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Services We Provide

Medication assisted treatment.

Utilizing guidance from the Hazelden COR-12 Model, our medical providers can discuss Medication Assisted Treatment options which include Suboxone, Sublocade, and/or Vivitrol. We will also work with you to develop a wean-down plan to live life opioid-free.

Therapy Services

Targeted case management, peer support services.

Peer support specialists assist in finding your recovery collateral and how utilize those strengths as you progress through treatment. They are also instrumental in connecting you to meetings, discussing the challenges of living a balanced recovery, and facilitating medication assisted recovery meetings to provide a peer-driven support system.

Career Planning

Career planning and employment readiness are a large part of a successful recovery pathway. Our Lift Up project is designed to assist individuals on their recovery journey by connecting them to resources that support well-being and productivity. Employment readiness is a large part of a successful recovery pathway. Our staff will assess each individual’s hope for the future and help them navigate pathways to reach their life goals. Working with our community partners at Life Learning Center or KY Career Center, our staff will help each person in gaining the life skills or education needed to enhance their employability and achieve their life goals. In the process, other challenges such as legal issues that may interfere with employability will also be addressed.

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Patient Journey Map

Substance use disorder treatment and recovery experiences, research report | june 2022.

Jessica Hulsey

Kayla Zawislak, MSW, CADC

About the Report

Addiction Policy Forum’s (APF) Patient Experiences Journey Map was developed through the input of patients in treatment and recovery from substance use disorder (SUD). The map underscores the obstacles and positive points patients encounter across seven distinct phases, from treatment to finding long-term, stable recovery.

The Addiction Policy Forum was named one of the winners of the National Institute on Drug Abuse “Mapping Patient Journeys in Drug Addiction Treatment Challenge”; funds from this prize were used to support the development of this report.

The qualitative study included 60 Life Course History interviews of individuals in recovery from substance use disorders across 22 states and Canada.

Participants Overview

Of the 60 participants, 55% identify as female (n=33) and 45% male (n=27). The race and ethnicity breakdown of participants is as follows: 60% non-Hispanic White; 17% Hispanic/LatinX; 10% Black or African American; 3% Native American/Alaskan Native; 3% Asian or Asian-American; and 7% multiracial. Participants were from 22 U.S. states and Canada.

The study included individuals in recovery from a SUD. Seventy-two percent report a single, primary SUD, 28% reported a polysubstance use disorder, and 98% report using multiple substances during active addiction. The breakdown of types of SUD is as follows: 19 participants reported an alcohol use disorder, 17 a polysubstance use disorder, 13 an opioid use disorder, 9 a stimulant use disorder, and 2 a cannabis use disorder.

Study Design

Addiction Policy Forum collected the data between August 12th and December 12th, 2021. All research protocols, instruments, and communication materials were reviewed and approved by an independent institutional review board. The interviews were conducted by CITI-trained APF staff who are in recovery from a substance use disorder. Sixty interviews were conducted with variance in geography, race/ethnicity, gender, socioeconomic background and SUD type. The project utilized a life course history structure, followed by a rapid qualitative inquiry to analyze the data.

Life Course History Interviews

As a concept, life course theory is defined as "a sequence of socially defined events and roles that the individual enacts over time." Life Course History interviews are a person-centered research method that requires “respondents to provide a subjective account of their life over a certain period of time, described in their own words, across their own personal timelines."

Life Course History one-on-one interviews empower patients with lived experience to tell their unique stories in a semi-structured interview process with time to reflect and describe their journeys. This qualitative approach to data collection allowed APF to build a comprehensive and accessible patient journey map that illustrates how complex interactions over the course of an individual’s life contribute to the onset, progression, and treatment of a SUD and the elements of long-term recovery.

Interviews included questions related to substance use; trauma and adverse childhood experiences; treatment episodes; facilitators and barriers to seeking and pursuing treatment and recovery; and other information related to lived experience with addiction and recovery, building upon existing validated instruments as well as open questions and conversation to allow for engagement.

Instruments used include the Addiction Severity Index (ASI), the Inventory of Drug Use Consequences (InDUC), Adverse Childhood Experiences Screening, and the Global Appraisal of Individual Needs (GAIN). Each interview began by securing consent from the participant. The audio recording and a transcript of each interview were used for text analysis and coding of individual responses.

Rapid Qualitative Inquiry

The Rapid Qualitative Inquiry (RQI) framework was used to quickly develop a preliminary understanding of the often complicated and varied experiences of accessing treatment and recovery for substance use disorder.

According to Dr. James Beebe, the RQI allowed for a team-based approach to quickly develop an insider's perspective to a specific situation. A small multidisciplinary team of four staff conducted the RQI. The multi-discipline strategy ensured that different perspectives were represented on the team and that individual biases were checked, a key component of rapid qualitative inquiry and the success of the patient journey mapping process.

The Addiction Policy Forum’s Patient Journey Map represents a common set of moments that individuals in treatment and recovery from a substance use disorder experience. While this map does not represent what happens to every individual who engages in treatment for addiction and recovery support, it highlights common elements, bright spots, and pain points in accessing care and finding and maintaining long-term recovery.

Quotes from patients are included to illustrate the salience of the moment. Common threads and insights are also provided, which can guide practitioners and leaders in the improvement of care and patient outcomes for individuals with a substance use disorder.

Each phase highlights the bright spots and pain points derived from actual patient feedback, along with common threads and insights relevant to the patient experience.

Onset and Progression

Onset is the age at which an individual develops or first experiences a condition or symptoms of a disease or disorder. This section of the Journey Map explains the experiences of onset, specific risk factors for the development of a SUD, as well as health consequences and criminal justice involvement of patients.

Average age of onset is 14 years old.

The average age of first substance use was 14, with the earliest initiation at five years old and the oldest at 19 years old. Patient SUDs include opioid, alcohol, stimulant, marijuana, sedative, and polysubstance use disorder. Nearly one out of four respondents report a primary polysubstance use disorder and 98% report using multiple substances during active addiction.

For participants with a polysubstance use disorder, 35% reported opioid/stimulant use disorder; 24% alcohol/stimulants; 12% alcohol /opioids; 12% alcohol/marijuana/stimulants; 6% alcohol/sedatives; and 6% marijuana/sedatives.

85% of patients report a family history of SUD

Eighty-five percent of the respondents reported a family history of addiction, with an average of two previous generations with SUD history.

Frequent childhood trauma

Of the study panel, 90% had at least one adverse childhood event. Of those with childhood traumatic events, the average ACEs score was 4.3, with 47% of patients reporting an ACEs score of 5 or higher. Over 83% experienced household dysfunction, 78% experienced abuse, and 55% suffered from neglect.

Adverse Childhood Experiences (ACEs) are traumatic events that occur between the ages of 0-17. There are many different kinds of ACEs, including losing a parent, neglect, sexual, physical, or emotional abuse, witnessing a parent being abused, mental illness in the family, and parental SUD. The more ACEs a child has, the more likely he or she is to experience problems later on in life. There are ten types of childhood trauma measured in the ACEs instrument that fall into three categories: abuse, neglect and household dysfunction.

90% of patients experienced household dysfunction, child abuse, neglect

The most common types of household dysfunction experienced were addiction in the household (62%), mental illness or suicide in the household (55%), parental divorce (55%), an incarcerated parent (22%), and domestic violence (17%). Types of abuse experienced were verbal abuse (58%), physical abuse (48%), and sexual abuse (40%).

3 out of 4 hospitalized due to their addiction

Three out of four patients were hospitalized due to their SUD, most commonly for injuries, infections, overdose, suicide attempt/self-harm, and car accidents.

70% of patients report justice-involvement

Seventy percent of patients report justice involvement – 63% reported time in jail related to their substance use disorder, 35% participated in a diversion program, such as drug court, and 22% served time in prison.

One participant shared: “I was laying there sick from drinking just a couple days before I was pulled over for a DUI-DWI and I was praying to the Creator to help me because I don't want to be like this anymore to help me stop drinking and then it happened, I was pulled over on August 8th of 2020, I hated it at the time I was sitting in jail because I was going through withdrawals bad but I was also thanking God because I knew I was going to have to stop, I had no choice. I was immediately put on supervision probation and Wellness Court; I believe Wellness Court saved my life, if it wasn't for that, outpatient treatment and the recovery App I would probably have drank myself to death. I couldn't stop drinking in fear of being sick from withdrawals.”

Damaged relationships and financial issues were most frequent problems caused by substance use disorder

Significant problems caused by SUD were reported by patients, from damaged relationships, to personality changes, to financial problems.

One participant shared: "I did a lot of damage to my family, and myself, self-harm, when I would be in blackout drunk I would carve myself up with knives, I was just so full of hatred, and I was abusive to my ex-boyfriend. I never grew up, I never grew up. I didn't graduate high school, I couldn't keep a job. I just never matured mentally."

Trigger Events

Multiple trigger events contribute to the decision to get help

On average, patients shared three separate trigger events that contributed to engaging in treatment, a cluster of events that constitute the “Aha moment.” The events weren’t necessarily close in timing, but represented meaningful moments for the patients.

Tired, wanting change is the most common reason for engaging in treatment

The most prevalent reason for engaging in SUD treatment was being tired/wanting change (87%), followed by health reasons (35%), pressure from loved ones (23%), parenting/custody concerns (22%), and pressure from the criminal justice system (20%).

Another participant shared: “So what stopped me? I just couldn't do it anymore, I was 45. I'm like, what am I doing, you know, shooting dope in my 40's? I've lost everything again, everything. Everything fit in that syringe. My home, my life, my job, my dignity, it all went in there. And I just couldn't sacrifice all of that anymore.”

Health reasons the second largest driver of engaging in treatment

Physical injury and health concerns were the second most common trigger events for participants. For example, one participant shared, "Two overdoses and had to go to an infectious disease doctor for hepatitis C." And another individual reported: "Bronchitis, and I was treated for sexual assault two times while under the influence."

Children and family cited most frequently as the bright spots early in the process

Bright spots, or positive moments during the trigger events phase, included children and family, relief, hope for change, and encouragement from others.

Pain points: Managing isolation and shame

Pain points, the difficulties and challenges faced during the trigger phase, included isolation, shame, lost relationships, and fear.

Getting Help

The help phase details the process that participants went through to research and identify services and resources for the treatment of their substance use disorder. This phase is largely marked by difficulties and barriers for patients.

Significant barriers encountered as patients try to find help

Patients identified the accessing help phase as extremely painful, disorganized, and difficult. Poor treatment access was a common experience among participants who experienced systemic barriers to addiction care, including high levels of stigma (32%); the complexity of navigating the substance use disorders care system (25%); wait times (20%); the high costs of treatment (8%); red tape payer policies such as fail first and prior authorization (7%); and transportation difficulties (5%).

High levels of stigma experienced by patients

Over 30% percent of participants cite stigma as a significant barrier during the process of finding help and treatment. Patients experience stigma from doctors and other healthcare professionals; stigma from families, friends and the general public, as well as experiences of self-stigma, which occurs when individuals internalize the stigmatizing beliefs and attitudes of the public and suffer negative consequences, including delayed treatment access.

Stigma from healthcare providers is also a pain point for patients. One individual shared: “I think stigma is a really big one, though, just within myself, not with seeking help outside but in having to confront that I have this thing that is frowned on in society.”

Patients most frequently searched for services for themselves

During the getting help phase, over 60% of patients looked for services for themselves. 42% looked for treatment directly and 20% researched and found support groups to attend.

Another 22% talked to a loved one/friend, 7% talked to counselor/mental health professional, 7% received a criminal justice referral, 3% called 911, 3% called their insurance company, and 2% distanced themselves from using location or moved back with family.

The complexity of the system hampers treatment access

Feeling overwhelmed and confused about how to access treatment, repeated attempts to find treatment with no success, and frustration and agony over lack of access points frequent experiences among patients.

Another participant shared: “Well, I would have been probably in treatment a lot more times if I would have been able to find it some of the times when I looked and didn't have any means to get to it.” Previous treatment and recovery experiences, along with recommendations from friends, family, and a person’s network, frequently form the basis for the treatment pathway selected.

