Tag: Drug Addiction

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How Occupational Therapy Advances Mental Health and Substance Use Recovery: Dr. Sarah Anderson

Important Note: In this article, I will use the term “Occupational Therapy Practitioner” (OTP) to refer inclusively to both Occupational Therapists (OTs) and Occupational Therapy Assistants (OTAs). This distinction is important because “Occupational Therapist” refers specifically to professionals with advanced education, training, and responsibilities. OTs hold a master’s or doctoral degree, while OTAs are required to have an associate degree and work under the supervision of an OT. If the term “OT” is used in the article, it will be to highlight a role or responsibility specific to Occupational Therapists that differs from that of OTAs.

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

Occupational Therapy in Mental Health and Substance Use Recovery: An Introduction 

Mental illness and substance use disorders impact more than just a person’s thoughts and beliefs about themselves, others, the world, and their relationships—they also greatly affect an individual’s ability to participate in daily life. Many mental health conditions can make it challenging for a person to get out of bed, brush their teeth, shower, make breakfast, care for themselves and others, and engage at work or school. While most mental health and substance use recovery centers have therapists and other psychiatric practitioners who can support processing trauma, emotional regulation, medication management, and inner child healing, very few have specialized professionals who can support skill building to enhance engagement in everyday life. This is where Occupational Therapy (OT) comes in. 

Occupational therapy practitioners (OTPs) are experts in helping people build skills needed to manage day-to-day life. These skills include decision making, time management, goal setting, communication, cooking, organization, establishing daily routines, as well as many others. 

OTPs focus on practical, personalized solutions that empower clients to engage in meaningful daily tasks, referred to as “occupations.” Within the field of OT, these occupations are categorized into ten distinct areas:

  1. Activities of Daily Living (ADLs) 
  2. Instrumental Activities of Daily Living (IADLs)
  3. Work
  4. Education
  5. Play
  6. Leisure
  7. Sleep
  8. Rest
  9. Health management
  10. Social participation1

OT is a broad and versatile field. You can find OTPs working in settings such as pediatric clinics, schools, hospitals, hand therapy, dementia care, and neuro-rehabilitation centers. Although only a small percentage of OTPs specialize in mental health today, the roots of the profession are deeply grounded in psychiatric care, making OT an essential part of recovery for many individuals2.

A Brief History of Occupational Therapy in Mental Health 

While some aspects of the profession can be traced back to the 1800s, OT as we know it today didn’t emerge until the early 20th century3. The profession was founded on the belief that meaningful engagement in daily activities could promote recovery and well-being for individuals with mental illness. The idea that participation in purposeful activities could help improve mental health was groundbreaking and laid the foundation for the profession2 which remains, to this day, the heart of what we do as OTPs.

In the early years of the profession, OTPs worked primarily with individuals who were institutionalized3, using activities to help patients develop a sense of purpose and reduce boredom. However, as medical and behavioral health care evolved, the role of OT expanded beyond psychiatric practice. Due to this expansion and other challenges, OT’s presence in mental health settings has decreased over the years2. Only about 2% of OTPs work in mental health4, which makes it challenging for people to access OT.

Occupational Therapy’s Role in Mental Health 

OT in mental health focuses on helping individuals participate in activities that give their lives meaning and structure. For individuals experiencing mental illness and/or substance use disorders, it can be challenging to maintain daily routines or manage the demands of work, school, and relationships. OTPs help clients identify activities that are important to them and develop strategies to overcome barriers that prevent participation5. 

Before working with a client an occupational therapist will evaluate a client’s current abilities to perform a variety of daily activities and work with them to set realistic and achievable goals. These goals often focus on improving self-care, building coping strategies, addressing sensory processing challenges, developing executive function, enhancing social skills, and establishing routines. For example, a client struggling with depression may find it difficult to get out of bed in the morning or prepare meals. An OTP can help by working with the client2 to develop a morning routine, break tasks into smaller steps, and use strategies to overcome fatigue or lack of motivation.

OTPs also focus on helping clients develop coping mechanisms to manage symptoms related to mental illness. For individuals with anxiety, this may involve teaching relaxation techniques or helping them use sensory-based strategies to reduce stress and dysregulation. For people with ADHD, it may include creating structure and organizational strategies to help them stay on track with tasks. 

It’s important to know that OT doesn’t stop at skill building; one of the core focuses of the profession is ensuring integration of learned skills into daily life. It’s not just about teaching and having clients practice skills in therapy; it’s about helping them take the skills and apply them in real time. The ultimate goal of OT is to help clients build and implement the skills they need to lead fulfilling, balanced lives.

Working with Clients in Substance Use Settings

Substance use disorders often co-occur with other mental health conditions such as trauma, anxiety, depression, and ADHD. OT can play a vital role in helping individuals with substance use disorders rebuild their lives5 by focusing on establishing healthy routines, improving self-care, and finding new ways to experience joy and fulfillment without the use of substances.

One of the key ways in which OTPs help individuals in substance use treatment is through exploration and development of leisure skills5. Clients with substance use disorder often lose the ability to engage in healthy, fulfilling leisure activities. Additionally, boredom is frequently reported as a significant trigger for relapse6 as it can lead to feelings of restlessness, isolation, and frustration. These are feelings that many people seek to reduce through the use of substances. 

Additionally, OTPs help clients in substance use recovery develop practical skills5 for daily life in recovery. This includes managing finances, preparing meals, finding and maintaining employment, and self-care. For many people in recovery, these are areas that are often neglected during substance use, and relearning how to manage them can be overwhelming. OTPs work with clients to break these tasks into manageable steps, build confidence, and develop the skills needed to maintain independence.  

In substance use recovery, OT empowers clients to explore new hobbies, interests, and activities that bring joy and meaning to their lives. By nurturing independent living skills and establishing structured routines, OT not only promotes a journey of healing but also lays a foundation for long-term recovery.

A Brief Overview of Mental Health Occupational Therapy Interventions 

OT interventions vary depending on the specific mental health condition a person is experiencing. For individuals with anxiety disorders or those who have experienced trauma, interventions might include developing coping strategies to manage symptoms7, such as deep breathing, progressive muscle relaxation, or sensory modulation techniques. If a client were experiencing depression and struggled to engage in self-care tasks, an OT would likely focus on establishing a daily routine2, setting small, achievable goals, and finding ways to increase motivation and energy. Clients with ADHD require an approach that focuses on creating organizational systems, such as using a planner, breaking tasks down into manageable steps, and using visual supports, like a timer, to stay on track. 

Additionally, OTPs are specially trained to assess and address sensory processing challenges, which are common among people with mental health conditions like anxiety, ADHD, OCD, bipolar disorder, SUD, and trauma. This is one of the most unique aspects of the profession. Sensory processing refers to how the nervous system receives and organizes sensory information8 from the environment so that individuals can respond appropriately. 

Dunn’s Sensory Processing Model helps occupational therapists understand a person’s unique sensory preferences by categorizing these preferences into four patterns: Sensory Sensitivity, Sensation Avoiding, Sensation Seeking, and Low Registration. Someone with sensory sensitivity patterns will likely become more easily overwhelmed with stimuli9 such as bright lights or loud sounds, which can lead to feelings of anxiety or agitation. In contrast, someone who has sensation seeking patterns will crave more intense input, such as jumping, pushing, or spinning, to feel calm and focused. 

By identifying a client’s sensory profile, occupational therapists can tailor interventions to support their nervous system needs so that they are more regulated and able to engage in their daily life (Pfeiffer et al., 2018). 

Summary

OT plays an essential role in the recovery journey for those with mental health disorders and substance use issues. While the profession may not be as well-known in mental health settings as other types of therapy, its unique focus on helping people engage in daily life makes it an essential part of the recovery process. Whether working on establishing a morning routine, building coping strategies, or developing new leisure skills, OTPs help clients regain a sense of purpose, independence, and fulfillment in their daily lives.

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25 Inspiring Quotes for Veteran’s Day

Veteran’s Day is a time to honor and celebrate the courage, sacrifice, and dedication of our military veterans. It’s a moment to pause and reflect on the freedoms we enjoy and the extraordinary individuals who have served to protect them.

Words have a unique power to connect, uplift, and inspire. On this day, we use them to express our deepest gratitude for the sacrifices made by veterans and their families. Through heartfelt quotes and messages, we aim to convey the appreciation they deserve for their selfless service and enduring commitment.

Join us in honoring these heroes by sharing words of gratitude that celebrate their unwavering bravery and dedication to our nation.

