management strategies.

Does the disease model of addiction remove personal responsibility?

No, the disease model doesn’t negate personal responsibility. It acknowledges the synergy of biological, psychological, and environmental factors that lead to addiction. Treatment focuses on building coping skills and making informed choices, alongside medical intervention.

Can a person recover from addiction without treatment?

While some people manage to overcome addiction without formal treatment, research shows that professional help significantly increases the chances of long-term recovery. Addiction is complex. Addiction treatment addresses underlying causes and offers strategies for managing cravings and preventing relapse.

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What is NAD Treatment?

Do you remember hearing mitochondria is the powerhouse of the cell? That’s because it synthesizes the energy you need to function, but it doesn’t do it without help. 

Nicotinamide adenine dinucleotide (NAD), a coenzyme found all throughout your body, is responsible for taking just the right electrical charges and reconfiguring them to create ATP1, better known as energy. Along with boosting ATP levels, NAD also affects parts of the DNA responsible for aging, opioid receptors in the brain, and can improve access to the neurotransmitters responsible for good mood, like serotonin. 

NAD levels shrink as you age or experience stressors like addiction. NAD treatment restores your levels of NAD and can subsequently improve a host of functions—even lowering withdrawal symptoms and cravings in recovery. It’s become a more well-known and used tool in addiction recovery; here’s why.

Introduction to NAD Treatment

Your body uses NAD for myriad of processes and functions, including,

  • Metabolism
  • Circadian rhythm
  • Lengthening telomeres, which slows aging 
  • Making energy
  • Repairing damaged DNA
  • Making DNA more resistant to damage and decay
  • Boosting physical and mental wellness
  • Reducing substance withdrawal symptoms

NAD treatment, typically administered through an IV, restores NAD levels that shrank naturally or because of poor health. Since it’s a natural coenzyme found throughout your body1, it’s readily accepted and processed. 

The Science Behind NAD Treatment

NAD synthesizes energy in the mitochondria1 thanks to one tiny atom: hydrogen. Hydrogen has one positive charge (proton) and one negative charge (electron) that NAD picks up to form NADH. NADH picks up charges from hydrogen throughout the process of compounds, like glucose, going through chemical changes. The results of these changes mean the energy (ATP)-making process begins, which releases more NADH. 

In short, NAD takes charges from the hydrogen within various compounds (like glucose) and releases them into the mitochondria, which uses those charges to create ATP, or energy.

NAD affects other cells in different ways. Mainly, it strengthens DNA and enhances neurological and physical functions1, including your cognitive abilities. 

Biological Importance of NAD

NAD does even more than synthesize energy. It keeps several key functions running smoothly, and can slow down, or even reverse, age-related diseases2 by its effects on DNA. NAD restores damage to DNA and protects healthy strands from damage. It boosts immunity and strengthens your metabolism, and helps brain fog dissipate. As an antioxidant, it helps you resist pollutants3 from food, the environment, and substances.

How NAD Therapy Works

Clinics can administer NAD in 3 ways: an IV infusion, an injection, or through a nasal spray. The IV infusion typically takes the most time and is most comprehensive, as the solution includes vitamins to boost your wellness. 

  1. IV Infusion: Nurses or physicians insert an IV tube to administer NAD and vitamins over the course of a few hours. The time for each infusion can vary by the clinic and your dose; expect 2-5+ hours. During that time you can work on a computer, read a book, or enjoy another hobby. 
  2. Injection: Similar to getting a flu shot, a specialist will inject a syringe of pure NAD (no extra vitamins) into your bicep, thigh, or buttocks. You can leave once they’re done; this option takes just minutes.
  3. Nasal Spray: A nasal NAD treatment involves short bursts of the NAD solution sprayed into each nostril. If you’ve ever used a nasal spray for allergies, it’ll be just like that.

After an NAD treatment, many patients feel a boost in energy and mental clarity. Some only feel change after a few sessions. If you’re using NAD treatment for addiction, you may experience an immediate lessening in cravings and improved withdrawal symptoms. An addiction treatment center will likely stack your NAD treatments close together to help you navigate withdrawals as comfortably as possible. 

Benefits of NAD Treatment

A hallmark of NAD treatment is the lack of medication needed for its results. It uses a coenzyme your body creates naturally, not a man-made medication with their unavoidable lists of side effects. In essence, it uses tools from your body’s toolbox to improve multiple functions.

Anti-Aging Effects

NAD offers anti-aging effects2 in 2 ways: it lengthens telomeres (caps on strands of DNA) and improves your cognitive and physical functions, reducing the likelihood of age-related diseases like cancer.

Telomeres maintain the stability and health of your chromosomes4 by capping off strands of DNA and protecting them from damage. The longer the telomere, the more protected the DNA is and better resistant to the decay of aging. 

Addiction Recovery

NAD helps repair cells damaged by addiction and significantly reduce effects of withdrawals5. NAD also bonds to opioid receptors in the brain, which can ease withdrawal symptoms and cravings for drugs or alcohol.  

NAD, an antioxidant, detoxifies your body. This can speed up withdrawals and make the process more comfortable. NAD can also lower cravings long-term by repairing damaged cells5 in your brain’s reward pathway and changing your genetic expression through epigenetics (or, a new way your genetic code is read.) 

Chronic Health Conditions

NAD treatment improves your metabolism and immune system, which can alleviate symptoms for chronic conditions like fibromyalgia, chronic fatigue syndrome, and neurodegenerative diseases. Since it makes repairs to damaged DNA, it can change genetic expression6 and reverse, or improve, chronic conditions and their symptoms. 

What to Expect During NAD Treatment

Before your session, the clinic will set up an initial assessment to determine your eligibility and what current health struggles you may have. Even if you’re getting NAD treatment at an addiction treatment center, they’ll likely still ask a few clarifying questions on your health and what your goals are for the treatment.

NAD treatment consists of little more than resting and relaxing while the transfusion happens. To prepare for your session, drink water and eat a healthy meal to give the NAD a better workspace. Avoid alcohol or caffeine too.

At your first appointment, the practitioners will explain a bit more of what to expect, and then you’re ready to go. Depending on how they administer the NAD, you’ll either receive an injection, a nasal spray, or an infusion. Infusions are more common and comprehensive. They’ll insert a needle into the crook of your arm and hook you up to a baggie with the NAD solution inside. You’re free to work, rest, practice a hobby, or call up a friend during the transfusion. They can take anywhere from 2-5+ hours and occur 1-3 times a week for 8-10 weeks.

Wear comfortable clothes and shoes. The clinic will likely have guidelines on what they allow you to bring to sessions, like snacks, drinks, and entertainment. Check with them to make sure you’re optimizing your time and making it the best experience for you. Some clinics also bring the treatment to you, which means you can stay at home during the transfusion.

After The Session

Once the transfusion is complete, the presiding nurse or physician will remove the IV to disconnect you from the NAD baggie. They’ll put a bandage over the insertion point (like they do when you get your blood drawn), see how you’re feeling, and send you on your way. You may also schedule the rest of your sessions then, which happen on a cadence suited to your needs. It could be once or twice a week or every other week, lasting 10+ weeks or less.

Possible side effects from NAD treatment include pain and tenderness at the injection site, feeling lightheaded, and headache. The practitioners will ensure you feel okay after each session and not experiencing possible side effects at home.

Clinical Evidence Supporting NAD Treatment

Various studies have both shown NAD treatment has life-improving effects and low safety risks6. Any side effects experienced, like headaches or sleep disturbances, didn’t impact the overall health of participants. It was also found to reduce withdrawal symptoms and cravings5 in addiction recovery.

Scientists are still seeking to find the best delivery method for NAD7, whether that’s transfusion, injection, a nasal spray, or even a pill. Studies can also improve on showing the efficacy for NAD treatment and mental illnesses like depression, rather than a causal link in NAD and symptom reduction.

Comparing NAD Treatment to Other Therapies

NAD treatment is one of many tools available to treat addiction, chronic health conditions, mental illnesses, and more. It has its pros and cons, like other treatments.

Advantages Over Traditional Methods

NAD treatment generally has fewer side effects than traditional treatment methods, which typically involve medications to treat health conditions. Since it uses something your body makes itself, introducing more NAD is rarely an issue. 

This easy introduction, lack of withdrawals, and natural tolerance can make NAD treatment an advantage over medications. It can be especially beneficial for those in addiction recovery, as NAD can have similar withdrawal-reduction benefits as opioid-based medications5.

Limitations and Considerations

NAD has its benefits and impressive capabilities, but it may only work for some. Practitioners can’t easily prove the NAD’s effects for each individual, nor can they guarantee it will relieve certain symptoms. The way your body processes the extra NAD will vary person-to-person.

NAD treatment also takes time to see certain results, like anti-aging effects or improved cognitive function. It’s not always a quick fix, like medications or other interventions can be. It’s also not covered by insurance, as other medications may be.

