Counseling? Rehab? Support groups? How does one know where to start when it comes to choosing a substance abuse treatment program?
First, you’ll want to get a formal assessment from a licensed professional to determine which treatment option is appropriate for you. Some substance abuse treatment options to consider are support groups, inpatient, and outpatient treatment.
AA, NA and other 12 Step programs
Support groups led by peers that focus on helping a person abstain from substances or behaviors.
Pros: offer additional support and can be a good place to find additional resources and information, free, many locations, various meeting dates and times
Cons: Abstinence is the only treatment goal option, lack of clinically trained support staff, religious undertones, little to no treatment for underlying psychological issues
Inpatient substance abuse treatment
Patients are required to stay in a facility for a pre-determined amount of time varying from 15 to 90 days or more.
Pros: safe, contained environment, trained professional staff, 24/7 support, sometimes the facilities are relaxing and luxurious, intensive treatment, various modalities including individual therapy, group therapy, expressive arts
Cons: expensive (plus you’ll have to take time off work), limited contact with outside support system, intensive treatment, there may be limited availability in your area
Outpatient substance abuse treatment
Patients attend treatment once or several times per week and address underlying issues plus addiction.
Pros: individualized treatment, local, clinically trained professionals, choice of abstinence or moderation, various modalities to choose from including individual therapy, group therapy, partial hospitalization or intensive outpatient
Cons: some treatment options may be expensive, may not be enough support or treatment for your needs, availability may be limited in your area
A partial hospitalization program involves daily treatment for 6 to 8 hours per day for one to two weeks. This is a good substance abuse treatment option for those who cannot afford inpatient treatment but would like intensive therapy or who live far away from an outpatient treatment program that specializes in the care they need. Intensive outpatient treatment (IOP) involves daily treatment for 1 to 2 hours per day and can last up to several months. This option works well for those who need substance abuse treatment more than once per week or who have time commitments that prohibit them from seeking more intensive treatment. IOP can even be done in the evening after work.
Some people will need to go through medical drug detoxification before starting substance abuse treatment and in some cases it may be a prerequisite for admittance into a program. If you are dependent on a substance, (especially alcohol, opiates or benzodiazepines) it is advisable to detox under medical supervision to avoid complications and discomfort from withdrawals.
Never stop using alcohol or benzodiazepines (Xanax, Klonopin, Valium, Ativan) cold turkey! The withdrawal effects can be severe and life threatening. It is necessary that you detox from these substances under medical care if you have been using them daily and at high dosages.
A note about harm reduction and abstinence: Harm reduction is at the core of all substance abuse treatment programs – abstinence based and moderation management. Harm is reduced by abstaining from the problematic behavior or through reducing negative consequences associated with it.Learn More
Addiction is not a character flaw and it most definitely is not a choice.
Addiction is a biopsychosocial phenomenon that results in negative consequences and feelings of shame and guilt. Biological, psychological, and social factors culminate into a dependent relationship to a substance or compulsive behavior as a means of coping with distressing emotional, psychological, and environmental states.
More specifically, addiction is characterized by several criteria:
- the inability to resist an urge to consume a substance or engage in a behavior that is harmful
- an increase in tension or arousal before the act, followed by gratification and relief
- a noticeable increase in amount and frequency of the act in order to achieve the desired effect (e.g. pleasure or escape)
- over-investment of resources, such as time and money, to engage in the act
The emotions associated with addiction are one of the most notable elements. Shame, guilt and powerlessness are hallmarks of addiction and often lead to feelings of self-loathing and isolation. Individuals suffering from addiction are often misunderstood by their families and loved ones, causing them to lie and keep secrets.
This website offers information about addiction, drugs, and compulsive behaviors, including the latest news and research. Resources for people with an addiction and their loved ones can also be found here.
Informing yourself can be the first step in gaining power over your addiction.Learn More
Are you thinking of taking a break from drinking? Maybe you overdid it over the holidays or you’ve noticed that your alcohol intake has steadily increased since the pandemic started. Perhaps you just aren’t getting the same enjoyment from a glass of wine or you’d like to get a healthier start to the new year. Whatever the reason, the perfect opportunity to take a break from alcohol is Dry January.
What is Dry January?
Dry January is a public health campaign that encourages people to abstain from drinking alcohol for the whole month of January. It’s an opportune time to take a break from drinking after the excesses of the holidays and usually lines up with people’s intentions to start off the new year with healthier habits.
