Tag: Mental Health

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What Is a “Dry Drunk”?

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

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

Who’s Most at Risk of Dry Drunk Syndrome?

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

Someone Who Never Went to Treatment

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

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

Without treatment, you risk developing dry drunk syndrome.

Someone Who Didn’t Complete Treatment

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

Someone Who Had Poor Treatment

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

Other Nuances of Dry Drunk Syndrome 

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

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

What Are The Signs of Dry Drunk Syndrome?

The signs of dry drunk syndrome2 include:

Changes in Mood 

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

Difficulty Concentrating

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

Isolating

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

Engaging in Other Addictive Behaviors

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

Going Back to Old Bars

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

Habitual Lying

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

Anger And Resentment

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

Exaggerated Self-Importance

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

How Is Dry Drunk Syndrome Treated?

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

Cognitive Behavioral Therapy (CBT)

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

Dialectical Behavioral Therapy (DBT)

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

Holistic Therapies

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

The 12 Steps

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

Find A Support Group

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

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Coming Out and Mental Health: Navigating the Emotional Journey

Coming out as a member of the LGBTQ+ community can feel daunting, liberating, scary, or all of the above. It can also have positive or negative impacts on your mental health, both of which you can navigate. 

Don’t feel like you need to follow a script, set of steps, or anything else to successfully come out. It’s up to you and what you’re comfortable with. You know your life and circumstances better than anyone else. 

But you do have resources for the journey and its emotional effects. 

Understanding Coming Out

The American Psychological Association defines coming out1 as, “self-awareness of same-sex attractions; the telling of one or a few people about these attractions; widespread disclosure of same-sex attractions; and identification with the lesbian, gay, and bisexual community.” 

For many, coming out shapes the rest of their lives. It can be one of the most significant journeys you ever face. For others, it’s not a big deal. It’s different for everyone, and that’s perfectly okay.

Challenges And Fears of Coming Out

A potent fear related to coming out is the possibility of rejection. Your loved ones could reject your core identity, and that would hurt. 

Social prejudices, misconceptions, and misguided views could also make coming out scary, both right away and in your future. Even if the reactions aren’t negative, they might not feel affirming, either. Both can hurt.

Picking the right time to come out can also feel like a challenge. When do you say it, and who do you tell? Should you tell one person, or a group of your friends and family? 

Only you can truly answer those questions. But the weight of wondering can affect your wellbeing. Drinking or using drugs could seem like a way to alleviate the stress. If you’re struggling with addiction, you can browse our list of LGBTQ+-affirming rehabs. 

Mental Health Considerations in Coming Out

Feeling unaccepted can lead to depression, anxiety, and even trauma. Society’s attitude towards the LGBTQ+ community can also cause minority stress2, which can exacerbate or cause mental health conditions. Some may experience chronic minority stress, which means they’re hypervigilant to possible discrimination, frequently worried about it, or carry internalized stigma of themselves. 

This stress, fear, grief, and trauma can create or worsen mental health conditions. It’s not hard to see why—but that’s not how the story has to go. 

The Impact of Attitudes And Acceptance on Mental Health

Coming out could relieve the emotional toll of hiding. When you come out, you won’t have to adjust your behaviors, actions, and words to hide who you really are. That can feel like a deep relief. 

But make sure you know how you feel about your identity. Take a deep and thoughtful search of your heart—what do you feel when you think about who you are? Internalized homophobia can add stress and shame to your coming out journey. As much as you’re able, try to find and challenge these feelings. 

Coming out can lead to self-acceptance, which can powerfully erase any internalized homophobia. And once you’ve accepted and embraced who you are, what others think might not matter so much. It’s okay and normal if it does. You have ways to navigate that, too. 

Mental Health Resources for the Coming Out Process

Many support groups, online chats, and other resources can help you through the coming-out process. Here’s a few:

  • PFLAG: A LGBTQ+ resource with 400 local chapters in America. Started in 1973, they were the first organization to offer help, education, and support to LGBTQ+ people and their families.
  • 988: They provide resources for LGBTQ+ people and a 24/7, nation-wide suicide crisis hotline. 
  • The Trevor Project: They’re the world’s largest crisis service for LGBTQ+ youth ages 25 and under. You can call, text, or chat the crisis interventionists here 24/7. 
  • Trans Lifeline: A crisis line for trans people that respects your rights and doesn’t use non-consensual interventions.
  • Pride Counseling: A specialized online counseling service for the LGBTQ+ community.
  • LGBT National Help Center: They provide a phone hotline for LGBTQ+ people of all ages to speak with an educated volunteer about identity struggles, coming out, and other concerns. 
comingout

Self-Care Strategies for Mental Well Being

Coming out likely won’t be completely stress-free, and that’s okay. Whether the stressor is big or small, you have ways to manage your emotions and improve your wellbeing. 