Accessing NAD Treatment

Availability and Costs

As NAD treatment becomes a more mainstream treatment option, more and more clinics and providers aim to offer it. A quick Google search will tell you if a NAD clinic is nearby. You can even order a vial of the NAD solution and inject it yourself—with a prescription from your doctor and oversight. 

Costs vary depending on the number of milligrams used in an NAD session. A shorter session will use less NAD solution and cost less. Longer sessions cost more. On average, a 2-hour session will cost $350 and a 5+ hour session will cost $600+. The final cost can vary widely by clinic, solution add-ons, and more. For the total package of continued sessions, you can expect to spend anywhere from $5,000 to $15,000+. 

Insurance and Coverage

Insurance doesn’t cover NAD treatment; they view it as a complementary treatment and may only cover small portions through various plan benefits. You can push for reimbursement by submitting a request to your insurance provider with your need for NAD treatment documented by a clinician.

Next Steps

Consult with your doctor if NAD treatment sounds like a good option for you. It has its benefits and drawbacks, but can be a life-changing treatment for those in addiction recovery, those with chronic ailments, and those with mental health conditions. See what your doctor thinks and set up an appointment with the NAD clinic of your choice to start the process.
You can also browse rehabs for addiction on Recovery.com and see photos, reviews, insurance information, and more.

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Guide to Finding State-Funded Rehab

A state-funded rehab receives funding from state governments, which means they can offer care at a lower cost—a solution for those without insurance or limited coverage. Each state may have different budgets and allotments for rehab funding.

To find a state-funded rehab, you can access your state government’s resources using the web, connect with helplines, or use a national locator like the Substance Abuse and Mental Health Services Administration’s (SAMHSA) website.

Understanding State-Funded Rehab Programs

State-funded rehabs meet the needs of people needing effective programs for residential treatment, detox, outpatient care, and medication-assisted treatment (MAT) programs—but without health insurance or excess money to shell out for private-pay centers. They’re instead funded by state and/or federal funding through Medicare, Medicaid, TRICARE, and other public insurance. Other grants and funding support people who don’t qualify for state insurance. 

State-funded rehabs come as a response to this ever-growing need, especially with rates of overdose and addiction increasing1. People living in poverty or low incomes are most at risk for addiction2. Various grants from the government3 (through SAMHSA) specifically address the needs of those incarcerated, pregnant, disabled, and more to make treatment accessible. Public health insurance may cover the costs of state-funded rehabs for those who qualify for Medicare and/or Medicaid.

Eligibility for State-Funded Rehabs

To attend a state-funded rehab, you’ll need to live in the state providing the care and have proof of your inability to cover the costs of private treatment through insurance or private pay.

General Eligibility Criteria

Here are the general criteria for attending a state-funded rehab:

  1. Proof you live in the state (like a bill from your water company sent to your address.)
  2. Proof you can’t afford non-state-funded rehab via your pay stubs and lack of insurance coverage.
  3. Documented need for addiction treatment and the specific level of care, like a doctor’s note saying you have a substance use disorder and need residential care.
  4. Proof of American citizenship.

How to Determine Eligibility

If you have questions about your eligibility for a state-funded rehab, you’ll likely get the quickest and most accurate answer by contacting the facility itself. Their admissions coordinators will ask what your income is, if you have private or public insurance, where you live, and your citizenship status. They may also ask questions to see if you qualify for other scholarships and grants offered by their facility or the state you live in. For example, some treatment centers may offer scholarships to Indigenous peoples or other minority groups.

You can also navigate to your state’s government website and search for addiction treatment to see their specific qualification criteria. This can help you determine your eligibility.

Benefits of State-Funded Rehab

State-funded rehabs often provide evidence-based care from experienced clinicians, along with a full continuum of care: detox, residential treatment, day treatment, intensive outpatient, outpatient care, and MAT. Lower costs don’t lower the impact treatment can have on your life. Their price makes treatment more accessible to people nationwide.

Affordability is another major benefit, since costs can be such a daunting barrier to care. Going to rehab has its challenges, but with costs off your plate, you have one more reason to commit to healing.

Locating State-Funded Rehab Programs

State-funded rehabs are under the umbrella of other government programs and initiatives, which means you can find out more about them on your state’s government website and online locators, like SAMHSA.

State Health Department Resources

Your state’s health department includes key information on how your state responds to health crises and day-to-day health needs. For example, the state of Wisconsin has a page of their website devoted to substance use care, your rights under state and federal laws, and resources for those needing to locate treatment facilities or find state-funded care. You can find this information on your state’s legal website too—search for “your state name”.gov.

SAMHSA (Substance Abuse and Mental Health Services Administration) remains the top-tier government resource for information on addiction and mental health treatment. It also provides additional grants and funding for rehabs and other recovery services.

Using Locators and Helplines

SAMHSA has a 24/7 helpline for finding treatment—they can help you locate a state-funded rehab near you. There’s also FindTreatment.gov, which is an American government-backed service for finding addiction and mental health treatment. They also list agencies by state, which oversee the recovery centers in each state and can help you pick a reputable center.

Application Process for State-Funded Rehab

Knowing what you’ll need to apply for a state-funded rehab program can make the process faster and easier. 

Documents Needed

Have these documents on hand for your application:

  1. Proof of income, like your most recent pay stub.
  2. A recent bill from a utility company or government agency to prove your address.
  3. Your driver’s license, passport, or other form of government identification to confirm your identity.
  4. Your insurance card, if you have one.

Step-by-Step Application Guide

To apply for state-funded rehab, you’ll use the provider’s website or go directly to their office to begin the admissions process. Once you submit the above documents, their team will review it and let you know if you got into the program. You’ll either join a wait list or start treatment right away. Preliminary tests may include drug testing, physical assessments, psychological assessments, testing for sexually transmitted diseases, and consultations with therapists.

After this process, you’ll be shown your room and given a tour of the facility. Staff will explain the typical schedule for day-to-day activities and expectations. Then, you’ll start treatment.

What to Expect in State-Funded Rehab

State-funded rehabs, like other centers, typically offer evidence-based therapies like cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and motivational interviewing. They’ll likely offer less 1:1 time with therapists and focus more on group sessions and peer recovery groups like Alcoholics or Narcotics Anonymous, which use the principles of the 12 Steps.

Clinicians and treatment providers will likely expect you to attend each session and socialize with peers during meals and free time. You may take assignments and homework with you after sessions, like a journal prompt or writing exercise to fill out. And though the center may not offer family therapy or have a family program, they’ll have a phone you can use to call loved ones at set times in the day. Your phone and electronics will likely go into a locker for safekeeping during your stay, given back at your release.

Challenges and Considerations

State-funded addiction treatment comes with several challenges and caveats, just like private treatment. Knowing the potential challenges can help you make an informed decision that’s most beneficial to you and your recovery.

Wait Times

Many people qualify for state-funded rehab, which can lengthen wait times. Each facility can only take a set number of patients at a time; once a current patient graduates, they can take someone off the waitlist. 

Not everyone has time to wait, though, which can make state-funded care an impractical option for some. While waiting, you can apply for lower levels of care (like outpatient instead of residential) or broaden your scope to rehabs further away. You can also attend peer recovery groups in the meantime—read our article on what to do if you get waitlisted for more tips and strategies. 

Limitations of State-Funded Rehabs

Due to limited funds, state-funded rehabs can’t offer all the bells and whistles of a private rehab funded by private insurance or out-of-pocket payments in full. A few limitations include:

  • Lack of 1:1 therapy
  • Fewer therapies available
  • Less activities and variety in daily life
  • Treatment plans aren’t personalized to each patient
  • Lack of advanced and/or alternative treatments, like ketamine therapy, transcranial magnetic stimulation (TMS), and trauma-focused therapies

Alternatives to State-Funded Rehab

Depending on impractical wait times and your willingness to attend a state-funded rehab, you can consider various other options to still get the care you need at an affordable cost. These include:

  1. Not-for-profit centers (offer treatment for lower costs; primarily funded by donations).
  2. Scholarships offered by the treatment center. You can check their websites or reach out to their admissions team to see what scholarship options they may have.
  3. Centers with sliding scale fees. Check with their admissions team to see if this is an option.
  4. If you direly need to detox and receive intensive care, go to the nearest emergency room for assessment and inpatient detox services at a hospital.

Affordable + Accessible = Hopeful

Going to a state-funded rehab connects you to vital recovery resources, including detox services, residential care, and a continuum of outpatient services to keep you on the path to long-term recovery. While these centers admittedly lack luxe amenities and more personalized treatment plans, they serve a vital need and purpose in the treatment industry—restoring lives and inspiring hope.

You can use Recovery.com to find rehabs near you and see photos, reviews, pricing information, and more.