This is the most popular of the month-long sober campaigns, so you’re sure to encounter lots of resources and support. You’re more likely to be successful if you plan ahead and share your intentions with others. Find an accountability partner who will either participate in Dry January with you or check in about it regularly.
Is Dry January worth it?
Dry January lets you have a taste of sobriety without feeling overwhelmed by the idea of giving alcohol up forever. It’s a useful experiment for folks who are sober curious and a great way to establish healthier drinking habits.
In addition, you’ll save some money, get better sleep, and improve liver and brain function. 31 days may seem like a long time if you’ve been drinking regularly and the first two weeks are usually the hardest. But if you can commit, there’s a lot you can learn about your relationship with alcohol.
Without the ability to cope with alcohol, you can uncover hidden feelings and unmet needs. Do you always have the urge to drink after work? What does this mean about your job, the work environment, or your work-life balance? Do you only overdrink in social situations? Could this indicate that you’ve been drinking to self-medicate social anxiety? Use Dry January to learn about changes that could improve your quality of life.
How do I know if Dry January is right for me?
A lot of us use alcohol to cope with boredom and stress or to have fun. But if you’re getting less enjoyment from drinking, it’s a strong indication that you should take a break. Are you feeling shame or guilt after drinking? Have others expressed concerns about your behavior? Are you having trouble keeping commitments?
It’s also a good idea to take a break if you’re drinking more than you’d like, more often than you’re comfortable with, and you find it increasingly difficult to stop yourself. Physical signs that you should drink less include shakiness or tremors (known as delirium tremens), redness in the nose or cheeks, frequent injuries, gastrointestinal issues, and brittle nails and hair due to chronic dehydration.
If you notice that reducing your alcohol intake leads to trembling, altered consciousness, hallucinations, or an irregular heartbeat contact your doctor right away. These are signs of severe alcohol withdrawal and they could lead to death. It’s actually better for you to not stop drinking completely and to go through a medicated detox instead.
How to Stop Drinking for Dry January
Want to give this challenge a try? Here are some tips and suggestions to succeed at Dry January:
1. Hide your booze
If you’re going to try Dry January, you might want to consider keeping alcohol out of sight and out of mind. Start by putting your alcohol stash away. Not that you have to throw it out, but you should place it somewhere where you can’t see it in plain sight – when you’re watching TV or working at your desk. You might try storing the alcohol in places where it’s hard to get to – like on the top shelf of a cupboard, in the garage, or even at your friend’s house. The moment you feel that it’s effortful to grab your beer, it might trick your mind that it’s not worth it.
2. Build some new social rituals
Focusing your mind on something else is also a good way to distract yourself from drinking alcohol. You might want to consider recruiting a partner for this challenge. Not only will going in on your alcohol-free month with a companion hold you more accountable, you’ll also have a built-in buddy to do non-drinking activities with. This person can be your support system, someone who can remind you why you signed up for the challenge.
Come up with healthy, compelling alternatives to drinking: long hikes, rock climbing, surfing, or biking – which are more fun if you have a buddy with you.
3. Make sure you have tasty, non-alcoholic beverage options
There’s a booming trend of non-alcoholic beverages ranging from alcohol-free beer and wine to gins. These mocktails might scratch the itch if you’re really missing the taste of hops or the herbaceousness of a terroir. Check out Monday Gin, Seedlip, or one of Athletic Brewing Company‘s delicious craft non-alcoholic beers.
4. Keep a journal
Keeping track of how you feel during Dry January can help you identify rewards that may not be obvious, like less conflict in your relationship or reduced anxiety levels. In fact, it’s best to start journaling now while you’re still drinking. This way, you can compare how drinking is currently impacting you versus at the end of a sober month.
Dry January encourages people to think about their drinking and engage in healthier habits throughout the year. Being alcohol-free for 31 days gives you the opportunity to experience enjoyment, relaxation, or socializing without booze and helps us develop skills to control our drinking. That implies we’ll be better equipped to make decisions about when and how much we drink for the rest of the year, preventing us from drinking more than we desire.
If you find that 31 days aren’t enough, you might want to consider seeking professional help. There are plenty of resources that address alcoholism or alcohol use disorder. Self-help workbooks like Responsible Drinking, How to Change Your Drinking, Over the Influence, and (shameless self-promotion) Power Over Addiction can help you interrupt problematic behaviors with alcohol. (Full disclosure, I make a small commission if you purchase books via these links).