You can practice mindfulness and meditation when your emotions feel overwhelming. Try to identify the support you have in your life, too. The resources listed above definitely count as someone you can talk to when you feel overwhelmed.

Be sure to practice self-care, self-compassion, and self-acceptance as you plan and execute coming out. Don’t force yourself to follow what anyone else did, either. The way and time you come out is unique to you—try to take comfort in that. Here’s some other self-care steps you can take:

Your mentor could be someone who came out months or years ago. They can help you through the process and offer support from someone who’s really been there. 

To find one, you can connect to an openly queer person in your life. Even if they’re not able to help you throughout the whole process, it might help you to know that they know what you’re going through. If you don’t know any potential mentors, or don’t feel comfortable doing so, you can connect with others online. 

Building Resilience and Creating a Supportive Environment

A negative reaction to your identity will probably hurt. But you can manage that pain by building resilience and creating a supportive, safe environment for yourself.

The American Psychological Association suggests group environments build resilience3. Your group may be other LGTBQ+ people in your neighborhood, work, or school, or a more formalized LGBTQ+ gathering. All your group must do is offer support and bring you happiness to strengthen your recovery. 

A supportive environment will feel safe and accepting. For you, this might include your family, friends, or others in the LGBTQ+ community. It differs for everyone, and that’s okay. If your environment becomes unsupportive, consider leaving it, if you can. Mental health professionals can help you navigate this change. 

Resilience also ties into self-care. The healthier you are physically, the more prepared you’ll be to handle emotional challenges. Take care of your mind, too. That’s where meditation, journaling, and mindfulness come in.

Reach The Other Side of Your Rainbow

Coming out is your unique journey. It can come with stress, worry, and fear, even if you’re excited for the change. But you have help available along the way. 

Along the way, make sure to prioritize your mental health and well being. You can do so through therapy, engaging in support, and actively practicing self-care. 

And remember that your coming-out process is your own. If you think writing out a script will help, do it! If a video seems more helpful, or even baking a cake, do that! The path you take is up to you.

Good luck and be well.

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

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

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

Defining Fawning as a Trauma Response

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

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

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

How Fawning Differs from Other Trauma Responses

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

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

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

Early Triggers Leading to Fawning

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

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

Psychological Mechanisms of Fawning

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

How Fawning Changes Attachment Styles

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

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

Fawning And c-PTSD

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

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

Effects of Fawning on Individuals

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

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

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

Healing And Recovery

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

Therapies for Trauma And The Fawn Response

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

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

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

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

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

Coping Strategies for Fawning

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

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

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

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

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

Practical Solutions for Fawning

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

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

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

Supportive Resources And Communities

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

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

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

Advocacy And Raising Awareness

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

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

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A Guide to the Biopsychosocial Model of Mental Health

According to the biopsychosocial model of mental health, there are 3 different dimensions of health and illness. Clinicians believe biological, psychological, and social factors can all affect your well-being.

Within this model, you’ll receive holistic treatment. Your care plan will include various therapies that focus on each aspect of your life. This comprehensive approach addresses your needs as a whole person, instead of just treating isolated symptoms. 

Understanding the Biopsychosocial Model

George L. Engel introduced the biopsychosocial model of mental health1—sometimes called the BPS model—in 1977. Since then, it’s gained widespread support among mental health professionals. 

According to Engel, health problems don’t happen in a vacuum. He defined 3 areas that contribute to any diagnosis: 

  • Biological
  • Psychological
  • Social

These 3 dimensions of wellness have a complex relationship. Having symptoms in any one of these areas can cause problems in the other two. 

For example, seasonal allergies are a biological issue. If you work outside, severe symptoms might force you to take a sick day. That could affect your income and your family, which are social issues. Sneezing all day can also put you in a bad mood, affecting your psychological state. What starts as a simple immune response can impact every aspect of your life. 

When you understand how your symptoms support each other, it’s easier to find the right types of treatment. For example, data shows that anger makes chronic pain more severe.2 If you have both of these issues, going to talk therapy for anger management could help you physically heal. 

The BPS model draws clear distinctions between its 3 areas of focus: 

Biological Factors

There’s a strong link between mental and physical health.3 On one level, this may seem intuitive. If you’re sick, you’ll probably have to rest instead of doing things you enjoy. But the connection goes much deeper. Having a heart attack, for example, raises your risk of depression. And some mental health issues, like PTSD, can have physical symptoms.4

Mental Health and Genetics

Many mental illnesses run in families,5 suggesting they might be genetic. However, until researchers can isolate the relevant genes, this will remain a theory. Today, experts believe that bipolar disorder, major depression, and schizophrenia, among other diagnoses, are likely hereditary. 