25 Inspiring Quotes for Veteran’s Day

Quotes about Honor and Sacrifice

#1: “A hero is someone who has given his or her life to something bigger than oneself.” — Joseph Campbell

#2: “We don’t know them all, but we owe them all.” — Unknown

#3: “This nation will remain the land of the free only so long as it is the home of the brave.” — Elmer Davis

#4: “On this Veteran’s Day, let us remember the service of our veterans and let us renew our national promise to fulfill our sacred obligations to our veterans and their families.” — Dan Lipinski

Quotes about Courage and Bravery

#5: “Courage is almost a contradiction in terms. It means a strong desire to live taking the form of readiness to die.” — G.K. Chesterton

#6: “Bravery is being the only one who knows you’re afraid.” — Franklin P. Jones

#7: “Never was so much owed by so many to so few.” — Winston Churchill

#8: “How important it is for us to recognize and celebrate our heroes and she-roes!” — Maya Angelou

Quotes of Gratitude for Veterans

#9: “To be free is the most wonderful thing in the world, but it comes at a great cost. Thank you, veterans, for paying that price.” — Unknown

#10: “In the face of impossible odds, people who love this country can change it.” — Barack Obama

#11: “The willingness of America’s veterans to sacrifice for our country has earned them our lasting gratitude.” — Jeff Miller

#12: “Veterans are a symbol of what makes our nation great, and we must never forget all they have done to ensure our freedom.” — Rodney Frelinghuysen

Quotes from Veterans Themselves

#13: “The true soldier fights not because he hates what is in front of him, but because he loves what is behind him.” — G.K. Chesterton

#14: “America’s veterans embody the ideals upon which America was founded more than 229 years ago.” — Steve Buyer

#15: “Some people live an entire lifetime and wonder if they have ever made a difference in the world. A veteran doesn’t have that problem.” — Ronald Reagan

#16: “I have long believed that sacrifice is the pinnacle of patriotism.” — Bob Riley

Famous Historical Quotes for Veterans

#17: “The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract.” — Abraham Lincoln

#18: “Freedom is never free.” — Unknown

#19: “In war, there are no unwounded soldiers.” — José Narosky

#20: “My heroes are those who risk their lives every day to protect our world and make it a better place—police, firefighters, and members of our armed forces.” — Sidney Sheldon

Modern Quotes for Veteran’s Day 2024

#21: “Honor to the soldier and sailor everywhere, who bravely bears his country’s cause.” — Abraham Lincoln

#22: “A veteran is someone who, at one point in their life, wrote a blank check made payable to ‘The United States of America’ for an amount of ‘up to and including their life.'” — Unknown

#23: “To our men and women in uniform, past, present, and future, God bless you and thank you.” — Anonymous

#24: “For it is the veteran, not the preacher, who has given us freedom of religion. It is the veteran, not the reporter, who has given us freedom of the press.” — Unknown

#25: “As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them.” — John F. Kennedy

How to Use These Quotes on Veteran’s Day

Sharing on Social Media

Veteran’s Day is an opportunity for all of us to come together and show our appreciation for the incredible sacrifices made by veterans. Sharing a heartfelt message or a meaningful quote is a simple but powerful way to honor their service. Consider taking a moment to reflect on what veterans’ sacrifices mean to you personally, and share those thoughts with others. Whether it’s through a conversation, a handwritten note, or a post on social media, your words can make a difference.

You can encourage others to join in by tagging veterans you know, thanking them directly, or highlighting the importance of their contributions. Using hashtags like #VeteransDay2024 and #ThankYouVeterans can help connect your message to a larger community of gratitude. 

More than anything, let your voice be a part of the collective recognition and support for those who have served. Your words of appreciation, no matter how small, have the power to remind veterans that their sacrifices are seen, valued, and deeply respected.

Including in Speeches or Letters

Veteran’s Day quotes hold the power to deepen our expressions of gratitude and honor for those who have served. Whether used in speeches, public ceremonies, or personal letters, they help us articulate the profound respect we feel for veterans’ sacrifices and dedication. 

In a speech, a well-chosen quote can set the tone or leave a lasting impression, highlighting the significance of their service. At public ceremonies, including a quote during a moment of silence or tribute, such as a flag-raising, adds depth and solemnity to the occasion. Personalized letters gain even greater meaning with a thoughtful quote that frames your message of thanks. In group gatherings, sharing a quote during a toast, prayer, or discussion encourages reflection on veterans’ contributions and sacrifices. 

However they are used, these quotes serve as a powerful connection to the enduring legacy of our nation’s heroes, ensuring their service is remembered and honored.

Creating Veteran’s Day Cards

Creating Veteran’s Day cards with meaningful quotes is a powerful way to honor the sacrifices and service of our veterans. These cards serve as a personal gesture of gratitude, showing veterans that their efforts and dedication are recognized and deeply appreciated. Including a meaningful quote alongside a heartfelt message allows you to convey your respect and admiration in a thoughtful way. Reminding veterans that their service has made a lasting impact and that their sacrifices are valued, offering them a tangible reminder of the gratitude felt by those they have served.

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What Is the Opposite of Addiction? Exploring Self-Esteem and Connection

While sobriety is an important part of recovery, many experts argue that true healing involves more than just quitting substances. Connection, self-esteem, and a supportive community all play huge roles in overcoming addiction and rebuilding your life.

The Conventional View of Opposites

The Traditional Perspective

Humans tend to think of things in binaries. We might envision pairs like hot and cold, light and dark, or addiction and sobriety when we think about opposites. 

If we think of addiction and sobriety as two ends of a spectrum, addiction is a lack of control over substance use, and sobriety is freedom from that dependency. In this view, it’s logical to assume that the ultimate goal in overcoming addiction is to stay sober. But the truth is, real recovery means so much more than that. 

Limitations of This View

While sobriety is an important aspect of recovery, viewing it as the sole solution to addiction can be limiting. The problem with defining recovery as simply stopping substance use is that it doesn’t address other dimensions of addiction. Getting sober without addressing the deeper root causes of addiction—like unresolved trauma or other mental health conditions—leaves us vulnerable to relapse. This is why some recovery communities use the term “dry drunk” to describe someone who’s sober but still living the emotional experience of active addiction. 

Recovery involves more than just abstaining from substances—it requires deep self-exploration, strengthening your self-esteem, finding purpose, and building a supportive community. By focusing only on sobriety, we may overlook other aspects of recovery and the true nature of the work that’s required to create lasting change.

The Idea of Connection as the Opposite of Addiction

Journalist Johann Hari popularized this concept in his 2015 TED Talk, reflecting on his quest to uncover what causes addiction.1 After losing a relative to a drug overdose, Hari set out to learn more about addiction. His journey took him into unexpected spaces all over the world. After talking to countless people from all walks of life, he concluded,

Almost everything we think we know about addiction is wrong. And if we start to absorb the new evidence about addiction, I think we’re going to have to change a lot more than our drug policies.

Hari began to realize that shaming people because of their addiction was “almost like the importing of the logic of the Drug War into our private lives.” Instead, he decided to take a different approach: 

What I’ve tried to do now—and I can’t tell you I do it consistently and I can’t tell you it’s easy—is to say to the addicts in my life that I want to deepen the connection with them, to say to them, ‘I love you whether you’re using or you’re not. I love you, whatever state you’re in, and if you need me, I’ll come and sit with you, because I love you and I don’t want you to be alone or to feel alone.’ 

Connection and Addiction 

While sobriety is obviously essential to recovery, it’s not the only factor. The modern recovery community is shifting to a view of recovery that makes connection the main focus. This is supported by the famous “Rat Park” study,2 in which 2 groups of rats were given a choice between regular water and water laced with cocaine or heroin. One group of rats was in a bare, lonely cage, while the other was in a park-like environment surrounded by friends, toys, and plenty of opportunities for play. To researchers’ surprise, the rats in Rat Park didn’t care for the drug-laced water at all, despite it being highly chemically addictive. The rats without social connection, however, didn’t fare so well.

This led scientists to believe that addiction has far more to do with our social environment and opportunities for healthy interaction than it does with chemical dependency. Do we feel seen, supported, and loved? If so, we may be far less likely to reach for things that make us feel less alone.   

This is also why building community is such an important part of the recovery process. Meaningful relationships that give us a sense of belonging are powerful protectors from the isolating nature of addiction.

The Importance of Relationships

It’s widely agreed upon in the behavioral health community that our relationships are the number-one predictor of happiness.3 But as our societies modernize, we’re instead becoming increasingly isolated. Hari points out that being pushed further into the digital space is only widening the distances between us:

I’ve been talking about how disconnection is a major driver of addiction and weird to say it’s growing, because you think we’re the most connected society that’s ever been, surely. But…if you have a crisis in your life, you’ll notice something. It won’t be your Twitter followers who come to sit with you. It won’t be your Facebook friends who help you turn it round. It’ll be your flesh and blood friends who you have deep and nuanced and textured, face-to-face relationships with.

Connection in Addiction Recovery

Luckily, the recovery space equips us with plenty of guidance on the importance of relationships in recovery—and avenues for cultivating them. That’s why group therapy, sober living environments, and support groups are such an important aspect of this journey, and why healthy human connection is encouraged in every recovery program regardless of their treatment approach. Social solid connections provide the sense of belonging, purpose, and emotional well-being vital for lifelong recovery.

