Tag: Drug Addiction

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Urge Surfing: A Mindful Technique to Navigate Through Cravings

Have you ever given in to a craving for sugar or salt? Coffee? A movie you’ve seen a dozen times, ignoring all the others on your roster?

These passing, innocent cravings happen to all of us. Indulging doesn’t usually cost your sobriety, relationships, or financial wellness. But the urge to take drugs, drink alcohol, or gamble can. Urges can arise at any point in your recovery journey and can derail even the straightest course. That’s where urge surfing comes in. 

Urge surfing, a specialized mindfulness technique, can help you “ride the wave” of an urge and experience them less and less. Urges typically last 30 minutes at most when they’re handled mindfully and calmly through urge surfing.

You can use urge surfing for more than addiction recovery, too. Use it to navigate any kind of urge, anytime, anywhere.

Introduction to Urge Surfing

Psychologist Alan Marlatt developed the mindfulness-based urge surfing technique1 as a quick and effective way for people to navigate cravings. Urge surfing is based on the mindfulness principle that urges, like waves, rise, peak, and eventually crash and dissipate. It sees addiction cravings as “rideable” and bearable with the right tools and practices.  

Compared to other interventions, like mindfulness-based cognitive behavioral therapy, urge surfing has a much faster impact. You may immediately notice benefits instead of the expected 2-4 weeks with traditional therapy and other interventions. You can also practice urge surfing almost anywhere, whereas traditional therapy often occurs in a specific setting (like an office you have to travel to). And, you can urge surf without the guidance of a professional, making it even more accessible.

With its ease and effectiveness, urge surfing has been used as a tool for addiction recovery1 and craving management. It teaches you to mindfully notice, sit with, and “ride” urges without self-judgment or fear.

Understanding Cravings and Impulses

Cravings are strong desires for something, like dessert after a meal or a cup of coffee on a groggy morning. People in recovery and active addiction often experience cravings for substances. Cravings can occur as your body adjusts to not having a substance, like alcohol. Certain places, situations, and emotions can also trigger cravings2, since your brain relates substance use to relieving stress and other unpleasant emotions. Even someone in long-term recovery can experience intense cravings. 

Impulses are sudden desires to do something. For example, you may see a soft blanket and feel a strong impulse to run your hand over it. You might reach out to touch it without even thinking about it. But, some impulses you first feel, notice, and then decide to act on it or not, like an impulse to touch a hot stove. While impulses are typically brief and fleeting, they can feel intense and usually lead to immediate action. This distinguishes them from cravings, which are persistent desires for something specific. 

An urge can feel more dire and discombobulating than a craving or an impulse. Negative emotions, like sadness and anxiety, can increase urges3 and make them harder to resist. But urge surfing can mitigate the urge and soothe the emotions flowing with it.

The Principles of Urge Surfing

The grounding principle of urge surfing is that you can navigate and alleviate urges without giving in. It hinges on mindfulness and experiencing emotions without self-judgment, fear, or worry. You may not experience a change in your urges, but rather in how you respond to them4. By staying present and focusing on the sensations in your body, you can ride out the urge without giving in to it.  

The “wave” you ride has 4 core parts: a trigger, rise, peak, and fall. As you continuously surf these waves, you’ll get better and better at understanding and alleviating urges. 

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Step-by-Step Guide to Urge Surfing

The process of urge surfing5, like cravings and urges themselves, varies from person to person. One person may quickly ride the wave of an urge, while someone else may need a half hour of peaceful solitude to reach the end of the wave. So–listen to your body and what works for you without expectations or judgment. If you don’t feel it helps right away, stick with it. Try it again and keep yourself open to the possibility of success.

Acknowledgment

Urge surfing starts by noticing and acknowledging what you’re feeling. This may look like:

“I want a drink right now. I feel my mouth watering and want the sensation of it in my stomach. I’m irritated and distracted because it’s hard to think of anything else.”

You can also notice your environment, mood, and other factors that may have triggered the urge. Did you see or feel something that triggered it? Make note of it if you can. 

Acceptance

Next, you accept the urge, rather than resist or condemn it. It’s happening, but you can choose how you respond to it. Now, if you want, you can also adjust your environment. Maybe sit in a private room, cross-legged with your eyes shut. Keep in mind you can urge surf anywhere, but have the option to pick your environment.

Stay Present, Curious, and Patient

Stay on the wave—notice and accept however intense the urge feels with curiosity and patience. Don’t force yourself to do anything about it, just experience it. Even if it feels bad or uncomfortable, you’re still in control. Picture a wave in your head, and that you’re on top of the crest as it moves towards the shore. 

Use your breathing as a grounding tool. Imagine it as the pulse of the water beneath you, moving within the wave. 

Reorient as You’re Ready

Check in on how intense the urge feels. Does it feel distant now? Do you feel more in control? If you do, you’re ready to come to shore. Reorient to your surroundings (what you can hear, feel, smell, and taste) and open your eyes if you shut them. 

Reflect on the experience and what you may have learned from it. Write it down or record a voice note. Keeping track like this can help you realize progress, learn what triggers your urges, and know yourself better.

Applications of Urge Surfing

You can use urge surfing for all sorts of cravings and urges, related to addiction or not. Less intense urges, like an urge to check social media or have a certain food, can pass quickly with urge surfing. The intense urges to use substances can take longer to “ride”, but it’s just as doable. 

You can also use urge surfing as a tool for emotional regulation, which works almost the same way. Instead of riding an urge, you move through an intense emotion like anger or panic. You’ll notice the emotion and accept it without judgment, then let it pass without acting on it.

Because you can urge surf almost anytime, anywhere, it’s a practical tool for the cravings, urges, impulses, and intense emotions encountered in daily life. You could surf the urge to respond angrily in a work email, or use urge surfing to cut down on or quit smoking.

Challenges and Support

Those who dislike or struggle with meditation may find urge surfing tedious. Practice and repetition can help, especially if you make your environment as comfortable as possible. Try playing instrumental music or binaural beats to help you focus.

The intensity and discomfort of urges can also pose a challenge, as urge surfing requires you to feel but not to act on the urge. Sitting with that discomfort can feel difficult at first. But as you keep doing it, you’ll get more used to the process and confident in your ability to “surf” safely to shore.

Build Hope as You Hang 10

Urge surfing serves as a powerful sobriety tool and resource for hope. Use it to manage urges to take substances, impulses, and reactive behaviors any time in your life. You can see just how capable you are of managing urges and navigating challenging moments.

As you become more adept at urge surfing, you’ll discover a growing confidence in your capacity to manage difficult situations and make empowered choices in your recovery. This skill doesn’t just apply to sobriety; it’s a life skill that enhances your overall self-efficacy and agency. Each successful experience of riding out an urge reinforces a hopeful outlook, showing you can overcome challenges and continue on your path to recovery and well-being.

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Ethical Care and Recovery: A Cornerstone for Healing

Ethics and quality treatment go hand-in-hand. One often doesn’t exist without the other and if they do, the impact of either lessens. In an industry shaped by unethical practices, some of which have just become the norm, a pursuit of ethics sets many organizations and providers apart.

We’ll explore what ethics are in the behavioral health industry and why they’re such an important part of recovery—regardless of the conditions present, the level of care, or patient preferences. Ethics remain the baseline of effective care.

Listen to our podcast episode with Marvin Ventrell, CEO of the National Association of Addiction Providers (NAATP), to learn more about ethics in treatment from the person who spearheaded the effort.

Ethics: What They Are and Why They Matter

At first thought, ‘being ethical’ may sound like feeding the homeless, treating others fairly, or being honest. People without ethics often star as villains in books and films, but in reality, a lack of ethics often shows in more subtle ways. Sometimes, that’s because we or another party don’t know the ethics of a certain industry, place, or demographic and act unethically by accident. Other times, acting unethically is an intentional choice to manipulate and mislead for personal gain. Usually, monetary.

Treatment that prioritizes ethics both improves the chances of success and helps patients feel respected and cared for, which maintains their dignity. Lacking ethics has consequences, from being hurtful to costing someone the recovery opportunity they deserved. In dire cases, unethical practices can directly or indirectly end someone’s life. 

Unethical Practices in Addiction Treatment

Ethics in the addiction treatment space have gotten more robust and structured, but that wasn’t always the case. Old practices still happen today and, unfortunately, can marr the otherwise respectable reputation of treatment providers. These are some of those practices.

Patient Brokering

Patient brokering is the practice of unethically attracting people to a certain treatment center through a broker that offers free flights, gifts, money, or even drugs. The ‘broker’ who refers them to treatment gets a compensation fee. Sometimes, brokers will help people relapse and then encourage them to go to the specific treatment center that gives them compensation. Brokers may share their fees to encourage patients to relapse and go to treatment.

The Affordable Care Act requires insurance companies to pay for addiction treatment, which means patients with good-paying insurance are often the targets of patient brokering, or body brokering. Once the patient’s insurance is charged, they’re run through treatment quickly, primed to relapse and return again to the center (so they can charge their insurance again). 

Thankfully, patient brokering has become illegal and therefore less common. But it still happens. States like Florida and California still battle shady providers and brokers, shutting them down as soon as they can. 