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Does Rehab Work?

Going to rehab requires investing what you can’t get back: time (and money). It’s an investment in your future and wellbeing. 

Fortunately, it’s time and money well spent since rehab does work for various reasons, mainly willingness to get help and a commitment to recovery. While it’s true that rehab isn’t a guaranteed success for everyone, if you have those in your pocket, you’ve got no reason to doubt rehab will benefit you. 

What Is Rehab?

Rehab is where you go for intensive treatment for addiction and/or mental health conditions. You can go to rehab for drug and alcohol addiction, mental health conditions, eating disorders, and co-occurring conditions (having an addiction and a mental health condition, for example).

You don’t have to be at your rock bottom or last leg to go to rehab. However, those with more urgent or intense needs often attend rehab because it’s the most intensive form of treatment—compared to outpatient levels of care or therapy sessions every so often. But reaching that point isn’t a prerequisite for treatment.

Rehabs typically provide both medical and therapeutic care, helping patients detox if needed, address health needs, and then begin the process of emotional growth and healing. Rehabs can vary widely in terms of the therapeutic approaches they use and the specific therapies offered. But you’ll often see a blend of evidence-based and holistic therapies tailored to comprehensive recovery.

Effectiveness of Rehab

No level of treatment expertise, fancy therapies, or luxurious amenities can guarantee rehab will be effective—thankfully, those aren’t what you need to make it successful for you. Here’s an overarching look at what makes rehab effective:

  • Desire to attend treatment
  • Commitment to recovery; willing to ‘put in the work’
  • Personalized care
  • Qualified staff

Success Rates

About 75% of people with an addiction recover1. Because recovery is diverse and variable by person, few ‘true’ statistics for the success of rehab specifically exist. But many researchers, clinicians, and scientists agree willingness to get treatment and get better leads to success. 

Factors Influencing Success

Going to rehab and getting treatment is largely credited for recovery, though not everyone who recovers from an addiction or mental health condition receives formal treatment in rehab. But for those who do, the length of time in treatment correlates strongly to its success2.  

Care that aligns with your preferences and culture can also improve your chances of success. For example, if spirituality plays an important role in your life, treatment that includes that will likely resonate better with you. 

Components of Effective Rehab Programs

Several components, such as a broad range of approaches, personalized care, and compassionate staff, set rehabs up for success.

Evidence-Based Practices

An evidence-based practice means there’s evidence backing its effectiveness. It’s been vetted by scientists, clinicians, and published case studies demonstrating how and why it works, and who it may not be as effective for. 

Examples of evidence-based practices include:

Personalized Treatment Plans

Therapies are more effective when they’re delivered in a personalized treatment plan. For example, if horses scare you, equine therapy probably wouldn’t be a great fit for you. Instead, a center with personalized care plans would offer you another option, like art therapy or EMDR.

Personalized treatment accounts for your conditions and diagnoses, cultural background, family history, and your preferences. Tailored treatment can help you connect more to the recovery process and feel hopeful on your journey.

Challenges in Measuring Rehab’s Effectiveness

Trying to measure the overall effectiveness of rehab is a bit like answering the question, “Does going to college mean you’ll get a good job?”

Theoretically, yes. But everyone’s experience is different. If you went to college, even got into Harvard, but didn’t put in the effort to pass your classes and loathed your time there, you wouldn’t get the same post-graduation results as someone who studies, does all their homework, and wants the education for the job they have in mind.

Similarly, someone who goes to rehab but doesn’t engage in treatment with the goal of recovery won’t have the same experience as someone who does. For them it wouldn’t be as effective, even though they went. 

Most Outcomes Go Unmeasured

Rehabs may try to collect information on their success rates so they can publish it on their website and make their outcomes public. But gathering that information takes time and work. Even if a rehab sends out a short questionnaire to each patient a year or so after their discharge,

  1. Not everyone will respond.
  2. There’s no way of knowing if their responses are truthful.
  3. People may do the survey but decline to have the information collected and published, especially if confidentiality is a major issue.

Plus, addiction can be a relapsing disorder3 like asthma and diabetes. Some consider ‘successful treatment’ as a recovery with zero relapses. Some view relapses as a natural part of the recovery process—they happen, but don’t mean rehab didn’t work. There’s no right way to feel about relapses. But they can alter the overall perception of rehab’s effectiveness.

Patient Experiences and Testimonials

Rehab can have life-changing effects, whether people go once, twice, or two dozen times. Many rehabs post the testimonials of past clients, highlighting their experiences in treatment. We asked two of our own at Recovery.com for their stories: Amanda Uphoff, Chief of Staff, and Cliff McDonald, Chief Growth Officer.

Success Stories

Amanda describes her rehab experience as this,

“My first residential treatment experience was eye-opening in that I truly learned the meaning of the phrase, “Wherever you go, there you are.” I was hoping for a silver-bullet situation, only to find that I was still me, with the same obsessions and character defects, just in a different place. I wasn’t ready to do whatever it took, and ended up back in treatment a couple years later. This program was a much better fit for me: gender-specific, farther away from home, and with a strong spirituality component. My recovery took root there, and for the first time, I practiced surrender. I admitted into a step-down IOP program before leaving that residential program, and began working with a mentor assigned through IOP. While relapse is a part of my recovery, I will celebrate 5 years of continuous sobriety this year. Don’t quit before the miracle!”

Amanda Uphoff, Chief of Staff

Cliff says, 

“I went to the same residential treatment center (rehab) twice in 2018 – the first time I went I didn’t want to go and I went because my family gave me an ultimatum – I checked myself out “AMA” (against medical advice) after two weeks. The counselors and the staff implored me to stay longer as they knew I was far from being prepared to deal with the real world – I had no idea that I was a really sick person and I was so naive. At the time I had a 34 year relationship with alcohol and hadn’t gone more than a week or two without being intoxicated from alcohol. I did manage to have 90 days of sobriety followed by a brutal relapse which landed me back there for a second tour – the relapse convinced me that I was powerless as I truly didn’t want to drink again. In the first week of my second visit I experienced a major shift in mindset and willingness and I surrendered – that was almost six years ago – I don’t think I could have achieved sobriety without residential treatment and I may not even be alive today had I not had this second opportunity with residential treatment. I am so grateful that these resources were available for me.”

Cliff McDonald, Chief Growth Officer

Challenges and Setbacks

Some people go to rehab to appease others. They don’t want to be there or recover, which makes committing to the process harder. A lack of willingness can become a setback when someone goes through the motions of rehab, gets released, and immediately goes back to substance use. While relapses don’t erase progress, they can delay long-term recovery and the benefits that come with it.

Rehabs with low-quality care can also set back someone’s recovery. Cost doesn’t always mean the care will match the value; any rehab can have great, or less passionate, professionals. Patient reviews, checking what therapies they have, and the clinician’s credentials can shed light on the true quality of a rehab’s care.

Role of Support Systems in Recovery

The support of family and friends can make all the difference in someone’s recovery4. They can 1) offer encouragement and motivation to stay committed to recovery and 2) help their loved one find their treatment options and go with them to any initial appointments as emotional support.

Many rehabs involve related or chosen family in the recovery process directly through family therapy. This setting helps the family unit heal emotional wounds, process their addiction, and strengthen relationships. Family members also learn how to better support their loved one once they return home, which can be crucial in preventing a relapse—and helping families know what to do if one happens.

Alternatives to Traditional Rehab

The ‘traditional’ route of residential rehab may not work for everyone, and that’s okay. Many other options exist just for that reason. For example,

  • Peer-support programs: Peers in recovery lead these sessions, instead of therapists or other mental health professionals. Groups may discuss a certain topic, challenges they’re facing, or what’s going well in life. They form bonds and a crucial sense of belonging. The 12-Step meetings of Alcoholics Anonymous (AA) are an example of a peer-support program.
  • Alternative treatments: A more holistic approach may appeal to those with different cultural backgrounds or spiritual preferences. Alternative treatments include Ayurveda, acupuncture, nature therapy, supplements, herbal remedies, and more. 
  • Psychedelics: As an emerging treatment option, psychedelics are becoming a more mainstream treatment option for addiction and mental health recovery. For some, they can have a more immediate and long-lasting effect than traditional therapies and medications. 
  • Virtual options: Virtual rehab is also becoming more and more mainstream. Those living in remote areas or with mobility limitations may find virtual options most effective.

Continuing Care and Relapse Prevention

Imagine treatment for a broken leg—even if you spend a lot of time at the hospital and leave with it in a nice cast, it still needs help and attention to heal completely. If you began walking on it, not going to follow-up appointments, or even taking the cast off simply because you got released from the hospital, the results wouldn’t be good.

Addiction treatment often follows a similar scenario. If you leave rehab and return to all your usual habits and behaviors, neglecting follow-up sessions and maintaining your progress, it’ll likely be much harder to stay on the path to recovery. 