Redefining the Opposite of Addiction

Self-Esteem and Addiction 

Self-esteem is another often overlooked but utterly essential aspect of healing. And it doesn’t just help you—it helps your whole social network.

We may have internalized the belief that being self-deprecating is helpful to others. But “if you have low self-esteem,” says Paige Alexander of Real Food Recovery, “everybody in the room is paying. If you’re operating from a place of weakness, somebody has to pay for that somewhere. Versus, if you’re operating from a place of strength, with high self-esteem and high worth,4 then you’re in a position to lift others up as well.”

How Self-Esteem Affects Addiction

Chronically low self-esteem can bring down your overall well-being. And of course, this has impacts on addiction and recovery, too. Numerous studies show a link between low self-esteem and addictive disorders.5 Someone with lower self-esteem may be less emotionally resilient, and quicker to give in to maladaptive coping strategies in challenging situations.

It’s worth noting that self-esteem and self-worth are 2 different things. While self-esteem is based on external validation and can change with your mood and circumstances, self-worth is an internal state that has more to do with your core beliefs about who you are.

Self-Worth and Recovery 

The way we feel about ourselves is inherently tied to addiction. Having a clear relationship with yourself can give you a sense of safety and security that forms a solid foundation for your life in recovery.  

Higher self-worth can also help you attract better relationships that support your recovery goals. We naturally gravitate toward people who mirror who we are. So as we grow in our self-worth, we naturally attract higher-quality connections.    

The Role of Self-Esteem in Addiction Recovery

Understanding Self-Esteem

“Self-esteem is your overall opinion of yourself,6 and your beliefs about your abilities and limitations,” says the team at Weber State University Counseling & Psychological Services Center. It’s “shaped by your thoughts, relationships, and experiences, including those related to culture, religion, and societal status. Many beliefs you hold about yourself today reflect messages you’ve received from others over time.”

Better self-esteem can impact everything from your performance at work7 to your relationships to your quality of life, which is why it’s such an important component of recovery.

Building a Healthy Self-Image

Developing a positive self-image involves challenging negative beliefs and growing your self-compassion. You can do this using several strategies:

  • Practice self-care: Make activities that support your physical and mental well-being—like exercise, mindfulness meditation, and hobbies—a normal part of your routine.
  • Celebrate achievements: It’s easy to get so focused on the steps ahead of us that we forget to look back and see how far we’ve come. Give yourself credit for all the work you’ve done, and remember to celebrate your wins, no matter how small. 
  • Surround yourself with support: Build strong relationships with supportive people who make you feel loved and uplifted. Avoid toxic relationships, which invariably erode your self-esteem.
  • Challenge negative thoughts: Learn to challenge negative beliefs about yourself and replace them with more positive, realistic ones. Cognitive behavioral therapy (CBT) can help you do this.
  • Seek professional help: A therapist can give you the guidance and tools you need to start rebuilding your self-esteem and address any emotional blocks that are getting in the way.

Emotional Distress and Addictive Behaviors

Low self-esteem often goes hand-in-hand with emotional distress. When you feel inadequate or unworthy, you might turn to substances as a way to cope with your feelings. Addressing underlying emotional issues and building self-esteem can help you shift away from old patterns and develop healthier coping mechanisms in their place.

The Connection Between Self-Perception and Addiction

Self-Perception’s Impact on Behavior

Self-perception, or how we view ourselves, significantly influences our choices and actions. Negative self-perception can increase vulnerability to addiction. If you perceive yourself as inadequate or unworthy, you may be more likely to engage in self-destructive behaviors—including substance abuse—as a way to cope with your emotions.

Shifting Self-Perception to Aid Recovery

Challenging your negative self-perception is important work in recovery. Cultivating a more positive self-image puts the focus back on your personal strengths and keeps you resilient in the face of life’s inevitable challenges. Here are some strategies you might explore for shifting self-perception:

  • Practice self-compassion: Treat yourself with kindness and understanding, recognizing that everyone makes mistakes.
  • Challenge negative beliefs: Identify and challenge negative thoughts about yourself. Replace them with more positive and realistic perspectives.
  • Focus on strengths: Acknowledge your strengths and positive qualities. This can help shift your focus from perceived weaknesses to areas of growth.
  • Set realistic goals: Establish achievable goals and celebrate your progress, no matter how small. This helps build a sense of accomplishment and boosts self-esteem.
  • Seek support: Surround yourself with supportive individuals who believe in you and encourage your growth.

Strategies for Cultivating Self-Esteem

Affirmations and Positive Self-Talk

Changing your life starts with changing the way you speak to yourself and see the world—and affirmations can help you do just that. By repeating affirmations daily, you can retrain your brain to focus on the positives. 

This is especially helpful when you do it repeatedly. Neuroplasticity, the brain’s ability to change itself by forming new neural connections, requires repetition. Just as addiction “wires” the brain in negative ways, we also have the power to rewire our brain in positive ways. That’s why the AA slogan “nothing changes if nothing changes” holds true.

“If you want to put gas on the fire,” says Mindset Mentor Rob Dial, combine your affirmations with visualization.8 Your brain can’t tell the difference between something that’s actually happening and something you’re visualizing—and you can use that to your advantage. “You’re not just telling your brain,” says Dial. “You’re actually showing your brain what you want.”

Setting Achievable Goals

While setting overly large or complex goals can overwhelm you in early recovery, setting and achieving small goals boosts your confidence and self-esteem. Start with manageable goals and gradually increase the level of difficulty as you progress. And remember to celebrate your successes to reinforce your positive direction.

Seeking Support and Counseling

If you’re struggling to build self-esteem on your own, it’s a great idea to get outside help. Counselors and therapists are specially trained to give you the guidance, tools, and strategies you need to help you develop a healthier self-perception. Counseling can also help address underlying mental health conditions that might be contributing to low self-esteem.

The Transformation Through Self-Discovery

Self-Discovery in Recovery

Addiction recovery requires a deep dive into our inner world to rediscover and change our relationship with ourselves. Understanding what’s important to you—your values, passions, and personal strengths—can help you rebuild your self-esteem and find your purpose in life.

Embracing Change

The recovery journey is one of embracing the change that leads to personal growth. By exploring new ways of being and responding to situations, we become more skillful at navigating life. Embracing change helps us break free from old behavioral patterns and live authentic lives that are truly aligned with our values.

Embracing Self-Esteem as the Key to Recovery 

Getting sober is the first step in recovery, but it’s not the whole story. Recovery is a lifelong process of improving your relationship with yourself, others, and the world around you. And it’s a powerful act of love.

So what is the opposite of addiction? As Hari says, 

The core of that message—you’re not alone, we love you—has to be at every level of how we respond to addicts, socially, politically, and individually. For 100 years now, we’ve been singing war songs about addicts. I think all along we should have been singing love songs to them, because the opposite of addiction is not sobriety. The opposite of addiction is connection.

Seeking Professional Help

Addiction is an overpowering experience, and breaking out of it often requires professional support. A comprehensive rehab program can help you get sober, address the underlying causes of your addiction, and connect with others on the same path. Search addiction treatment centers by price, location, specializations, and more, and reach out to their admissions team to get started on your journey today.

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7 Most Commonly Used Drugs in College

College is where you start new things—new classes, new friendships, new relationships, new jobs, and, for some, drugs and addiction. Many young adults experiment with substances in high school or college, which can lead to more intense use in college; potentially, addiction.

College students tend to use drugs most accessible to them. We’ll cover the 7 most common drugs used in college, emerging trends, and how students can find treatment.

Alcohol: The Top Contender

Alcohol ranks #1 as the top-used drug in college1, with well over half of students reporting they drink. It’s easily accessible, cheap, and found outside class in most (if not all) social settings. College parties and campus Greek culture notoriously include alcohol, often consumed in excess by students with a low tolerance. 

Parties are a regular part of college culture, occurring on game days, weekends, and… spontaneously. Roommates may drink together on non-party days or go to bars after class. Alcohol is seen as celebratory and a catalyst for meeting friends and garnering social connections. Many students struggle to avoid it, even if they’d like to or hadn’t planned on making alcohol a cornerstone of their college experience.

Regular use and binge drinking can lead to addiction and other adverse health effects.

Marijuana: The Most Prevalent Recreational Drug

College students might turn to alcohol for a night out with friends or use marijuana to relax and unwind. Much like alcohol, marijuana is readily accessible on most campuses, regardless of its legal status in the state.

Students may smoke weed to relax after class, to socialize with peers, or because they feel an intense urge to take it. This often signifies an addiction.

Weed use can be more challenging to conceal, since it leaves a distinct odor.

Prescription Pills: A Double-Edged Sword

When used as prescribed, prescription pills can help students navigate chronic pain and mental health conditions like attention deficit hyperactivity disorder (ADHD). College students can also use these medications recreationally.