Misleading Marketing

Some treatment centers rely on misleading marketing to draw in patients—and their insurance. AI-generated images or generic stock photos make the center look nicer than it is, or advertise amenities and therapies that don’t actually exist (like private bedrooms, a pool, or equine therapy). The center could also claim they have more experienced or higher qualified staff than they actually do, like saying all their therapists are masters-level when they aren’t.

Thinking they’ve found an amazing center at an equally amazing price, patients or their loved ones may commit to treatment and pay upfront for their care without realizing they’ve been duped. 

Paying for Leads

Some treatment providers pay for ‘leads’ to their website, which are website clicks, phone calls, or messages indicating interest in treatment. For example, a treatment center may pay a directory or call center to send them a certain amount of leads. One way a call center can do this is by saying other treatment centers are full or closed, leaving the one paying them as ‘the only option.’ 

Lack of Transparency

Some treatment centers purposefully make it difficult to ascertain what they do and how they do it. They may also distort what the living conditions will look like, using vague statements like, “Patients are onsite.” (Living where? What are the rooms like? Is it actually residential? Will there be meals?)

The admissions staff are often just as vague, encouraging you to make your payments, get through the admissions process, and start treatment instead of answering questions. Once you get to the center, you may realize it’s not a good fit or not at all what you expected. 

Exposing Patient Identities

One of the last things many patients want is to see their face plastered over marketing materials or used on the website of the place they went to get treatment. Addiction and mental health treatment is deeply personal and often vulnerable; not something people often want disclosed (especially celebrities or high-ranking corporate employees/employers).

Unethical providers sometimes use pictures of patients to capture their treatment services and amenities. If treatment centers do use pictures of patients in their marketing materials or on social media, the patient must be fully aware and give their approval before the image can show anywhere on the internet or printed materials. 

Ethical Practices in Addiction Treatment

Many treatment providers and industry leaders recognize and prioritize ethics in treatment, slowly but surely changing the entire industry and restoring its reputation. Here’s how.

Clear Advertising

This applies to the treatment center advertising themselves and 3rd-party sites advertising the center. For the center, it means any material or messaging about their center is clear and not misleading. They clearly state what they are, what they do, and what patients can expect. Not only is this ethical and kind, it reduces fear of the unknown (FUD), which can be a barrier to treatment.

Third parties prioritize ethics by clearly marking which listings on their website are paid advertisers. At Recovery.com, for example, you’ll see we mark each treatment provider that pays for an extended reach. This lets visitors and potential patients know what is and isn’t an ad. 

Accurate Language and Images

The way a center portrays themself makes a big difference. If they say they’re the best rehab ever and upload a dozen stock images of a luxury spa, that’d likely change the way a potential patient views them—and sway their treatment decision. 

Sticking to the facts of what they treat, how they treat it, and including pictures of their center only make for a more ethical portrayal. Clear content and pictures also help potential patients make quick, informed decisions at a difficult time.

Updated and Accessible Licensing Information

A good indicator of quality care comes from 1) clinical licensure from the center’s country and state and 2) accreditation from organizations like the NAATP, The Joint Commission, LegitScript, and CARF. 

Many providers make these accreditations and licenses easily viewable on their website. You can also search the accreditor’s website for the specific treatment center to see if they’ve been accredited by them.

While licensure and accreditations don’t guarantee successful treatment, they can help you decide on a center and feel more confident in the quality of care you or a loved one will receive. 

Cultural Competency

Cultural competency means the staff at a treatment center have a learned or lived experience that allows them to understand someone’s culture, and how their culture can affect treatment. Cultural competency can help LGBTQ+, non-white, religious, and disabled people feel more comfortable, safe, and understood in treatment.

Making Every Effort to Offer Effective Care

Imagine if you went to the doctor for a sprained ankle and the staff only tossed you an ice pack. Some treatment providers do close to the same thing for addiction and mental health treatment; bare minimum services that don’t address core issues. 

Ethical providers do the opposite: making every effort to give you the best, most effective care they can. They collaborate with each other to better understand your needs and check that they’re addressing them. Depending on their services and available resources, you’ll receive the therapies and practices best attuned to what you need to recover.

Though effort and best intentions don’t guarantee recovery, they go infinitely farther than lackluster care and band-aid solutions. 

Organizations Enforcing Ethics

How does the treatment space enforce the concept of ethics and ethical practices? It takes the bravery and efforts of many organizations determined to improve the space and save lives. One of those organizations is the NAATP, who’s CEO we were privileged to talk with in our recent podcast episode. You can listen to that to learn more about his story and how the NAATP put their stamp on ethics. 

The Joint Commission also offers accreditation for many types of treatment providers. To gain accreditation from the NAATP and The Joint Commission, treatment providers go through rigorous screenings and approvals similar to state licensing. These organizations focus more on ethical care, though, which differs them from a center meeting the state requirements to operate. 
With these organizations and the passion behind them, finding quality, ethical addiction treatment is more than possible. People care. Hope is for everyone.

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Addiction Education in Rehab: Empowering Recovery Through Knowledge

Understanding addiction and mental health provides crucial stepping stones to long-term recovery. That’s why many rehabs provide psychoeducation, which teaches patients about behavioral health conditions. In a psychoeducation class, you’ll learn more about particular substances, how they work, their long-term effects on your brain and body, and why cravings happen. It also explains the connection between addiction and mental health conditions.

Gaining this understanding of yourself and your recovery journey can better prepare you for the road ahead, helping you feel confident in your ability to identify triggers, coping mechanisms, and relapse risks. 

Introduction to Addiction Education

Addiction education1 teaches the biological, psychological, and social aspects of addiction. The goal is to demystify the process of addiction recovery and provide vital insights into treatment. Learning about addiction can help people feel more empowered in their recovery and in supporting loved ones.  

Psychoeducation raises awareness about the nature of addiction, including how drugs impact the brain, the progression of tolerance and dependence, and the addictive cycle. Understanding the scientific basis of addiction can help people acknowledge the chronicity of the disorder and why long-term management plays a crucial part in their recovery.

Addiction education in rehab also emphasizes and teaches coping skills for relapse prevention. Patients learn how to recognize triggers, handle cravings, and navigate high-risk situations (like acute stress) without resorting to substances as a coping mechanism. It prepares them for “real-world” settings to bolster confidence in their recovery.

What It Looks Like

Psychoeducation in rehab looks a lot like a regular classroom. You’ll sit in a circle, at tables, or in rows with a whiteboard or screen up front. A “teacher” leads the lessons; they may be therapists, counselors, psychologists, doctors, or someone with lived experience. You’ll commit an hour or so to learn, potentially watching videos and engaging in discussions with the teacher and your peers. Your teacher may also encourage you to take notes.

Core Topics Covered in Addiction Education

Addiction education typically covers the neurological effects of substances, the impact of mental health conditions, the health risks of addiction, and how to recognize and cope with triggers. These topics can go in-depth, like learning how addiction rewires the brain, or broadly address ideas and themes. Classes may also focus on a specific substance, like cocaine or fentanyl. 

Methods of Delivering Addiction Education

Peer interaction, group discussions, and lecture-style lessons provide addiction education. Videos and written projects also contribute. You may watch videos or animated depictions of how substances affect the brain, for example. The educator will likely ask questions or prompt group discussions each session. You and your peers are encouraged to voice questions throughout the lesson to help yourself and others learn.

Psychoeducation may also include interactive workshops, where you and your peers have a more hands-on experience by acting out scenarios or seeing creative depictions of them. For example, you might study a plastic brain to see where addictive substances impact the reward system. Cartoons and drawings help visual learners1 understand and relate to information.

Learning could take place individually, in a group, or in a family setting2. The exact setting will depend on your program and how they structure psychoeducation.

The Impact of Addiction Education on Recovery

Learning about addiction helps you become more self-aware1 and make better-informed choices on your recovery journey. Knowing what triggers cravings can help you avoid them. And, you’ll learn coping tools to manage cravings both long-term and in the moment. These tools, gained by psychoeducation, can strengthen your recovery and empower greater confidence in your journey.

Psychoeducation has been found to improve treatment outcomes1 by reducing relapses and promoting abstinence. It also improves treatment compliance, which can help people stay in treatment longer and get the healing they need.

Integrating Education with Other Treatment Modalities

Psychoeducation in addiction treatment flows in tandem with therapy, medical care, and holistic therapies. It complements each facet of treatment by helping patients better understand the process and how each component works towards recovery.

For example, psychoeducation can educate patients on the medications they’re taking. They’ll learn more about the medication and what it does, helping them understand its benefits, potential side effects, and commit to taking it as prescribed. 

Overcoming Challenges in Addiction Education

Participants can run into challenges in psychoeducation, despite its many benefits. Challenges won’t necessarily make addiction education ineffective, but they can limit how much patients engage in the lessons. Here are some examples of common challenges in addiction education:

  1. Unengaging teaching styles 
  2. Unenthusiastic facilitators
  3. Poorly designed and confusing lessons distracting from the content itself
  4. Mental health and/or learning conditions affecting learning abilities
  5. Peers not getting along
  6. Bias, prejudice, and lack of cultural competency from facilitators

To face these challenges, providers can ensure they assign competent, enthusiastic teachers with clearly defined lesson plans that patients can access beforehand to know what to expect. A syllabus, for example, would detail what patients can expect to learn and keep their lessons moving toward defined goals and milestones.