The Neurochemistry of Addiction

Behavioral health problems can also have biological components. For example, the neurotransmitter dopamine plays a role in addiction.6 This naturally occurring chemical makes you feel a sense of reward. 

When you have an addiction, the act of taking drugs stimulates the release of dopamine. That’s true no matter which drugs you’re using. Your brain can come to depend on substance use as the trigger to produce this essential neurochemical. In other words, you’ll only feel a sense of achievement when you drink or take drugs. 

This chemical balance can get worse over time, making it harder and harder to quit. While that cycle is a biological process, it also has serious emotional consequences. 

Psychological Factors

Psychological factors, like self-esteem, can affect your mental health.7 On its own, low self-esteem isn’t technically a symptom of mental illness. But it can lead to more severe issues. For example, one study found that people with less self-esteem had a higher risk of anxiety, depression, and attention problems.

Cognitive Processes

A cognitive process is the way your brain performs a task.8 Learning, decision-making, and paying attention are all examples of cognitive processes. 

Mental illness affects your cognitive processes. For example, data shows that depression interferes with memory formation.9 And ongoing memory problems can affect your work, social life, and overall well-being.

This connection goes both ways. Poor cognitive processing10 increases your risk of developing a new mental illness. Without proper treatment, this can lead to a spiral of worsening symptoms. 

Social Factors

Interpersonal relationships have a major impact on mental health.11 Social support lowers your risk of developing mental illness and addiction. And if you do have mental health issues, strong relationships improve your chance of recovery. 

Cultural Norms

There’s more to your social life than relationships. Your cultural background also influences your mental health.12 That’s because your values affect the way you think about your behavior. In some cultures, for example, it’s okay to have a beer with friends after work. In others, drinking is strictly taboo. Either way, your beliefs may affect how you define alcohol abuse. 

It’s important to find treatment that supports your values. With the biopsychosocial approach, clinicians may design a clinical care plan just for you. They may employ a variety of treatment methods, depending on your unique recovery goals. 

Socioeconomic Status

Your economic status matters, too. Researchers correlate lower socioeconomic status with higher rates of mental illness.13 This is probably due to the chronic stress of financial insecurity. That stress can also damage relationships, cutting you off from valuable social support. And what’s more, a lack of resources makes it harder to afford mental health treatment.

Application of the Biopsychosocial Model in Assessment

Under the biopsychosocial model, treatment starts with a comprehensive assessment.14 This approach to diagnosis is the standard of care. In other words, experts agree that it’s an effective way to start planning your long-term recovery. 

During the assessment, your care team will ask a series of questions15 about your physical, mental, and social well-being. These interviews are extremely detailed and may vary between providers. However, most assessments will include certain basic questions:

  • Do you have any past or present medical diagnoses?
  • Do you have any past or present mental health diagnoses?
  • Do you have a family history of any physical or mental illnesses?
  • What symptoms are you currently experiencing?
  • Do you now, or have you ever taken illicit drugs?
  • What is your living situation?
  • How much sleep do you normally get in a night?
  • Who is part of your support network? Does it include family, friends, healthcare providers, etc?
  • What is your highest level of education?
  • Are you currently employed?

Clinicians use this information to understand how your symptoms fit together. If you don’t already have a diagnosis, they may give you one before discussing treatment. Either way, the next step is to develop your plan of care. 

Treatment and Interventions

Despite the evidence that supports it, biopsychosocial treatment is not widely available.16 One study found that in hospital settings, few doctors perform comprehensive assessments. Instead, most providers focus on physical symptoms. If you’d like to receive treatment under the BPS model, you may need to seek out a specialized program.

By definition, biopsychosocial care includes multiple types of treatment.17 Each one addresses a different aspect of your health. For example, your care plan might include some or all of these therapies:

  • Biological: Medical care, nutrition counseling, physical therapy
  • Psychological: Talk therapy, behavioral therapy
  • Social: Family therapy, support groups

In many programs, your clinicians will work together18 to provide integrated treatment. You may meet with your care team as a group, and they may meet privately to discuss your case. This close communication allows them to track your progress and make adjustments to your care plan if necessary.

Limitations and Criticisms

While biopsychosocial assessment is the standard of care, this model has some limitations.19 Specifically, it focuses more on diagnosis than treatment. Without formal guidance on how to design a care plan, every provider takes a slightly different approach. This makes it hard for patients to know what they can expect during recovery. 