Use of Prescription Painkillers

Doctors often prescribe opioids for severe pain, typically after a surgery or for conditions like cancer. As an opioid, these medications can also trigger a flood of dopamine2 and sense of wellbeing (especially when not used as prescribed), which reinforces the action. Some college students seek out this effect even after their prescription runs out, or they’re no longer in pain.

Illegal opioids can contain fentanyl, which is a synthetic opioid 50x stronger than heroin3. More college campuses are including Naloxone kits to help students reverse an overdose to opioids or fentanyl. But the best way to avoid the risk is only taking prescribed medications as prescribed.

Study Drugs

A grade can determine a lot—if you get accepted into a competitive program, if you meet requirements for a scholarship, and the quality of future jobs. Many college students also want good grades for their own sense of accomplishment. Achieving A after A isn’t easy, which is why some college students (around 4%) reach for study drugs.

Study drugs are prescription stimulants used to improve focus and energy4, theoretically. Not all cases of taking a stimulant imply this, though. Study drugs include4

  • Adderall 
  • Ritalin 
  • Desoxyn

A student taking one of these medications would likely have a prescription. It becomes a study drug when they don’t have a prescription or don’t take the drug as prescribed (like doubling their dose or taking extra when they have an exam).

Stimulants: Enhancing Focus or Creating Dependence?

The occasional use of a study drug, like once or twice before midterms, can be a regular practice for some college students. Those with heavy course loads or challenging classes, like pre-med or pre-law students, may feel particularly overwhelmed getting through school on their own strength. They can become reliant, and then addicted, to illicit or prescription stimulants like meth and Adderall. 

Some students may turn to caffeine, which is cheaper and more accessible than stimulants. They may take caffeine pills or regularly consume energy drinks. These pills and drinks can have 150-300 milligrams of caffeine each. The recommended daily limit is 400 milligrams, though one person might be more sensitive to caffeine than another. Drinking 3+ energy drinks a day, or having 3+ caffeine pills, puts a student at 450-900mg of caffeine. These high levels of caffeine can lead to heart issues5 and, rarely, death.

Cocaine: The Party Drug of Choice

Media still depicts cocaine as a “luxury” drug used by professionals and rich partygoers. College students’ attitude towards cocaine has become more positive6, leading to more experimentations and mimicking cocaine’s use as portrayed in media. 

Cocaine is a stimulant, causing a sense of euphoria and the ability to ‘let loose,’ which students might find appealing at a party—especially when it’s seen as the cool thing to do. But this can lead to addiction and health consequences, along with poor academic performance.

Ecstasy: The Allure of Raves and Euphoria

Ecstasy is a stimulant that can have psychedelic effects, which is why some college students use it at raves and parties for a more ‘trippy’ experience. Ecstasy often goes by the name Molly. It causes a strong feeling of euphoria and inhibition, but taking too much, too often can lead to addiction and other side effects. 

Ecstasy use correlates to dehydration and serotonin syndrome7, which happens when drugs or prescribed medications add too much additional serotonin. Young, thrill-seeking college students may be especially at-risk of taking too much ecstasy and becoming dangerously dehydrated, addicted, or sick from serotonin syndrome.

Vaping and Synthetic Drugs: Emerging Trends

Vaping Nicotine and Cannabis

College students and young adults in general vape more than older adults8. Vaping is generally seen as a safe alternative to cigarettes (it’s not). Nicotine vapes often come in appealing packaging and with tasty flavors, which a study found was one of the top reasons college students vape. 

Cannabis vapes often have flavoring too, and offer greater convenience compared to smoking a bong or blunt. Students may find this component especially beneficial, but it makes the likelihood of regular use and addiction, plus negative health effects, much higher.

Students can vape other drugs too, including synthetic drugs.

Synthetic Drugs

Synthetic drugs and designer drugs mimic ‘pure’ drugs with natural origins. For example, fentanyl is a synthetic opioid whose natural origin is the opium poppy plant. Synthetic marijuana, or synthetic cannabinoids, mimic the effects of the marijuana plant.

Some synthetic drugs come from clandestine labs and undergo zero quality control or testing. Manufacturers may market them as ‘supplements’ that are ‘not intended for human consumption.’ College students may purchase and take these drugs not knowing their addictive potential, or how they interact with other substances.

Factors Influencing Drug Use: Peer Pressure and Stress

A theme of stress and a desire to connect with others emerges throughout the college experience. Add in a greater tendency for experimentation and thrill-seeking, and you capture more of the landscape for college students and young adults.

Many students face extreme academic pressures and stress, which can lead to mental health conditions like depression and anxiety. Some students alleviate symptoms by chemically altering their state of mind. For example, a study on college students who vape8 reported a top reason was to “improve depression.”

Without effective on-campus support, students may turn to substances to manage stress. College campuses can help by improving access to their counseling services and educating students on the risks of substance use, and what to do if they need help. 

Consequences of Substance Use: Health Risks and Academic Impact

Substance use in college can lead to poor academic performance, below-average grades, lost scholarships, and expulsion. Many colleges have guidelines on substance use and documented consequences, especially as it relates to performance-boosting drugs.

Students also risk health consequences from substance use, including

  • Uncomfortable withdrawal symptoms
  • Higher risk of cancer from the carcinogens found in nicotine
  • Lung and cardiovascular diseases
  • Skin lesions
  • Dehydration
  • Weight loss
  • Addiction
  • Organ damage/failure

Treatment Options and Recovery Resources

Campus Resources

College students have a myriad of recovery resources available to fit their needs. For example, many college campuses offer free or discounted mental health care. Most campuses also have infirmaries that can assess a student’s physical health and recommend the next steps in their care. These clinics can also distribute medications and treat wounds.

Importantly, more colleges now have Naloxone kits available throughout campus. This means you have better access to the overdose-reversing medication Naloxone, which is easy to use and effective. If you notice signs of an overdose, including shallow breathing, blue lips, and unconsciousness, call 911 and administer Naloxone as soon as you can.

Off-Campus Treatment

College students can access off-campus recovery resources via public transit, their own car, carpooling, or by using virtual services. Off-campus treatment includes

  • Residential rehabs, where patients live at a treatment center for 28+ days and receive intensive treatment. Some centers, especially ones specifically for college-aged patients, allow time for schoolwork and attending classes online.
  • Outpatient care, including day treatment (most intensive), intensive outpatient, and general outpatient (least intensive). These structured programs offer robust care with the flexibility students often need to continue attending school.
  • Holistic and alternative treatments like acupuncture, ketamine therapy, yoga, and creative arts.
  • Therapy sessions as needed.

Majoring in Hope and Recovery

College offers a uniquely formative and memorable experience for students. Substances can add dangers and hurdles, but by using available resources, students can find the support they need for a comprehensive recovery.

You can find rehabs for young adults using Recovery.com and compare prices, check insurance coverage, read first-hand reviews, and more.

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The Addiction Cycle: What Are the 5 Stages of Addiction?

Addiction often follows a cycle with distinct stages. It’s repetitive in nature since the act of taking addictive drugs releases dopamine, which reinforces the behavior—causing repetition. 

As this cycle repeats, the likelihood of addiction grows until it’s realized. Thankfully, treatment works at each stage, whether you’ve just started or have been in active addiction for years. 

Stages of The Addiction Cycle

The stages of addiction typically involve initiating substance use, developing dependence, and eventually becoming addicted. This cycle can repeat through relapses, but it can also be broken with the proper support and intervention.

1: Initial Use

Your first time taking a substance counts as the initial use. This could be a beer on your 21st birthday or marijuana between classes in high school. You may consciously decide to take the substance or initiate it due to external factors like peer pressure and a desire to connect with others.

2: Regular Substance Use

After the first use, you may come back to the substance occasionally. These occasional uses can then become a regular part of your routine, like drinking every day after work instead of just during social events.

You may start to plan your day around substance use or start canceling plans that might keep you from it. 

3: Tolerance Development

As your use increases, you’ll grow more tolerant to the substance1 and its pleasurable effects. This means you need more, more often. 

Regular use means your brain receives a flood of dopamine. It can get so used to this, becoming tolerant, that it starts making less naturally2, which can mean you’ll need more of the substance to make up for the loss and take the substance more often to not experience a low.

4: Dependence Formation

You can become dependent on the substance to function without discomfort or unhappiness3, especially as your brain learns to make less dopamine and simply wait for more to come from the substance. 

Physical dependence shows when you feel sick without taking the substance. Your body starts using the substance to meet a sense of homeostasis, and if you stop taking it, you’ll likely feel sick. In particular, opioids can make you feel highly unwell if you stop taking them4 without a professional detox. Alcohol withdrawals5 can lead to tremors, hallucinations, and seizures.

5: Full-Blown Addiction

At this final stage, substance use fully dominates life. It becomes all you think about and what you feel you need to function. Along with feeling physically sick without it, you’ll experience cravings and urges to use the substance. Obtaining and taking more becomes as necessary as eating or sleeping, especially since addiction affects your judgment and decision-making skills3.