Teachers should also have access to a variety of learning materials, helping them adapt to various learning styles and meet the needs of their ever-evolving students. Additional training on inclusivity, diversity, and anti-bias can help facilitators create more welcoming environments students feel comfortable engaging in.

Continuing Education and Support Post-Rehab

Addiction education doesn’t end after rehab. You can keep learning every day, in big or small ways. 

Educational Courses and Training

Online training or college courses can deepen your knowledge of addiction and earn you a certification or degree. Your classes will mimic psychoeducation classes in rehab but with graded homework and assignments or other completion requirements. Colleges may offer these courses or platforms like Coursera. 

Support Groups

You can find local or online support groups by searching the internet or connecting with your local community. For example, you could check with your community center for guidance and see where local groups take place. Alcoholics Anonymous (AA) or other 12-Step groups likely exist in your area and actively welcome new members. Online groups connect you to others in your state, country, or worldwide to share and receive support.

Community Engagement

Your town or city may have activities and groups for those in recovery, like monthly dinners or sports clubs. Even if they’re not geared toward people in recovery, you can still join a group that seems fun to you and meet new people, learn about their experiences, and build your support system.

Learning to Hope

Addiction education in rehab serves as a powerful tool in recovery. It helps you understand how addiction works, what it does to your brain, and why certain triggers cause cravings. Psychoeducation helps you create relapse-prevention strategies centered on your new knowledge of your addiction and contributing factors, like mental health conditions, to empower your recovery.

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Recovery Amid Wealth And Opportunity

It’s not uncommon to hear of a celebrity going to rehab, or finding out a successful CEO has struggled with alcohol use. Sometimes these figures drop off the map, resurfacing once they’ve ‘cleaned up,’ only to make the news again a few months later for the same issues.

But aren’t they rich? They could buy the whole rehab—what’s stopping them from just getting better?

News stories and celebrity gossip often center around that idea, pointing out the unique opportunities the top 10% and 1% have to pursue recovery from addiction and mental health concerns. Why don’t they, when it seems so easy? 

Another question is this: if they do, can they clear the pitfalls of a life that often requires perfection, secrets, and exceeding even the most unattainable expectations?

Life in The Top 10%

Who’s the richest person you know? How does their lifestyle compare to yours?

Then, for most of us, triple or quadruple that level of excess and wealth. That’s the top 10%: actors, singers, royalty, oil tycoons, owners of high-end tech companies, and CEO’s of multi-billion dollar enterprises. They easily afford multiple homes, luxury cars, and don’t flinch at an ivy-league education for their kids. They vacation on tropical islands or massive mountain mansions. They have staff to do what we could consider daily tasks: shopping, paying bills, making meals. 

People in the lower 30%, or even 70%, meanwhile, carefully calculate each shopping trip, each vacation, and each bill to make sure they can cover their basic costs: food, rent, utilities, and other essentials. It’s all too common for a health issue or property damage to send individuals and families into a financially dark place. 

How much easier and better life would be with no financial worries!

The Corroded Side of The Coin

Life in the top 10% looks shiny on one side. On the other, though, it’s often a much different visage. With their positions and prestige the top 10% typically face intense pressure to perform, maintain an image of success, and meet expectations set by the public, their industry, and themselves. 

It’s true we all face pressures, stress, and expectations, regardless of our income or socioeconomic status. However, many of us would agree it sounds daunting to lead a global company with a worldwide impact and reputation to maintain. The stakes change. To maintain their image of success, some of the top 10% may use substances like alcohol, cocaine, or heroin to cope and reach past their normal human capabilities.

This can spiral into addiction—they may even feel destined to struggle with substances like so many of their coworkers and friends. It could seem like a normal part of life, but that’s fortunately not the case. 

Unattainable Expectations And Using Substances to Cope

The nature of someone’s profession can impose high-stakes expectations. An actor, for example, may be expected to win an Oscar by a certain point in their career. To do this they need to get cast in the right films and do everything they can to improve their acting skills, which may involve long hours of training and filming. 

They may not feel capable of meeting their expectations on their own, using substances like cocaine to feel more alert and work longer. This can be just as true for a CEO or a politician with images to maintain and benchmarks to hit. What begins as a seemingly foolproof way to boost performance and retain their success can quickly bloom into dependence, then addiction.

How Wealth And Prestige Can Protect Against Common Consequences

The rock bottom myth purports hitting your rock bottom as the ultimate motivation for treatment. (This is often true, though not at all required.) For many in the top 10%, their wealth and prestige serve as a cushion against rock bottom. This can lead them to believe their substance use has no consequences and causes no harm.

This belief is easy to understand—if you have the cash to make issues go away or cover them up (even from people close to you), they probably won’t seem like a big deal. Excess money also allows you to buy almost whatever you want, whenever you want it, whether that’s a new car or dozens of prescription pain pills a day. The top 10% can fund their addiction without financial consequences, at least in the beginning.

No financial consequences likely means they won’t experience homelessness or resort to criminal behaviors to get extra cash. This protects them from legal troubles and sullying their reputation.

Misconceptions And Biases Towards Treatment

Living a life of luxury and wealth can dissuade the top 10% from seeking treatment, as they assume they’ll be living in a dinky facility with restrictive rules and peers they can’t relate to. A major down-grade, essentially. Privacy concerns can also make treatment seem unfeasible to a celebrity or influential executive.

Going to rehab can seem like a degrading experience to someone who’s used to being treated with prestige and respect. They picture rules, bedtimes, and a strict treatment regime they must follow along with everyone else—people who are nothing like them. 

The Truth About Treatment for The Wealthy

None of these misconceptions and biases end up being true, depending on where you go to treatment. Many luxury rehabs exist just for this unique population, offering high-end accommodations, customized treatment plans, and stringent privacy measures. They also cater to working executives with flexible technology policies and time to work.

At rehabs like these, their clientele enjoy amenities like private bedrooms, fun extracurricular activities, chef-prepared meals, housekeeping, pools, gyms, saunas, and much more. Additionally, and perhaps most crucially, they encounter others in treatment with similar backgrounds—affluent, successful, and likely apprehensive about the process.

The Importance of Community

Some members of the top 10% may prefer fully private treatment, but for those who don’t, healing in a community can have a powerful impact. They’ll find real-life proof they aren’t alone in their struggles. They’ll gain support from others and offer it back. They’ll grow new friendships and form connections with both peers and staff. These connections and the tangible sense of not being alone can strengthen their recovery journey for years to come.

Treatment centers often offer group therapy and group activities to help peers connect. Group activities provide a dynamic way for clients to deepen their understanding of themselves and their peers. Depending on the location, these activities can range from tranquil nature excursions and exploring cultural landmarks to more exhilarating adventures like whitewater rafting and ziplining. Additionally, visits to spas offer a serene reprieve, rounding out the diverse array of experiences designed to rejuvenate body and mind.

Leveraging Wealth And Success for Recovery

Wealth and prestige can significantly enhance the recovery experience. For instance, people in the top 10% have the financial means to access high-end treatment services that fit their needs and preferences. The premium costs of these rehabs ensure a more comfortable environment and access to top-tier medical professionals, cutting-edge therapies, and exceptional amenities. Luxury rehabs often include private rooms, gourmet dining options, and expansive grounds.

Top-tier rehabs also create personalized treatment plans tailored to each client. This could include a blend of traditional and alternative therapies, private counseling sessions, and holistic approaches like yoga, meditation, and art therapy.

These aspects not only provide comfort but can also boost the overall effectiveness of treatment, making a higher-priced rehab a worthwhile investment for those who can afford it. But, bear in mind that luxury and private-pay only facilities aren’t the only places to get high-quality treatment. Many, many rehabs worldwide offer life-saving care for affordable prices and accept insurance. 

Recovery in Excess

Ultimately, money doesn’t solve everything. The aspects that come with excess wealth, like extreme pressure to perform and privacy issues, can dissuade people from going to treatment. However, many rehabs around the world exist specifically to address these concerns and more. You can find ultra-luxury centers on Recovery.com and see photos, reviews, and more. 
And to hear more about the recovery experience from a Wall Street trader and CEO of a luxury sober living center, listen to our recent podcast episode with Trey Laird here!

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From Wall Street to AA Meetings: An Executive’s Path to Healing, and How He Uses It to Help Others

Trey Laird is a man in long-term recovery, a CEO and founder, and a member of our advisory board at Recovery.com. He founded The Lighthouse Sober Living and The Lighthouse Recovery Coaching 365 Program, both of which cater to men and women needing support and a safe, comfortable environment in early recovery. 

As one of our advisory board members, Trey plays a key guiding role with lived experience in recovery and the treatment space. Listen to his episode and hear from other guests here!