Importance of Aftercare

Aftercare begins after you leave rehab. It’s less intensive and requires less time than residential treatment, like weekly therapy sessions and 12-Step meetings. Residential rehabs often offer their own form of aftercare, which typically includes check-ins from staff and resources for the patient to connect with help 24/7. 

Aftercare serves as a crucial median between the world of residential rehab and outside life5. It eases the transition, helping patients strengthen their newfound recovery and avoid relapse. It also solidifies that patients are still cared for and valued, even after they leave intensive care. 

Back to the example of the broken leg, aftercare would look like using crutches and going to all your doctor’s appointments. You would avoid stairs, bumpy terrain, and practice pain-reducing habits like icing and elevating your leg to make the recovery process smoother. Addiction recovery isn’t all too different—you’ll avoid places you used to go to use substances (like a bar or club), go to your aftercare sessions and join a recovery group, and practice habits like self-care and stress reduction to proactively address the intense emotions that could lead to relapse. 

Strategies for Long-term Success

Recovery is an active state you have to continually choose. Strategies and habits can strengthen this practice and help you get back on track in case of a relapse. Here are some examples:

  1. Have accountability partners. Identify which friends or family members could help you stay accountable to your sobriety. They may send you a text each morning to check in, or they can be the person you call when cravings and temptations get strong.
  2. Integrate self-care into your routines. This doesn’t mean take a bubble bath every night (though you could), rather, to habitually practice activities that relieve negative emotions and bring you joy. Set aside a little time each day to spend time doing these activities.
  3. Connect to a support group. Join a local recovery community to stay in regular contact with others in recovery. This could be a 12-Step group, a SMART (Self-Management and Recovery Training) Recovery group, or even a sports league with people in recovery.
  4. Prioritize continued care. Maintaining your recovery is as important as achieving it in the first place. Going to therapy or an outpatient program can help you navigate stressors and challenges as they arise, strengthen your overall recovery, and keep you connected with treatment professionals. 

Making The Decision to Enter Rehab

How do you know if going to rehab is the right thing to do?

A crystal-clear answer likely won’t come—you’ll have to listen to yourself and your gut. Ask yourself questions like,

  • Do I want to keep living the way I am now, or am I willing to make a serious effort for change?
  • Can I get through a day without using substances?
  • Are the physical effects of stopping too uncomfortable to bear? (Note: it’s always safest to detox in a professional setting and not by yourself.)
  • Can I really get better on my own or do I need help?
  • Will I lose relationships with my loved ones if I go on like this?

You can start your search for the best treatment for you using Recovery.com. Talk about it with your support system, too; they can help you with the technical details and offer emotional support.

As you make your decision and commit to treatment, keep in mind rehab isn’t a cure-all and often reaps benefits based on your willingness to recover, and if you’re ready to commit. Not everyone goes to rehab once and never relapses again, and that’s okay. 
Rehab is much more than a substance-free place—it teaches you skills for recovery, connects you to peers, and addresses underlying causes of addiction through therapy and personalized healing. Find a rehab that fits your needs on Recovery.com.

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Can You Be Predisposed to Addiction?

Your genes affect your hair color, height, personality, and even your music taste. But can they go so far as predisposing you to a substance or behavioral addiction? Research says yes—but the reasons aren’t as cut-and-dried as having a certain gene or not. 

But in any case, it’s crucial to note that being predisposed to addiction doesn’t mean you’ll become addicted. Other factors contribute much more heavily to addiction, like your environment, life situation, past traumas, and more.

When The Apple Doesn’t Fall Far From The Tree

Certain genetic functions and traits can pass through families and predispose you to addiction, much like being predisposed to a condition like diabetes, depression, or heart diseases. The DNA you inherit can make you up to twice as likely to develop an addiction compared to someone with a different genetic makeup. 

So if your parents or grandparents have had an addiction, you’re more likely to develop one too. The likelihood varies slightly by substance, but hovers around 2x for most. 

This phenomenon has been meticulously studied and documented, mainly because it can seem so counterintuitive. If you see first-hand how an addiction has hurt a parent and affected your life, falling into the same patterns would seem like the last thing you’d expect to happen. But those genetic variables, plus your environment and life history, can turn casual substance use into an addiction right under your nose.

Genes Related to Addiction

Several genes code for different traits and predispositions that can lead to addiction. These genetic influences show a pattern of causation, but the exact reasons for those patterns isn’t as well-known or understood, yet. Here are a few examples of specific genes and genetic variants that can predispose someone to addiction:

  • One variation of the dopamine receptor gene can make you more susceptible to the addictive effects of substances because it changes how substances influence your brain’s reward pathway.
  • Variations in genes Per1 and Per2 can trigger someone (especially a teenager) to drink more alcohol than another, especially when stressed.  
  • People can be more likely to develop an alcohol or opioid addiction if they have a certain variation in their mu opioid receptor gene.
  • Dual copies of a gene called CHRNA5 makes people twice as likely to become addicted to nicotine, since the coding of that gene makes cells more sensitive to nicotine.

Is There an “Addiction Gene?”

In short, no. No one gene codes someone to become addicted to substances. And even for the genetic variations that can lead to addiction, it’s not a given that having those WILL make you addicted. That’s because addiction is the product of much more than your DNA. 

While there are “risk genes,” these aren’t the same as a gene that guarantees addiction. More often, genetic addiction risks relate to how your brain processes risk and reward, and if you’re more or less impulsive. How your brain regulates dopamine signaling also contributes to addiction risk, which is determined by your genes and various genetic variants.  

The Role of Epigenetics

Your behaviors and environment can activate or deactivate parts of your genes, a process called epigenetics. These changes aren’t to the DNA itself, but rather how your body reads and interprets genetic sequences. This can result in more or less proteins being made and when your body makes it, which can have cascading effects throughout your body. Epigenetic changes are reversible, unlike DNA mutations. They’re also what determines the function of your cells, like whether they become heart cells or nerve cells. 

A change in your behavior or environment could result in an epigenetic change that makes you more susceptible to addiction. For example, a highly stressful situation (like job loss) could vary how your body reads a sequence of DNA, triggering the small biochemical changes that make you more susceptible to addiction—like altering how your reward pathway handles dopamine. 

The epigenetic changes that make addiction more likely can happen with or without the inherited changes that can predispose you to addiction. 

Stress and Trauma as Triggers for Change

Trauma at any stage in your life can result in epigenetic changes, designed to help you survive in some way. These changes can also be passed down from a mother to her child. For example, mothers who experience greater stress and poor nutrition during pregnancy pass down epigenetically altered genes and the higher risk for diseases and addiction.

Chronic stress associated with trauma or other events can change how genes are expressed. The hormone released when we’re stressed, glucocorticoids, makes these changes through epigenetics. Other physiological changes related to hormones like adrenaline and cortisol also make epigenetic changes, altering how genes are read and expressed. When these changes affect your reward pathway, decision-making skills, and dopamine levels, you can become more predisposed to addiction.

Environment: The Other Side of The Coin

Your environment greatly affects if you do or don’t become addicted to substances or a behavior, like gambling. Did you grow up around others who used substances, or in a traumatic and chaotic home? Did your peers at school normalize substance use? Is instability and stress a daily norm for you?

Factors like these strongly contribute to both substance use and mental health conditions like depression, complex post-traumatic stress disorder (c-PTSD), and more. 

Social pressures make up your environment, too. If everyone around you uses substances, you’re more likely to as well. They might even encourage it as a bonding mechanism. Being genetically predisposed to addiction can make these environmental influences all the more impactful.

Would Knowing Risk Levels Lower Addiction Rates?

If you knew you had a higher risk of addiction based on your genes, would you be less likely to drink or take drugs? Some people might, but not everyone.

Studies found genetic risks don’t usually inspire changes in behavior. Risk doesn’t equal sureness, so people may not feel they need to make any changes. 

However, some people would find that information invaluable, much like discovering their genetic risks for cancer could help them navigate its prevention and treatment. It might inspire them to them take the appropriate steps to screen for it regularly and catch it early on. Depending on their risk levels, they may make changes to their lifestyle and diet to lower their risk of developing cancer. 

Similarly, someone who knows they’re at-risk to develop addiction can make lifestyle adjustments (like not drinking) and work on stress-management to lower their risk.

Knowing Your Risk Without Genetic Testing

You don’t need lab results to let you know if you’re predisposed to addiction or more likely to develop it. While that’s the most accurate route, you can also take a look into your past.

Did you have a parent or grandparent that struggled with addiction? You’ve likely inherited small genetic variations that make it more likely for yourself. And, that might also mean you’ve grown up in an environment that would contribute to addiction’s development. You may have PTSD, a mental health condition, or chronic stress from an unstable household or emotionally unavailable parenting, which can all heighten your chances of addiction.