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Significant difficulties waiting to access treatment

Long wait times and the pain and discomfort of withdrawal symptoms during that time were a consistent pain point for participants. One individual shared: “It took about a month to get it, though, so it didn't happen right away… that was a long month that was for sure.” Another participant remarked: "The wait, the wait time is long. I was in withdrawal, so the desire to leave and go, you know get well, was really strong."

Problems navigating insurance

Participants noted difficulties navigating insurance.One individual shared: “Found it to be difficult navigating the insurance. Having to call back all the time and leave your name, because they want to know that you're really serious. And there wasn't a lot of choices, so there was really only one or two places in this town that I was from in Florida, and that was actually much bigger than where i'm at now but there wasn't Enough beds. You know so. That I remember that being a really huge challenge the phone.”

Average of 10 years of disease progression and 6 distinct treatment episodes

On average, patients report 10 years between realizing they have a SUD and finding recovery, participating in an average of 6 treatment episodes that had an additive, or cumulative effect in the success of the most recent treatment engagement. Previous treatment and recovery experiences, along with recommendations from friends, family, and a person’s network, frequently form the basis for the treatment pathway selected.

Perspectives on Most Frequent Ways Patients Get Help

Friends and family in recovery a bright spot in the help phase

Bright spots included having family/friends in recovery, not feeling alone, finding a smooth transition into treatment, and finding a community. However, many patients reported no bright spots at all during this phase.

Waiting for access and managing withdrawal symptoms are pain points for patients

Pain Points included waiting for access, withdrawal symptoms, difficulty finding treatment, navigating insurance, financial barriers and family friends not being supportive.

Care Begins

The care phase details the connection to treatment or other services, and the assessment process if applicable.

Most patients connect directly with specialty treatment providers

Previous experiences and treatment episodes guide the first contact and research conducted by patients. Direct engagement with a specialized treatment provider was the most often utilized first point of contact to find help (37%), followed by hospital or emergency room (20%), doctors (15%), mental health provider/counselor (7%), and criminal justice agencies (3%).

Of note, 18% of participants had no involvement with specialty treatment or recovery services and instead managed their symptoms and sobriety independently. One individual shared: “I had zero contact with the professional world when it came to my substance abuse.”

Patients often fearful as care begins

Patients report strong emotions and high levels of uncertainty and fear as care begins. One participant shared: “I did have this mental breakdown in the intake process. Because I just like the revelation that, like my life was going to be changing, and I was also scared as well, so it's like a big mix of emotions and also I was coming down so there's an issue.”

Stigma encountered in healthcare settings

Feeling stigma from healthcare providers and other professionals during the care phase was a continued pain point for patients. One individual shared: “I think stigma is a really big one, though, just within myself, not with seeking help outside but in having to confront that I have this thing that is frowned on in society.

Co-occurring mental health disorders prevalent

While 68% of patients received a formal SUD assessment, assessments are also needed for co-occurring mental health disorders, physical health, and trauma, as 67% have a co-occurring mental health disorder. Depression, anxiety disorder, and bipolar disorder are the most common diagnoses.

Trauma experienced during active addiction

Trauma often experienced during active addiction, including physical violence and sexual assault.

One participant shared: "Women, like me, are not supposed to make it, but we do and I think that we tend to judge and not support women that have made some of the choices I've made and been in some of the situations I've been in. I think that there needs to be more support and longer term care for women that are victims of sexual assault in childhood or otherwise, that have been in the sex industry, because it'll kill you. That have been victims of domestic violence, it's not just about getting clean, right? It's about healing this other trauma, there's a lot of trauma."

Patients report that repetitive assessments and interviews are triggering and difficult

A consistent pain point among patients was repetitive assessments and interviews during the care phase, with reports of feeling triggered and interrogated. Patients also questioned the utility of multiple interviews and the coordination of providers.

Engagement with friendly providers and peers a bright spot in the care phase

Bright spots during the care phase include friendly engaging staff, peers/recovery coaches, and having employment and housing.

Negative effects of repetitive assessments and isolation are frequent pain points

Treatment and Recovery

The treatment and recovery phase includes the diverse services and resources accessed by the patient, both within the healthcare system and outside. Patients report that previous treatment episodes provided a foundation for treatment and recovery success. Rather than viewing previous episodes as a failure, the skills and tools learned accumulated over time.

Multiple services utilized, not a single intervention

On average, patients utilized four different services for treatment and recovery support, not a single treatment or intervention. Services accessed were support groups (88%), counseling/mental health treatment (57%), intensive outpatient treatment programs (52%), followed by residential programs (37%), aftercare programs (30%), medications for addiction treatment (28%), sober living (22%), and faith-based programs (12%).

Skills and tools from both current and previous treatment episodes helpful

Patients report that previous treatment episodes provided a foundation for treatment and recovery success. Rather than viewing previous episodes as a failure, the skills and tools learned accumulated over time.

Layered interventions necessary across 3 key domains – biological, psychological, and social.

Patient feedback shows the need for layered interventions across three critical domains: 1) biological, or physical health, 2) psychological, and 3) social.

Biological interventions range from medications for addiction treatment, medical care for other health conditions, taking prescriptions for mental health disorders and other chronic conditions like heart disease and diabetes, as well as self care priorities that include sleep, exercise and proper nutrition. Forty-seven percent of participants utilized an intervention or service to address physical health.

Three out of four patients required psychological interventions. Psychological interventions include mental health counseling, group counseling, cognitive behavioral therapy, building a relapse prevention plan, identification and awareness of triggers for substance use to include high risk people, places and things, and skills and resource focused strategies like learning new coping skills.

Ninety-five percent of patients require social interventions. Social components include building a positive social network, commonly through support group participation, new hobbies and activities, and cutting out old friends and the individual’s using network.

Low recovery literacy among healthcare providers creates challenges

A pain point in treatment for patients is encountering low recovery literacy among healthcare providers. Patients share the need to learn how to manage their chronic disorder, and frustration when selected providers are not well versed in the supports and layered interventions that are necessary to achieve stable recovery. Patient input suggests the need for a paradigm shift for SUD management to focus on empowering the person with an addiction to manage the disease successfully and to improve their quality of life.

Managing a SUD requires significant effort on the part of the patient. Whether education and services are embedded with care providers, linkage facilitators, handoffs to peer services, guidance from the primary SUD treatment provider on the components of managing the disease and skills and resources available is beneficial to the patient.

Encounters with providers without the knowledge to assist in the chronic disease management plan are difficult. One participant shared: “For me it really has to do with the level of care. I was going to when I first learned about suboxone I was literally just going to like what I could best described as a meat market, a place that you would go and you get your prescription. And that was it like as long as you had your money you could get the medicine and there was really no recourse for following treatment, so I really wasn't educated about my disease and what recovery was.”

45% of patients accessed medications for addiction treatment (MAT )

Forty-five percent of participants utilized a medication for addiction treatment (MAT) at one point in their life. All three FDA-approved medications were utilized by patients -- Buprenorphine (52%), Naltrexone (48%), and Methadone (33%).

Low utilization of medications to treat alcohol use disorder

20% of patients with a primary alcohol use disorder (AUD) utilized an FDA-approved medication for AUD at one point in their life for treatment. Of the 30 AUD participants, 33% were prescribed Naltrexone, 20% Acamprosate, and only 10% of participants utilized Disulfiram.

Patient perspectives on MAT positive, though stigma around medication prevalent

Experiences with MAT were mostly positive, but the stigma around using medications created challenges for patients. One participant shared: "I guess stigma from other people, being on a MAT. I live in... like, it's not a big city. So I would say that this area for a long time has been indoctrinated in the 12 steps. And that includes like medical professionals, I went to my family doctor they wouldn't even entertain anything else other than getting off the methadone. They told me how bad it was and all kinds of things. And then my job, I mean, it was a struggle, because they of course didn't want anybody to know I was on it. And just from friends that weren't using but were in recovery they you know, had an issue with it."

Another shared: "Dealing with the anxiety and the you know all the guilt and shame from before my use so now I don't have that drug to numb me anymore um and. Honestly, a lot of it is a you know, probably people saying that you're not clean, you know i'm not really clean because i'm one method on so like i'm still using something, which I don't really like get to me, but you used to and then also the weight gain you know and people making fun of me for my weight because i've gained a lot of weight."

Bright Spots: Positive social connections and helpful clinicians

Bright spots included positive social connections, helpful clinicians, new tools and skills, learning about the disease, and peer/recovery coaches.

Pain Points: Hard work and managing shame

Pain Points included the hard work/difficulty of treatment, managing shame and self-stigma, cutting out friends/old networks, transportation challenges, and unhelpful home/work environments.

Lifestyle Changes

Engaging in treatment and lifestyle modifications are concurrent, not sequential, in finding stable recovery

Lifestyle changes are cited by patients to be as critical to success as treatment and recovery services. Patients share that the things encountered every day play a critical role in supporting or hampering recovery.

Building a positive social network is a critical lifestyle change

Creating a positive, supportive social network is a dominant feature of successful recovery, along with avoiding individuals, places, and other triggers that present memory and physical cues to resuming substance use (i.e. using friends, bars, parties, concerts, boredom.) The exact constellation of triggers is unique to each patient.

Common lifestyle modifications include avoidance of high-risk people, places, and things (42%), changing friends (40%), becoming honest open-minded and accountable (25%), self-care such as exercise, nutrition, and sleep (23%), and developing a consistent routine (13%).

Finding a community and feeling happy again are bright spots for patients as they manage lifestyle changes

Bright spots include creating a positive support network, feeling happy again, being present in life again, being reunited with children/family, and feeling physically healthier.

Difficulty making amends and stigma around medications are pain points for patients

Frequent Pain Points include difficulty making amends, triggers associated with high-risk people, places and things, MAT stigma, trouble sleeping, and sadness/depression.

Ongoing Support

An average of 3 services utilized for ongoing support

Participants shared that they rely on multiple supports in long-term recovery with an average of three services utilized. The most common services were support groups (65%), family and friends (55%), volunteer and service work (38%), and mental health/counseling (22%). Patients in recovery from SUDs continue supports specific to their needs for years or even decades.

Over half of patients work with a sponsor or professional to help manage their recovery

58% of patients report having a physician, recovery coach or other professional to help manage their recovery.

42% have a sponsor

27% see a counselor

15% see a psychiatrist

13% see a physician

5% have a recovery coach

Before and After: Active Addiction to Stable Recovery

Analysis of 60 life course history interviews conducted during the study showed specific themes from onset, progression to treatment and recovery. A word cloud is a visual representation of word frequency where the more commonly used terms in the analyzed text appear larger in the visualization. Themes and tags relevant to active addiction included homelessness, job loss, trauma, children and custody issues, health challenges, school suspension and expulsion, negative impact on friends and family. In contrast, common themes related to recovery include improved relationships, experiencing life, freedom, health and wellness and words like good, love and amazing.

Having a full life and the feeling of accomplishment are bright spots in recovery

Health consequences and limited access to services are pain points in recovery

Ways Forward

Key next steps based on the findings of this report include:

1. Reduce barriers to treatment

Patients encounter systemic barriers to addiction care, including long wait times; high treatment costs of treatment; and red tape payer policies such as fail first and prior authorization. Patients require assistance navigating the substance use disorders care system, determining evidence-based care options, and support for the management of the chronic condition.

2. Ensure stigma training for all healthcare providers

Research has found that individuals who experience stigma due to an SUD are more likely to continue engaging in substance use, and manifest greater delayed treatment access and higher rates of dropout. Patients in the study shared the difficulty of interfacing with healthcare professionals with stigmatizing beliefs and attitudes. Efforts to decrease stigma should include increasing addiction literacy levels to counteract education gaps and misconceptions about SUDs.

3. Streamline the assessment process

Patients share the tremendous discomfort and trauma of repetitive assessments and interviews when accessing treatment. Responses include feeling triggered and interrogated and questioning the utility of multiple interviews. Clinicians can streamline the assessment process and share information with other providers.