People in stage five may show signs of addiction in other areas of life, like having financial issues, losing their job, and having trouble with their relationships. 

The Role of Relapse in the Addiction Cycle

Relapses can trigger the start of another addiction cycle. They can also happen between stages, like tolerance development and dependence formation, when someone tries to stop their use but starts again.

Understanding Relapse

Relapses occur more often than you might think,6 and they’re a common part of the addiction cycle. They typically have a trigger related to your environment and/or emotional state. 

For example, if you’ve been sober a few weeks but meet a friend at a bar you used to go to, the environment could trigger an intense urge to drink that leads to relapse. Overwhelming stress or sadness can also lead to relapse as someone reaches for their old coping tool.

Relapse as a Learning Opportunity

Sometimes, you don’t know about a trigger until it happens. For example, you might unexpectedly realize scenes of drinking or drug use in a movie trigger an urge to take the substance, even though the depiction isn’t real. You might leave the theater feeling frustrated, uncomfortable, and disappointed in yourself—but you shouldn’t.

Now you know to avoid those types of movies. Even if the trigger led to a relapse, you’ve still gained a tool for your future recovery and sobriety. You gain the same learning opportunity from any relapse, regardless of its cause or trigger.

Preventing Relapse

Most people’s ideal recovery journey doesn’t include relapsing. It’s okay if it happens, but it’s also something you can proactively work to prevent. You may practice these skills in professional treatment, like joining a relapse prevention group in rehab. Therapy can teach you how to regulate your emotions and how you respond to them. You can also keep a few strategies in hand to mitigate a relapse before it happens.

  1. Learn a few grounding techniques to distance yourself from the negative emotions caused by a trigger. Here are some examples:
    1. Box breathing. Breathe in for 4 seconds, hold for 4 seconds, and breathe out for 4 seconds until you feel your mind and body calm.
    2. Urge surfing. This practice teaches you to “ride the wave” of an urge, showing you you’re capable of getting through them.
    3. Progressive muscle relaxation. You’ll start by tensing your muscles, holding the tension, then relaxing them. People often work from their toes to their head, tensing and relaxing before moving to the next muscle group, but you can take any direction. 
  2. Write down the trigger and how it made you feel. For example, you might say, I went out for dinner with a friend and I kept smelling the wine at the table next to us. I really wanted some and felt angry that I can’t anymore.
  3. Stay connected to professional support. Maintain regular contact with a therapist, counselor, or mentor. 
  4. Attend peer meetings focused on recovery, like the Alcoholics Anonymous (AA) meetings of the 12 Steps or secular SMART Recovery groups. 
  5. Stay mindful of your emotional landscape. Stressors at work, relationship conflicts, or big decisions can quickly build up and become overwhelming, even if they happen in the background. Being mindful of your emotions can help you know when you need to practice self-care or seek professional help.

Understanding the Signs and Symptoms of Addiction

Knowing how addiction looks is a key step to finding treatment—and recovery. You can look for these signs in someone you love or in yourself.

Identifying Initial Use Signs

Someone who’s started using substances may show signs of inebriation, like stumbling when they walk, slurring their words, or seeming spaced out. Hiding and spending more time alone can be a sign too, as this would keep other loved ones from noticing some of the more obvious signs.

You might notice your loved one going to bars more frequently or attending parties with drinking or drug use. As another example, maybe your spouse starts having a glass of wine every night after trying some at a restaurant.

Recognizing Symptoms of Escalating Use

As use escalates, you’ll likely notice signs like these:

  • They’re around less, spending more time procuring substances and taking them. Young adults especially may spend more and more evenings at parties or bars.
  • Acting secretive or making excuses for why they’re having more of the substance. For example, they might try to subtly refill their wine glass and, when caught, give an excuse as to why.
  • They start struggling with money, spending considerably less on their usual purchases or voicing their worries about paying bills.

Signs of Tolerance and Dependence

As someone’s substance use increases, so does their tolerance and physical dependence on the substance. Signs of this happening often include consuming more of the substance; more enough for you to notice. For example, one glass of wine might turn into one and a half, and then two in a relatively short amount of time. They may seem the same after two glasses as they did after one—that’s because their tolerance increased.

You might also notice they seem distracted and uncomfortable if they don’t have the substance regularly. As their dependence on it grows, they can feel sick, irritable, and unfocused until they have more.

Indicators of Addiction

Once the cycle reaches the addiction phase, you’ll likely notice all the signs from before grow in intensity. For example,

  • They spend more time away to find and take their substance and come down from its effects. 
  • Their struggles become more pronounced—money worries turn into missed payments and evictions. Trouble prioritizing work responsibilities deepens to job loss and unemployment. 
  • Their friend group changes, likely to include others who use the substance and can connect them to more of it. 

What may stick out most is this: they keep using despite consequences to themselves and others. They lose control of their ability to stop. Their reward system has rewired, combining with their physical dependency to create an overwhelming need for the substance. 

Triggers That Contribute to Addiction

Addiction doesn’t happen on a whim. It’s often triggered by something, like the environment you live in, stressors, and mental health conditions. 

Environmental Triggers

Where and how you grow up can contribute to addiction. If your environment gives you easy access to substances, is highly stressful, or includes others who use substances (and encourage or pressure you to, too), you’re more likely to develop an addiction.

Emotional Triggers

Mental health conditions, stress, and grief can all trigger the need for soothing and distraction. Drugs and alcohol can serve as a tool for self-medication, providing temporary relief from symptoms of depression, anxiety, trauma, and others. 

Social Influences

Substance use and addiction can become normalized by your social circle and culture. If everyone around you, whether friends or family, uses substances and struggles with addiction, you’re more likely to as well7. These influences can start the first stage of the cycle: initial use. When substance use is normalized and even a way you bond with others, it can progress through the 5 stages more quickly.

Treatment Strategies for the Addiction Cycle

You can break out of the addiction cycle at any stage. Professional treatment aims to treat both the physical and emotional aspects of addiction, helping you detox safely and process the underlying causes for addiction.

Detoxification Approaches

Detox is often the first step in addiction treatment. It’s the medical process of removing drugs and toxins from your body and bringing it back to homeostasis. Detox professionals may use medication-assisted treatment (MAT) to make the detox process safer and more comfortable.

Many rehabs offer detox as part of their residential programs, or you can detox at a hospital. Once your body is free of toxic substances, you can begin the emotional side of healing.

Therapeutic Interventions

Therapy addresses the root cause of addiction in 1:1, group, or family settings. Your therapist will work with you to uncover how your addiction developed and what purpose it serves in your life. Together, you’ll begin to heal past wounds and learn coping tools to use in the future. Common therapies for addiction include

  • Cognitive behavioral therapy (CBT), which teaches you to catch and correct untrue thoughts or beliefs before they lead to distress. You’ll learn to challenge unhelpful beliefs and black-and-white thinking that can make you feel worse.
  • Dialectical behavioral therapy (DBT) reflects CBT in some ways, but differs in how you respond to emotions and the beliefs you have. It focuses on validating your emotions and experiences and altering how you react to them—like going for a run instead of drinking.
  • Eye movement desensitization and reprocessing (EMDR) helps heal trauma and lower the effects of post-traumatic stress disorder (PTSD). EMDR uses eye-tracking as you recount (verbally or in your head) what happened to you. By following an object back and forth and busying your mind, the memories lose their emotional impact and can be easier to process in just a few sessions.
  • Individual therapy happens with just you and your therapist. You may learn a variety of skills from CBT, DBT, and other approaches during your sessions. You’ll likely explore key issues and develop coping strategies to use once you’re out of treatment.
  • Group therapy can also use skills specific to CBT or DBT, but in a group setting. For example, you may learn a new way to manage a negative emotion and then practice it with others in your group through an imaginary scenario.

Aftercare and Support Systems

Aftercare contributes to an effective recovery journey8. It supports your recovery after you leave more intensive treatment, like residential rehab. Aftercare can include sober living, ongoing therapy sessions, and continued contact with staff from your treatment center. Many rehabs also have strong alumni communities with events, 12-Step groups, and more to keep patients connected and supported long after they leave treatment. 

Importance of Prevention and Early Intervention

Early intervention can be one of the most effective forms of ‘treatment,’ but preventing substance use altogether offers the greatest crop of benefits. Here’s how that can happen.

Preventing Initial Use

Education on addiction and the risks of substance use can encourage people to not take substances in the first place. Open discussions on addiction, especially with children, can teach the realities of substance use. When people know more about it, they can make informed decisions about their use.

Early Intervention Techniques

The earlier an intervention happens, the less likely substance use is to cause addiction8. Studies have shown early interventions from people like doctors, nurses, or counselors during routine appointments can “educate and motivate many individuals who are misusing substances to understand and acknowledge their risky behavior and to reduce their substance use.”

Loved ones can also intervene early and motivate change. This could look like a casual conversation, or something more structured and planned. It depends on your situation and how far their use has progressed.