Some experts argue that the biopsychosocial approach is outdated.20 Critics say that scientific breakthroughs “have changed the very face of psychiatry in the last few decades,” leaving Engel’s theory behind. This new research suggests that some mental health issues have purely biological causes. However, we need much more data before we can confirm these theories.

The BPS model is more holistic21 than other approaches—maybe to a fault. S. Nassir Ghaemi, Director of the Mood Disorder Program at Tufts Medical Center, explains that “its boundaries are unclear.” In the effort to include so many dimensions of health, Engel left room for practitioners to interpret information as they see fit. As a result, their personal biases may affect treatment. Biopsychosocial treatment “gives permission to do everything, but no specific guidance to do anything,” Ghaemi writes. 

Future Directions and Implications

Despite these critiques, other experts say we can keep learning from this approach. For example, experts posit that focusing on the biopsychosocial model might reduce burnout among medical students.22 This could have far-reaching implications for the future of treatment. By setting an example for the next generation of healthcare providers, we might be able to reduce the stigma around mental illness. 

Biopsychosocial care also offers unique opportunities during recovery. Because treatment is so personalized,23 you and your care team may develop a closer bond. That connection can help you commit to treatment more fully. 

For a complete assessment of your physical, mental, and social needs, reach out to a treatment center and inquire with their admissions team. From there, you can begin planning the next phase of your recovery journey—and the rest of your life. 

Frequently Asked Questions About the Biopsychosocial Model of Mental Health

What is the biopsychosocial model of mental health?

The biopsychosocial model of mental health recognizes that biological, psychological, and social factors all contribute to a person’s well-being and the development of mental health issues. It emphasizes holistic treatment that addresses each aspect of a patient’s life to provide comprehensive care.

What are the 3 dimensions of the biopsychosocial model?

The biopsychosocial model consists of 3 dimensions: biological, psychological, and social. These dimensions interact with each other, and symptoms in one area can impact the other two. By understanding these connections, healthcare providers can develop tailored treatment plans.

What types of treatment are involved in the biopsychosocial model of mental health?

In the biopsychosocial model, biological treatments may include medical care, physical therapy, and nutrition counseling. Psychological treatments may involve talk therapy and behavioral therapy. Social treatments may include family therapy and support groups. Integrated care, where different treatment providers collaborate, is common in this model.

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What Is The Most Addictive Drug?

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

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

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

Heroin

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

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

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

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

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

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

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

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

Alcohol

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

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

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

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

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

Nicotine

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

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

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

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

Benzodiazepines

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

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

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

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

Methamphetamines

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

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

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

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

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

Cocaine

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

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

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

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

Crack Cocaine

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

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

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

Barbiturates

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

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

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

Methadone

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

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

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

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

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

Marijuana

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

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

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

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

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

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

Find Effective Drug Addiction Treatment Near You

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

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

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Sober Women of History

Sober women have contributed to the recovery movement in America since it first began. Their early contributions helped make the recovery space more accessible and acceptable for women. 

Women also advocated for gender-specific treatment, support groups, and 12-Step meetings. Their work is still felt around the world today. Some rehabs cater to just women, too. 

Women in Recovery Who Made a Difference

Each and every woman in recovery makes a difference. Women who challenged the stigma of addiction and recovery early on paved the way for continued advocacy, fresh recovery programs, and support. 

Betty Ford (1918-2011)

Former First Lady Betty Ford left a large mark on the addiction treatment scene and the stigma surrounding it. After a battle with opioid and alcohol addictions, an intervention, and treatment, Betty realized she was in a unique position to make a difference. 

First Lady Betty Ford helped create her own treatment center, the Betty Ford Center, designed to help both men and women find recovery. Betty Ford Centers have since expanded across America. 

The Betty Ford organization merged with the Hazelden Foundation in 2014. Hazelden pioneered the Minnesota-model of treatment1, which focuses on 12-Step treatment. Their merge broadened the impact of Betty’s first decision to make her addiction known and use her notoriety to help others.

Jean Kirkpatrick, Ph.D (1923-2000)

Jean Kirkpatrick, sociologist, formed Women for Sobriety in 1975. She attended 12-Step AA (Alcoholics Anonymous) meetings throughout her recovery process. After finding a need for women-focused treatment, she created a solution herself: Women for Sobriety2. 

Women for Sobriety groups meet across America now. Dr. Kirkpatrick’s history of repeated relapses, research, and life-long determination brought a gift to the world many women continue to enjoy. 

Elizabeth Taylor (1932-2011)

American actress Elizabeth Taylor lived a lavish, seemingly ideal life. But after a spinal surgery and other health conditions, she became addicted to prescription pain pills3. She also struggled with alcohol addiction. 