4. Individualized care and management plans needed

The majority of patients utilize multiple services for treatment and recovery support, not a single treatment or intervention. Patients on average utilized four services during treatment and three in long-term care management. Lifestyle modifications, such as building a positive social network and discontinuing contact with those still using substances, are critical elements of recovery stability. More education for both patient and providers is needed to reinforce the individualized, multi-faceted management plans needed.

5. Screen for ACEs

Most patients have experienced multiple adverse childhood experiences, particularly living in a household with SUD. Evidence-based prevention strategies are available and yet underutilized, including screening, early intervention, programs to address ACEs and children impacted by parental substance use disorder, as well as primary prevention interventions. Preventing the development of substance use disorders must be a priority and can change the trajectory of the crisis.

Addiction Policy Forum

Addiction Policy Forum aims to eliminate addiction as a major health problem by translating the science of addiction and bringing all stakeholders to the table. The organization works to elevate awareness around substance use disorders and help patients and families in crisis. Founded in 2015, Addiction Policy Forum empowers patients and families to bring innovative responses to their communities and end stigma through science and learning.

Jessica Hulsey, Addiction Policy Forum

Kayla Zawislak, MSW, CADC, Addiction Policy Forum

Acknowledgments: Supported in part by the National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), U.S. Department of Health and Human Services (HHS).

Suggested Citation: Substance Use Disorder Patient Experiences through a Journey Map. Addiction Policy Forum. (2022).

Sales, rights and licensing: To purchase APF publications, see https://www.addictionpolicy.org/store.

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What Are the 6 Stages of Addiction Recovery?

Understanding Motivation and Behavioral Change

The Complex Nature of Addiction and Recovery

Reducing Relapse Risk

Holistic Approach to Relapse Prevention

Healthy Coping Tools
Harm Reduction

Individuals grappling with substance use disorder (SUD) and addiction often face complex challenges, necessitating a multifaceted approach for resolution. The journey to recovery is highly individualized, with diverse paths tailored to unique circumstances. One influential framework guiding this process is the “Transtheoretical Model of Change” (TTM) , developed by Dr. James Prochaska and Dr. Carlo DiClemente. This model delineates six stages through which individuals cycle during their recovery journey, elucidating the mechanisms that drive behavioral transformations.

Central to the TTM is the concept of motivational interviewing (MI) , a clinical tool seamlessly integrating with the Stages of Change Model . MI proves particularly efficacious within the addiction population. By fostering a non-confrontational and empathetic therapeutic environment, MI aligns with the stages individuals navigate, promoting intrinsic motivation for change. The collaborative nature of MI respects the diverse progression of individuals through the stages, acknowledging their readiness and ambivalence.

Through the lens of TTM and MI, the recovery process emerges as a dynamic and fluid evolution. These models recognize the cyclical nature of change, emphasizing the potential for relapses and reinforcing the importance of ongoing support. As individuals traverse the stages – pre-contemplation, contemplation, preparation, action, maintenance, and termination – the integration of motivational interviewing ensures a tailored and responsive approach. Ultimately, embracing the nuances of each individual’s journey, TTM and MI provide a comprehensive framework for clinicians and individuals alike to navigate the intricate terrain of addiction recovery .

DiClemente and Prochaska devised the Transtheoretical Model (TTM) to comprehensively elucidate the recovery process by delineating six distinct stages. The Stages of Change model, an integral part of TTM, incorporates an environmental dimension, examining how targeted behavior changes manifest within the broader context of an individual’s life. For instance, when addressing smoking cessation, clinicians employing this model delve into aspects like lifestyle, diet, and exercise habits, recognizing their impact on overall health. This holistic understanding proves instrumental in motivating tangible and sustainable behavioral changes.

The Stages of Change Model Unfolds Across Six Stages:

Pre-contemplation: At this initial stage, individuals have no immediate intention to alter their behavior within the next six months. Often, they may be unaware that their behavior is problematic.
Contemplation: In this stage, individuals are cognizant of their problem and actively contemplating healthy changes in the near future (within the next six months), though a firm commitment to action may be lacking. Ambivalence can persist despite recognition.
Preparation/Determination: Individuals in this stage express an intent to take action within the next 30 days, initiating small behavioral changes toward their desired goal.
Action: This stage witnesses individuals actively changing their behavior in the past six months, committed to continued progress and the cultivation of healthy habits. Positive momentum becomes evident as new behaviors take root.
Maintenance: Participants in this stage have sustained behavior changes for an extended period (more than six months), proactively working to prevent relapse and maintaining their commitment to ongoing action.
Relapse: In the relapse stage , individuals revert to old behaviors. For those adhering to a harm-reduction model, relapse doesn’t necessarily indicate a return to active addiction, depending on the alignment with long-term goals.

Understanding Motivation and Behavioral Change: The Stages of Change Model

Breaking down motivation: diclemente’s perspective.

Dr. DiClemente views motivation as a series of tasks, each integral to the process of change. The Stages of Change model delineates these tasks, encompassing concerns, decision-making, preparation, planning, commitment, effective action, plan revisions, and integration of behavioral change into one’s lifestyle.

Behavioral Changes as Core Contributors to Health

In treatment settings, clinical diagnoses and health problems often focus on behavioral changes as a fundamental element for health prevention and maintenance. Establishing rapport between client and practitioner becomes pivotal, with identified short-term and long-term goals pursued actively through client motivation.

Non-Linear Progression: Navigating the Stages

Individuals may not progress linearly through the stages of change; some take steps forward and then regress. For instance, someone aiming for alcohol abstinence may initially opt for moderation. The concept of recovery varies individually, with not everyone considering full abstinence as indicative of recovery.

Adapting to Ebb and Flow: The Stages of Change Model

The Stages of Change model accommodates this ebb and flow in individuals’ progress. Practitioners gauge a client’s stage to understand their readiness for change. Motivational interviewing, aligned with the Stages of Change, acts as a skillful clinical style, motivating clients for behavioral changes that enhance well-being.

Neurological Impact and Behavioral Reprogramming

Addiction involves brain mechanisms , particularly in the dopamine system crucial to reward processing. While stopping drug use is a pivotal aspect of recovery, it is only one part. The process often requires reprogramming deeply ingrained thought patterns, and forming new behaviors.

Relapse and its Likelihood

Relapse is a common aspect of addiction recovery. Science indicates that triggers such as people, places, things, moods, and drug exposure play significant roles. Recognizing addiction’s multifaceted nature is crucial, understanding physiological, psychological, and social components.

Reducing Relapse Risk: Building a Supportive Environment

Reducing the risk of relapse in addiction recovery is intricately tied to building a supportive environment that fosters well-being and sustains positive behavioral changes. A robust support system plays a pivotal role in an individual’s journey towards recovery. This support can come from family, friends, support groups, or a combination of these, offering encouragement, understanding, and a sense of belonging.

Adherence to an after-care plan is crucial in maintaining recovery progress. After completing a formal treatment program, individuals often receive an after-care plan tailored to their specific needs. This plan may include ongoing therapy, support group participation, and regular check-ins with healthcare professionals. Consistently following this plan provides structure and guidance, helping individuals navigate the challenges that may arise post-treatment.

Living in an environment conducive to recovery is another key factor. An environment free from triggers associated with substance use, surrounded by positive influences, and offering a sense of safety contributes significantly to maintaining sobriety. Lastly, recognizing the importance of seeking help during stressful times is vital. Developing healthy coping mechanisms and reaching out for support when facing challenges are proactive measures that can substantially reduce the risk of relapse. By combining these elements, individuals can create a resilient and supportive foundation, enhancing their ability to sustain recovery efforts over the long term.

Experts acknowledge addiction’s multifaceted nature, encompassing physiological, psychological, and social components. A strong support system, adherence to an after-care plan, a recovery-friendly environment, and seeking help during stress reduce the risk of relapse.

Comprehensive Rehabilitative Services

Recognizing addiction’s impact on various life aspects, the best programs integrate diverse rehabilitative services . Clinical advances in addiction treatment align with the Stages of Change Model, offering a valuable tool for therapists, counselors, and health professionals facilitating clients’ recovery goals.

Healthy Coping Tools Instead of Alcohol Use

Stress can be a major factor leading to excessive alcohol use. If you are able to find healthy replacements instead of turning to alcohol, you will develop positive coping strategies to strengthen your health and well-being, which aid in prevention.

Some healthy coping methods include:

Exercising and eating regularly.
Avoiding excess caffeine and sugar intake.
Avoiding illegal drugs , alcohol and tobacco.
Learning relaxation exercises (abdominal breathing, yoga, meditation).
Developing assertiveness.
Decreasing negative self-talk and focusing on a positive mindset.
Finding joy and happiness in small things.
Listening to music, talking to a friend, drawing, writing, or spending time with a pet.
Building a network of friends who help you cope in a positive way.
Volunteering in the community.

Harm Reduction in Addiction Recovery

Addiction recovery is a complex and nuanced process, and recognizing the diversity of individual experiences is crucial in developing effective strategies for sobriety. The concept of harm reduction, along with various modalities, offers a flexible and personalized approach to cater to the unique needs and circumstances of each individual on their journey to recovery.

Harm reduction acknowledges that not all individuals may follow a linear path toward abstinence and that there are different ways to minimize the negative consequences of substance use. It promotes a pragmatic and compassionate stance, focusing on reducing the harm associated with addictive behaviors rather than solely emphasizing complete cessation. For instance, someone struggling with alcohol dependence might initially work on moderation before committing to full abstinence.

Understanding the dynamic nature of addiction, harm reduction aligns with the idea that relapses may occur and should be viewed as opportunities for learning and adjustment rather than as failures. By adopting harm reduction strategies, individuals gain the tools to make healthier choices, manage risks, and gradually work towards minimizing the impact of substance use on their lives.

Moreover, integrating various modalities into addiction recovery recognizes that there is no one-size-fits-all solution. Each person’s journey is shaped by a myriad of factors, including physiological, psychological, and social elements. Therapeutic modalities such as cognitive-behavioral therapy (CBT) , motivational interviewing, and mindfulness-based interventions offer diverse tools to address the multifaceted aspects of addiction.

By providing options for recovery, individuals can choose the approaches that resonate with their needs and preferences. This inclusivity fosters a sense of empowerment, encouraging active participation in the recovery process. Whether through individual or group therapy, medication-assisted treatment , or holistic interventions, tailoring the approach to the individual’s circumstances enhances the effectiveness of addiction recovery efforts.

In conclusion, embracing harm reduction and diverse modalities recognizes the uniqueness of each individual’s journey in addiction recovery. By acknowledging differences, offering alternatives, and emphasizing flexibility, the recovery process becomes more accessible, person-centered, and ultimately more effective in promoting lasting positive change.

Published on January 31, 2024

Written by the Addiction Resource Editorial Staff

Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.

These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

American Psychiatric Association. (2023). What is a substance use disorder? https://www.psychiatry.org/patients-families/addiction-substance-use-disorders/what-is-a-substance-use-disorder
National Institute on Drug Abuse (2023). Drugs, Brains, and Behavior: The Science of Addiction. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
DiClemente, C. (2009). Health behavior insights: The transtheoretical/stages of change model. Health Promotion Practice. http://journals.sagepub.com/doi/abs/10.1177/1524839908323519
Bischof, G., Bischof, A., & Rumpf, H. J. (2021). Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice. Deutsches Arzteblatt international, 118(7), 109–115. https://doi.org/10.3238/arztebl.m2021.0014
Raihan N, Cogburn M. Stages of Change Theory. [Updated 2023 Mar 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556005/
Guenzel N, McChargue D. Addiction Relapse Prevention. [Updated 2023 Jul 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551500/
Anthenelli, R., & Grandison, L. (2012). Effects of stress on alcohol consumption. Alcohol research : current reviews, 34(4), 381–382. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860387/#:~:text=The%20connection%20between%20stress%20and,consumed%20to%20reduce%20the%20anxiety.
Single E. (1996). Harm Reduction as an Alcohol-Prevention Strategy. Alcohol health and research world, 20(4), 239–243. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876518/
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Dr. Anjali Talcherkar is a researcher and writer specializing in the use of Complementary & Alternative Medicine (CAM) in addiction...