Breaking The Addiction Cycle

The addiction cycle isn’t a vortex whirlpool-ing you to despair. It can be broken at any point, no matter how many times you’ve spun through it or how long you’ve been spinning. Early intervention, professional addiction treatment, and relapse-prevention strategies offering a mooring line of hope.
You can connect with addiction treatment providers on Recovery.com, comparing prices, amenities, treatment services, and more to find the best treatment for you.

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How Much Does Rehab Cost in California?

Rehabs in California combine addiction treatment with the idyllic setting of a summer vacation. They offer privacy, a change of scenery for those out of state, and coveted year-round warmth, making California a go-to recovery destination.

But how much does it cost?

Average Cost of Rehab

The National Center for Drug Abuse Statistics (NCDAS) found the average cost for rehab is $50,469. This price reflects a stay of 30-60 days. Outpatient programs average around $8,000 per person. 

Services like medication-assisted treatment (MAT), detox, and sober living contribute to the complete price or can be offered as independent programs. An outpatient MAT program, for example, costs around $7,000. Sober living typically costs $1,500-$2,000 per month across America.

Costs of rehab vary due to factors like treatment staff, amenities, and whether or not they accept insurance. For example, a private rehab with highly experienced staff and luxury accommodations will cost much more than a state-funded rehab. 

Rehab Costs in California

California has over 2,000 active treatment centers to serve the nearly 100,000 people seeking treatment in the Golden State annually. It ranks as the 23rd cheapest state in America for residential rehab, with costs averaging out to $56,654 per person for a stay of 30+ days. The amount you end up paying varies widely by your insurance provider and the specific plan you have.

This picture from NCDAS captures average costs across states.

average cost of residenital drug rehab per state
From National Center for Drug Abuse Statistics

What’s Included in $56,654?

The cost of a California residential rehab typically includes these services:

  1. Detox  
  2. Room and board  
  3. All meals and food  
  4. Therapy sessions in a 1:1, group, and family setting
  5. Holistic therapies like yoga or creative writing
  6. Any amenities (like a pool or weight room) included at the facility
  7. Some extracurricular activities, like hikes, sightseeing, or adjunct treatment services  
  8. Alumni services like recurring alumni meetings, help finding work and housing, and ongoing contact from staff

What’s (Usually) Not Included

Some rehabs will offer certain services for an additional cost. Check with the center see what services are included in the total fee and which are add-ons. Potential add-ons include:

  1. Spa services like facials, manicures, and massages
  2. Medication-assisted treatment (MAT) when needed, including psychotropic medications for mental health conditions
  3. Alternative treatments like NAD+ therapy or ketamine-assisted therapy
  4. Psychedelic therapies may come as an extra cost unless the center specializes in this type of treatment and offers it in their primary care package 
  5. Private rooms may come as an extra cost unless the center solely offers private rooms
  6. Advanced clinical services like genetic testing, blood analysis, and creating nutritional profiles

Some rehabs will offer all of the above within their total cost of services. Others may charge a set cost for each service and allow clients to add them to their bill. 

Benefits of Going to Rehab in California

Recovery Community

California is home to a uniquely supportive recovery community. Its warm weather and coastal vibes have drawn treatment providers to open more and more rehabs, making it one of the most rehab-populated states in America. The density of providers means you have more options to find the best treatment for you.

City or Rural Options

California rehabs offer an urban or rural experience, depending on where in the state you go. For example, you can go to a rehab in Los Angeles or Malibu to experience the city or opt for a rehab near places like Lake Tahoe to connect with nature.   

Warmth and Ocean Access

Many rehabs along California’s coast offer beach trips. Some sit right on the shore for easy ocean access at a moment’s notice. Most areas in California also stay warm year-round, even in the winter months. This can be particularly appealing to people from northern states.

A New Environment to Heal

Going to rehab in California takes you to a new environment to focus solely on your recovery. Leaving your current environment can offer a few key benefits, like

  • Removing you from people or places that trigger substance use
  • Additional privacy, since you won’t be around people you know from home
  • Inspiration and motivation from a new setting

Finding Treatment in California

A California rehab could be an ideal recovery setting for you or your loved one. California rehabs offer various treatment approaches, such as evidence-based, holistic, faith-based, or alternative care. They typically accept major insurance plans or government coverage from Medicaid and Medicare.
Use Recovery.com to browse California rehabs and see their costs, insurance information, photos, reviews, and more.

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Why “Just Say No” Failed: Unpacking the Ineffectiveness of a Simplistic Anti-Drug Message

The “Just Say No” anti-drug movement, buoyed by good intentions and hopes to end the newly redeclared War on Drugs, sank to the depths of unimportance and, worse, ineffectiveness. Despite nationwide efforts and leadership from First Lady Nancy Reagan, teens remained just as likely to use drugs as before—in some cases, more likely.

Why? How could something so simple not succeed?

It was largely due to the placement of blame for drug use and a lack of education on addiction. We’ll explore why that had such a negative effect and what America and the world learned from this failure. 

Origins and Objectives of “Just Say No”

“Just Say No” came as a response to crack cocaine1’s birth in the 1980s. As a cheaper and more accessible version of cocaine, crack use soared, coupled with violent crimes and incarceration. President Reagan redeclared the War on Drugs; his wife and First Lady created the campaign to ‘just say no’ to drugs. Abstinence was seen as the only solution.

Police gave talks at schools across America to highlight the dangers of drug use and it being a criminal offense. They grouped all drug users together as criminals and the ultimate sign of failure, encouraging students to avoid this through abstinence. The Drug Abuse Resistance Education (D.A.R.E.) was borne from police efforts, and still well-known today.

Just Say No and D.A.R.E were meant to instill a desire to remain with the ‘good’ group, where you’d be seen as a lawful contributor to society. And, you’d be safe from overdose. The public quickly accepted the movement, largely because Nancy Reagan led it and, with her husband, made the War on Drugs a top issue among Americans.

Critiques of the “Just Say No” Approach

One primary critique of this proposed response to drugs is, “It’s not that simple1.” What made Just Say No so accessible became its demise. 

Just Say No failed to address the complexities and nuances of substance use, like genetic predisposition, peer acceptance and pressure, using substances as a coping tool for mental illness, and the experimental nature of adolescents. 

In 2001, America’s Surgeon General, Dr. David Satcher, labeled D.A.R.E and Just Say No1 as “ineffective primary prevention programs.” Data showed teens still used drugs2 at the same rate, if not a little more, despite the public’s remarkable awareness and understanding of the campaign. 

“Why Should I Say No?”

The Just Say No campaign seemed to picture a conversation about drug use going like this:

“Hey, do you want to take some of this cocaine?”

“No.”

“Okay.”

In reality, conversations and the general conception of drug use look something more like this:

“I’m struggling so bad to keep my A in this class. I just can’t pay attention.”

“Try these, they help me.”

Or, 

“I always smoke weed after school to relax. It helps me handle the stress.”

“Oh, really? Can I try some?”

Just saying no fails to teach the dangers and realities of drug use3 to a highly vulnerable population: kids. Without a proper understanding of how drugs work, the dangers of fentanyl, and how to prioritize their safety, many school-aged kids simply follow what their friends and peers do. If they can drink or smoke weed and be fine, so can they—they don’t need to say no.

Simply being told not to do something can work momentarily, but human nature tends to supersede this command across all age groups, races, and genders, making it ineffective. 

What Actually Works?

Simplicity didn’t cut it. The message didn’t need to become more complex either, it just needed to focus more on the truth: many teens will use drugs, from their own desire to or a lack of education on the risks. 

For example, many teens and college students don’t understand the risks of taking fentanyl and overdosing. Fentanyl accounts for the “vast majority” of overdose deaths in teens3. One way this happens is by taking a laced pill, which is a counterfeit pill designed to look like a safe prescription medication. The Drug Enforcement Administration (DEA) recently found 7 out of 10 counterfeit prescription pills contain a lethal dose of fentanyl4. 

Taking just one on a whim can end someone’s life. Had many overdose victims known the true dangers and risks, they might have used fentanyl test strips, avoided illicit drugs altogether, or relied solely on prescriptions from their doctor.

Education in Schools and Homes

Most teens don’t receive adequate education on drugs3, drug use, and the risks it poses. This makes them vulnerable to addiction and overdoses, plus legal and academic consequences as their use progresses. Effective education at school and the normalization of honest conversations at home can give teens the information they need to make safer choices. 

For example, schools could incorporate drug and addiction education into their health classes, which cover nutrition, reproductive health, and other crucial areas of personal health. Students would learn what drugs do to their brain and body, how to get help for addiction, and the deadly risks of illicit drug use and fentanyl. Importantly, schools can teach students how to use Narcan, which reverses an opioid overdose. Spreading awareness about fentanyl test strips and using clean needles promotes harm reduction. 