Trey headshot

A Successful Start

Trey Laird initially worked as an equities trader on Wall Street. He’d graduated from Dartmouth College and began his career quickly, despite spending much of college steadily consuming alcohol and cocaine. Trey then found success in forming and maintaining positive relationships with his Wall Street clients—usually strengthened by drinks or parties after work. Describing his focus with clients, he says,

“It was building relationships…. One of my key positive attributes is I’m generally curious about other people and generally curious about what makes them tick. And today it’s super helpful because that may unlock a door to helping them recover.”

After graduating and beginning his career on Wall Street, Trey married and started a family. Then, at 32, a surgery left him with prescribed pain medications, which turned into a daily habit, and then into an addiction. 

Realizing The Need for Help

Trey eventually took prescription pain pills throughout the day and drank at night, going to bars where he wouldn’t be recognized. He began seeking solitude to drink or use substances, which went far out of his usual character as an extrovert. Trey says, 

“Being somebody that liked to be around a lot of people going to someone that, you know, wanted to not be around those people, was a big warning flag for me.”

Trey soon realized his drinking and substance use kept him from being the husband and father he wanted to be. He recognized his need for help and started looking for treatment options close to him.

Entering The Treatment Space

Trey sought treatment without knowing how it worked or what going to rehab really meant. But he went anyway, mentally prepared to stop his drug use. Trey initially planned to keep drinking after treatment, then was required to stop after he joined a 90-day outpatient program. At his wife’s request, Trey moved into his own place. He began going to 12-Step meetings in treatment and during his outpatient program, where he committed himself to at least make it through the 90 days. 

The meetings and the supportive community he found in Alcoholics Anonymous (AA) took him by surprise. It was not the cult-like setting he expected, rather, men with stories like his living in recovery. By the end of the 90-day program, his mentality surrounding treatment and substance use radically changed. Trey says,

“And it got to the point where I was like, what would the benefit be of having a beer again?” … “I like what I’m feeling. And more, maybe more importantly, I like the people that I’m around.”

Overcoming Challenges With The Support of a Sober Community

Trey’s path to recovery was strewn with formidable obstacles. During the financial crisis 2008, America’s economy teetered on the brink, presenting an unprecedented challenge. As a Wall Street trader, Trey found himself in the eye of the storm. Yet, his sober community became his anchor, providing unwavering support. 

Trey’s personal life also faced challenges. His wife filed for divorce. The stakes were heightened as the conditions of the divorce mandated that Trey pass a drug-free test to maintain visitation rights with his children. This requirement added another layer of pressure and was a crucial motivator in his steadfast commitment to sobriety.

“Going through that time period and meeting these men who just showed me how to live a life, no matter what, stuck with me. That’s what launched me into my recovery.”

He also adds, 

“The opportunity to interface with a live recovery community was essential.”

Accomplishments and Plans for The Future

New leadership at the company Trey worked for inspired him to leave the finance world and provide other men like him with the recovery community he found so vital. He wanted to offer a link between intensive treatment and home, and so in 2016, he opened The Lighthouse Sober Living. The luxury setting catered to men at first, opening homes for women later. Trey also remarried and has since added more children to his family.

The Lighthouse uniquely offers a sober living space for men like Trey, who have monetary means and have become comfortable in more professional settings. This, and the expectation to ‘man up,’ can make it even more impactful when clients instead embrace vulnerability. 

Since opening The Lighthouse, Trey has also begun a recovery coaching program, The Lighthouse Recovery Coaching 365 Program. Graduates of their sober living program attend the 365 program for 3-6 months, gaining professional recovery coaching and family coaching.

Trey aims to open more sober living homes for men and women and strengthen his local recovery community, extending the gift of support (and recovery) to as many people as he can. We’re excited to have him on our advisory board and call him a friend!


Listen to Trey’s podcast episode here, where our hosts Dr. Malasri Chaudhery-Malgeri and Cliff McDonald discuss Trey’s journey and all he’s accomplished—personally and professionally. Don’t miss it!

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Patience in Recovery: Keep Calm and Stay on the Path

The road to recovery from addiction is full of ups and downs. While milestones and moments of clarity can bring immense joy, the truth is that progress isn’t always easy. Patience allows us to weather the inevitable storms, understanding that healing takes time. 

Let’s look at why patience is so important to addiction and mental health recovery, and explore practical techniques to help you cultivate this essential skill and build a foundation for lasting success.

Understanding the Role of Patience in Recovery

The Nature of Recovery

Just like progressing in any other area of life, recovery is not a linear process. There will be victories—conquering cravings, having breakthroughs in therapy—but there will also be setbacks. Like any hero’s journey,1 in recovery, you’ll undoubtedly face challenges that test your commitment to the journey. This is where patience comes in. 

Creating change takes time. Developing new life skills is like building muscles: it takes consistent effort. As you rebuild your life after addiction, progress might look like two steps forward and one step back. It’s still progress. With patience and dedication, you’ll eventually find yourself well down the path toward lifelong recovery.

Benefits of Patience

While it may sound passive, patience isn’t just about sitting around, waiting for things to come to you. It can actually be an empowering way to take charge of your recovery process. Embracing patience helps you reduce stress and anxiety, which are common triggers for relapse.2 Maintaining a calmer state of mind makes it easier to manage difficult emotions and put your new coping skills into practice. 

Patience also leads to better decision-making. You’ll be less likely to make impulsive choices fueled by frustration, and more likely to take intentional steps toward your recovery goals. With patience as your guide, you’ll cultivate a calmer, clearer mind: an essential asset as you redesign your life. 

Challenges to Cultivating Patience

Losing patience is part of the nature of addiction3 itself, as addiction specialist Dr. David Fawcett explains: 

When we’re in our active addiction, the part of brain where addiction lives is badly overstimulated with all the intensity going on; with the dopamine and all the signals for more and more intensity. That really teaches the brain to forget about patience, because it always wants that instant gratification. And that is a real problem because over time, not only does the intensity increase, but behaviors become more impulsive.

Developing patience is key to countering this impulsivity. But there are other challenges along the way that tend to complicate things.

Frustration With Ourselves

On the road to recovery, you’re sure to encounter plenty of frustrations. There will be times when you hit plateaus and yearn for faster progress and more immediate rewards.  

When progress feels slow, it’s easy to get discouraged. Usually, our default mode in these times is to be self-critical. But while we may think this leads to improvement, the truth is that it often impedes our progress.

“Being hard on ourselves is familiar to many of us,” says meditation teacher Tara Brach. “We often distance ourselves from emotional pain—our vulnerability, anger, jealousy, fear—by covering it over with self-judgment. Yet, when we push away parts of ourselves, we only dig ourselves deeper into the trance of unworthiness.”

The antidote to this is self-compassion.4 “Whenever we’re trapped in self-judgment…our first and wisest step towards freedom is to develop compassion for ourselves,” says Brach.

Setbacks—even relapses—are a common part of this journey. If you find yourself comparing your progress to others, remember that recovery isn’t a race. It’s a deeply personal journey that looks different for everyone. Acknowledging these challenges and focusing on self-compassion lets you cultivate the patience you need to thrive in recovery.

External Pressures

Patience in recovery can also be tested by pressures from the outside. Societal expectations of immediate results can fuel your frustration. Family members might push for faster progress, lacking an understanding of the internal work involved. For many who return home after rehab, the pressure to return to their “old self” at work and in other aspects of day-to-day life can be overwhelming. But recovery is a journey of self-discovery, not a race to return to who you once were. Communicating your needs—setting boundaries with your family and having honest conversations with your employer—creates an environment that supports your sobriety.

Personal Expectations

Your desire for quick results can also be a major hurdle. You might set unrealistic goals or expect immediate changes. All this pressure is a recipe for disappointment and feeling like you failed. But recovery is a healing journey, not a destination. It takes time to rewire ingrained patterns and let go of long-held narratives. Take note of your small wins each day and stay focused on your long-term vision. By letting go of the need for instant gratification, you grow the patience needed for lasting transformation.

Recovery Strategies for Cultivating Patience

Meditation and Mindfulness in Recovery

In the throes of recovery, patience can feel elusive. Here’s where mindfulness and meditation can help. By focusing on the present moment, you detach from cravings and frustrations that fuel impatience. 

Start with simple exercises: focus on your breath, feel your feet on the ground, and listen to surrounding sounds. Notice these sensations without judgment. With practice, your mind will become calmer, allowing you to observe and breathe through intense emotions. As you become more present, you’ll find the space to accept hard moments and overcome frustrations in recovery.

Setting Realistic Goals

The road to recovery is paved with small victories. Instead of setting all-or-nothing goals, focus on achievable milestones. Break down long-term goals into smaller, manageable steps. Regularly review and adjust your goals as you evolve. This keeps you motivated, gives you a sense of accomplishment, and reminds you of the steady progress you’re making. 

Positive Self-Talk

Recovery can be tough, and negative self-talk can easily sabotage your patience. Instead, cultivate an inner voice5 that’s kind and encouraging. Acknowledge setbacks, but don’t dwell on them—reframe them as learning experiences. Remind yourself that this is only a bump in the road, not the end. Positive self-talk boosts your confidence and grows your patience. It reminds you that you’re capable of overcoming challenges—including building a life free from addiction.

Building a Support System

Leaning on Loved Ones

Loved ones are essential to our happiness, in recovery and in life. Surround yourself with supportive people who understand your struggles and celebrate your success. Share your recovery goals with them and ask for their encouragement. Their belief in you can be a powerful source of motivation.