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Recovery From Addiction Is a Journey. There’s No One-and-Done Solution.

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A photo of a man working on a laptop indoors.

The atmosphere inside the Allen House is easygoing as residents circulate freely through the hallways, meet in group sessions, or gather on a large outdoor patio that features a dirt volleyball court with an oversize net.

The 60-bed safety-net residential treatment center in Santa Fe Springs, run by Los Angeles Centers for Alcohol and Drug Abuse , has a dedicated detox room, on-site physicians and nurses, substance abuse counselors, licensed therapists, and other practitioners. It offers group counseling as well as individual and family therapy, and it endorses the use of medications for addiction treatment, such as buprenorphine and naltrexone, which are increasingly considered the gold standard.

Willard Sexton, a staff member and former Allen House patient, says the most important part of his job is speaking with each resident daily. Most of them, like him, came to treatment straight from jail or prison, and he knows as well as anybody how stressful it is to stop using.

“It’s similar to grief and loss,” says Sexton, 35. “The drug was their best friend for a long time.” Interacting with them, he says, helps him in his own ongoing recovery.

At a time when drug use is among the nation’s gravest public health crises, a visit to the Allen House offers key lessons: Addiction is a chronic illness requiring constant vigilance, there’s no one-and-done solution, and relapses are part of the journey to recovery. Peer mentoring is an invaluable element of drug counseling, since people who have plodded the difficult path from dependence to sobriety understand the mindset of patients on a visceral level.

And most importantly for those who feel despair in the grip of addiction, there is hope. “Recovery happens,” says Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association of California. “Every single day people come into treatment and succeed in addressing their substance use disorders.”

Drug-related overdoses kill almost as many Californians as lung cancer, more than diabetes, and two to three times as many as car accidents, according to a report by California Health Policy Strategies , a Sacramento consulting group. The report showed there were about 11 times as many fentanyl-related deaths in 2021 as in 2017, accounting for more than half of overdose fatalities. And addiction can ruin lives even if it doesn’t end them.

But proper care for substance use disorders can still be hard to find. Experts in the field say residential treatment beds are in short supply. A pandemic-driven shortage of health care workers has hit the drug treatment world . Unscrupulous operators, with an eye on their bottom lines , may take advantage of people desperate for any answer. Commercial insurers often deny treatment requests or propose cheaper alternatives.

Some treatment programs shun anti-addiction medications that have proven effective . Physicians, nurse practitioners, and other providers with the requisite training can prescribe these drugs in California, but too few seem willing or able to do so — though that could change now that federal law no longer requires them to get a special waiver.

A page on the website of the Substance Abuse and Mental Health Services Administration ( www.samhsa.gov ) allows you to find practitioners in your area who treat patients with buprenorphine.

There’s no one-size-fits-all solution for addiction. Treatment can differ depending on the substance — opioids, alcohol, or methamphetamine, for example. And people with substance use problems come from all walks of life: Some are straight off the streets or out of jail or may have serious mental or medical conditions that require additional care. Others may be otherwise healthy with good jobs and insurance. If a clinic tries to sell you on a standardized treatment program, cross the place off your list.

And if someone tells you that after one stint in their program you or a loved one will be drug-free for life, run the other way. For many people, addiction is a chronic condition that ebbs and flows over many years. Too often, patients in the throes of an overdose are revived and then discharged with no follow-up.

“If we talked about treating other chronic illnesses like diabetes or asthma in the same way we often approach treating substance use, people would think we were crazy or would sue the doctor for malpractice,” says Bradley Stein, a psychiatrist and senior physician policy researcher at the Rand Corp.

A photo of bunk beds in a treatment center dormitory.

Finding the treatment that is right for you or a loved one will take legwork.

Whether it should be a residential or outpatient program depends on multiple factors. People who need to be shielded from exposure to a dealer or a toxic domestic situation, require detox, or have mental health or medical conditions on top of their drug use generally are better off in a residential setting, says Randolph Holmes, medical director of the Los Angeles Centers for Alcohol and Drug Abuse. Outpatient settings are more suitable for people with stable lives and better health or those transitioning from residential treatment, he says.

The cost of treatment can vary widely depending on duration and the patient’s circumstances. In some cases, it can reach tens or hundreds of thousands of dollars.

Various websites allow you to search for nearby addiction treatment. The Substance Abuse and Mental Health Services Administration has a treatment locator at www.findtreatment.gov , or you can call its help line at 800-662-HELP (4347). Shatterproof ( www.shatterproof.org ) is another source for finding treatment. In California, the Department of Health Care Services publishes a list of substance use help lines by county.

If you’re on Medi-Cal, California’s version of the federal Medicaid program for low-income residents, your county is a good place to start. It can point you to several options, at least in more populous areas. Almost all patients with the Los Angeles Centers for Alcohol and Drug Abuse, for example, are Medi-Cal enrollees.

If you have commercial insurance, call your health plan first. Parity laws require insurers to cover substance use treatment, though they often find reasons not to provide the treatment your provider recommends. If your plan denies you treatment you think you need, you can file an appeal. The Department of Managed Health Care ( www.dmhc.ca.gov ), the state’s primary health plan regulator, has a help line (888-466-2219) that can assist in appealing your case. Or you can do it online . If the department does not regulate your plan, it can steer you in the right direction.

And remember that recovery is a long-term commitment.

When Sexton first started using in his early 20s, his drug of choice was meth. He later started smoking it with heroin and fentanyl mixed in, he says.

Several years ago, Sexton spent 45 days in residential rehab and got clean. Then he started seeing a woman who was addicted to heroin. He thought he’d help her get sober but ended up doing drugs with her instead. He landed in jail for two months, and a judge ordered him back into residential drug treatment.

Sexton says he continues to actively pursue his recovery even as he helps others do the same. “There are bumps in the road, but I feel like I’m in a Range Rover,” he says. “I’m not going to spill my coffee.”

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This article was produced by KFF Health News , which publishes California Healthline , an editorially independent service of the California Health Care Foundation .

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By Bernard J. Wolfson June 6, 2023

“It’s similar to grief and loss,” says Sexton, 35. “The drug was their best friend for a long time.” Interacting with them, he says, helps him in his own ongoing recovery.

The cost of treatment can vary widely depending on duration and the patient’s circumstances. In some cases, it can reach tens or hundreds of thousands of dollars.

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Making Recovery from Addiction a Shared Journey

Including loved ones in the recovery process may lead to better outcomes..

Posted June 17, 2021 | Reviewed by Chloe Williams

When a person has cancer, loved ones are often involved in the person's treatment. With substance use disorder, loved ones are often left out.
Traditional opaque models of treatment for substance use disorder may be unsatisfying to loved ones and unlikely to enhance sustained recovery.
Loved ones should be involved in conversations about treatment options as well as likely outcomes and discuss goals when someone exits treatment.

Imagine that you recently learned that a loved one was diagnosed with a potentially terminal illness, like cancer. Your first reaction would most likely be anxiety , followed by a natural inclination to want to know more, as well as how you might be able to help. This scenario, of course, is perfectly natural and normal. Unfortunately, it is not the experience that many people report having when the potentially terminal diagnosis is addiction.

Treatment for Addiction Tends to Be an Opaque Process

Loved ones of those who find themselves caught up in the throes of a substance use disorder, for example with alcohol or opioids, are typically very anxious about the problem while it is untreated (and possibly worsening) and will usually report that they experience some degree of relief if and when the substance abuser makes the decision to enter treatment of one kind or another. But that is where the analogy to cancer treatment typically ends. While cancer treatment tends to be more transparent to loved ones, and even engages them as collaborators in many ways, substance abuse treatment tends to be an opaque process in which loved ones have little insight and often find themselves left out in the eventual outcome. When a loved one has cancer, family and friends are often enlisted in ways such as attending doctor's meetings and taking notes, discussing treatment options and their likely outcomes, accompanying the patient to treatments, helping to build a support network of fellow survivors, and so on.

Not so with addiction treatment. A more common scenario reported by loves ones goes something like this: “Take care of yourself and leave the treatment process to us, and recovery to the substance abuser.” Needless to say, this can be immensely frustrating to loved ones who are, in truth, stakeholders in recovery as much as the substance abuser.

The time has come to change the above scenario and to move both treatment of and recovery from a substance use disorder to a more collaborative process. It will likely be more successful, as in cancer treatment, when it is approached as a shared journey that includes the patient and other stakeholders in his or her life.[i]

Substance Abuse in the Time of COVID

Researchers and clinicians have reported a significant increase in both mental health and substance abuse diagnoses since the advent of the COVID pandemic—a trend that unfortunately continues to this day. According to the Centers for Disease Control and Prevention, as of June 2020, 13 percent of Americans reported starting or increasing substance use as a way of coping with stress or emotions related to COVID-19 .[1] Although the pandemic itself is not the only source of the current substance abuse crisis, the reality is that more and more families are finding themselves confronted by an alcohol, opioid, or prescription drug abuse problem in a family member. For this substantial portion of our population, the traditional opaque treatment model is neither satisfying nor likely to enhance the prospects of sustained recovery.

What is more likely to work is to approach treatment and post-treatment recovery as a shared journey that includes the patient and loved ones who are stakeholders in the outcome. This post will describe some of the elements of such a collaboration .

Recovery as a Shared Journey

Recovery begins when the substance abuser takes that first step in engaging in treatment. That may be residential rehab, intensive outpatient treatment, or simple weekly outpatient treatment—and here is where the first critical step needs to be confronted in a frank way. Just as some individuals who are told that their diagnosis is cancer (or diabetes, emphysema, or heart disease) may refuse to accept that reality, so it is for the substance abuser. He or she may simply deny that the problem is there, or try to minimize its consequences for them and their family. She or he may “talk the talk” and say that they are addicted and need to abstain from all substance use, while privately holding on to some belief that they can control or “moderate” their use: “A couple of cocktails on the weekend can’t hurt,” or “Just a little painkiller helps me get through the day.”

As a first step, loved ones as stakeholders have a right to know exactly what “treatment” for the substance abuse problem looks like. When a loved one is diagnosed with cancer, family members typically are included in discussions of treatment options (chemotherapy, radiation, surgery, etc.) and what the likely outcomes associated with each option are. So it should be with substance abuse treatment.

The fact is that substance abuse treatment is currently an unregulated industry, and that while there are generally accepted treatments for most medical problems, that is not the case when it comes to substance abuse. The result is that not all substance abuse treatment programs (on the inside) are the same. Loved ones, as well as the person with substance use disorder seeking help, need to know this and therefore take time to inquire about just what the “treatment” program looks like. Some programs, for example, offer treatment that may include hot tubs and horseback riding that appear to appeal to people as vacations more than treatment. Fortunately, there are what are called “evidence-based” treatments for substance abuse disorders that have been tested and are supported by sound research.[2] Loved ones as well as the substance abuser can spend a little time reviewing these options and then inquiring with a prospective treatment program about their use of such treatments. And while in treatment, the person with substance use disorder should share their experiences with being involved in such evidence-based treatments.

Supporting Loved Ones as They Enter and Leave Treatment

Loved ones who are stakeholders in recovery also do well to engage the substance abuser at the time she or her both enters and leaves treatment about what he or she truly believes about the substance abuse problem, and what the solution should be. It is common knowledge that the risk of relapse following rehab is high. With that reality in mind, if the newly sober person and his or her loved ones are not on the same page in this regard, the chances of success are significantly reduced, as research has shown that, for a severe substance abuse problem, choosing abstinence as a goal (as opposed to moderation or “controlled use”) leads to better outcomes.[3]

Loved ones need to be informed of research like this when they engage the newly sober person in this discussion of what they truly believe and therefore what their real goal should be. No use pursuing different goals based on different beliefs about what the real solution is. An honest dialogue at this early juncture can make the difference between recovery as a collaborative effort among stakeholders and a risky venture.

With this as a starting point, treatment and recovery move from being an opaque process in which loved ones play little to no role (other than being bystanders) toward being co-equal stakeholders. Needless to say, the responsibility for recovery rests mainly on the shoulders of the substance abuser; but in a collaborative approach, the journey to recovery stands to be more successful due to a common commitment and shared involvement.