At home, parents can normalize discussions about drug use and its risks. One conversation can make kids aware of fentanyl, the dangers of addiction, and what to do if they start struggling with substance use or witness an overdose. Parents can reiterate how they’re there to help, listen, and connect their child to treatment when needed. 

Activities Over Lectures

While talking is essential to educate students on drugs and addictions, activities can seal their understanding. One in-school program shows how sugar and salt mixed into a glass pitcher of water look the same3—indiscernible to the eye, like fentanyl-laced pills. Students mixed each solution and saw firsthand how they couldn’t tell the 2 apart. This can have a greater impact than just hearing it.

Real-Life Stories

Stories from people who have gone through addiction can highlight both the dangers of substance use and the hope available in treatment. Schools can invite speakers with lived experiences to describe their realities with drug use, treatment, and preventive measures they found beneficial (or think would have helped them).

Seeing someone who recovered from an addiction offers inspiration and fights the stigma surrounding substance use and mental health conditions. Students see how untrue many stereotypes about addiction and those with a substance use disorder really are, which can boost their willingness to get help or start conversations with friends. 

Lessons Learned and Future Directions

Just Say No’s failure showed the complexity and multifaceted nature of addiction. Simply declining to take drugs wasn’t an effective strategy for most people. Learning why they shouldn’t take drugs, how to do it safely if they choose to, and knowing how to reverse an overdose promises tangible change.

It’s a bit too early to tell how much of an impact this will have as more and more schools and households adopt an education-first approach to drug use prevention. Many professionals agree meeting teens where they’re at should be the first effort3, whether they’re in active addiction, curious about drinking or using drugs, or ambivalent to drug use. 

With these changes, we can shift the way an entire generation views addiction and mental health, save lives, and reduce the negative impacts addiction has on teens and their families.

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At a Glance: The Fentanyl Crisis in America

Headlines about fentanyl being ‘a crisis’ increasingly pepper local and national news outlets. 

At first thought, a drug may not seem like a crisis in the same way floodings, pandemics, and wars do. But fentanyl has thoroughly earned its label as a crisis, and this article will delve into why—plus, how you can keep yourself and others safe.

What Is Fentanyl?

Definition and Uses

Fentanyl is a synthetic opioid1, deadly at extremely small doses (less than a couple grains of salt). In the medical setting, opioids and its synthetic versions, like fentanyl, are used to manage pain. After surgery, for example, most patients receive a few days’ worth of opioid pain medications since they’re much more potent than NSAIDS like ibuprofen. Small doses of prescribed fentanyl can relieve after-surgery pain and pain from chronic conditions like cancer. 

The medical uses for fentanyl aren’t why it’s become a crisis. It’s outside this setting where people in America lose their lives daily.

Dealers of drugs like cocaine, heroin, and meth often cut the pure substance with fentanyl to make it stronger and more addictive. In theory, this means their customers will buy more because they become addicted faster and increase their tolerance. They’ll keep coming back and buy in higher quantities.

Potency and Risks

A deadly dose of fentanyl fits on the tip of a pencil. It’s 100x more potent than morphine and 50x stronger than heroin1. Anyone who’s unfamiliar with its potency and how much they can safely take runs an extremely high risk of overdose. Those with more experience taking fentanyl and a higher tolerance for opioids run a lower risk of overdose. Most overdoses happen by accident, with the consumer unaware the drug they took had any fentanyl in it. Or, they take the drug after a period of abstinence, and their usual dose overwhelms their body and causes an overdose.

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A lethal dose of fentanyl, photo from the DEA.

Fentanyl-laced drugs kill people of all ages and experience levels. A first-time drug user could die as easily as someone who’s been taking heroin for decades. Even ‘safe’ drugs like synthetic marijuana have been found laced with fentanyl2 or other opioids, leading to accidental dosing. Some may also choose to mix fentanyl with other drugs, like adding it to a stimulant to make a speedball. 

Shockingly, the Drug Enforcement Administration (DEA) found 7 out of 10 confiscated pills had a lethal dose of fentanyl3, over 2mg. 

Causes of The Fentanyl Crisis

Fentanyl’s deadly potency and the way people often have no idea they’re taking it (and subsequently overdose) makes it an urgent health crisis in America.

Illegal Production and Distribution

Fentanyl has made its way into more and more drugs as dealers clamor to up their profits and get their customers hooked. Clandestine labs make fentanyl, which cartels and other illicit networks then distribute to reach drug dealers. It may be cut into pure drugs before it’s given to the dealers, or the dealers may use it as a cutting agent themselves. Sometimes, the dealers aren’t even aware what they’re selling has fentanyl in it. 

It’s not legal to make fentanyl on your own, purchase it, or sell it—you can only take it legally if you have a prescription. Getting a prescription is also the only way you can know the pill (or other substance) contains what you think it does, and in the correct dosage. Even someone who regularly takes opiates and considers themselves pretty tolerant to its effects can experience a fatal fentanyl overdose, since they can’t test the potency or know for sure how much fentanyl is in what they’re taking.

Prescription Practices

Some people have turned to fentanyl as a cheaper alternative to opioids. The heavy-handed use of opioids for pain relief largely contributes to this, as people can quickly become addicted to the opioids they were prescribed after a surgery or other short-term need. Once their prescription runs out, they face several options: buy it illegally from drug dealers (with no insurance coverage), try to find another doctor that will prescribe it, or go for the cheaper alternative, fentanyl. 

Accessibility and Affordability

Fentanyl is easier to access than pure drugs like cocaine, heroin, and prescription opioids. It’s also cheaper, which can drive people to make it their substance of choice. The lower costs also encourage drug dealers to supplement pure drugs with fentanyl, saving them money by creating a drug that has less of the pure substance but is still ‘just as strong.’ 

Impact of The Fentanyl Crisis

Overdose Deaths

Overall, fatal drug overdoses have gone down4. But fentanyl-caused deaths continue to rise and contribute more and more to the total death rate, making fentanyl the primary cause of drug overdose deaths5 in America (not including deaths caused by alcohol).  

In 2022, 76,226 out of 108,000 reported overdose deaths were due to fentanyl4, per the Center for Disease Control. That dropped to 74,702 in 2023. Synthetic opioids like fentanyl kill 150-300+ people each day. That’s the equivalent of a commercial plane crashing and killing everyone inside, every day. If that were happening, could you imagine the outcry? 

Public Health

People who experience an overdose need medical care as soon as possible. Naloxone (or Narcan) reverses overdoses for opioids and synthetic opioids like fentanyl. With fentanyl use and overdoses going up, emergency rooms and other treatment centers receive an influx of patients. Other non-deadly effects of fentanyl, like organ damage, also require medical care. This can strain the health system nationwide.

Social and Economic Consequences

Using opioids, synthetic or natural, contributes to economic issues through workplace accidents6, not going into work due to substance use, quitting work, and leaving gaps in the workforce due to deaths and resignations. Workplaces and businesses overall function less efficiently with these challenges, contributing to a poorer economic state.

Taking a substance can change how you behave, which can lead to criminal activities and legal consequences. Illegally procuring fentanyl can also get you into trouble. These consequences put strain on the judicial system and can affect the workplace through firings.

Efforts to Combat The Crisis

Many organizations, state-level and federal, are actively working to uproot the fentanyl crisis. And thankfully, they and others have had some success.

Law Enforcement Actions

Law enforcement’s primary role in stopping the fentanyl crisis isn’t to arrest people who take fentanyl; it’s to stop its distribution and production. Most of America’s fentanyl comes from China7, Mexico, and more recently, India. It’s smuggled through America’s borders through craftier and craftier ways, making it harder to catch. But advanced technologies, searching techniques, and more stringent rules vastly reduce the total amount of fentanyl that could make its way in.

American law enforcement has collaborated with Mexican officials to find and shut down fentanyl labs in Mexico, often operated by cartels. Recent collaborations with China aim to stem the flow of fentanyl there8. The United States Drug Enforcement Administration (DEA) focuses much of their operations on reducing fentanyl’s flow into the U.S., preventing over 381 million lethal doses of fentanyl3 from reaching consumers. This includes arresting distributors and drug dealers. Those who buy fentanyl illegally may also face legal consequences.

Public Health Initiatives

While public health organizations and programs can’t make arrests or shut down fentanyl labs, they can spread education and awareness on the dangers of fentanyl and its rising prevalence. Proper education on where it’s found, what happens if you take it, and what to do in the case of an overdose can prevent people from taking it entirely, and save their lives if they do.

The Center for Disease Control (CDC) has a Stop Overdose campaign, which offers education on fentanyl and its dangers. Similarly, the DEA’s One Pill Can Kill campaign highlights fentanyl’s dangers and the public’s need to carefully weigh the risks before taking illicit drugs. It also reinforces the safe practice of only taking pills prescribed to you, as buying pills elsewhere could mean you take a counterfeit laced with fentanyl. 

Many cities, universities, corporations, and commuting hubs are joining the Naloxone distribution project (funded by SAMHSA) to place Naloxone kits in easily accessible areas. Think of the fire extinguishers you see in a glass case—that’s the hope for Naloxone kits.