It can be hard to ask for help, especially when we need it. Your loved ones aren’t there to judge, but to offer a safe space, a listening ear, and unwavering support on your mission to improve your life.

Professional Support

Therapists, counselors, and support groups are invaluable recovery allies. Therapists can help you identify the causes of your addiction and addressing them in a safe, supported way. Support groups provide a safe space to connect with others who understand what you’re going through. Professional support can also help you identify and address underlying reasons for addiction, like unhealed trauma. With professional support, you can develop the emotional resilience you need to navigate the ups and downs of recovery.

Practical Tips for Maintaining Patience

Daily Practices

Not everyone is naturally super patient, and that’s okay! Like any skill, patience can be learned. Try these techniques as a starting point:

  • Journaling gives you an outlet for processing emotions, and can help you identify triggers that make you feel impatient. 
  • Gratitude practices, like listing things you’re thankful for, shift your focus to what you already have instead of what you lack. 
  • Urge surfing helps you manage cravings by riding out feelings without acting on them. 
  • Relaxation techniques like deep breathing and meditation help you manage stress and cravings in the moment.

Results come with consistency over time. Try to make these a regular part of your daily routine. Start small—5 minutes of journaling each morning, or 3 deep breaths to center yourself when you feel frustrated. Over time, you’ll see how practicing these simple techniques helps you approach recovery with more ease. 

Managing Triggers

Patience can be especially thin when you’re confronted with a trigger. 

To address this, identify situations, people, or emotions that spark cravings or frustration (your therapist can help with this). Maybe it’s a certain bar, a high-pressure presentation at work, or an argument with your partner. Once you know your triggers, you can start to develop coping mechanisms. Avoid the bar altogether, use a relaxation technique to center yourself before work meetings, and learn how to better communicate with loved ones to reduce conflict. 

Having a plan in place empowers you to manage triggers effectively, preventing them from derailing your patience—and progress in recovery.

Celebrating Small Wins

The path to recovery is paved with small victories. You don’t have to wait for major milestones—acknowledge your daily wins! Did you resist a craving? Attend a therapy session?  These are triumphs worth celebrating.  

Take a moment to appreciate your progress, no matter how seemingly small. Journal about your accomplishments, reward yourself by doing something you enjoy, or share your win with a supportive friend. Taking stock of your wins reinforces positive behaviors, boosts your confidence, and grows the patience you need to persevere in recovery. Every step forward is a reason to celebrate!

Patience and Long-Term Recovery

Sustaining Motivation

Patience contributes to sustained motivation and long-term success in recovery. Embracing patience means you’re less likely to get discouraged by setbacks and more likely to retain your determination. Focusing on the long game, instead of chasing quick fixes, lets you trust the process. As you build your mental and emotional resilience, you position yourself for long-term success. 

Preventing Relapse

Preventing relapse involves tuning in to your emotions and triggers. This self-awareness helps you recognize early warning signs of relapse, like heightened stress or cravings, before they get out of control. Taking proactive steps like using techniques you learned in rehab, reaching out to your support system, or attending a support group meeting keeps you from veering further away from your goals. Patience empowers you to address these warning signs calmly and effectively, preventing them from escalating into a full-on relapse. 

“I had the patience and the willingness to stay sober.”

One man in recovery, Peter, credits patience with helping him finally stay the course toward recovery after years of being in denial about his addiction. He recalls his decision to commit to recovery6 while he was in the hospital after a car accident that happened under the influence:

I could easily have made a phone call but I wanted to quit. I had really had enough of it, and I had the patience and the willingness. I made the adjustments in my life that I had to, to stay sober.

Keep Trusting the Process

Patience in recovery doesn’t always come easy. But having the perspective to stick out tough times and see the process through is what allows you to reach the place where you can start reaping rewards. Nothing truly rewarding comes without effort. Sometimes all we can do when the road seems unclear is to keep putting one foot in front of the other. 

Find addiction treatment programs to support your path to a life in lasting recovery.

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Is Addiction a Choice? What Experts Say 

Is addiction a choice, or is it a disease? In the addiction treatment community, this seemingly simple question is a source of complex debate. On one hand, some view addiction as a moral failing: a result of poor choices and a lack of willpower. On the other, science reveals a different story: one of altered brain chemistry, overpowering cravings, and a chronic disease that requires professional attention.  

If you struggle with addiction, or love someone who does, learning how it works can only help. People affected by addiction need treatment to escape its grasp and heal its effects on their lives. By better understanding this multifaceted disorder, we can better address the problem—and treat those on this journey with compassion and care.

The Nature of Addiction

Definition of Addiction

Addiction goes far deeper than your garden-variety bad habit. It’s a chronic, relapsing disorder that takes hold by affecting pathways in your brain. Here’s how the American Psychological Association defines addiction:1

Addiction is a state of psychological and/or physical dependence on the use of drugs or other substances, such as alcohol, or on activities or behaviors, such as sex, exercise, and gambling.

Treatment professionals have different perspectives on what the exact nature of addiction is. But most of the behavioral health community agrees that it’s characterized by these 3 traits: 

  1. It’s chronic. 

Addiction is chronic. Repeated substance abuse alters brain chemistry, making it extremely hard to control cravings and resist use, even after periods of abstinence. This underlying brain change is why addiction requires ongoing management and support for long-term recovery.

  1. It involves the risk of relapse. 

Addiction has a high risk of relapse.2 Brain change caused by prolonged substance use can trigger intense cravings, making it hard to resist using again, even if you’ve been sober for awhile. This is why addiction treatment centers often address relapse upfront by building relapse prevention planning into their programs. 

  1. It’s compulsive. 

Addiction isn’t simply a matter of willpower. It’s characterized by compulsive drug use despite its negative consequences to your health, relationships, finances, and other areas of life. This comes from changes in the brain caused by repeated substance use. These changes disrupt the brain’s reward system, causing intense cravings that make it feel virtually impossible not to use, even if you know it will cause harm.

As a disease of the brain, [addiction] requires medical treatment in addition to an emotional commitment to treatment and recovery. Calling addictive disorders a habit denies the medical nature of the condition and implies that resolution of the problem is simply a matter of willpower.3

  • Partnership to End Addiction

Types of Addictions

Addiction isn’t limited to just drugs and alcohol. Both substances and behaviors can hijack the brain’s reward system and lead to compulsive use. 

Substance Use Disorders

  • Alcohol
  • Opioids (prescription pain relievers, heroin)
  • Stimulants (cocaine, methamphetamine)
  • Marijuana
  • Synthetic drugs 

Behavioral Addictions

  • Gambling
  • Internet addiction
  • Gaming addiction
  • Sex addiction
  • Eating disorders 

Scientific Perspectives on Addiction

Addiction and Brain Chemistry

Addiction is rooted in changes to your brain chemistry. A key player in all this is the reward system, a network of brain regions activated by pleasurable experiences, including addictive behaviors and substance use. This system releases neurotransmitters like dopamine, which reinforces those pleasurable experiences and motivates us to repeat them.

With repeated drug or alcohol use, your brain adapts to the presence of that substance. Over time, it takes more and more of the substance to produce the same effect. At the same time, your brain stops producing as much natural dopamine, making it harder to find pleasure outside of your addiction. 

This is why you can’t “just quit” using substances: your brain believes your life depends on them and urges you to act accordingly.

Genetic Factors in Addiction

How much of addiction can be attributed to genetics4 has long been a topic of scientific debate. “Even the most extreme environmentalists along the nature-nurture continuum in psychology now acknowledge that genes often contribute to individual differences in behavior,” says neuroscientist and behavior geneticist Dr. John C. Crabbe. 

Your genes, however, are not your destiny. While they may provide a blueprint that increases your vulnerability to addiction, which genes get expressed depends largely on your environment and lifestyle choices. 

Environmental Influences

Environmental factors play a major role in developing addiction. Childhood trauma due to neglect, abuse, or household dysfunction can impact the experiences we have later in life. In fact, there’s a direct link between how many adverse childhood experiences (ACEs)5 someone has and their likelihood of developing addiction as an adult. 

Addiction and trauma expert Dr. Gabor Mate explains that this “wiring” for addiction6 has to do with people’s ability to regulate their emotions: 

If the parents are not there in an attuned, nonstressed way to regulate them, self-regulation never develops. Then there is no impulse control. If they’re stressed to begin with, then they are going to go for anything to reduce the stress. One thing that addictions all do is they reduce stress momentarily.

Addiction can also result from trauma that happens later in life. Even if you’re not severely traumatized, chronic stress can lead you to self-soothe with substances. And if alcohol or drug use is normalized in your friend group and substances are easily available, social factors can play a part in developing addiction, too.  

Psychological and Behavioral Factors

Mental Health and Co-Occurring Disorders

Addiction is often related to an underlying mental health disorder. These co-occurring conditions can be a vicious cycle. While people who live with mental health issues might use substances to cope with their symptoms, substance use itself can also lead to—or worsen—mental health problems.

If you’re struggling with both addiction and your mental health, it’s important to find a specialized program that can effectively treat both at the same time. 