Reflect on how drinking or taking drugs makes you feel—this can be another great indicator of your addiction risk, but it takes mindfulness and being willing to recognize issues. Ask yourself,

  • Do you feel markedly less afraid, anxious, or stressed after drinking or taking drugs? 
  • Do you like yourself better after you’ve drank or taken drugs?
  • Do you feel like you need it?

Recognizing these results early on and proceeding cautiously can prevent casual use from becoming an addiction. You may decide to abstain all together if the potential for addiction feels too great. The choice is yours. 

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Addiction vs. Habit: What’s the Difference?

Do either of these sound like a true addiction, something that has the power to disrupt lives? Cause death, even?

“I’m addicted to these chocolates! I buy them without even thinking about it.” 

“I’m so addicted to watching my TV show at night! I love ending my day with TV!”

“I got so addicted to having a latte in the morning! I can’t imagine life without it now!”

These proclamations align more with habits, which are activities practiced regularly and usually without much thought. Think of brushing your teeth, wiping your shoes on the mat before stepping inside, or turning the lights off before you leave the house. 

Correctly identifying a habit versus an addiction can help you understand your potential need for treatment and empathetically communicate with others.

Addiction and Habits Defined

So a habit and an addiction aren’t the same thing—Why? What are they?

What Is a Habit?

The Merriam-Webster dictionary defines a habit1 as ”an acquired mode of behavior that has become nearly or completely involuntary.” In some contexts, the word habit can appear synonymous with addiction, but they differ quite drastically. Swapping one for the other can inadvertently cloud the truth of an addiction and the effects it can have.

Examples of habits include:

  • Having a cup of coffee in the morning
  • Talking evening walks
  • Reading before bed
  • Meditating
  • Making your bed 

If needed, you can choose to not do a habit. Though doing it may come instinctually, you could stop with some conscious effort. Even if it feels a bit weird or uncomfortable, it doesn’t cause physical withdrawal symptoms or consume your thoughts. 

What Is Addiction?

Addiction is a “chronic, relapsing disorder2 characterized by compulsive drug seeking and use despite adverse consequences.” The medical community defines addiction as a brain disorder, since it changes the brain circuits related to self-control, reward, and stress. Even after someone stops taking drugs (including alcohol), these brain changes persist.

At first, someone usually has control over their substance use and chooses to initiate it. But once the self-control aspects of their brain become impaired, so does their ability to control their compulsions and cravings. 

Some people are more at risk of developing an addiction2 than others. For example, one person can take or leave an alcoholic drink, while another may try a drink once and feel an immediate draw to the substance, until it becomes essential. Several risk factors, like genetic predispositions, childhood abuse, and influential environments, make repeated use and addiction more likely. 

Examples of addiction include:

Addiction primarily differs from a habit in that stopping has consequences. Many people who try to stop experience withdrawals, which are physical and mental reactions to not having the substance3. Someone with an alcohol addiction, for example, may experience tremors and sickness if they try to stop—even seizures and death. 

Characteristics of Habits and Addictions

Habits and addictions form differently and have distinct characteristics that set them apart. 

Formation and Development

You’ve probably heard the adage: “It takes 21 days to build a habit.” In reality, the timeline differs from person to person and depends on how much effort they put into solidifying their habit. All habits form through repetition4 and the positive reinforcement they bring. Habits become automatically followed formulas in your brain with triggers, actions, and results. For example, going to your bathroom sink after showering triggers the action of brushing your teeth. You get clean teeth and better dental health as a result, which reinforces the action.

Addictions form differently. They may start voluntarily2, like winding down for bed with a glass of wine. But as the circuits and functioning in your brain change, and your tolerance to the substance builds, your voluntary enjoyment becomes compulsive. Self-control fades. You need more and more of the substance to get the feelings you want. Your body can grow dependent on the substance too, leading to painful and potentially dangerous withdrawal symptoms when you try to stop or cut back.

Control and Consciousness

You can stop a habit at-will. Could you imagine going through painful withdrawals or intense emotional angst if you didn’t make your bed in the morning? You could stop any habit and, usually, suffer only mild inconveniences or discomfort. Conscious effort and practice are all you need to break a habit.

Addiction requires more than conscious effort plus a desire to stop. Even though you may know and feel the negative effects on your life, the urge to take substances overrides all reasoning. You could decide to stop and throw out all your substances but find yourself buying more a day later. Life without the substance seems scary and unmanageable—much different than a life without taking your shoes off before going inside.

Impact on Daily Life

Making your bed, brushing your teeth, and taking a shower all have positive impacts on your life. You give yourself a cleaner space, you improve your oral health, and you take care of your hygiene—all good things. Some habits may have no tangible effect on your life, like checking your phone in the morning. Habits also differ person-to-person, affecting their lives differently depending on their personalities and ways of living.

Addiction often has a devastating impact across the board. You may spend more time and money procuring and consuming substances, leading to job loss and financial crises. Your actions under influence could sever relationships, leading to divorce or being cut off from loved ones. In dire cases, substances and the actions people take when impaired can lead to legal consequences and death.

Psychological and Biological Factors

Both a habit and an addiction affect your brain, but addiction has a stronger impact.

Brain Chemistry

Both habits and addiction come from neurotransmitters traveling through certain pathways in the brain. The positive results of habits (like saving money by shutting off your lights) reinforces them, much like the positive feelings from substances can reinforce their use. Dopamine, a neurotransmitter, drives this feel-good sensation5 and encourages you to repeat the action.

With substance use, these pleasant feelings and the release of dopamine increase tenfold. That’s what most drugs are meant and designed to do—make people feel good and enforce repetition. They send a rush of dopamine through your brain’s reward system6, telling you to do it again because it has a positive result. As your brain adapts to the unnatural effects of the substance and overflow of dopamine, it learns to stop making its own. It becomes hard to feel pleasure any other way, causing cravings and urges to use the substance. 

Psychological Dependence

Once you become addicted to a substance, procuring and taking it can consume your thoughts and affect your mental state. You may feel emotionally reliant on it to relieve stress, discouragement, or boredom. A habit doesn’t consume your thoughts—even if you like doing it, it’s not an absolute necessity.

Physical Dependence

Taking less of a substance or stopping altogether can lead to withdrawals, which is why many people in treatment need professional detox services. Depending on the substance and how long you’ve been taking it, withdrawal can include symptoms like7:

  • Tremors
  • Headache
  • Irritability
  • Flu-like symptoms
  • Vomiting and diarrhea
  • Insomnia
  • Hallucinations
  • Seizures

If you don’t make your bed in the morning, you know it won’t make you throw up or have a seizure. That’s another way habits and addictions vary.

Behavioral and Social Implications

Seeing someone pull out their phone in a slow checkout line doesn’t come as a surprise; you probably wouldn’t even notice it. But what if they took out a liter of vodka, or shook pills into their hands? 

Social Acceptance

Habits are generally accepted and encouraged—online, you can find almost endless lists of suggested habits and books dedicated to building healthy habits. Addiction is met with stigma and seen negatively by the public. Those with addiction often hide their behaviors to avoid consequences and the stigma surrounding addiction.

Conversely, telling a friend you meditate with your morning cup of coffee would likely garner admiration and respect, casting you in a positive light. 

Behavioral Flexibility

Integrating new habits, or stopping one, usually just takes a bit of focus and effort. They can become part of your routine in just a few days or weeks. Stopping an addiction, however, isn’t nearly so simple. It often requires professional help and detox services to safely undergo withdrawals. It can take months or years to mentally, physically, and spiritually recover.

Recognition and Diagnosis

How do you know if something you do is an innocent habit or problematic behavior?

Identifying Habits

Perhaps the easiest way to identify a habit vs. an addiction is to stop doing it and see how it feels. Do you think about it all the time and feel distressed? Do you feel sick not doing it?

You can also ask yourself how your life changes, positively or negatively, if you cut out the activity. Are you happier, are your loved ones happier? Do your relationships improve? If you notice a positive change, that’s a good sign your habit may have been a problematic behavior or an addiction.

Diagnosing Addiction

A medical professional diagnoses addiction; the information provided here or anywhere else online isn’t a diagnosis. But you can use online resources to identify your concerns and acknowledge your need for professional help. An overview of the diagnostic criteria for an addiction8 is as follows: 

  1. Substance use becomes out of control, where you take more than intended and can’t cut back, despite wanting to.
  2. Craving the substance.
  3. Spending significant time getting the substance, taking it, and recovering from its effects (often in secret).
  4. Continuously taking the substance despite clear consequences at home, work, and socially.
  5. Substance use prevents you from fulfilling your obligations and responsibilities.

Treatment Approaches

Many treatment approaches can help you heal from addiction. Small behavioral changes and tips can help you break a habit, too.