Nowinski, J. Recovery After Rehab: A Guide for the Newly Sober and Their Loved Ones. Rowman & Littlefield, 2021.

Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1external icon.

https://novarecoverycenter.com/treatment/evidence-based-addiction-treat…

Bujarski, S., O’Malley, S. O., Lunny, K., & Ray, L. A. (2013). The effects of drinking goal on treatment outcome for alcoholism. Journal of Consulting and Clinical Psychology, 81 (1) 13-22.

Joseph Nowinski, Ph.D., is a clinical psychologist in independent practice as well as assistant professor at the Hazelden Betty Ford Graduate School of Addiction Studies.

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Sobriety and The Hero's Journey

Path along a hill leading toward a view point.

The hero's journey is a concept explored by Joseph Campbell. A great admirer of Jung, Campbell observed that across time, many cultures told tales about the journey of a hero. He saw the monomyth lay beneath all these stories, with similar arcs occurring in cultures with geographic and temporal separation. He realized that the hero's journey is a blueprint in the human psyche. As the stories we tell follow this arc, so do the journeys we take in our lives. So, it is no great surprise then that the journey towards sobriety can take a path similar to the hero's journey.

The hero's journey is often shown as taking place over 12 steps, though not all myths have all these steps. However, since 12 is the number of steps in many programs of recovery, it is well aligned for this topic.

The hero's journey begins in the ordinary world. Harry Potter is living under the cupboard. Luke Skywaler is farming with his parents. Our hero is going through the motions of daily life. This is in the heart of the ordinary. For someone using substances, perhaps the substance itself has become ordinary, and is simply part of life. For me it had become background noise. I took it at the same time I brushed my teeth every morning. Somewhere along the way the pain that had once motivated me to use had softened, and all that was left was dissatisfaction with how my life was going.

The second step of the hero's journey is the call to adventure: Harry receives a letter in the mail. Neo learns about the matrix that imprisons him. In recovery, this could be learning about sobriety through a counselor, or watching a friend go to rehab or stop using substances.

Sometimes this is followed by a ‘refusal of the call.’ Recovery literature talks about how many ways people try to change their habits on their own. I tried to stop drinking and just do other substances, and vice versa. I went to a SMART recovery meeting, and never went back to meetings for over a year and a half. Other refusals of the call could be slips or relapses early in the process before a more stable sobriety occurs.

The fourth step on the hero's journey is meeting the mentor: Neo meets Morpheus, Luke meets Obi Wan Kenobi. Harry meets the wise old magician, Dumbeldore. Although I’ve had many mentors in my life, and would soon meet many more, here I think of the psychiatrist who helped place me in rehab. He and I had been through a lot, and when I was ready to stop going through the motions and try something new, he helped me find a place to go. In the twelve steps, this could also be seen as beginning the fourth step with a sponsor, an act that takes courage, trust, and dedication.

The fifth step is crossing the threshold. This is a visceral, painful event. When Neo wakes up, he is in a tub filled with goo, pulling suction cups off his skin. His own body has become alien to him. This was how going through benzodiazepine withdrawals felt. It felt as if my body, mind, and soul were dissolving. I felt disconnected, alternately hot and cold, with my skin itching. I was so anxious I thought I’d explode, while also nodding off randomly and jerking awake. In short, my body had become alien to me. The ordinary world had been left behind, and at first it was extremely painful. The 5th step in any 12 step program is also a crossing of the threshold, though it is more internal. It allows an individual to see themself in a new way for the first time. During my 5th step, I realized how many of my own regressive behaviors I had justified. I had been blind to large truths about myself, and was able to see my own imperfections in a way I never had before. It was a tough pill to swallow.

The sixth step in the hero’s journey is known as ‘Tests, Allies, and Enemies.’ Upon his arrival at Hogwarts, Harry meets Ron and Hermione, but also Snape and Malfoy. He finds Hogwarts challenging, and finds himself pitted against Malfoy on the quidditch field. Neo learns that agent Smith is hunting him. What this step calls to mind for me is what it was like making friends in early recovery, and finding which of my friends were people who I could be my best self around. Lots of people I met in recovery are my closest friends. With some people I found that I felt more like using while I was around them. Some of my friends I no longer had things in common with. I also found this to be a time where I needed to question who I decided an enemy was. As often as not, these were stories in my head. The enemies and the allies can be internal energies as often as they are external. The drive to use a substance I knew I no longer wanted in my life was the adversary, and the challenge was whether or not I chose that route. The allies were my friends and mentors, and the voice in my head that helped me see why using was anathema to the person I was becoming. I was starting to be proud of that person. In the 6th step in 12 step recovery, the character defects or defaults are identified, and these are the regressive behaviors that will be left behind by the hero.

The seventh step of the hero's journey is the approach to the inmost cave. In Star Wars they must enter the Death Star, in Harry Potter they go into the dungeons below Hogwarts to find the philosopher’s stone. Here, Frodo puts on the ring, and sees that he is susceptible to the same evil powers that created Sauron. In the 12 steps, step 7 is turning over character defaults to your Higher Power, and identifying their opposite behavior. If avoidance is the default, opposite action and moving towards the fear is the new behavior. My experience was that while these steps were as enlightening as any other steps, offering me concrete options to change old patterns, I felt myself energetically approaching the 9th step of the 12 step recovery journey.

While my eye was on the horizon, I found that after the revelations of the 5th step and sharing my innermost secrets with my sponsor, I felt myself looking inward more. I was seeing my part in creating my problems, and could witness myself hurting loved ones. It was not a good feeling, and my trust in myself was shaken. It felt like midwinter, and since it was during the first shutdown of early Coronavirus, the slow pace of quarantine offered me lots of time to journey inwards. I was afraid of the person I was, and the things I had done. At that time I couldn’t imagine myself as a good person. I very much wanted to hide.

The eighth step of the hero's journey is the ordeal. Here Harry faces the challenges in the dungeon’s that protect the sorcerer’s stone. Stitch wants a family, and so he must rescue Lilo. For me, I knew I needed to complete the twelve steps in my recovery program so I could stay sober. I also knew I needed to make amends to the people in my life who I'd hurt. Writing these amends, and getting ready to offer them was a nerve wracking process, yet I was committed to doing something difficult and unpleasant, a sensation I had never before experienced. To me this seems the paradox of the self: before sobriety, I was primarily only able to think about what was comfortable for me. While thinking about myself, I felt impermanent, as if I were blown about like a leaf. As I prepared for the ninth step, dedicated to doing something that would make me uncomfortable in exchange to do something good for others, I felt stable, permanent, and capable. In short, as soon as I was focused on doing something for a purpose ‘greater’ than myself, I found my sense of self and began to feel stable and real. In my eyes, the 9th step of making amends in recovery corresponds with the 8th step ordeal in the hero's journey.

The ninth step of the hero's journey is the reward! Luke kisses Leia, Harry saves the stone, Stitch gets a family. Famously in the AA big book, the ‘promises of the program’ are listed right after the 9th step, and oftentimes occur in an individual's life upon completion of the ordeal that is amends. It is interesting to note that Campbell originally identified the ninth step as Atonement With The Father. ‘The Father’ can be understood as the sense of doing right and being aligned with one's own morals and higher power after making amends.

Step ten of the hero's journey marks the transition back to the ordinary world. This is ‘The Road Back.’ The hero has completed the ordeal, and has gained the reward. For Frodo he literally walks back home after destroying the ring. In AA the 10th step is the daily upkeep, an inventory done to make sure one is living in accordance with the wisdom of their new self. Integrating from the extraordinary world and the journey back to the ordinary world can be challenging. Here the new skills learned are brought back into mundane life.

The eleventh step of the hero's journey is the resurrection. Harry has already found the Sorcerer’s stone. Now he must face professor Quirrel, who is harboring Voldemort on the back of his head. When I consider that the 11th step of 12 step recovery programs is prayer and meditation, I think of my greatest challenge in recovery, and in life: learning to accept all the thoughts and emotions I experience in my own mind, and to hold them with lightness and ease. In this step the Hero defeats their enemy. In recovery, this could be seen as someone finally growing beyond the regressive energy which keeps them stuck in unhealthy patterns with substances, allowing them to become the person they were meant to be. In learning to meditate in recovery, we can come to terms with the great challenge that it is to handle our emotions and thoughts.

Which brings us to the final step of the hero's journey, and the 12 steps to recovery: The Return With The Elixir. Having completed the final challenge, the Hero can return to their life. The elixir represents having gained something on their journey which they can share with the people around them. The knowledge gained on their journey has transformed them. In the 12 steps of recovery, the 12th step is sponsoring others. Having learned how the steps work and found sobriety, a person can then help another find sobriety. They share the elixir of recovery wisdom.

The Personal Journey from Addiction to Freedom

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The journey to freedom can be a rocky one for anyone who has become addicted to a substance. Each unique journey has its own twists, turns, and rocky areas but they all include the same steps.

The personal journey from addiction to freedom is influenced through biological, psychological, and social factors, which can include gender, age, the abused substance, past drug use, and even family history.

According to the National Institute on Drug Abuse , although addiction cannot be cured completely, it can be successfully treated. Research has led to the development of interventions that prove that evidence-based interventions do help addicts stop using and resume their lives in a productive way.

Be Aware of Addiction

The first step in recovery is the awareness of a problem and a realization that something needs to change. Many times, this awareness comes from a conversation or intervention from their friends, family, or co-workers but it can also occur due to an addiction related financial, health, legal, or work problems.

The addict will still be engaging in their addictive behaviors and it is not a very large step in the progress toward recovery but it is still a very important stepping-stone in the journey to addiction freedom.

This step can lead to acknowledgement, which is where the action is truly needed in order to make the alteration from denial to a desire to change.

From Awareness to Action

In the second step toward recovery, the addict will be ready to take the first real step toward recovery. The addict is most likely to research more about their addiction to find out what impact it is having on not only their own lives, but also the lives of their loved ones.

This stage is very important because it allows the addict to take a hard look beyond themselves to the lives of their friends, colleagues, and family to see the negative impact their behavior has on them.

At this point, addicts still have not made any active motions toward recovery but they are gaining very invaluable information and insight that will inspire and motivate them to begin their journey toward recovery.

Action toward Recovery

With the motivation to change their lives and the insight on the impact their choices had had on their loved ones, the addict is ready to make small steps toward seeking professional help.

For example, the addict may begin to explore the ideas of moderation and abstinence. Many claim that this is where the journey toward recovery genuinely begins. During this phase, addicts will explore what it means to live a sober life and what the necessary steps to complete the recovery process.

It is possible that they will discuss personal experiences with those closest to them to explore treatment options. This stage is often seen as the turning point in the journey toward freedom from addiction, as many addicts in this stage make the important decision to enter a recovery center with the proper treatment program for their situation.

The Recovery Begins

In the early stages of recovery, there are positives and negatives that create significant greats and risks. On a positive note, the addicts in recovery will stop using the substance that caused the addiction and begin to learn coping mechanisms to remain drug-free in their lives.

The downside for addicts is the vulnerability that is associated with leaving their friends, activities, and actions in order to embrace the foundation of their drug-free lives.

According to the White House , effective treatment programs help people to counter the powerfully disrupting effects on the brain and their behavior while lessening the burden that substance has on society.

During early recovery, relapse is not only possible but also common and can be damaging to the recovery process for those who have not developed the necessary coping skills yet to keep them from reverting to their addiction.

In this stage, the addict will learn healthier habits, rebuild their relationships with their loved ones, and learn new coping skills to keep them from falling back into their addiction.

The Maintenance of Recovery

Addicts in this stage can celebrate their sobriety through the progress they have made to this point. The fight is far from over but the worst part has been worked through and the recovering addict is reminded that he/she will need to work hard for the rest of their lives to remain sober.

This means that the individual must be conscious of their behaviors and thoughts with their continued practice of their newly acquired skills through support systems and alertness to what triggers and tempts them to use their substance.