For more on this, see our article on treatment for co-occurring disorders. 

Decision-Making and Impulse Control

Addiction’s grip extends beyond physical dependence. It significantly disrupts the brain’s decision-making and impulse control centers. The brain’s reward system, designed to motivate healthy behaviors, is rewired to seek the addictive substance or behavior. This leads to intense cravings that override rational thought.

Addiction impairs your frontal cortex,7 the part of the brain responsible for decision-making, planning, and foresight. As a result, it gets harder to resist impulsive urges in favor of long-term goals like sobriety. This is why people struggling with addiction may fully understand the negative consequences of their actions, but still feel powerless against the overwhelming urge to use. 

Societal and Cultural Influences

Stigma and Misconceptions

Recovery requires us to be honest with ourselves and others about what we’re going through, and reach out for help. But for many, stigma is a huge barrier to getting the help they need.8 

There are widely held misconceptions of addiction as a moral failing, a lack of willpower, or a bad habit that’s easily kicked. These views don’t just promote discrimination against those who are struggling, but hinder their steps toward recovery.

Learning the science behind addiction helps us understand why healing requires professional help—and why those in this process deserve as much compassion as anyone else. 

Societal Pressures

Societal pressures and cultural norms influence substance use and shape our views on addiction. 

Certain cultures may normalize heavy drinking9 or social drug use, creating an environment where experimentation seems acceptable. This can be especially risky for teens, who are more susceptible to peer pressure and may underestimate the potential for addiction.

Media portrayals that glamorize substance use blur the lines between harmless recreation and dependence. Societal pressures to succeed create the conditions for burnout that often leads to self-soothing with substance use. Meanwhile, while much of the content we consume normalizes drinking as a way to relax. 

But social influences can also play a positive role. Our growing mental health awareness is reducing stigma around seeking help. And communities that promote healthy lifestyles and provide strong social networks create environments that support healing.

The Argument for Addiction as a Choice

Initial Use vs. Chronic Use

There’s a difference between the initial choice to use a substance and the loss of control that characterizes addiction. While the initial decision to use a substance might be a conscious one, addiction itself is not.  

Someone might try a drug or alcohol for the first time because they’re simply curious, or they’re influenced by peer pressure. But with repeated use, the brain undergoes significant changes. As tolerance builds, cravings intensify, and the ability to control impulses declines, addiction takes hold. 

Understanding how addiction develops shifts the focus from blaming people for their initial choice to supporting them through undoing the changes to their brain chemistry that perpetuate addiction. This paves the way for effective treatment that addresses the underlying causes and empowers people to regain control over their lives.

Addiction and Personal Responsibility

While addiction’s hold on neuropathways means behaviors aren’t always a willing choice, recovery empowers you to reclaim your personal agency. Once you recognize that you have a problem, you have choices: to seek treatment, to stay committed to recovery, and to respond differently to the challenges that arise.

Taking ownership over changing your life means actively participating in treatment, which might include individual therapy, medication, and support groups. It also involves making lifestyle changes that reduce your risk of relapse and support your well-being. This includes avoiding people or places that encouraged your substance use, learning healthy ways to deal with stress, and practicing self-care. As Dr. Gabor Mate says: 

We may not be responsible for the way the world creates our mind, but we can learn to take responsibility for the mind with which we create our world.10

The Argument for Addiction as a Disease

Chronic Illness Model

The disease model of addiction11 views this disorder as a chronic illness, similar to conditions like diabetes or heart disease. Just as these diseases alter biological processes and require ongoing management, addiction disrupts brain chemistry and requires long-term treatment.

Treatment for chronic diseases focuses on managing symptoms, preventing complications, and promoting overall health. Addiction treatment follows a similar arc. Initially, detox (if necessary) treats the physical symptoms of addiction. Intensive treatment approaches like inpatient rehab work on the underlying issues that drive addiction, and continuing care helps you prevent relapse and live a fulfilling sober life in the long term. 

The disease model works against the stigma of addiction, and highlights the need for effective treatment approaches that cater to each person’s needs.

Medical and Therapeutic Interventions

Just like treatment for other illnesses, addiction can be treated effectively with medical and therapeutic interventions: 

  • Medication is often used to manage withdrawal symptoms and reduce the cravings that lead to relapse. 
  • Individual therapy helps you uncover and address the root causes of your addiction, which may include unresolved trauma.  
  • Group therapy gives you a space to process what you’re going through and practice new skills with recovery peers. 
  • Holistic therapies complement clinical treatment by helping you access parts of the brain that talk therapy doesn’t. 
  • Support groups provide access to a sober community that can help you feel less alone as you navigate the ups and downs of recovery.

Many rehabs also offer relapse prevention planning and life skills coaching to help you reintegrate with your community when you return home, and hone the skills you need to stay sober as you work toward your life’s purpose. 

Integrative Perspectives

A comprehensive understanding of addiction goes beyond the disease-versus-choice debate.

The Biopsychosocial Model of Addiction

The biopsychosocial model12 acknowledges the interplay between biological, psychological, and social factors that contribute to addiction:

  • Biological: Genetic predispositions and brain chemistry changes
  • Psychological: Mental health conditions, personality traits, and coping mechanisms
  • Social: Exposure to substances, peer pressure, and a lack of support systems 

This integrative approach recognizes that addiction isn’t solely a brain disease or a personal failing. It’s a complex issue shaped by multiple factors, and addressing each of these areas in treatment is crucial for long-term success. Through biological interventions, psychological therapy, and social support systems, the biopsychosocial model offers a holistic approach to healing and empowers individuals to overcome addiction on multiple levels.

Personalized Treatment Approaches

The biopsychosocial model highlights the importance of personalized treatment plans in addiction recovery. Because everyone’s journey with addiction is unique and shaped by so many factors, treatment needs to address your specific needs. If you’re a woman recovering from PTSD, for example, you might feel safer discussing what you’re going through in a women-only therapy group. If your religion is your preferred path to healing, you might benefit from faith-based addiction treatment. 

A personalized treatment plan empowers you to identify and address what’s driving your addictive behavior, and to create lasting life change. 

Moving Beyond the Debate

Fostering Empathy and Support

Debates over the nature of addiction can often overshadow the most critical aspect of recovery: empathy and support for those who need it. Regardless of someone’s initial choices, addiction’s grip is a complex reality with profound physical and psychological effects. Blaming and shaming only hinder someone’s ability to make the life changes recovery requires.

Instead, our focus should shift toward understanding, compassion, and connecting people with quality care. The less stigma there is around addiction, the easier it is for people to seek help without fear of judgment. 

Humans are wired for criticism, and we often believe this is the best way to make change. But in fact, the opposite is true. Self-love empowers people to choose better for themselves. It’s easier to do the hard work of building a new life if you believe you’re worth it. 

Encouraging Treatment and Recovery

Addiction can feel overwhelming, but it is treatable. 

If you’re struggling with addiction, the first and most important step is to seek help. Talk to a doctor or mental health professional about your options. There’s no shame in voicing your needs—it only signals your strength and commitment to change. 

Recovery involves challenges along the way, but with dedication and support, you can overcome them. 

To find a program that’s a good fit for you, search our list of addiction treatment centers and reach out to one directly today. 

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Debunking the Rock Bottom Myth: A New Perspective on Addiction Recovery

The “rock bottom” myth suggests someone must hit a catastrophic low point before they recover from addiction. While pain and negative consequences can motivate change, it can be misguided and even dangerous to require this of everyone with an addiction. Many recover or start treatment without hitting their rock bottom. Staying connected to loved ones, work, and daily life often supports recovery.

Rock bottom is considered the ultimate low in someone’s life, like losing loved ones, money, status, freedom, and possessions. It can be a singular event of cumulation of consequences. Everyone will have a different rock bottom, which makes the myth even less defined—one person may consider becoming homeless and unemployed rock bottom, another may consider getting divorced to be their rock bottom.

Viewing “rock bottom” as the only entry point into treatment can harm a person with addiction and their loved ones. Instead of waiting to reach rock bottom, they can take agency over their treatment journey and seek help whenever they feel it’s necessary.

What Is The Rock Bottom Myth?

The rock bottom myth views hitting “rock bottom” as a requirement1 for addiction recovery. It sees pain, grief, and negative consequences as motivators for going to and engaging in treatment. While this can be true and often is, not everyone needs to hit a breaking point to get treatment or want help. You certainly don’t need to reach rock bottom to deserve help. 

The rock bottom myth originated in the 12-Steps2 of Alcoholics Anonymous (AA), where hitting rock bottom was once a sign participants were ready to practice and commit to the 12 Steps (and recovery). Rock bottom was portrayed as a launching pad into recovery. If participants didn’t reach this point, they weren’t seen as being able to commit to recovery and/or recover fully.

More recently, the rock bottom myth has faded to make room for unique recovery journeys, motivations, and underlying causes of addiction.

The Dangers of the Rock Bottom Myth

Waiting to hit rock bottom and going through it as a prerequisite for recovery poses several dangers. The components of rock bottom can be dangerous in themselves, like homelessness or committing a crime. 