Self-help groups like AA, Refuge Recovery, and SMART Recovery are widely available if abstinence is your long-term goal. If you prefer to try moderation, check out Moderation Management groups or look for a harm reduction therapy group in your area. Interacting with people who are going through the same experience as you is a big help. The sense of belongingness, being understood, and not judged is a big factor in one’s journey to improving their relationship with alcohol.
Psychotherapy sessions – individual therapy and groups, can be especially helpful if you’ve had a chronic problematic relationship with alcohol or if you’re also impacted by other psychological problems like depression, anxiety, or trauma. Find a licensed professional in your area who specializes in addiction or alcohol treatment and who will support your chosen goal of either moderation or abstinence.
Let us know if you decide to try Dry January. We’d love to hear how it goes and if there are other resources we can provide. We hope you have a restful holiday season and a healthy new year!Learn More
The holidays are a time of festivities, joy, family, and friends. It can also be a time of stress, consumerism, high levels of demand, and lots of libations. Whether it be food preparation, decorations, shopping for gifts, cleaning, entertaining, or planning family events – these can all add to the stress of the season.
Whether at the company party or over dinner with the family, the holiday season introduces many opportunities to drink. In fact, according to the Distilled Spirits Council, the distilled spirits industry makes more than 25% of its profits between Thanksgiving and New Year’s Day.
Add a global pandemic to the mix and our chances of coping with alcohol increase significantly. For some, the added stress of the holidays or painful memories can trigger compulsive drinking. For those who already engage in problematic drinking, the stress can worsen drinking behaviors.
The good news is that we can navigate family events to make them more bearable (including avoiding them altogether) and we can create alcohol moderation or abstinence plans to help us manage how much we drink.
For some of us, the holidays are the only opportunity we get to spend quality time with loved ones and catch up. But these occasions are often accompanied by emotional pitfalls and triggers – and that’s normal.
How to Cope with Family Gatherings
Instead of drinking your way through that awkward conversation with your uncle, here are some tips on how to cope up with family gatherings over the holidays:
1. Have a Plan
To prevent yourself from getting caught in an uncomfortable situation, make a list of topics and people you want to avoid. Speak up when you feel uncomfortable and offer an alternative topic to talk about. Make a list of topics you feel comfortable with so you don’t have to come up with one on the spot.
Consider meeting with relatives or friends before gatherings to hash out past conflicts or resentments. Meeting in a public space like a coffee shop to apologize or communicate your needs can be more disarming than attempting the conversation under the influence of alcohol.
2. Prioritize Your Self-Care
Don’t negate your need for sleep, exercise, and healthy foods over the holidays. You will have access to more patience, grace, and empathy if you’re feeling well rested. Your stress levels will be lower if you’ve had a chance to get some cardio before a triggering family gathering. And while the holidays are an excuse to indulge in our favorite treats, make sure you’re also getting the nutrients your brain needs to produce mood regulating neurotransmitters.
3. Choose a Safe Place to Escape
If you’re familiar with the venue, pick a safe place you can go to when you feel overwhelmed. Have an alternate location where you know you can take a moment to calm yourself down without anyone interfering. This may mean having an exit plan if you become too triggered. Consider staying in a hotel or with a friend and renting a car so you don’t have to depend on relatives to get around.
4. Don’t Take Negative Comments to Heart
It is a reality that some of our family members criticize a little too much. The key is to not take negative comments to heart. It’s not going to be easy, but doing so can lessen your stress and anxiety. If the commentary becomes unbearable, set a boundary and let your family member know you’d rather not hear their opinions about you. And if boundary setting doesn’t stop them, be prepared to leave. You’ll ultimately gain more respect by walking away than taking the bait.
5. Small Talk Is Not Your Enemy
Small talk can be awkward but it can also be a great way to get reacquainted with a family member you haven’t seen in a while or someone you want to get to know better. Don’t be pressured to always know what to say, just enjoy the conversations that happen naturally. And if you can’t stand another round of “How has the pandemic changed your life?” check out these 36 questions known to increase closeness.
6. Create Boundaries
You have to expect that nosy relatives may ask too many questions or deeply personal ones. If you are caught in a situation with a loved one who pries too much, remember you are under no obligation to answer their questions. Politely steer the conversation in a different direction or kindly tell them you’d rather not answer.