Elizabeth Taylor made the decision to publicly announce her admittance to Betty Ford Center, Betty Ford’s first treatment center. By doing so, Elizabeth gave permission for other celebrities to do the same. She also normalized treatment for women—even pretty, successful ones like her.

As a Hollywood Icon, Elizabeth Taylor embodied who many women wished they could be. So seeing her go to rehab, openly admit it, and then go again after a relapse may have been more impactful than she’ll ever realize.  

Nora Volkow (1956-Present)

Nora Volkow, current director of the National Institute of Drug Abuse (NIDA), changed the way we see addiction. Her work in brain imagery showed that addiction isn’t a character flaw or personal failing. Rather, it’s a tangible change in the brain. 

Her work contributed heavily to the disease model of addiction4. This revolutionized the old idea of addiction being something to punish. Now, for many, it’s something to treat.

Women in Alcoholics Anonymous (AA)

Alcoholics Anonymous (AA) provides a resource for Americans struggling with alcohol addiction. While it didn’t specifically exclude women, they weren’t welcomed in the same way men were. Usually, women were seen as the supportive spouse, attending just for their husbands’ sake. Or, women were villainized for their addiction. 

Some of the very first women in AA decided to change that.  

Florence R. (?-1943)

Florence was one of the very first members of AA5. She joined one of the pioneering groups in New York, wrote the first section written by a woman in the Big Book, and tried to start an AA group in Washington. 

Though she didn’t succeed, and eventually returned to drinking, Florence made AA meetings somewhere women could go, too. Those early members became family to her—something that still happens to this day.

In Florence’s case, just showing up to meetings made her an early AA icon. Despite her sobriety not lasting, she still made AA meetings a more accepting, open place for women.

Marty Mann (1904-1980)

Marty supported the disease model of addiction, a brave move at a time when it wasn’t yet proven. She was one of the first women to bring awareness to addiction6 as something to heal, not punish. Marty fought against the stigma women in particular received: that they were promiscuous, uncontrollable, and without value. Instead, she advocated for recovery through acceptance.

Marty Mann also founded the National Council on Alcoholism and Drug Dependence. She encouraged other women to get help, and those in the LGBTQ+ community. As a gay woman, Marty Mann bridged gaps between 2 underserved communities and the help they deserved. 

Dr. Ruth Fox (1896-1989)

Dr. Fox became the first medical director of The National Council on Alcoholism in 1959. She was one of the first psychoanalysts to take alcoholic patients. And she pioneered the use of Antabuse7 to treat alcohol addiction, which we still use today.

Dr. Ruth Fox also founded the American Medical Society on Alcoholism and Other Drug Dependencies. 

Dr. LeClair Bissell (1928-2008)

Dr. Bissell co-founded the American Society of Addiction Medicine (ASAM)8. Like Marty Mann, she helped change the way the public saw addiction, women in recovery, and gay women. LeClair also advocated heavily for alcoholism treatment in professionals, specifically medical professionals. 

All these women changed the way women and the world see recovery. They made healing seem like a safe option for women who were scared, embarrassed, and without hope–but wanted out.

Those options for recovery still exist today, for men and women. And we have a lot of people to thank for that.

Find a Recovery Program Today

Much has changed from the early days of AA and recovery as a whole. While the stigma surrounding addiction hasn’t yet disappeared, these early women in recovery diminished it bit by bit. 
Thanks to them and many others around the world, ethical, women-focused recovery programs exist globally. You can browse our list of women-only rehabs and see photos, reviews, insurance information, and more.

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2023 Oscar Nominated Movies That Include Addiction

Films and TV shows tend to shape how culture views a certain subject (or profession). Recently, the idea of therapists, mental health, and addiction in pop culture became more mainstream. However, some films and shows do more harm than good—overdramatizing addiction and mental health, or just poorly representing it.

Others capture the rawness, truth and importance of addiction and mental health. 

All the Beauty and the Bloodshed 

Winning an Oscar for best documentary, All the Beauty and the Bloodshed recounts photographer Nan Goldin’s experience with addiction. She depicts her addiction to prescription painkiller OxyContin, and her frustration with the Sackler family.  

America’s Opioid Crisis

All the Beauty and the Bloodshed shows that Nan’s addiction began after an injury. Doctors prescribed a common medication at the time, OxyContin – which is highly addictive if taken incorrectly1. It contains oxycodone, which causes a high similar to heroin. 

Nan, like many others, became addicted to OxyContin after a perhaps thoughtless pain management plan. Nan formed P.A.I.N.2, Prescription Addiction Intervention Now, to “speak for the 250,000 bodies that no longer can.”

The Sackler family, owners of Purdue Pharma, received backlash for pushing OxyContin prescriptions when they perhaps weren’t needed. Nan worked to get museums and other Sackler-supported institutions to publicly separate from the family. 