The rock bottom myth can also keep someone from getting treatment and continuing in their addiction, which harms their mind and body. Waiting for a flip to switch, an epiphany, or acute realization of being at rock bottom delays treatment and can contribute to denial.

Someone may hesitate to pursue treatment if they’ve not hit a clear breaking point. They may worry treatment professionals won’t take them or their needs seriously if they don’t have evidence of hitting rock bottom. This can delay treatment, cause shame, and deepen hopelessness. These feelings can even build into a crisis point.

Rethinking Recovery: Early Intervention and Support

Early intervention is found to be the most effective preventative measure2 against addiction and its consequences. It can prevent addiction from worsening to a breaking point, and the harms that come with that. Knowing you can get treatment at any point, not just at the end of your rope, can encourage people to seek treatment sooner. 

Recognizing signs of addiction can help you get treatment early. For example, you may notice you’re drinking every night and feel uncomfortable or ill when you try to stop. Even though it hasn’t affected your relationships, work, or finances, you still feel like something’s wrong. Getting treatment once you realize that can stop its progression and hitting rock bottom.  

Alternatives to the Rock Bottom Approach

Many avenues to recovery don’t rely on hitting rock bottom or anything close to it. You can find the motivation to heal and treat underlying symptoms through therapy, supportive relationships, and various community resources.

Therapies like cognitive behavioral therapy (CBT) and motivational interviewing can disrupt unhealthy thought patterns and teach healthy coping mechanisms. Exploring past events and trauma can also help you identify triggers, connect them to substance or behavioral addictions, and find new ways to cope.

Connecting to peer support and community resources prevents the isolation and loneliness that can feed into substance use. Stay close to friends and loved ones, and try joining an in-person or online group focused on recovery. Twelve-Step groups may be a good option for you, or you could attend non-12-Step groups like SMART recovery. You could also join non-recovery focused communities, like clubs or sport teams, to meet new people and grow your support network. 

These communities and support networks can jumpstart your recovery by offering a subjective view of your situation. For example, an honest conversation with a friend or family member may open your eyes to your need for treatment, before you start experiencing consequences. Listening to their concerns and ideas can inspire you to begin treatment with their support. 

Shifting Societal Perceptions on Addiction and Recovery

Addiction and mental health conditions aren’t fully understood by the public—unless it happens to them or someone they love. This misunderstanding can lead to prejudice and stigma, which can make it hard for anyone to admit to struggling with a mental health condition or addiction. This can hinder early intervention and land people at their rock bottom.

Awareness on addiction, mental health, and the realities of recovery can change how the public views these conditions. Rather than seeing it as something that must reach a certain drastic point for treatment, addiction can instead be seen as something you treat as soon as you notice symptoms, much like most illnesses or wounds. If addiction or mental health conditions were seen in this light, more and more people might feel willing to admit their struggles and seek treatment before it becomes consuming.

Thankfully, many efforts and organizations are actively working on making the public aware of the realities of addiction and mental health—and reducing stigma along the way.

  • To Write Love On Her Arms raises awareness for depression, suicide, self-injury, and addiction. They offer a message of hope and unity and donate to treatment efforts by selling merchandise. 
  • The Herren Project helps individuals and families find treatment with personalized support and scholarships to cover treatment costs. They’re founded by former NBA player Chris Herren, who recovered from addiction and seeks to reduce the stigma surrounding recovery, bring awareness, and provide hope.
  • Red Ribbon focuses on youth and drug use prevention in schools. They advocate for drug use prevention and recovery, hosting events to spread awareness and help more and more people commit to drug-free lives.
  • The Pan American Health Organization (PAHO) runs a mental health awareness campaign addressing stigma and discrimination. They encourage countries and people to #DoYourShare in reducing stigma and making treatment more accessible.
  • CALM’s “Suicidal doesn’t always look suicidal” campaign uses photos and videos of people before the took their own life to bring awareness to suicide, encourage treatment, and start much-needed conversations without shame or judgment.
  • State campaigns are often run by state governments and aim to bring awareness to addiction and help people connect to treatment. Search the internet for local campaigns or check community centers, libraries, and churches in your town or city.

How to Seek Help Without Hitting Rock Bottom

You don’t have to hit rock bottom to heal. If you’re experiencing symptoms of addiction or a mental illness and notice they have an effect on your life, ask yourself, “Do I want to keep living like this?” The answer can inform what you do next.

If you answer no, you can begin seeking treatment or implementing changes into your daily life. You can set up an appointment with your primary care physician, bring your concerns to them, and see what they recommend. Keep questions like these in mind to get a full understanding of your condition and treatment options:

  1. Do my symptoms and experiences fall under a diagnosis? If so, which one(s)? (This can help insurance cover the costs of treatment.)
  2. What lifestyle changes or new habits would you recommend to improve my symptoms?
  3. Do you recommend I start medication to manage my symptoms? If so, which one, and what are its side effects?
  4. What type of treatment or level of care would you recommend?
  5. Will I need a referral for my next steps in treatment?

Use Recovery.com to find treatment centers for your condition and preferences, filtering by insurance coverage, amenities, and location. 

Helping Someone Else

An open and non-judgemental conversation with a friend or loved one could save them from the life-altering effects of hitting rock bottom—and even save their life. 

You may notice a friend or family member acting differently; seeming ‘off.’ They may drink more often or get drunk more regularly. They may seem sad and view life through a suddenly cloudy lens. If you notice signs like these or just intuitively know something’s wrong, voice your concerns calmly, non-judgmentally. Here’s how that could look:

  • “I’ve noticed you seem down lately. Would you like to talk to me or someone else about it?” 
  • “I see you’ve been drinking more and more often. Do you think you might need help to stop?”
  • “I feel like you’ve been acting differently lately—you seem sad. Can I help you, or help you find help?”

Together, you can look into treatment options, just talk, or both. Your support and care can make all the difference. 

Bridging Rock Bottom With Early Intervention

You don’t have to hit your breaking point to heal. Though the rock bottom myth holds truths about motivation to change, it’s not necessary for successful recovery. Getting help as soon as you notice signs in yourself or someone else can be key to early intervention and healthy living.
Browse Recovery.com to find a treatment center that fits your needs.

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Rural Recovery: Challenges and Hope

Rural areas offer great benefits, like a slower pace of life, open fields, and close-knit communities. But what happens when they can’t provide the resources someone vitally needs, like addiction and mental health treatment? Lacking what many urban dwellers take for granted—access to resources—can endanger the billions of people living in rural communities worldwide. 

Thankfully, technology has opened new doors for rural areas. With just a phone or laptop and internet access, people can attend therapy online and even virtual rehab. Increased mental health awareness in small communities may also create new and improved resources for areas in desperate need.

To learn more about the healthcare challenges in rural areas and how providers navigate them, listen to our recent podcast episode featuring Dr. Jonathan Rosenthal!

Behavioral Health Challenges in Rural Areas

About 1/5th of rural Americans have a diagnosed mental health condition1. Urbanites make up close to the same. However, those in rural areas have more trouble accessing care and finding clinicians, as opposed to urban cities with multiple clinics and practices to choose from. 

Over 60% of rural Americans live in ‘mental health provider shortage’ areas1, with 65% of rural counties without psychiatrists. Waiting lists for therapy or more intensive care can extend for months. Limited mental health knowledge and stigma often prevent rural residents from seeking treatment at all. If they do, low availability often means they must choose the first provider they can get, whether they’re a knowledgeable fit or not. Personalized care can become more of a luxury than a necessity.

Primary care physicians (PCPs) often become the first and only line of defense for mental health conditions and substance use. While PCPs can prescribe medications and recommend next steps, they often don’t have the specialized training in mental health or addiction to educate and support patients properly.

A Top Challenge: Growing Suicide Rates in Rural Communities

Rural residents are twice as likely to die by suicide than urban residents1. Isolation, stigma, poverty, and an inability to access care contribute to the steadily growing rate of rural suicides. Timely access to care, crisis services, and increased awareness of mental health could lower the risk of suicide among rural residents, particularly veterans and young adults. 

Boundaries to Effective Care in Rural Communities

People in rural areas face several prevalent barriers to care, including limited availability of resources, long travel times to get to treatment, and stigma. 

Lack of Access

Here’s a story highlighting a common treatment scenario in rural communities, where the necessary treatment simply isn’t available:

  • Rosie has been struggling with severe depression and loneliness. After months of waiting, she finally got into therapy. Rosie thinks group therapy would help her feel less alone and stigmatized. Her therapist agrees, but tells Rosie they don’t have any groups in town. Rosie keeps going to individual therapy but misses out on an aspect of treatment she feels is crucial.

Not having access to is the biggest bar to effective care1. Often, those in rural communities simply don’t have clear or easy access to treatment (or any access at all) and thus don’t receive it. And when they do seek treatment, overwhelmed medical providers can only refer to whatever resources they have and hope availability opens up.

Rosie’s story is a poignant illustration of the challenges faced by those seeking mental health care in rural areas. After enduring a prolonged wait to receive therapy, she encounters another hurdle: the absence of group therapy options in her area, which she and her therapist agree could be vital for her recovery. This scenario highlights the disparity in mental health resources available in less populated regions and the significant impact it can have on those in need of comprehensive care.