By now, the addict has finally reached the lives they had hoped to achieve, and can maintain it by creating a schedule, keep up regular appointments, and going to support groups, if necessary.

The personal journey from addiction to freedom can be treacherous but the outcome is worth the fight. When an addict moves from awareness and acknowledgment to consideration of their loved ones and recovery, their unique experience can lead them to a substance-free life that is healthy and prosperous.

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Recovery and Recovery Support

SAMHSA's working definition of recovery defines recovery as a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. Recovery signals a dramatic shift in the expectation for positive outcomes for individuals who experience mental and substance use conditions or the co-occurring of the two.

On March 1, 2022, President Biden announced his administration’s strategy to address our nation’s mental health crisis as outlined in the 2022 Presidential Unity Agenda. To meet this goal, SAMHSA collaborated with federal, state, tribal, territorial, and local partners including peer specialists to develop the National Model Standards for Peer Support Certification .

2 in 3 adults who ever had a mental health problem considered themselves to be recovering or in recovery.

7 in 10 adults who ever had a substance use problem considered themselves to be recovering or in recovery.

50.2 million American adults considered themselves to be in recovery from their substance use and/or mental health problems.

Guiding Principles

Hope, the belief that these challenges and conditions can be overcome, is the foundation of recovery. A person’s recovery is built on his or her strengths, talents, coping abilities, resources, and inherent values. It is holistic, addresses the whole person and their community, and is supported by peers, friends, and family members.

The process of recovery is highly personal and occurs via many pathways. It may include clinical treatment, medications, faith-based approaches, peer support, family support, self-care, and other approaches. Recovery is characterized by continual growth and improvement in one’s health and wellness and managing setbacks. Because setbacks are a natural part of life, resilience becomes a key component of recovery.

The Four Major Dimensions of Recovery

Health - Overcoming or managing one’s disease(s) or symptoms - for example, abstaining from use of alcohol, illicit drugs, and non-prescribed medication if one has an addiction problem- and for everyone in recovery making informed, healthy choices that support physical and emotional well-being
Home - Having a stable and safe place to live
Purpose - Conducting meaningful daily activities, such as a job, school volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society
Community - Having relationships and social networks that provide support, friendship, love, and hope

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NA and Other Peer Support Groups for Drug Addiction

Choosing a Drug Rehab Addiction Program

Dual Diagnosis: Substance Abuse and Mental Health

Choosing an alcohol rehab treatment program, staying social when you quit drinking.

Vaping: The Health Risks and How to Quit

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Meet Our Team

The first step to overcoming drug abuse and addiction

Explore your addiction treatment options, find support for your addiction recovery, learn healthy ways to cope with stress, be aware of drug triggers, cope with drug cravings, build a meaningful drug-free life.

Don't let relapse keep you down

Overcoming Drug Addiction

Ready to deal with your drug abuse problem? This step-by-step guide can help you cope with cravings, deal with relapse, and overcome your substance use disorder.

Developing an addiction to drugs isn’t a character flaw or a sign of weakness, and it takes more than willpower to overcome the problem. Abusing illegal or certain prescription drugs can create changes in the brain, causing powerful cravings and a compulsion to use that makes sobriety seem like an impossible goal. But recovery is never out of reach, no matter how hopeless your situation seems or how many times you’ve tried and failed before. With the right treatment and support, change is always possible.

For many people struggling with addiction, the toughest step toward recovery is the very first one: recognizing that you have a problem and deciding to make a change. It’s normal to feel uncertain about whether you’re ready to start recovery, or if you have what it takes to quit. If you’re addicted to a prescription drug, you may be concerned about how you’re going to find an alternate way to treat a medical condition. It’s okay to feel torn. Committing to sobriety involves changing many things, including:

The way you deal with stress.
Who you allow in your life.
What you do in your free time.
How you think about yourself.
The prescription and over-the-counter medications you take.

It’s also normal to feel conflicted about giving up your drug of choice, even when you know it’s causing problems in your life. Recovery requires time, motivation, and support, but by making a commitment to change, you can overcome your addiction and regain control of your life.

Think about change

Keep track of your drug use, including when and how much you use. This will give you a better sense of the role the addiction is playing in your life.
List the pros and cons of quitting, as well as the costs and benefits of continuing your drug use.
Consider the things that are important to you, such as your partner, your kids, your pets, your career, or your health. How does your drug use affect those things?
Ask someone you trust about their feelings on your drug use.
Ask yourself if there’s anything preventing you from changing. What could help you make the change?

Preparing for change: 5 keys to addiction recovery

Remind yourself of the reasons you want to change.
Think about your past attempts at recovery, if any. What worked? What didn’t?
Set specific, measurable goals, such as a start date or limits on your drug use.
Remove reminders of your addiction from your home, workplace, and other places you frequent.
Tell friends and family that you’re committing to recovery, and ask for their support.

Once you’ve committed to recovery, it’s time to explore your treatment choices. While addiction treatment can vary according to the specific drug, a successful program often includes different elements, such as:

Detoxification . Usually the first step is to purge your body of drugs and manage withdrawal symptoms.

Behavioral counseling . Individual, group, and/or family therapy can help you identify the root causes of your drug use, repair your relationships, and learn healthier coping skills.

Medication may be used to manage withdrawal symptoms, prevent relapse, or treat any co-occurring mental health condition such as depression or anxiety.

Long-term follow-up can help to prevent relapse and maintain sobriety. This may include attending regular in-person support groups or online meetings to help keep your recovery on track.

Speak to a Licensed Therapist

BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.

Types of drug treatment programs

Intensive inpatient treatment . This is a short-term clinical treatment for people who have developed a physiological dependence on a drug and need help with withdrawal symptoms.
Residential treatment . Residential treatment involves living at a facility and getting away from work, school, family, friends, and addiction triggers while undergoing intensive treatment. Residential treatment usually lasts from 30 days to several months.
Day treatment/Partial hospitalization programs (PHP) . Partial hospitalization is for people who require ongoing medical monitoring but wish to still live at home and have a stable living environment. These treatment programs usually meet at a treatment center for at least 20 hours a week, but you return home at the end of each day.
Intensive outpatient programs (IOP) . Similar to PHPs, IOPs don’t require you to live at a treatment center. However, they differ from PHPs in that they only require between 9 and 19 hours of treatment each week, so you can schedule treatments around school and work.
Therapy . One-on-one or group therapy sessions can be useful in developing coping skills, identifying triggers, and exploring the roots of your addiction.

Remember that everyone’s needs are different. For example, not everybody requires medically supervised detox or an extended stint in rehab. Whether you have a problem with illegal or prescription drugs, addiction treatment should be customized to your unique situation. It’s also important to find a program that feels right for you. Read Choosing Drug Rehab and Addiction Treatment to learn more.

Tips for finding the best drug addiction treatment for you

Remember that no treatment works for everyone. Everyone’s needs are different. Whether you have a problem with illegal or prescription drugs, addiction treatment should be customized to your unique situation. It’s important that you find a program that feels right.

Treatment should address more than just your drug abuse. Addiction affects your whole life, including your relationships, career, health, and psychological well-being. Treatment success depends on developing a new way of living and addressing the reasons why you turned to drugs in the first place. For example, your drug dependency may have developed from a desire to manage pain or to cope with stress, in which case you’ll need to find a healthier way to relieve pain or to handle stressful situations.

Commitment and follow-through are key. Drug addiction treatment is not a quick and easy process. In general, the longer and more intense the drug use, the longer and more intense the treatment you’ll need. And in all cases, long-term follow-up care is crucial to recovery.

There are many places to turn for help. Not everybody requires medically supervised detox or an extended stint in rehab. The care you need depends on a variety of factors, including your age, drug-use history, medical or psychiatric conditions. In addition to doctors and psychologists, many clergy members, social workers, and counselors offer addiction treatment services.

Seek treatment for any mental health problems simultaneously . As you seek help for drug addiction, it’s also important to get treatment for any other medical or psychological issues you’re experiencing. Your best chance of recovery is by getting combined mental health and addiction treatment from the same treatment provider or team.

Don’t try to go it alone—reach out for support. Whatever treatment approach you choose, having positive influences and a solid support system is essential. The more people you can turn to for encouragement, guidance, and a listening ear, the better your chances for recovery.

Lean on close friends and family. Having the support of friends and family members is an invaluable asset in recovery. If you’re reluctant to turn to your loved ones because you’ve let them down before, consider going to relationship counseling or family therapy.

Build a sober social network. If your previous social life revolved around drugs, you may need to make some new connections . It’s important to have sober friends who will support your recovery. Try taking a class, joining a church or a civic group, volunteering , or attending events in your community.

Consider moving into a sober living home. Sober living homes provide a safe, supportive place to live while you’re recovering from drug addiction. They are a good option if you don’t have a stable home or a drug-free living environment.

Make meetings a priority. Join a 12-step recovery support group, such as Narcotics Anonymous (NA) , and attend meetings regularly. Spending time with people who understand exactly what you’re going through can be very healing. You can also benefit from the shared experiences of the group members and learn what others have done to stay sober.

[Read: NA and Other Peer Support Groups for Drug Addiction]

After addressing your immediate problems with addiction and starting treatment, you’ll still have to face the problems that led to your drug abuse. Did you start using to numb painful emotions, calm yourself after an argument, unwind after a bad day, or forget about your problems?

Once you’re sober, the negative feelings that you dampened with drugs will resurface. For treatment to be successful, you’ll first need to resolve your underlying issues.

Once you have resolved your underlying issues, you will, at times, continue to experience stress, loneliness, frustration, anger, shame, anxiety, and hopelessness. These emotions are all a normal part of life. Finding ways to address these feelings as they arise is an essential component to your treatment and recovery.

There are healthier ways to keep your stress level in check. You can learn to manage your problems without falling back on your addiction. When you’re confident in your ability to quickly de-stress, facing strong feelings isn’t as intimidating or overwhelming.

Quickly relieve stress without drugs

Different quick stress relief strategies work better for some people than others. The key is to find the one that works best for you.

Movement . A brisk walk around the block can be enough to relieve stress. Yoga and meditation are also excellent ways to bust stress and find balance.

Step outside and savor the warm sun and fresh air. Enjoy a beautiful view or landscape.

Play with your dog or cat. Enjoy the relaxing touch of your pet’s fur.

Experiment with your sense of smell. Breathe in the scent of fresh flowers or coffee beans, or savor a scent that reminds you of a favorite vacation, such as sunscreen or a seashell.

Close your eyes and picture a peaceful place. Think of a sandy beach, or a fond memory, such as your child’s first steps or time spent with friends.

Pamper yourself. Make yourself a steaming cup of tea, give yourself a neck or shoulder massage. Soak in a hot bath or shower.

Your recovery doesn’t end at getting sober. Your brain still needs time to recover and rebuild connections that changed while you were addicted. During this rebuild, drug cravings can be intense. You can support your continued recovery by avoiding people, places, and situations that trigger your urge to use:

Step away from your friends who use. Don’t hang out with friends who are still doing drugs. Surround yourself with people who support your sobriety, not those who tempt you to slip back into old, destructive habits.

Avoid bars and clubs. Even if you don’t have a problem with alcohol, drinking lowers inhibitions and impairs judgment, which can easily lead to a relapse. Drugs are often readily available and the temptation to use can be overpowering. Also avoid any other environments and situations that you associate with drug use.

Be upfront about your history of drug use when seeking medical treatment. If you need a medical or dental procedure done, be upfront and find a provider who will work with you in either prescribing alternatives or the absolute minimum medication necessary. You should never feel ashamed or humiliated about previous drug use or be denied medication for pain; if that happens, find another provider.

Use caution with prescription drugs. If you were addicted to a prescription drug, such as an opioid painkiller, you may need to talk to your doctor about finding alternate ways to manage pain. Regardless of the drug you experienced problems with, it’s important to stay away from prescription drugs with the potential for abuse or use only when necessary and with extreme caution. Drugs with a high abuse potential include painkillers, sleeping pills, and anti-anxiety medication.