Breaking a Habit

Several tricks and strategies can help you break habits like checking your phone when you feel bored, stressed, or need to pass the time. For example, you could leave sticky notes to remind you not to do something, limit your screen time, or sell/throw away the item to stop the habit.

Staying mindful of your behaviors and actions can also help you break a habit. You can modify habits with habit stacking4, which uses one habit (like brushing your teeth) as a launchpad for another (like checking your calendar afterward.)

Treating Addiction

Various treatment approaches for addiction offer healing to everyone. Generally, approaches include:

  1. Evidence-based
  2. Holistic
  3. Alternative

Personalized treatment plans usually blend these approaches to your specific needs so you can engage in evidence-based therapies, holistic services, and alternative treatments all together. 

Therapy is often the cornerstone of addiction treatment, including cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and eye movement desensitization and reprocessing (EMDR). Detox and medications also serve as important aspects of recovery, especially for more severe cases. In all stages of recovery, support groups can serve as an invaluable place to connect with others in recovery and build resilience.

Professional Help

Getting professional help for addiction is often vital to recovery. Many treatment professionals can help—your primary care physician may be the first step, who can then suggest next steps and refer you to other providers. This could mean you start inpatient treatment and detox, long-term residential treatment, outpatient levels of care, or therapy.

You’ll likely work with at least one therapist, along with medical professionals to manage withdrawal symptoms safely. You may also work with group therapists and providers specialized in trauma treatment, or another type of mental health condition.

Forming New Habits in Recovery

Addiction recovery often involves new habits, like dedicating time to attend support meetings, practicing self-care, and making time for your relationships. You may even add meditation, journaling, or exercise to your daily routine, too. New habits like these can strengthen your overall recovery and improve your quality of life.

Leverage the power of habits, now knowing how they come to be and how you can optimize your routines for your benefit.

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Reshaping an Industry: Quality Care and Advocacy as Tools for Recovery

We were honored to have Marvin Ventrell, CEO of the National Association of Addiction Treatment Providers (NAATP) on our podcast this week. All three of our hosts gathered to lead an insightful, fun conversation on the treatment space and Marvin’s ideas for improvement. 

Listen to Marvin Ventrell’s episode to learn more about the improvements the NAATP has made in addiction treatment, how they plan to make a broader impact, and how Marvin’s career as an attorney and man in recovery led him to their leadership.

Beginnings of an Impactful Career

Marvin began his career in his early twenties as an attorney. Marvin has also worked as a teacher, director, and CEO of a previous organization. He spent 15 years working in the child and family welfare system, authoring influential books and building the practice of law for children, which became recognized as a specialization by the American Bar Association (ABA). 

Marvin recognized the need for the addiction treatment industry to have the same structure and ethical guidelines as children’s law. At the NAATP, Marvin immediately strived to expose the “bad stuff” in the industry as the first step to improvement, saying, 

“So we’re going to look in at our, we’re going to clean up our own house. And we’re going to create an ethics code. And if you can’t follow it and you don’t fit it, you’re out.”

This met immediate critique and pushback, but Marvin and the NAATP persisted. Much of Marvin’s passion for improving the treatment space and broadening people’s ability to access quality, ethical treatment comes from his own recovery story.

A Personal Passion for Ethical Treatment

“I’m working in this field largely because I am a person in long term-recovery.”

Marvin began using substances like alcohol and marijuana in highschool, where partying was seen as a sign of ‘coolness’ as it still often is. His substance use continued throughout college and into law school, where a professor even urged students to not turn to substances to manage stress. Marvin recalls,

“My attitude was like, well, you don’t know me. I can. I can do it. I can do both…. Yeah, normal person can’t drink and get straight A’s, but I can.”

Marvin became a successful attorney, married, and found continued success in his career with leadership roles. Then finally, in his late thirties/early forties, a switch flipped and casual use turned into an addiction. 

“And I then needed the substances. I couldn’t not have them. And I, and I was breaking.”

Marvin’s previous company, which he was the CEO of, lovingly directed him to get treatment. He did, and Marvin has been sober since. His treatment experience taught him more about the treatment industry, as did his wife’s recovery journey. It also pointed out a dire need for change.

Leading The Charge in The NAATP

The NAATP lists vetted, accredited, and licensed treatment providers that abide by their ethics code and quality assurance manual. In short, they’ve taken as many liberties as possible to ensure any provider that’s part of the NAATP will be ethical and focused on providing high-quality care. The NAATP also offers a guide for selecting treatment.

Our co-host, Cliff McDonald (Chief Growth Officer), notes this about the beginnings of Recovery.com and the notable impact the NAATP has had on each facet of the treatment space:

“They [Recovery.com founders] have modeled the ethical standards that we have for our business after NAATP. They credit NAATP and you as the ones that turned around the space and cleaned it up. So that is wonderful.”

When Marvin and the NAATP voiced concerns about the ethics of the treatment space and exposed shady practices, they promptly received pushback and criticism for “talking crap” about the treatment industry. They were even sued, but won the case. Marvin responds to such critics with,

“And, you know, that’s not what I was doing at all. I was saying, look, we’re wonderful, but we’ve got to recognize where the poison is and get it out so that we can be successful.” … “And, because we thought, you know what we need, if we need to get smaller to get better, we’ll get smaller to get better.” … “And within a year of our, removing, if you will, certain members and not having others renew or allowing others to renew, we grew. Significantly beyond where we started, right? And so we made our footprint in ethics.” 

The NAATP also launched a recent initiative to measure outcomes in addiction treatment using their strong ethical and quality standards. This allows treatment providers to improve their programs with applicable, actionable data.

Goals in The Recovery Space

Marvin and the NAATP recognize stigma as a tall barrier to treatment. They’ve made progress in reducing stigma through addiction education, which is an ongoing goal for the NAATP.

Marvin also discusses emerging trends in substance use, like increased deaths from alcohol and stronger marijuana. The effects of these trends are another reason why he and the NAATP want to ensure people seeking treatment have a trustworthy place to find it.

Treatment Decided by Doctors and Scientists, Not Accountants

Marvin explained how insurance coverage works for behavioral health treatment and how insurance companies often dictate who gets treatment, and what level of care they receive; not doctors or scientists with education on the matter. Marvin says,

“In any universe that I can imagine, managed care means that the scientist doesn’t decide what health care you get. The accountant decides what health care you get.”

Ideally, insurance companies would respond better to a documented clinical need for a service and cover treatment. Reshaping how and what insurance covers improves access to care and has the power to reduce stigma as more conditions and needs are recognized as clinical conditions deserving compassionate care.
This episode dives into these subjects and more with humor, compassion, and intrigue. Listen to Marvin Ventrell’s episode now to explore these topics further and learn more about the addiction treatment industry.

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What Happens in Family Therapy?

Family therapy for addiction or mental health conditions may come as an unexpected aspect of treatment. If you’re not the one getting treatment, why are you getting involved? Many families initially wonder the same thing.

Many family members also want to, and would, do anything to help their loved one get better. If that means going to family therapy, they’ll do it in a heartbeat, even if it’s unexpected. Others may feel more skeptical and resistant, depending on the nature of their family dynamics and their mental health literacy. 

However, each group will likely have the same question: what’s family therapy like? What happens? 

We’ll help you learn more about it and what to expect in this article. You can also explore more about family therapy and group work by listening to our recent podcast episode with Dr. Claudia Black.

What Is Family Therapy?

Some family members first assume family therapy means hearing everything they did wrong and getting blamed for their loved ones predicament. That’s false. If behaviors from family did contribute to the patient’s condition, that will likely come up, but in a respectful, compassionate way. Family therapy isn’t a trick for the patient and their therapist to gang up on family members—it’s meant to restore loving relationships and heal their family dynamics.

The therapist, psychologist, or counselor who leads family therapy strives to help both the patient and their loved one verbalize and work through problems with respect and love, not judgment or blame. Through open communication, patients and their families can resolve issues, forgive, and learn how to modify potentially harmful behaviors. 

Many treatment centers strongly suggest and offer family therapy as part of their core treatment. That’s because family therapy has the power to heal relationships, improve the support system of the person in treatment, and give the whole family unit hope in recovery. You can also attend family therapy as a stand-alone service, without your loved one being in a residential or outpatient program.

Goals and Reasons for Family Therapy

The ultimate goal of family therapy is to help the person in treatment get better. Since family is often an extension of ourselves, their involvement in this healing is often crucial. 

And, after patients leave treatment, the closest and most impactful support system they return to is often their family. Discussing concerns, past issues, and resolving conflict in family therapy can create a stronger support system for when they get back. 

Another crucial reason for family therapy is to give loved ones the chance to heal. They often have their own recovery journeys to walk, even if they weren’t the one struggling with an addiction or a mental health concern. For example, some family members fall into codependency as a way to have some grasp at control over their loved one’s condition. Family therapy can help you recognize your own recovery needs and process the experience of your loved one’s condition without guilt, anger, or self-responsibility.