America’s opioid crisis may have begun with overprescription of pain meds3, but it’s since grown for new reasons, like cheap, accessible products. Fentanyl, too, plays a large role in the 1,500 opioid-related deaths per week.

Treatment Options for Opioid Addiction

Many rehabs treat opioid addiction. In a residential setting, you’ll likely go through a medically supervised detox first, then begin therapeutic treatment. 

Therapies for opioid addiction could range from talk therapies to contingency management plans, which offer rewards for each step you complete in treatment. Talk therapies like cognitive behavioral therapy (CBT) will help you work through the thoughts and emotions causing your behaviors. Then, you’ll learn new ways to process and manage what you feel.

You’ll learn coping tools for the future, relapse prevention strategies, and typically engage in an aftercare program to keep you well supported. 

All the Beauty and the Bloodshed explored prescription medication addiction. Other nominated movies this year blazed new trails, like The Whale.

The Whale Explores Grief And Binge-Eating

The Oscars nominated Brendan Fraser for Best Lead Actor. The Whale depicts Charlie’s (Fraser) journey through binge eating, grief, and depression. His coping mechanism began after the death of his partner. 

The story highlights the power of grief and the hold of eating disorders, and how they can function as a coping tool. Different characters in the film try to help Charlie, but as it often is, his grief is persistent. 

What Is Binge Eating Disorder?

Binge eating is eating without control4—it might feel impossible to stop. Sometimes, after binging, a purge happens; this is the pattern of bulimia nervosa5. You might purge through throwing up, taking laxatives, excessive exercise, or starving yourself. It’s meant to “undo” the binge. Not every binge eater purges, though. 

Binge eating might be your coping tool, especially if you’re dealing with something as powerful as grief.

Grief And Depression

Depression is a stage of grief6, as proposed by Kübler-Ross. In The Whale, Charlie mourns the loss of his partner, who died by suicide. Depression became a strong stage in his mourning. 

If you or someone you know is considering suicide or self-harm, you can call or text the number 988.

The film suggests binge eating became Charlie’s own way of committing suicide.

Getting Help for Grief And Depression

There’s help for the millions of others like Charlie. Grief and depression can weigh heavily—sometimes unbearably so. But you do have options to heal. 

Complicated grief therapy (CGT)7, for example, can help with grief and all its stages. Using loss- and restoration-focused care, “the therapist works to facilitate the progress of grief to help the client come to terms with the death.” 

Cognitive behavioral therapy (CBT) can help with depression and grief7. Using CBT, your therapist can help you modify your thoughts and change your behaviors. For grief, CBT could help you process your loss in a more productive way.

To Leslie And Blonde

Both To Leslie and Blonde highlight drug and alcohol addiction. They were also both nominated for Best Leading Actress in the 2023 Oscars. Ana de Armas played Marilyn Monroe in Blonde, and Andrea Riseborough played Leslie in To Leslie.

To Leslie depicts a mother’s struggle with addiction, spurred on by a seemingly-ideal lottery win. Leslie reaches new lows and eventually seeks help for her daughter’s sake and herself. 

Blonde retells the life story of Marilyn Monroe, who tragically and famously died after an overdose. 

Drug And Alcohol Addiction: Not Just for The Famous

Movies like Blonde make addiction seem almost ritzy—something only people with deep pockets can do. Then, To Leslie goes and proves that wrong. So which is true? 

It’s both. 

Addiction doesn’t discriminate. In each movie, despite the contrasts in leading women, their reasons for substance abuse were similar. The case remains true for many today. Stressors, mental illnesses, or trauma can start a habit you can’t stop on your own. 

Stories like Leslie’s and Monroe’s can help the larger public see this through a cleaner lens. Addiction wasn’t a moral failing of either woman. It was how they coped. 

But there’s more than one way to find that same sense of control. Treatment can help you see that.

Treatment Options for Drug And Alcohol Use

Many rehabs treat drug and alcohol addiction. Here, you’d have constant monitoring, individualized care, and a structured treatment schedule. Most residential rehabs also offer on-site detox. 

Depending on your situation, you might find an intensive outpatient program (IOP) or partial hospitalization program (PHP) more suitable. Each of these programs provides effective treatment, and you get to go home at night. IOP is less intensive, usually lasting 3-5 hours a day, while PHP could go for 5-8. 

In these treatment settings, you’ll learn relapse prevention skills and work on the thoughts behind your behaviors. Rehabs typically offer a variety of therapies to meet your needs. 

You can browse our list of rehabs to see reviews, pricing, and insurance information, and more.

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Homelessness and Addiction: How Are They Related?