In addition to conversation boundaries, you may also need to implement physical boundaries with your family. This means considering staying at a hotel instead of a relative’s home or significantly limiting how much time you spend with your family. It’s ok if you can only stay for an hour or two. Remember that you’re an adult capable of making your own decisions based on your needs and preferences. These choices may lead to awkward conversations or feelings of disappointment, but your emotional safety and comfort are worth it.
The holidays may be a stressful time, but they are also a wonderful time to share with the people you love—including yourself. Make the most of this time with those you care about. Create an intention to connect with someone over the holiday; that may even be yourself.
Create an Alcohol Moderation or Abstinence Plan
In addition to managing family dynamics, having an alcohol moderation or abstinence plan will help you manage urges to drink.
But before you decide whether moderation or abstinence is best for you, it’s important to assess your relationship with alcohol. Drastically cutting off alcohol may have negative effects on your mood and your physical safety. Ask yourself, how and when do you use alcohol? How does it make you feel? What needs are you trying to meet by drinking?
If you notice that reduced drinking leads to trembling, altered consciousness, hallucinations, or an irregular heart beat, contact your doctor right away. These are signs of severe alcohol withdrawal and could lead to death. It’s actually better for you to not stop drinking completely and to go through a medicated detox instead.
Once you’ve decided you want to reduce or take a break from drinking, make note of your intentions, hopes, and goals. How long of a break will you take? How many drinks per day or week do you want to limit yourself to? How will you know your efforts have been successful? How will you feel? What feedback will you receive from loved ones? Revisit these questions whenever you feel like having a drink.
Take time to think about what will trigger you to drink during the holidays. One of the top reasons people drink is stress. Because alcohol is a depressant and releases GABA in the brain our nerves calm down once we take a sip, allowing us to feel more relaxed.
Be mindful of who you choose to spend time with, set a spending limit, schedule breaks from work and social events, and be mindful of the media you’re consuming. If it feels safe, let your friends know that you’re on a drinking break and opt for activities that don’t involve drinking. If you’re going to be around alcohol, make sure you have a tasty, non-alcoholic beverage option. This would be a great time to try Monday Gin, Seedlip, or one of Athletic Brewing Company‘s delicious craft non-alcoholic beers.
The best way to manage urges to drink while taking a break is to come up with fun, compelling alternatives. Distract yourself by doing things not related to drinking and alcohol – exercising, cooking, biking or reading. It’s also helpful to talk it out with someone you trust. Acknowledge the feeling of having the urge to drink and share your thoughts and feelings about it with someone who understands. Most importantly, remind yourself why you are taking a break or cutting back on drinking. What values are you honoring by changing your relationship with alcohol?
Abstinence from all alcoholic beverages may be the best strategy. But for those who don’t want to abstain or who simply want to be mindful of how much alcohol they consume, moderation is key.
Tips for moderating alcohol during the holidays
- Drink on a full stomach. Pair your wine or beer with delicious cheeses. Don’t forget snacks when planning a cocktail party. Plan for dinner before heading to the company holiday party.
- Plan your night before you start drinking. Think about how many hours you will be partying and set a limit of how many drinks you’d like to have. Remember it takes approximately one hour to metabolize one drink. And one drink is probably less than you think: a 12 oz beer, a 5 oz glass of wine, or 1.5 oz of 80 proof liquor. Tell someone supportive about your plan—a spouse, friend, coworker, or family member. Ask them to check in with you to help keep you accountable.
- Count your drinks. If you’re drinking beer, keep the bottle caps in your pocket or purse to help you keep count. Keep pennies in your left pocket and move one over to your right pocket each time you have a cocktail. Send yourself a text each time you order a new drink.
- Drink a full glass of water between each alcoholic beverage. Hydrate and keep hangovers at bay!
- Dress up a non-alcoholic beverage like a cocktail. Cranberry juice with a lime looks just like a Cape Cod. Same goes for Sprite and soda water. If you’re drinking beer, refill your bottle with water. No one will know the difference!
- Lighten up! Turn that glass of wine into a spritzer with some soda water. Go for a lower ABV beer. Instead of a shot of tequila, how about adding some ice and ginger ale? If you start with a cocktail, consider switching to beer. The lower alcohol content will be absorbed more slowly.