Sometimes craving cannot be avoided, and it is necessary to find a way to cope:

Get involved in a distracting activity. Read, see friends, go to a movie, immerse yourself in a hobby, hike, or exercise. Once you’re interested in something else, you’ll find the urges go away.

Talk it through. Talk to friends or family members about craving when it occurs. Talking can be very helpful in pinpointing the source of the craving. Also, talking about craving often helps to discharge and relieve the feeling and will help restore honesty in your relationship. Craving is nothing to feel bad about.

Challenge and change your thoughts. When experiencing a craving, many people have a tendency to remember only the positive effects of the drug and forget the negative consequences. Therefore, you may find it helpful to remind yourself that you really won’t feel better if you use and that you stand to lose a lot. Sometimes it is helpful to have these consequences listed on a small card that you keep with you.

Urge surf. Many people try to cope with their urges by toughing it out. But some cravings are too strong to ignore. When this happens, it can be useful to stay with the urge until it passes. This technique is called urge surfing. Imagine yourself as a surfer who will ride the wave of your drug craving, staying on top of it until it crests, breaks, and turns into less powerful, foamy surf. When you ride out the craving, without trying to battle, judge, or ignore it, you’ll see that it passes more quickly than you’d think.

The three basic steps of urge surfing:

Notice how you’re experience the craving. Sit in a comfortable chair with your feet flat on the floor and your hands in a relaxed position. Take a few deep breaths and focus your attention on your body. Notice where in your body you experience the craving or urge and what the sensations feel like. Verbalize what you’re experiencing. For example, you could tell yourself: “My craving is in my mouth and nose and in my stomach.”
Focus on one area where you’re experiencing the craving. What are the sensations in that area? Describe them to yourself. For example, perhaps you feel hot, cold, tingly, or numb? Maybe your muscles are tense? How large an area is involved? Notice if the sensations change as you focus on them. “My mouth feels dry. There is a numbness in my lips. When I swallow, I can imagine the feeling of using.”
Repeat by focusing on each part of your body that experiences the urge. Describe to yourself how the sensations change, how the urge comes and goes. Many people notice that after a few minutes of urge surfing, their craving has disappeared. The purpose of this exercise, however, is not to make the urge go away but to experience it in a new way. If you regularly practice urge surfing, you’ll become more familiar with your cravings and find it easier to ride them out until they go away naturally.

You can support your drug treatment and protect yourself from relapse by having activities and interests that provide meaning to your life. It’s important to be involved in things that you enjoy, that make you feel needed, and add meaning to your life. When your life is filled with rewarding activities and a sense of purpose, your addiction will lose its appeal.

Pick up an old hobby or try a new one. Do things that challenge your creativity and spark your imagination—something you’ve always wanted to try. Learn a musical instrument, a foreign language, or try a new sport.

Adopt a pet. Yes, pets are a responsibility, but caring for an animal makes you feel loved and needed . Pets can also get you out of the house for exercise.

Spend time in nature. Take a scenic hike, go fishing or camping, or enjoy regular walks in a park.

Enjoy the arts . Visit a museum, go to a concert or a play, take an art class or write a memoir.

Get involved in your community. Replace your addiction with drug-free groups and activities. Volunteer , become active in your church or faith community, or join a local club or neighborhood group.

Set meaningful goals. Having goals to work toward and something to look forward to can be powerful antidotes to drug addiction. It doesn’t matter what the goals are, just that they are important to you.

Look after your health. Regular exercise , adequate sleep , and healthy eating habits help you keep your energy levels up and your stress levels down. The more you can stay healthy and feel good, the easier it will be to stay sober.

Don’t let relapse keep you down

Relapse is a common part of the recovery process from drug addiction. While relapse is frustrating and discouraging, it can be an opportunity to learn from your mistakes, identify additional triggers, and correct your treatment course.

What causes relapse?

Different “triggers” can put you at risk of relapsing into old patterns of substance use. While specific causes of relapse differ from person to person, some common triggers include:

Negative emotional state (such as stress, sadness, anger, or trauma)
Positive emotional state (feeling happy and wanting to feel even better, such as having a good time with friends)
Physical discomfort (such as pain or withdrawal symptoms)
Trying to test your personal control (“I can use just once” or “have just one pill”)
Strong temptation or urge (craving to use)
Conflict (such as an argument with your spouse or partner)
Social pressure (being in a situation where it seems everyone else is using)

The important thing to remember is that relapse doesn’t mean drug treatment failure. Don’t give up. Call your sponsor, talk to your therapist, go to a meeting, or schedule an appointment with your doctor. When you’re sober again and out of danger, look at what triggered the relapse, what went wrong, and what you could have done differently. You can choose to get back on the path to recovery and use the experience to strengthen your commitment.

Support organizations

Most of these 12-step programs have worldwide chapters:

Narcotics Anonymous

Cocaine Anonymous

Crystal Meth Anonymous

Marijuana Anonymous

Read: NA and Other Peer Support Groups for Drug Addiction

Professional help for drug treatment and recovery

Use the Substance Abuse Treatment Facility Locator , call the SAMHSA helpline at 1-800-662-4357, Get One-on-One Help to Address Your Child’s Substance Use , or call the Partnership for Drug-Free Kids helpline at 1-855-378-4373.

Find NHS drug addictions support services or call the Frank helpline at 0800 776600.

Finding Quality Addiction Care (Canadian Centre on Substance Use and Addiction)

Find drug and alcohol services in your State/Territory (Department of Health & Aging).

More Information

Step by Step Guides to Finding Treatment for Drug Use Disorders - Guides for adults, teens, or those helping someone addicted to drugs. (National Institute on Drug Abuse)
Effective Treatments for Opioid Addiction - Medications used in the treatment of opioid addiction. (National Institute on Drug Abuse)
What is Substance Abuse Treatment? A Booklet for Families - Learn about treatment options and what you can do. (SAMHSA)
Principles of Drug Addiction Treatment - Effective treatment of substance abuse and addiction. (National Institute on Drug Abuse)
How can prescription drug addiction be treated? - Treatment options for prescription drug addiction including addiction to opioid painkillers. (National Institute on Drug Abuse)
Darkness Before Dawn - Collection of writings that offer guidance and perspective on depression from a HelpGuide affiliate . (Sounds True)
Friedmann, P. D., Saitz, R., & Samet, J. H. (1998). Management of Adults Recovering From Alcohol or Other Drug ProblemsRelapse Prevention in Primary Care. JAMA, 279(15), 1227–1231. Link
O’Brien, Charles P. “Evidence-Based Treatments of Addiction.” FOCUS 9, no. 1 (January 1, 2011): 107–17. Link
Pettersen, H., Landheim, A., Skeie, I., Biong, S., Brodahl, M., Oute, J., & Davidson, L. (2019). How Social Relationships Influence Substance Use Disorder Recovery: A Collaborative Narrative Study. Substance Abuse: Research and Treatment, 13, 1178221819833379. Link
Santucci, Karen. “Psychiatric Disease and Drug Abuse.” Current Opinion in Pediatrics 24, no. 2 (April 2012): 233–37. Link
Kelly, Thomas M., and Dennis C. Daley. “Integrated Treatment of Substance Use and Psychiatric Disorders.” Social Work in Public Health 28, no. 3–4 (2013): 388–406. Link
Magill, Molly, and Lara A. Ray. “Cognitive-Behavioral Treatment with Adult Alcohol and Illicit Drug Users: A Meta-Analysis of Randomized Controlled Trials.” Journal of Studies on Alcohol and Drugs 70, no. 4 (July 2009): 516–27. Link
Grant, Bridget F., Frederick S. Stinson, Deborah A. Dawson, S. Patricia Chou, Mary C. Dufour, Wilson Compton, Roger P. Pickering, and Kenneth Kaplan. “Prevalence and Co-Occurrence of Substance Use Disorders and Independent Mood and Anxiety Disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions.” Archives of General Psychiatry 61, no. 8 (August 2004): 807–16. Link
Substance-Related and Addictive Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association. Link
About the ASAM Criteria . (n.d.). Retrieved October 11, 2023, from Link
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Mutschler, C., Junaid, S., Tellez, C., Franco, G., Gryspeerdt, C., & Bushe, J. (2022). Community‐based residential treatment for alcohol and substance use problems: A realist review. Health & Social Care in the Community , 30 (2). Link

More in Addiction

The different options and what they offer

Choosing Drug Rehab and Addiction Treatment

A guide to drug addiction services

Coping with addiction and a mental health problem

A guide to alcohol addiction treatment services

Cutting down on alcohol doesn’t have to mean losing your social life

The health risks in young people and how to quit

The hidden risks of drinking

Binge Drinking

Help if you have trouble stopping drinking once you start

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The Next Chapter

Journey to Recovery

KET addresses opioid epidemic with Journey to Recovery documentary

Opioids – including heroin and prescription opioids such as oxycodone and hydrocodone — killed more than 33,000 people in 2015, more than any year on record, according to the Centers for Disease Control and Prevention. Deaths due to opioid overdoses claim the lives of 91 Americans every day.

As families touched by addiction know all too well, our nation is in the midst of an opioid epidemic. In an effort to address the epidemic and provide information about treatment options available in Kentucky, KET presents Journey to Recovery , a new documentary that explores personal stories of triumph over addiction using various recovery programs.

Journey to Recovery , narrated by Grammy-nominated recording artist and Kentucky native Sturgill Simpson, airs Monday, Feb. 13 at 8/7 pm on KET.

The documentary examines an array of treatment and recovery programs offered across the state, including abstinence-only programs – such as faith-based and 12-step based programs – as well as medication-assisted treatment programs. The program also interviews many of the nation’s top experts on addiction, including Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), and Dr. Robert DuPont, a former NIDA director and former White House Drug Chief who continues to advocate for a reduction in illegal drug use through his role as founding director of the Institute for Behavior and Health, Inc.

Journey to Recovery is part of KET’s ongoing Inside Opioid Addiction initiative, funded in part by the Foundation for a Healthy Kentucky. The initiative’s website, KET.org/opioids , includes archived KET and national programs addressing America’s growing opioid problem.

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Drugs, Brains, and Behavior: The Science of Addiction Treatment and Recovery

Can addiction be treated successfully.

Yes, addiction is a treatable disorder. Research on the science of addiction and the treatment of substance use disorders has led to the development of research-based methods that help people to stop using drugs and resume productive lives, also known as being in recovery.

Can addiction be cured?

Like treatment for other chronic diseases such as heart disease or asthma, addiction treatment is not a cure, but a way of managing the condition. Treatment enables people to counteract addiction's disruptive effects on their brain and behavior and regain control of their lives.

Does relapse to drug use mean treatment has failed?

No. The chronic nature of addiction means that for some people relapse, or a return to drug use after an attempt to stop, can be part of the process, but newer treatments are designed to help with relapse prevention. Relapse rates for drug use are similar to rates for other chronic medical illnesses. If people stop following their medical treatment plan, they are likely to relapse.

Treatment of chronic diseases involves changing deeply rooted behaviors, and relapse doesn’t mean treatment has failed. When a person recovering from an addiction relapses, it indicates that the person needs to speak with their doctor to resume treatment, modify it, or try another treatment. 52

While relapse is a normal part of recovery, for some drugs, it can be very dangerous—even deadly. If a person uses as much of the drug as they did before quitting, they can easily overdose because their bodies are no longer adapted to their previous level of drug exposure. An overdose happens when the person uses enough of a drug to produce uncomfortable feelings, life-threatening symptoms, or death.

What are the principles of effective treatment?

Research shows that when treating addictions to opioids (prescription pain relievers or drugs like heroin or fentanyl), medication should be the first line of treatment, usually combined with some form of behavioral therapy or counseling. Medications are also available to help treat addiction to alcohol and nicotine.

Additionally, medications are used to help people detoxify from drugs, although detoxification is not the same as treatment and is not sufficient to help a person recover. Detoxification alone without subsequent treatment generally leads to resumption of drug use.

For people with addictions to drugs like stimulants or cannabis, no medications are currently available to assist in treatment, so treatment consists of behavioral therapies. Treatment should be tailored to address each patient's drug use patterns and drug-related medical, mental, and social problems.