Homelessness and addiction are related. Despite this relationship, the correlation is not a certainty. But many think they are, so myths and speculations abound: 

Myth 1: “All homeless are addicts. They just need to stop using and things will get better.”

Myth 2: “Addicts always become homeless. It’s their fault.”

Myth 3: “Homeless people are violent because they’re always on drugs.”

Research, time, and empathy have proven both statements (and related ones) wrong. But homelessness and substance abuse do connect in some ways.

The 2 have a bidirectional relationship1—they can both feed into each other. Rehabs for drug and alcohol addiction can sometimes help with both issues at once, but usually, homeless people rely on shelters and specific resources for their population2. 

Homelessness and Addiction Statistics

A 2022 study by Statista found that roughly 55,000 unsheltered homeless people experience addiction3. In other studies, a third of addiction treatment patients say they’ve experienced homelessness1. And, 

Looking at the numbers, you can see addiction and homelessness connect. Addiction isn’t always the cause, but it definitely can be—and vice versa. 

How Does Addiction Lead to Homelessness?

Addiction doesn’t exclusively lead to homelessness, but it can cause it. Economic statuses, marital statuses, family relationships, and social-economic factors can all make addiction a cause of homelessness.

As an example, someone making minimum or median income would feel the financial effects of addiction almost immediately. As their limited income depletes, paying rent gets harder. 

For additional context, street prices of illicit and prescribed drugs average out to $356 per gram6. The price can be as high as $500 for heroin. An average 24-pack of beer costs around $17. 

Addiction isn’t cheap.

Many homeless adults don’t have the option of staying with family when they can’t afford rent. Their loved ones may have cut them off, moved away, or passed on. Their only viable option could be living in a shelter or on the street.

…And Does Homelessness and Drug Use Lead to Addiction?

It can. Some homeless people use opioids, weed, alcohol, and other substances to cope with the trauma of becoming homeless5. Others do it to fit in with the community. 

Homeless people may also start using substances to stay awake, sleep, or stay energized when they’re malnourished. Drug addiction can become a crutch for living homeless that takes up the funds, time, and energy they could otherwise use to get help. Homeless people might also run into legal trouble and tarnish a clean record.

And even though help exists, it’s not always easy for this population to get it.

Understanding The Challenges And Seeking Help

Whatever the cause may be of addiction and homelessness, getting help has its challenges. A lack of money, support, and knowledge leaves many thinking there’s no way out.

But there is. 

Barrier #1: Shelter And Safety

Getting help for addiction might not seem like a top priority if you don’t have somewhere safe to stay. You might be more concerned with getting cover, keeping yourself safe from others, and keeping yourself out of trouble. You likely wouldn’t have much time or mental energy to focus on treatment. 

Not all homeless people have access to shelter, even temporary overnight lodging. If they do find shelter, it’s rarely long term. 

Having a home base, even if it’s a temporary living situation in a shelter, can help your fight-or-flight mode ease down. Then, thinking about help and taking the next steps might not seem so unfeasible. 

Barrier #2: No Social Support Network

Many homeless adults don’t have anyone to help them help themselves. They don’t have anyone cheering them on. Getting help rests almost entirely on their shoulders, which can be overwhelming. 

And, if addiction is the norm in your community, you might lose what little social support you have if you stop. This could be the case for many homeless people. Even when they want to stop, change their lives, and get help, they might feel pressured to keep using. 

Barrier #3: Mental Illness And The Effects of Addiction

Mental illnesses like schizophrenia, bipolar disorder, depression, and PTSD can prevent homeless individuals from wanting–and getting–help. Treatment for these conditions may also be difficult to maintain. Homeless people might miss treatment sessions, have to relocate, or feel unable to add repeated treatment to their lifestyle. These factors can make healthcare providers less willing to work with the homeless population1. 

Active addiction could also make getting short and long-term help difficult.

The symptoms and effects of addiction can mirror some mental illnesses, like schizophrenia. Some drugs, like lysergic acid diethylamide (LSD) and opioids7, can cause psychosis. Many substances, including alcohol and weed, put you in an altered state of mind. This can make decisions difficult, even important ones about your health and wellbeing.

But for each barrier to treatment, even if they seem insurmountable, you have opportunities to reach them. Help awaits.

Find Support for Homelessness and Addiction

Homelessness and drug addiction don’t have to be your story. 

You can begin your recovery journey by finding shelter, if you’re living unsheltered. Some shelters take in men only or women only, while others welcome all genders. Others specifically welcome teens and runaways. Here’s a few options to consider:  

While shelters offering treatment options for substance use disorders (SUDs) aren’t as common as regular homeless shelters, they do exist across America. Most of these SUD-specific shelters provide medication-assisted treatment8 (MAT) for opioid use to combat the growing opioid epidemic. They also provide encouragement, hope, and can lower the mortality rates of addiction and overdose.
You can also find treatment in a residential rehab center as your journey continues. To see rehabs that treat drug and alcohol addiction, you can browse our list of centers with pricing, reviews, photos, and insurance.