What Family Therapy Looks Like: First and Continuing Sessions

Family therapy typically begins once your loved one has stabilized, expressed approval for family therapy, and has shown initial progress in their treatment. This means your sessions could start anywhere from a couple weeks to 1+ months after they admit into treatment. It’ll depend on their preferences and progress. Once they’re ready and their treatment team determines it beneficial, you’ll come in for your first session.

Before that, you’ll likely meet with the family therapist to go over expectations, ask questions, and become more comfortable in the space. This might happen as soon as your loved one admits into treatment or just before your first official session.  

First Session

Your very first family therapy session will likely include these key parts:

  1. Setting expectations together.
  2. Agreeing (and even signing a written contract) on how you will conduct yourself and treat others in your session. For example, you may all sign a contract promising to listen without interrupting or to not raise your voices.
  3. Outlining what your goals are for family therapy and how the therapist will know if they’re being met.
  4. Defining a direction and plan for your future sessions.
  5. If time allows, diving into how everyone’s feeling and any conversations they’d like to have now, or something they’d like to understand about their loved one in treatment.

You’ll likely sit in a small, private room—probably the therapist’s office, or the designated family therapy room if the treatment center has one. Your sessions will stay confidential and what’s shared won’t leave the room. Before you leave, your therapist may check in with how you’re all feeling and how you think the session went.

Continuing Sessions

Treatment centers vary in how often they provide family therapy. Some will schedule it once a week or once every couple weeks; others will designate 3-5 consecutive days for loved ones to engage in education and family therapy. This format is called a family week, or family program. Family programs often split their focus between 1) education and multi-family support groups and 2) family therapy with the patient and their loved ones. 

If your loved one isn’t participating in a residential or outpatient treatment program and instead attending family therapy as a stand-alone treatment, your sessions may be more regular and adaptable to your schedules. For example, you could request weekly or bi-weekly appointments. 

In continuing sessions, you’ll build off the goals and outlines set in your first session. They may also flow more organically, addressing issues as they arise or as they come to mind. For example, you may talk about something that happened recently or, during your session, your discussions may remind you of a past event you want to go over.

You’ll check in continuously with others and the therapist to ensure you’re meeting the goals set in the beginning, and that you’re finding the therapy beneficial. If you have changes or suggestions in mind, you may discuss these at the very beginning or end of the session.

Who Can Go to Family Therapy?

You don’t need to share DNA to go to family therapy. Chosen family can come too—anyone who supports the patient and that they trust. When asking the patient about family therapy, the therapist will see who they’d like included or excluded. Here are just some of the people that can come to family therapy:

  • Parents
  • Siblings
  • Friends
  • Cousins
  • Step-siblings
  • Step-parents
  • Coworkers
  • Children
  • Foster parents
  • Foster children
  • Grandparents
  • Grandchildren
  • Honorary and/or chosen family members

Is Family Therapy Required?

No. The patient may not want to engage in family therapy, or family members may not want to participate. No one is forced to, though family therapy is often strongly recommended.

For example, patients who were abused and traumatized by their families would not find it appropriate to bring their family members into treatment. Their treatment providers would agree. In these cases, and any other time the patient doesn’t want their family involved, family therapy will not be required or pursued.

Family Therapy vs. Family Education

Therapy and education for families aren’t the same things. They may overlap in some ways, but they have different goals and purposes. 

Family Therapy

Family therapy aims to heal relationships and reconnect loved ones, strengthening their bond and support system. They learn how to communicate better and process disagreements with respect and love. 

Family Education

Family education focuses on teaching loved ones about addiction and mental health conditions. It covers how conditions develop, contributing factors, and the recovery process. Families learn the biological background of addiction and mental health conditions, helping them see behavioral health conditions don’t arise from a lack of willpower. 

If a treatment center offers a family program, they may include workshops and presentations from a variety of professionals or those with lived experience. These sessions are often more interactive between the educator and other family members. 

Family therapy will likely touch on these aspects as questions arise or to explain behaviors of the patient. But the main focus of family therapy isn’t education.

Resources for Family Healing and Education

Family members have many resources and support available, whether their loved one is in treatment or not. 

Online Resources and Groups

Here’s a few online resources to access support:

Call Lines

And here are some numbers you can call for support or crisis care:

Books

These books offer education and support for family members of someone with behavioral health concerns:

  • Undaunted Hope by Dr. Claudia Black, “Stories of Healing from Trauma, Depression, and Addictions”
  • Unspoken Legacy by Dr. Claudia Black, “A far-ranging examination of how the effects of addiction and trauma in the family can reverberate for generations”
  • Codependent No More by Melody Beattie, “How To Stop Controlling Others And Start Caring For Yourself”
  • Addict in The Family by Beverly Conyers, “Rather than providing simple solutions or definitive answers to every question, Conyers’ careful research and warm writing offer education and support from those who “have been where you are” and the healing, isolation-breaking power of shared experiences.”

Family members can also attend individual therapy to discuss their experiences, process trauma, and develop coping skills in a 1-1 setting. These private sessions offer greater personalization and may be helpful for family members who don’t feel comfortable sharing in a family setting.

Ultimately, family therapy in rehab benefits both the person in treatment and the ones who love them. It’s often a critical aspect of recovery, and one you can support simply by attending and participating in sessions. 
To learn more about family therapy and its importance in recovery, you can listen to our recent podcast episode with expert Dr. Claudia Black!

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Does a Relapse Erase Progress in Recovery?

Does a relapse erase all your recovery progress? Definitely not. 

While setbacks can be discouraging, they’re a totally normal part of recovery. In fact, they can be a hugely helpful opportunity to identify triggers, take advantage of professional help, and build an even stronger support network. Relapse is a chance to learn, grow, and keep taking steps toward the best version of yourself.

What Does Relapse Mean in Drug Use or Alcohol?

Relapse, in the context of addiction recovery, is a return to drug or alcohol use after getting sober. The American Psychological Association defines relapse1 as the “recurrence of substance abuse after a period of abstinence.” 

After all the work you put into your recovery, you might wonder what happens if you relapse. The recovery journey isn’t linear, and feeling like you’re taking a step backward can be discouraging—but it doesn’t erase the progress you’ve made. Instead, it’s a chance to identify underlying triggers, strengthen your coping mechanisms, and recommit to staying sober. It’s a common hurdle on the road to recovery.

Why Did I Relapse?

Understanding why you relapsed can help you prevent problems down the road. Common triggers can be internal or external. 

  • Internal triggers usually have to do with emotional distress like anxiety, depression, or boredom. These can lead to overwhelming urges to use substances to cope.
  • External triggers can include social situations where drugs or alcohol are present, people from your past who enabled your addiction, or places you associate with your past substance use. 

Identifying your specific triggers is a hugely helpful step toward preventing relapse. By recognizing triggers and developing skills for coping with them, you’ll empower yourself to stay focused on your life in recovery.

What’s the Difference Between a Slip and a Relapse?

While a slip-up might involve one instance of unplanned substance use, a relapse is a more serious return to old behavioral patterns. 

A slip is an unplanned, isolated incident of substance use after being sober for some time. It might be fueled by a strong craving or an unexpected situation. A slip doesn’t necessarily signify a return to full-blown addiction. But it does serve as a warning sign that you may need to adjust your recovery plan.

A relapse, on the other hand, indicates a more serious setback. It involves a return to regular or problematic substance use, and is usually accompanied by old behavioral patterns. A relapse might involve using for a longer period or neglecting other areas of life, and may require you to restart formal treatment.

While both slips and relapses can be discouraging, they can also be valuable learning experiences. By acknowledging what happened and getting help to correct its cause, you can return to your path with renewed determination and perspective.

What Counts as a Relapse?

The line between a slip and a relapse can be blurry. So what, exactly, counts as a relapse?

  • Frequency and quantity of use: A relapse might entail daily or near-daily use, exceeding the amount you previously used before recovery, or using for an extended period.
  • Impact on daily life: A relapse disrupts your daily functioning. You might neglect responsibilities like work, school, or relationships as substance use takes priority.
  • Loss of control: Cravings are overwhelming and you struggle to control your substance use, even when you genuinely want to stop. 
  • Return to pre-recovery behaviors: You re-engage in activities or social circles that are heavily associated with your past addiction. This could involve using with old friends or in familiar settings.

A single slip doesn’t define you. But experiencing these behaviors might signal a relapse and the need to recommit to your recovery plan with additional support.

Relapse as an Opportunity for Growth

Kara of Sober Girls Houston says relapse was a huge part of her recovery journey.2 The numerous relapses, time in jail, and stays in rehab were all opportunities for reflection that eventually led her to break through the beliefs that kept her stuck in unwanted patterns. She cites one particular relapse as a breakthrough moment: 

That relapse provided an opportunity for me to get honest with myself, be desperate enough for change, but most importantly drop the ego. I needed that I needed that relapse.