Treatment And Support Programs

Addiction treatment from medical and therapeutic professionals can save lives. Attending treatment as early as possible can prevent addiction from worsening and leading to a potential overdose. Many addiction treatment centers specialize in treating fentanyl addiction, offering services like detox, residential treatment, and outpatient levels of care.

Treatment programs often provide a blend of medical and therapeutic care, with 1:1 and group therapies focused on underlying conditions and building coping tools for relapse prevention. Evidence-based and holistic therapies form personalized treatment programs to comprehensively address fentanyl addiction.

Preventative Measures

Prescription Regulations

Since opioid use can lead to fentanyl use, regulating opioid prescriptions can lead to fewer mishandled prescriptions, opioid addictions, and fentanyl reliance. The recent settlement cases against big pharmaceutical companies have made other entities, including the general public, more aware that opioids aren’t always necessary, and that even prescription medications can lead to addiction.

In 2016, the Center for Disease Control (CDC) released the CDC Guideline for Prescribing Opioids for Chronic Pain which details 12 recommendations for safe, effective opioid prescribing. The guidelines are meant to reduce addiction and overdose rates while still prioritizing the patient’s health and well-being. When used properly, these guidelines can save and improve lives.

Some states put caps on the amount of prescription opioids9 for acute pain (like after a surgery) to 7 or less. Other states mandate Naloxone with each opioid prescription with risk factors like a high dose or if it’s prescribed alongside a benzodiazepine. 

Safe Use and Harm Reduction

Harm-reduction strategies for fentanyl use include distributing fentanyl test strips10, Naloxone, and clean syringe needles to reduce the spread of HIV and other diseases. Fentanyl strips test substances for fentanyl, which can make drug use safer and reduce overdoses. 

Community and Education

The DEA aims to partner with more and more local communities11 to educate people of all ages and backgrounds on the dangers of fentanyl. They’re calling it Operation Engage—educating, broadening awareness, and creating a sense of community in the effort to stop fentanyl overdoses. 

More schools and businesses have begun incorporating educational material on fentanyl to support these efforts. For those in recovery from fentanyl use, local peer support groups offer community and connection.

Curing a Crisis 

New initiatives and harm-reduction strategies can’t bring back the lives lost from fentanyl, but they can slow the spread and eventually mitigate the crisis. America and other countries see a future where fentanyl overdose deaths no longer make the news—because they’re not happening at all.
Treatment marks a big step towards this goal. You can use Recovery.com to find a fentanyl rehab and see photos, reviews, insurance information, and more.

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IOP vs. PHP: Which Treatment Is Best for You?

Can a couple of acronyms help you recover from addiction and mental health conditions? They can, and they’ve been doing it for decades.

Here’s what they mean: IOP is intensive outpatient program; PHP is partial hospitalization program. They’re both outpatient programs and primarily differ in intensity levels and time requirements. Depending on your treatment needs, one may be more effective and convenient.

We’ll explore the differences between IOP and PHP and highlight their benefits to help you decide on your care.

Understanding Intensive Outpatient Programs (IOP)

IOPs serve those who don’t need 24/7 care or detox1 for their recovery needs. They typically last 1-3 months with 3+ sessions weekly. Each session lasts a couple of hours and often includes therapy, psychoeducation, and other structured activities to keep you well connected to peer and professional support. You’ll likely receive 1:1 and group therapy; some IOPs offer family therapy too. IOPs also focus on practical tools for recovery, like relapse prevention, building coping tools, and how to navigate triggers.

You can go to IOP as a standalone treatment or as a step-down from residential care, which provides 24/7 monitoring and detox services. IOPs provide structure, community, and the continued treatment that can be vital to long-term recovery. Some programs require continuous drug testing, others don’t. Check with the program you have in mind to see what their participation requirements are.

People in IOPs can work or go to school, since sessions can occur in the morning, afternoons, or evenings, depending on the program’s availability.

Exploring Partial Hospitalization Programs (PHP)

PHPs are more intensive than IOPs, but still an outpatient program. You can expect to attend treatment for 5-6 days a week, usually for 5+ hours at a time. PHPs focus on skill-building and honing coping tools through group and 1:1 therapy, plus educational sessions to grow your knowledge of addiction and mental health. 

PHPs mimic residential treatment in their intensity, but with the ability to go home after treatment. They’re a great bridge between residential treatment and lower levels of outpatient care, like IOP, or patients can join them as a stand-alone treatment. PHPs often address both substance use disorders and mental health conditions; they may focus on one or the other, or each as a dual-diagnosis.

Those in PHP may have time for part-time jobs, but can expect to spend most of their day in treatment. PHP is commonly called day treatment to highlight this.

Key Differences Between IOP and PHP

PHP is more intensive than IOP. It will likely have a structured day-to-day schedule, similar to residential treatment. IOP primarily offers group therapy with less oversight and structure from staff. Its flexibility generally allows you to pick when you attend treatment, like in the morning, afternoon, or evening, whereas PHP is an all-day commitment.

Because it’s more intensive, PHP typically costs more than IOP. It can better serve someone experiencing severe symptoms of addiction and mental illness with its structure and therapeutic variability.

Someone with more manageable symptoms and recovery experience would likely find an IOP more beneficial and relevant to their needs. They still need support and treatment, but not as structured or intensive as a PHP. 

Factors Influencing Treatment Choice

Several factors can help you choose between an IOP or a PHP, like

  1. The severity of your condition. How strong of an impact does it have on your day-to-day life?
  2. The safety and support of your home environment. Is it conducive to your recovery?
  3. Your time availability and other personal demands. Do you need to work or take care of children?
  4. Costs and insurance coverage. How important is cost, and will your insurance be able to cover the program?

For example, if you have a severe mental illness or substance use disorder, an unsafe home environment, and struggle to navigate your symptoms on your own, PHP would be a good option for you. PHP can be an even better fit if your insurance covers the program and you have work flexibility (either taking a leave or working 1-2 days weekly).

If your symptoms are more manageable, you feel supported at home, and more confident in your ability to navigate day-to-day life without relapsing, IOP could be a better option. This is especially true if you have less funding available for your care and less time to spend outside work and personal obligations.

Considerations for Dual Diagnosis and Co-Occurring Disorders

Many substance use disorders occur alongside a mental health condition2 like anxiety, depression, or trauma. Attending treatment that doesn’t address these conditions can make it less effective, which is why so many outpatient and residential facilities make sure they do. 

Due to their less intensive nature, not every IOP or PHP will focus on mental health conditions as a core component of substance use. They may concentrate solely on relapse prevention skills, addiction education, and learning how to navigate triggers. There’s overlap for mental health recovery, but not a precise focus.

Plenty of IOPs and PHPs do offer either core or co-occurring mental health treatment. They’ll discuss how mental health conditions contribute to or cause addiction, and how managing your mental health can improve your addiction recovery. You may learn more about prescription medications for mental health (like antidepressants), self-care strategies, and habits for keeping your mind and body healthy.

Effectiveness and Outcomes

Attending an IOP or PHP can produce markedly better treatment outcomes1. It keeps you connected to treatment and teaches relapse prevention skills, coping tools, and other practical assets for long-term recovery. And since they typically require abstinence, it keeps you sober longer, which can increase the likelihood of long-term recovery3.

Studies found outpatient services like IOP and PHP can even have the same level of effectiveness as residential care1; effectiveness meaning sustained sobriety and reduced symptoms. While IOPs and PHPs won’t fit everyone’s needs and preferences, they offer a hopeful, effective alternative to residential treatment and the time and monetary commitments that come with it.

Choosing The Right Treatment Program

Choosing an IOP vs PHP is a decision made by you and whomever you count on for support. This could be your primary care physician, therapist, work mentor, parent, sibling, or friend. 

Reflect on these questions as you make your decision:

  1. Do you feel sick if you don’t take your substance daily, or even hourly? If so, you most likely need professional detox services. Here’s how to prepare and what to expect.
  2. Does your home environment feel safe and supportive of your recovery?
  3. Are triggers making it a daily challenge not to use substances, and making you feel nervous you’ll relapse or experience worse symptoms?
  4. How comfortable do you feel with your ability to handle stress and negative emotions without turning to substance use? Could your coping skills be improved?
  5. If your symptoms feel manageable without residential care, how much time can you realistically allocate to treatment—when seeing it as the priority it is?
  6. What matters most to you about treatment—staff interactions, peer support, medical treatment?

You can also note the specific offerings, amenities, and practical factors of the programs they have in mind. What’s their approach to recovery? Do they solely use 12-Step principles? How will the environment look and feel? Are there any groups specific to your demographic? 

Keep notes on what you find and see which program feels like the best fit for you. Remember that either option is a step towards recovery—positive, brave, and uniquely yours. 
You can use Recovery.com to find an IOP or PHP that fits your needs.

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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.