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

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

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

How to Spot Cocaine Use

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

Physical Signs

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

Emotional And Mental Signs

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

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

Slang Names for Cocaine

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

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

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

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

What Is Cocaine?

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

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

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

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

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

Is There a Difference Between Cocaine and Crack?

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

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

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

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

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

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

The Effects of Cocaine Use

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

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

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

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

What Is Cocaine Cut With?

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

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

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

Cocaine Mixtures

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

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

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

Treatment for Cocaine Addiction

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

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

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

Therapy for Addiction

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

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

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

The 12 Steps

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

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

Aftercare

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

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

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

Find Power Through Recovery

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

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


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

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Goals of Depression Treatment (AAA)

You need more than a quick fix to treat depression. Depression won’t go away overnight, but that’s okay. That’s why therapy is a continual process that supports medication management, and vice versa. The goal, then, of depression treatment is to work through its root causes and teach you how to navigate daily life with more hope, ease, and joy. 

Through treatment, you can learn to manage depression and navigate your emotions. Talking with your doctor can help you decide which level of care is best for you. You could even attend a rehab for depression. 

Depression treatment could take many directions. Dr. Malasri, psychologist and Senior Director of Content at RehabPath, describes her AAA method below. 

“The more we focus on perseverative thoughts, the more they will prevail. To work through them, it is crucial to take the AAA approach: Acknowledge, Acknowledge, Action. The first round of Acknowledgement involves listening to yourself and acknowledging what you are truly feeling. In the second round of acknowledgement, you need to acknowledge the aspiration—what do you actually want to bring to your life, what are you seeking? Finally, take action—this is where you create an action plan that will enable you to take your solutions and break them down into monthly, weekly, and daily goals.”

You can use this method during and between therapy sessions. Using AAA, you can have progressive conversations with your therapist and yourself, and an all-around more successful treatment experience.

AAA Infographic2
The AAA method.

Acknowledgement 

The first step and goal of depression treatment is acknowledgement. You can acknowledge your symptoms, how they affect your life, and that they could mean you need extra help. Doing so might be your first step to healing.

You can do this with yourself, a therapist, or both. Because therapy doesn’t stop once you leave a session—it’s also every moment in between.

Your therapist can help you work through and resolve what contributes to your symptoms, especially if it feels hard to identify. For example, you might try to navigate a difficult job situation by identifying its pain points and seeing if you can relieve them. Or, your therapist could help you navigate a toxic relationship or living situation.

Once you’ve acknowledged what’s going on and how you’re feeling, you can move onto the second phase of acknowledgement.

Acknowledge What You Want

What do you want to happen next? What do you seek? Take some time to reflect on this. Dream, visualize, and see what you can imagine for yourself.

What does happiness look like? What does your ideal work experience look like? What motivates you? What are your sources of inspiration? 

Try to be realistic as you do this—taking off too big a chunk might feel daunting. Identify what you want here. Think of a blank canvas, and what picture you want to paint. 

And once you know what you want, you (and your therapist) can begin making it happen.

Action: Plan Your Next Steps 

Sometimes, leaving the cycle of depression can seem scary—paralyzingly so. Once you acknowledge this cycle and your goals, you can redirect your energy into action. Alone or with help, you can identify manageable steps that you can accomplish daily, weekly, and monthly. These form your action plan. 

You need to paint your dreams with paced, manageable steps. Here, it’s important to remember that small steps in your plan might feel easier to follow and commit to. 

For example, you might take a walk each day. Some days you might feel up to something bigger. Take that motivation and focus on the pace you created. On the days where it seems undoable, take that energy, go back to acknowledging those emotions, breathe through it, and remind yourself of your paced approach. 

Give yourself compassion—and space to breathe in your action plan.

Committing to the process could be invaluable, especially since, like other conditions, depression requires maintenance. It won’t vanish on its own. And once it’s gone, there’s always the chance it could come back. 

Maintaining your treatments, like therapy, self-care and medication management, can keep recurrent episodes at bay. 

And you can always come back to AAA. The process has no expiration date, and it’s yours. 

Break The Chains Without Fear

Despite how it may feel, depression can go away with proper treatment. The goal of treatment isn’t to give you a fast cure. Rather, it’s to give you systems and plans to manage the condition.
If you think residential treatment for depression could help you best, you can browse our list of depression rehabs and see pictures, pricing, and reviews.