All those struggles helped her get clearer on her relationship with herself, and with recovery. Today, she’s more proactive about making relapse prevention a part of her daily life.

I have to do things on a daily basis that take care of me, and it’s a very clear program now that I work for myself. That has been absolutely life-changing for me.

For Many, Relapse Is Part of Recovery

Hufsa Ahmad, who struggled with intense episodes of psychosis and suicidality after being severely bullied in school, says her mental health relapses3 taught her important lessons about long-term recovery:  

“Those 4 relapses were the lowest points in my life. Yes, I suffered greatly, but I gained something from every relapse: 

  1. Empathy: I learned what it’s like to live with mental illness. 
  2. I saw how much my friends cared about me: something I was so delusional I couldn’t see on my own. 
  3. I witnessed what the illness took away from me, but I also saw what I could gain from it.
  4. That relapse is part of recovery: that I will fall over and over again, but the important thing is to be proactive about relapse not reactive to it; to stay vigilant and take care of myself because my relapses—my struggles—have made me the person I am today.”

Proactively Preventing Relapse

Thankfully, the causes of relapse aren’t a mystery. Research shows that these factors make relapse more likely: 

Causes of relapse among women5 include difficulty severing ties with their substance-based social networks, how their self-worth is affected by relationships with men, and interpersonal conflicts that increase negative thoughts.

Conversely, these factors protect against relapse: 

Rebuilding After a Relapse

If a relapse does happen, it doesn’t have to derail your entire recovery journey. Plenty of resources are available to help you get back on track.

Professional Help

Reconnect with your rehab center. If you attended inpatient treatment, your rehab likely has resources available for alumni. These might include refresher courses, retreats, or connections to groups in your local community.

Look for a short-term or outpatient rehab program. A short-term stay at a rehab of your choice, or an outpatient program at a treatment center near you, can give you the time and space you need to stabilize yourself and adjust your recovery plan.

Find the best alcohol treatment or prescription drug treatment centers near you using our treatment finder tool.

Reach out to your therapist. Let your therapist know what you’re going through. Consider increasing your session frequency for a while to give yourself additional support during this vulnerable time. Together, you can explore the triggers that led to the relapse and develop ways to address them. 

Social Support

Surround yourself with positive people who support your recovery. When you feel safe to do so, let your trusted loved ones know about your relapse and lean on them for strength and accountability. Beyond friends and family, your support network might also include your AA sponsor, recovery peers, or other people from your sober community. 

You Can’t Change the Past, But You Can Rewrite the Future

No one wants to relapse, but the clarity you gain from tough moments can be transformative. Kara reflects on how her perseverance empowered her to build a better relationship with her daughter: 

The legacy that I am able to leave behind is one of a woman who really messed up in a big way, but never gave up. And now I’m affecting my life and her life and our family’s life as a whole. I can’t change the past, but we are rewriting the future. And it’s the most amazing experience.”

You, too, can rewrite your future. Find a treatment center that helps with chronic relapse, and regain control of your life. 

Frequently Asked Questions About Relapse in Recovery

Does one drink break sobriety?

Whether or not one drink breaks sobriety depends on what recovery philosophy you adhere to. For people who practice complete abstinence, having one drink can be a significant event. Even for those who don’t, it could signal a change that’s worth paying attention to. What’s important to remember, however, is that while a single drink might be a setback, it doesn’t erase all the progress you made. Use slip-ups as opportunities to assess what went wrong and adjust your recovery plan accordingly, and focus on progress, not perfection.

Is relapse a part of recovery?

Yes, relapse is a common occurrence in addiction recovery. In fact, many people who struggle with addiction will relapse at some point.

Relapse can be a valuable learning experience. It can help you identify your triggers and build your coping strategies to better manage them in the future. It’s important to seek help from your therapist or an addiction treatment specialist after a relapse to get back on track with your recovery plan.

How can I help someone who has relapsed? 

There are a few steps you can take to help someone who has relapsed:

  • Act with compassion: Listen without judgment and offer emotional support.
  • Set boundaries: Avoid enabling behaviors while still encouraging their recovery efforts.

Support them in getting professional help: Encourage them to seek help from addiction treatment specialists via inpatient rehab or an outpatient program.

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Finding Sobriety, Strength, and Hope as an “Alcoholic in Long-Term Recovery”

This week’s podcast episode features one of our Recovery.com cohosts, Cliff McDonald! Cliff is the Chief Growth Officer at Recovery.com and identifies as an alcoholic in long-term recovery. In this episode, Cliff shares his recovery story and details his path as a successful entrepreneur, Wall Street businessman, coach, father, and mentor. 

You can find Cliff’s episode and listen to our past guests here. 

“A Ticking Time Bomb”

rehabpath cliff mcdonald 2

Cliff was raised in a robust Irish Catholic drinking culture. His father, a Boston police officer and professional boxer, along with his grandfather, a decorated World War II veteran, both drank heavily. Alcohol was a staple at family gatherings, where even as a child, Cliff had “sips of beer” and occasionally Jameson whiskey. By 13, Cliff had not gotten used to alcohol but to also anticipate opportunities to drink.

“I had this other life where I was getting severely intoxicated with my friends since I was 13 years old. And that was a secret. And that remained a secret for a long time, until it didn’t. So, I experienced wholeheartedly the progressive nature of this disease.”

Cliff played football in high school and at Dartmouth College, where he sank deeper into the party culture and drinking habits of fraternities. His once-stellar grades dropped. At this point, he started noticing how he drank more than everyone else and seemed more reliant on it, especially during the off-season.

Cliff followed most of his college peers to Wall Street and made a successful career. He married and moved to Madison, WI, where he opened and ran several Irish pubs. Then, his father passed away at just age of 55, which Cliff suspects was because of his drinking. 

The slow-burning fuse became a racing flame. 

Gradual Descent to a Public Rock Bottom

As Cliff navigated the challenges of losing his father, managing a business, and balancing the responsibilities of parenting and marriage, drinking shifted from a habit to a necessity. He expanded his career beyond owning Irish pubs by taking on the role of COO at a company. But during visits to check on the pubs, what started as a routine beer gradually escalated to a beer paired with a shot. About this, Cliff says, 

“So these little changes, right, over time, and then, the next phase, which ended up being this real, real chaos for about 18 months, two years, when I became severely alcoholic.”

After having one too many at a company party, Cliff was let go. In 2018, he went to rehab for the first time but checked himself out after 14 days. His counselor said he’d see him again. Cliff recalls, 

“So I went home here to Madison and I had 90 days of sobriety. Brutal sobriety. Not going to meetings, not having a sponsor, just white knuckling it.”

And then, 

“After 90 days, I decided that it would be okay to have a drink.”

Wading Through The Mire

Life darkened after that drink. Cliff’s wife didn’t want him living in their house if he drank again, and held firm to that. He ended up in his own apartment, unemployed, and drinking around the clock. 

“I think I was drinking to die. And, really, no will to live.”

Cliff also remembers, 

“People were reaching out to me for a while, like, checking in, and I remember I wouldn’t answer the phone a lot, because I didn’t want to talk to people, and I was hiding.” … “Then the phone stopped ringing, and I had never felt alone in my whole life, and I was alone in this apartment without, it’s crazy, with no one near me, no one checking in on me.”

After not hearing from him for a few days, Cliff’s wife made a welfare check and found Cliff needing dire help. He returned to treatment after detoxing in a hospital for 6 days. 

Rising to Recovery

Cliff’s second time at rehab had a much different effect. Remembering what his counselor told him this second time, Cliff quotes, 

“”Some people are alone. You’re not. You have people who still love you and still care for you.” And it hit me. Like it hit me and it hit me hard.”

A spiritual experience and working the 12 Steps of Alcoholics Anonymous set Cliff on the path of long-recovery. After rehab he went to sober living, and then got a sponsor. His therapist at the sober living home told him: 

“She referred to me as a ticking time bomb. She was like, it’s amazing. You held it together as long as you did, and you were just destined to explode. And you did. Now we can do the rebuilding, but let’s dive into why.”

As for what kept him on the path to recovery the second time, Cliff says, 

“So therapy was huge. Prayer and meditation is huge. Fellowship is huge.”

Now, Cliff sponsors other men in recovery and brings his lived experience with addiction and the treatment space to his work as our Chief Growth Officer. He’s also written a book, called Don’t Sell, Generate Revenue. You can buy that here. 


Cliff credits his recovery and his Higher Power with reinstating his creativity, leading him to entrepreneurship and business success again, and being the husband and father he wants to be. Listen to his episode on the Recovery.com Podcast to hear more!