- Arrive late to the event or leave early. Seeing others intoxicated may motivate you to moderate. Plus, it will likely be very entertaining! Make an intention to mingle for 30 minutes before you start drinking. Set the tone for the night.
- Sip, don’t gulp your drink. Practice mindful drinking. Describe the notes of that IPA on your nose (“Ah, yes. It smells of a warm summer day frolicking in the grass.”) and on your palette (“And tastes of toasty, roasted hops.”) Write a mental review of each drink you have. Be mindful about the experience the drink is creating for you. Is it sweet or sour? Cold or room temperature? Does it conjure memories?
- Pay attention to self-talk. Are you trying to convince yourself to drink more because “it’s the holidays” and you “deserve it?” Check in with yourself before each drink. Do you really want another one? Will it get in the way of any plans you’ve made for the rest of the evening or tomorrow?
- Don’t forget to have fun! Focus on your friends, family, coworkers, and the setting. Let the experience engross you. Dance!
This should go without saying, but please do not drink and drive. It is estimated that 1,200 people will die this holiday season due to drunk or buzzed driving. Always designate a sober driver or make other arrangements to get home after a night of drinking.
If you think you have a drinking problem or are struggling with moderation, there are many ways to get help. Self-help workbooks like Responsible Drinking, How to Change Your Drinking, Over the Influence, and (shameless self-promotion) Power Over Addiction can help you interrupt problematic behaviors with alcohol. (Full disclosure, I make a small commission if you purchase these books via these links).
Self-help groups like AA, Refuge Recovery, and SMART Recovery are widely available if abstinence is your long-term goal. If you prefer to try moderation, check out Moderation Management groups or look for a harm reduction therapy group in your area. Interacting with people who are going through the same experience as you is a big help. The sense of belongingness, understanding, and compassion are big factors in improving one’s relationship with alcohol.
Psychotherapy sessions – individual therapy and groups, can be especially helpful if you’ve had a long-term problematic relationship with alcohol or if you’re also dealing with other psychological problems like depression, anxiety, or trauma. Find a licensed professional in your area who specializes in addiction or alcohol treatment and who will support your chosen goal of either moderation or abstinence. And it’s ok if you don’t know yet! They should be able to help you with that choice.
From everyone on our team, we hope you find peace, joy, and tons of rest this holiday season!Learn More
Often times, the people who I support are attempting to fill a parent-sized void with addiction. They have unmet needs from childhood or they’re survivors of trauma. Regardless of the degree of severity, addiction becomes a tool for coping with stressors and unpleasant emotions. Over time, the person develops a relationship to their drug or compulsive behavior of choice and an attachment bond forms. More often than not, this attachment is seen as a source of stability, predictability, and comfort — much like the attachment one expects from healthy parenting.
This is not necessarily bad and, in fact, can be seen as an adaptive survival strategy when a person lacks other tools. Without emotional regulation skills or the bandwidth required for self-reflection, it’s very easy for anyone to turn to problematic coping strategies. However, recovery from addiction is only possible when one cultivates awareness around these attempts to fill a void and responds in an intentional way.
Here are some indications of maladaptive coping:
- Feelings of shame following the attempt to cope
- I used ketamine to escape overwhelming feelings of rage but I’ve been trying to abstain from using it.
- Interruptions to work and relationships
- A fear of being judged by my partner leads me to drink in secret to cope with trauma symptoms
- Need for more coping due to the intervention
- After drinking too much to cope with loneliness, I feel hungover and turn to compulsive sexual behaviors for comfort.
The need to manage feelings of rage, loneliness, and anxiety is real and healthy. Your need for coping is not the problem, it’s the maladaptive strategies being implemented. What’s one small thing you can do today to become more aware of your emotional and relational needs?
- Meditate for 5 minutes
- Jot down all your feelings at the end of the day
- Journal for 5 minutes before bed
- Take 5 minutes to reflect on feelings of anger, resentment, or betrayal
The difference between surviving and thriving lies in the choice to make intentional, thoughtful, and empowered choices to cope versus impulsive, desperate, and destructive ones. Thriving means living your best life, being your best self, and managing your mental health despite the challenges life throws your way. It doesn’t mean life is perfect or easy, but it does mean that you feel confident, competent, and willing to tackle stress, pain, and urges to engage in problematic drug use.
Let us know in the comments how you cultivate awareness around your needs. We’d also love to hear about the healthy coping strategies you implement for relapse prevention.