Long Wait Times

Waiting time poses another barrier to care. Here’s a second scenario highlighting this:

  • Darren has a paralyzing fear of socializing and talking in groups. He feels something isn’t right and seeks out therapy, but hears he’ll have to wait at least five months to get in. To manage his symptoms in the meantime, Darren starts bringing alcohol with him to work and getting tipsy to deal with his social anxiety. 

With these long wait times, symptoms can worsen; patients could lose motivation and back out. Being unable to access care could lead to substance use as a way to cope with conditions like depression, trauma, or anxiety. 

Darren’s situation underscores the pressing challenges that arise from the lack of timely access to mental health services. Suffering from a paralyzing fear of socializing and speaking in groups, Darren recognizes the need for professional help and reaches out for therapy. However, he bumps into a discouraging five-month wait. In a desperate attempt to manage his escalating anxiety, Darren resorts to bringing alcohol to work, using it to lessen his discomfort in social situations. This scenario highlights the detrimental effects that can occur when immediate mental health support is unavailable.

Behavioral Health Illiteracy

People in rural communities may not know how to identify behavioral health issues1 or how to get treatment. Bigger cities and communities often have more programs and initiatives highlighting behavioral health treatment and broadening awareness.

Stigma

Without adequate knowledge of behavioral health conditions, stigma can make mental health challenges and addiction seem unimportant or weak, discouraging rural residents from seeking help. Living where everybody knows everybody, they may worry they’ll be judged if they try to get help or admit to a problem. 

Travel Times

Rural residents often have long drives to get to a treatment facility or clinic that meets their needs. Juggling the time spent on the road, work, and other personal obligations can delay care2 or keep them from seeking it altogether. Here’s a predicament a farmer may face when trying to get treatment:

  • Bill seeks out treatment for his alcohol use disorder and needs a psychiatrist to go to once a week. The closest psychiatrist to him practices an hour and a half away, which means he’ll be gone for almost four hours each time. But Bill runs his own cattle farm, and he needs to milk his cows every morning and ensure they’re fed. Leaving for 4 hours feels out of the question; he cancels his appointments and decides to deal with his symptoms alone. 

Solutions for Better Access and Support

Rural areas need more general physicians, therapists, and specialists to meet the rising demand for behavioral health services. Incentive programs in some states encourage new physicians to practice in rural areas1, which could steadily grow their workforce and improve access to care. Other solutions, many already in play, include:

Virtual Care

Virtual care uses the internet3 to connect patients and care providers virtually. Since COVID-19, virtual care has become more commonplace and can serve as a vital connection for rural residents and treatment providers. You only need a phone or laptop and an internet connection to access virtual care. You’ll use a secure online platform to conveniently meet with a doctor, therapist, psychiatrist, or other healthcare provider.

With virtual care, you don’t have to live in a certain city or near a therapist’s office. You can even attend residential rehab online and outpatient levels of care. And with a larger pool of providers and specialists to choose from, you can get into treatment faster and find care specialized to your needs. 

Incentives for Rural Providers

Some state governments have incentivized more healthcare providers1 to practice in rural communities. If they practice for a set number of years, they receive additional financial compensation. If every state had the funding for this initiative, it could repopulate the rural workforce with eager health and mental health providers.

Increased Behavioral Health Training

Additional training would benefit current rural providers1 and help them make better-informed decisions on patient care. Primary care physicians would understand all the available options, including virtual care and local crisis services for mental health and addiction. Some programs have started training non-professionals to provide peer support, which has had success in the rural Native Alaskan community.

Known and Accessible Suicide Prevention Strategies

Death by suicide occurs more commonly in rural populations1, especially in kids, young adults, and older adults. Social isolation and not knowing what support they have can lead to untreated crises. Many programs and crisis services do exist and specifically serve rural populations, like local crisis teams, but residents don’t often know they’re there.

Educating community members on their available crisis services and support programs could save lives. Community leaders could make their crisis services more prominent and accessible by posting them in daily newspapers and highlighting crisis hotlines like 988 (National Suicide Prevention Hotline). Schools, churches, and businesses could also spread the word to destigmatize mental health and inform residents of their resources.

Better Support for Physicians

Physicians and mental health professionals face burnout in all settings, but rural providers can end up shouldering high caseloads and pressure to treat more people than they reasonably can. Compassion fatigue and discouragement can drive providers to areas with better support, so providing support in rural settings could help them stay. Financial incentives could bring more practitioners to rural areas, also lightening the load for current practitioners. 

Psychological care, peer support, and financial benefits can help providers retain their well-being and compassion, essentially helping them help others.  

Future Goals and Ideas

In an ideal world, rural populations would have the same access to and knowledge of mental health and addiction care as urbanites. Virtual health would fill in the gaps, with more better-trained and better-supported providers meeting the high need and demand for behavioral healthcare. Awareness and education on behavioral health would reduce stigma and help people feel more comfortable asking for help. 

Low-Cost Clinics

Low-cost clinics, funded by grants or donations, could offer the affordable care many rural residents in poverty need. Staff at these clinics could educate patients on good mental and physical health, with free resources for improving their diet and creating healthier habits.

Funding Local Resources

Funding for local programs could strengthen community services, too, helping them offer more robust non-clinical services. For example, funds to a local crisis support unit could go towards hiring full-time staff with specific crisis training.

In rural areas and beyond, everyone who needs treatment should have a clear path to it and support along the way, whether from their doctor, family, other community members, or all three. 

Learn more about future goals and ideas in improving rural healthcare by listening to our recent podcast episode here!

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Beyond Paradise: Exploring The Realities of Rural Healthcare in Hawaii

We were thrilled to talk with Dr. Jonathan Rosenthal, a hospitalist from Kauai, Hawaii, about his 23+ years as a hospitalist and his unique experiences practicing in rural Hawaii. In our newest episode, Dr. Jonathan Rosenthal talks with hosts Dr. Malasri Chaudrey-Malgeri, Editor-in-Chief, and Cliff McDonald, Chief Growth Officer.

Listen to Dr. Rosenthal’s episode and hear from our previous guests here!

Finding a Fit as a Hospitalist

Dr. Rosenthal is a hospitalist in an intensive care unit (ICU). He sees people in the emergency room and admits them into hospital care, working with his patients daily until they’re ready to leave treatment. Dr. Rosenthal has been working as a hospitalist in the remote town of Kauai for almost 13 years, starting his career in urban Seattle.

Dr. Rosenthal came to Kauai seeking a better quality of life and settled in, now living on the island with his wife. Kauai’s rural setting means Dr. Rosenthal works at the only major hospital on the island. He and his other 5-7 coworkers balance the needs of the island’s hospitalized patients. 

Challenges Faced in Rural Populations

Dr. Rosenthal’s community faces distinct challenges, like not having access to care, poverty, health illiteracy, and unhealthy eating. He frequently encounters metabolic disorders like diabetes, obesity, and hypertension as residents don’t have the means or access to healthy foods. Meth use also runs rampant:

“​​I was blown away that, like how frequently, you would come across people who are using methamphetamine. It’s really rampant. It often leads to problems that I need to see them for.”

Dr. Rosenthal notes his community has no public resources for the issue of meth use, making awareness and treatment difficult. Finding affordable care also poses a challenge for impoverished residents. 

For the physicians, they face discouragement from a lack of resources and support. Compassion fatigue, burnout, and the grief of being unable to help everyone pose significant challenges for providers in Kauai and other rural areas.

Encountering Wide-Spread Addiction and Mental Health Concerns

Of patients Dr. Rosenthal sees from the ER, he estimates:

“Almost every single time if you have to be hospitalized and you’re under 40, maybe 90 percent of the time, you have some sort of substance abuse and/or mental health, usually both, problem accompanying whatever else is going on.”

As the first line of defense, the emergency room takes the primary load of cases involving addiction and severe mental health concerns. Dr. Rosenthal highlights the inadequacy of emergency treatment for long-term recovery, as patients receive treatment for symptoms but not underlying issues.

Ideas and Solutions for All Rural Communities

Dr. Rosenthal notes Kauai actually has one of the highest life expectancies in America, but a large subset of the population are “still quite unhealthy” and don’t have access to healthy foods, as most of Kauai’s wealthier residents do. Nutrition education could go a long way in re-shaping eating habits and lowering the high rate of metabolic disorders.  

As for the addiction concerns his community faces, Dr. Rosenthal says, 

“We need to come up with some sort of public health system that will incentivize people to get clean and stay clean. And to be healthy in general.”

Dr. Rosenthal dreams of opening a low-cost clinic for impoverished residents to get affordable care and pick up fresh fruits and vegetables. Healthy food in his hospital’s cafeteria would also improve access to healthy foods. Showing residents what healthy foods they could buy with constrained budgets and providing cooking classes would educate residents and encourage healthier eating. 

Virtual addiction and mental health services can also make care more accessible for rural patients, as they’d only need a device and internet access to get treatment. Services like these could lighten the burden for Kauai’s emergency rooms and providers like Dr. Rosenthal. Making these resources known through community outreach plays a vital role in patient education and people using their resources.

Listen to Dr. Rosenthal’s episode on The Recovery.com Podcast to hear about his inspiring work and ideas.