What medications and devices help treat drug addiction?

Different types of medications may be useful at different stages of treatment to help a patient stop abusing drugs, stay in treatment, and avoid relapse.

Treating withdrawal. When patients first stop using drugs, they can experience various physical and emotional symptoms, including restlessness or sleeplessness, as well as depression, anxiety, and other mental health conditions. Certain treatment medications and devices reduce these symptoms, which makes it easier to stop the drug use.
Staying in treatment. Some treatment medications and mobile applications are used to help the brain adapt gradually to the absence of the drug. These treatments act slowly to help prevent drug cravings and have a calming effect on body systems. They can help patients focus on counseling and other psychotherapies related to their drug treatment.
Preventing relapse. Science has taught us that stress cues linked to the drug use (such as people, places, things, and moods), and contact with drugs are the most common triggers for relapse. Scientists have been developing therapies to interfere with these triggers to help patients stay in recovery.

Common medications used to treat drug addiction and withdrawal

Buprenorphine
Extended-release naltrexone
Nicotine replacement therapies (available as a patch, inhaler, or gum)
Varenicline
Acamprosate

How do behavioral therapies treat drug addiction?

Behavioral therapies help people in drug addiction treatment modify their attitudes and behaviors related to drug use. As a result, patients are able to handle stressful situations and various triggers that might cause another relapse. Behavioral therapies can also enhance the effectiveness of medications and help people remain in treatment longer.

Cognitive-behavioral therapy seeks to help patients recognize, avoid, and cope with the situations in which they're most likely to use drugs.
Contingency management uses positive reinforcement such as providing rewards or privileges for remaining drugfree, for attending and participating in counseling sessions, or for taking treatment medications as prescribed.
Motivational enhancement therapy uses strategies to make the most of people's readiness to change their behavior and enter treatment.
Family therapy helps people (especially young people) with drug use problems, as well as their families, address influences on drug use patterns and improve overall family functioning.
Twelve-step facilitation (TSF) is an individual therapy typically delivered in 12 weekly session to prepare people to become engaged in 12-step mutual support programs. 12-step programs, like Alcoholic Anonymous, are not medical treatments, but provide social and complementary support to those treatments. TSF follows the 12-step themes of acceptance, surrender, and active involvement in recovery.

How do the best treatment programs help patients recover from addiction?

Worried man touching forehead while sharing his problems with colleague.

Stopping drug use is just one part of a long and complex recovery process. When people enter treatment, addiction has often caused serious consequences in their lives, possibly disrupting their health and how they function in their family lives, at work, and in the community.

Because addiction can affect so many aspects of a person's life, treatment should address the needs of the whole person to be successful. Counselors may select from a menu of services that meet the specific medical, mental, social, occupational, family, and legal needs of their patients to help in their recovery.

For more information on drug treatment , see Principles of Drug Addiction Treatment: A Research-Based Guide , and Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide .

Hemingway's Books and Records

Books on Drug Addicts: Discover the Top 20 in our 2024 Updated List

Are you searching for gripping and insightful books on drug addicts? Whether you’re looking for fiction or non-fiction, the world of literature offers a wealth of compelling stories and narratives that delve into the lives of drug addicts. From memoirs to novels, these 20 best books about drug addicts will take you on a journey through addiction, recovery, and the human experience. Get ready to explore the complexities of addiction and the resilience of the human spirit in these powerful reads.

1 20 Best Books About Drug Addicts
2 A Million Little Pieces
3 Tweak: Growing Up on Methamphetamines
5 Go Ask Alice
6 Permanent Midnight
7 Trainspotting
8 Beautiful Boy: A Father’s Journey Through His Son’s Addiction
10 The Basketball Diaries
12 In My Skin: A Memoir
13 The Night of the Gun
14 The Heroin Diaries: A Year in the Life of a Shattered Rock Star
15 Dopesick: Dealers, Doctors, and the Drug Company that Addicted America
16 Scar Tissue
17 The Electric Kool-Aid Acid Test
18 The Lost Weekend
19 Fear and Loathing in Las Vegas
20 A Scanner Darkly
21 The Big Fix: Hope After Heroin
22 Conclusion

20 Best Books About Drug Addicts

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A Million Little Pieces

By james frey.

A Million Little Pieces by James Frey is a controversial memoir that follows the author’s journey through addiction and recovery. This book chronicles Frey’s struggles with substance abuse, his time in rehab, and his eventual path to sobriety. A Million Little Pieces provides a raw and unflinching look at the life of a man grappling with his demons, making it a compelling read for anyone interested in the human experience of addiction. While the book was initially marketed as a memoir, it later came under scrutiny for its accuracy, leading to a public debate about the ethics of creative nonfiction. Despite the controversy, A Million Little Pieces remains a powerful and gripping account of one man’s battle with addiction.

Tweak: Growing Up on Methamphetamines

By nic sheff.

Tweak: Growing Up on Methamphetamines is a raw and honest memoir by Nic Sheff, chronicling his struggles with addiction and recovery. The book offers a harrowing glimpse into the world of substance abuse, as Sheff details his experiences with methamphetamines and the devastating impact it had on his life. Through vivid and unflinching prose, the author takes readers on a journey through the highs and lows of addiction, offering a candid portrayal of the challenges faced by those battling substance abuse. Tweak is a powerful and poignant exploration of the complexities of addiction, and a testament to the resilience of the human spirit. This book about drug addicts is a compelling and eye-opening read that sheds light on the harsh realities of addiction.

by William S. Burroughs

Junky by William S. Burroughs is a gritty and unflinching portrayal of the life of a drug addict. The novel follows the protagonist as he becomes ensnared in the dangerous and destructive world of addiction, exploring the harrowing realities of drug abuse and the seedy underbelly of society. Burroughs’ raw and unapologetic writing style pulls no punches, offering a stark and unfiltered look into the mind of a drug user. Through vivid and visceral prose, the author delves deep into the psyche of the addict, shedding light on the desperation and despair that often accompanies addiction. Junky is a haunting and compelling read that offers a sobering glimpse into the lives of those struggling with substance abuse, making it a must-read for anyone interested in the human experience of addiction.

Go Ask Alice

By anonymous.

Go Ask Alice is a riveting and harrowing account of a young girl’s descent into the dangerous world of substance abuse. This book follows the tragic and gripping diary of a teenage girl as she struggles with addiction, peer pressure, and the overwhelming desire to fit in. Written by an anonymous author, this first-person narrative provides a raw and unflinching look at the life of a young person caught in the grip of addiction. The diary entries detail the protagonist’s experiences with drugs, her inner turmoil, and the devastating consequences of her choices. Go Ask Alice offers a powerful and eye-opening exploration of the struggles faced by individuals caught in the throes of substance abuse. This book is a must-read for anyone interested in gaining insight into the tumultuous and often heartbreaking world of addiction.

Permanent Midnight

By jerry stahl.

Permanent Midnight is a harrowing memoir by Jerry Stahl, chronicling his descent into the dark world of addiction. This compelling book delves into the author’s struggles with substance abuse, providing a raw and unflinching look at the life of an addict. Stahl’s candid and brutally honest storytelling captivates readers as he navigates through a world of drugs, despair, and self-destruction. The book offers a poignant and unfiltered portrayal of the author’s battle with addiction, making it a gripping and powerful read for anyone interested in the human experience of addiction. Permanent Midnight is a must-read for those seeking insight into the world of addiction and the complex journey of recovery.

Trainspotting

By irvine welsh.

Trainspotting by Irvine Welsh is a gritty and raw novel that delves into the lives of a group of young heroin users living in Edinburgh. The book provides a harrowing and unflinching portrayal of addiction, poverty, and desperation, as the characters struggle to navigate their lives amidst the chaos of their drug-fueled existence. Through a series of interconnected stories, Welsh explores the dark and destructive world of addiction, offering an unapologetic and unfiltered look at the lives of those caught in its grip. The novel’s intense and often shocking narrative pulls readers into the turbulent lives of its characters, making it a captivating and unforgettable read. Trainspotting is a powerful and unvarnished portrayal of the harsh realities faced by those caught in the grip of addiction.

Beautiful Boy: A Father’s Journey Through His Son’s Addiction

By david sheff.

Beautiful Boy: A Father’s Journey Through His Son’s Addiction by David Sheff is a poignant memoir that delves into the harrowing reality of drug addiction. Sheff chronicles his son Nic’s descent into substance abuse and his own struggles as a father trying to save his son. The book explores the impact of addiction on families and the relentless cycle of hope and despair that comes with loving someone who is battling addiction. Sheff’s raw and honest account offers a powerful insight into the complexities of addiction and the toll it takes on individuals and their loved ones. This compelling narrative sheds light on the devastating effects of drug addiction and the unwavering love and resilience of a father trying to help his son.

by Ellen Hopkins

Crank by Ellen Hopkins is a gripping and raw novel about the devastating impact of addiction. This book follows the story of a teenage girl named Kristina who becomes addicted to the dangerous drug crystal meth. Through powerful free verse poetry, the author delves into the heart-wrenching experiences of drug addiction, exploring the physical, emotional, and psychological toll it takes on the user and their loved ones. The novel provides a haunting and unflinching look at the downward spiral of addiction, the desperate need for the next fix, and the painful consequences that follow. Crank is a powerful and eye-opening book about drug addiction, shedding light on the harsh realities faced by those struggling with substance abuse.

The Basketball Diaries

By jim carroll.

The Basketball Diaries by Jim Carroll is a raw and gritty memoir that delves into the turbulent world of addiction. This coming-of-age story follows the author’s descent into a life of crime, drugs, and homelessness during his teenage years in New York City. Through vivid and unapologetic prose, Carroll paints a vivid picture of the struggles and temptations faced by young people in the 1960s. The book offers a harrowing and unflinching portrayal of the author’s experiences with substance abuse and the destructive impact it had on his life. The Basketball Diaries is a compelling and haunting account of the author’s journey through addiction, making it a must-read for anyone interested in the human experience and the complexities of addiction.

by Melvin Burgess

Smack by Melvin Burgess is an intense and gripping novel that delves into the gritty world of addiction. Set in the streets of Bristol, England, the story follows the lives of a group of young adults who become caught in the destructive cycle of drug abuse. The book provides a raw and unflinching portrayal of the lives of substance abusers, depicting the harsh reality of their struggles and the consequences of their choices. With its brutally honest and unapologetic narrative, Smack offers a powerful and eye-opening look into the lives of those affected by addiction. This book about drug addicts is a poignant and thought-provoking read that sheds light on the complexities of addiction and the impact it has on individuals and their relationships.

Recommended for you:

recovery from addiction books. books on recovery from addiction

In My Skin: A Memoir

By kate holden.

In My Skin: A Memoir by Kate Holden is a gripping and raw account of the author’s struggle with addiction and her journey to find redemption. The book delves into the world of substance abuse, chronicling Holden’s experiences as she grapples with her demons and battles to overcome her addiction. Through vivid and evocative prose, the author provides a poignant and honest portrayal of the challenges faced by individuals struggling with substance dependency. In My Skin offers a powerful and intimate insight into the lives of those dealing with addiction, shedding light on the complexities and hardships that drug addicts endure. Holden’s memoir is a compelling and thought-provoking read that will resonate with anyone seeking a deeper understanding of the struggles faced by those battling addiction.

The Night of the Gun

By david carr.

The Night of the Gun by David Carr is a gripping memoir that offers a raw and unflinching look into the author’s past as a drug addict. Carr, a renowned journalist, takes a unique approach to his own story by investigating his own past through interviews with friends, family, and acquaintances, as well as by combing through old documents and records. This method adds a fascinating layer of depth and authenticity to the narrative, allowing readers to piece together the truth alongside Carr. The book is a powerful and unapologetic exploration of addiction, recovery, and the complexities of human nature. With its candid and brutally honest approach, The Night of the Gun is a must-read for anyone interested in understanding the struggles and triumphs of those who have battled addiction.

The Heroin Diaries: A Year in the Life of a Shattered Rock Star

By nikki sixx.

The Heroin Diaries: A Year in the Life of a Shattered Rock Star by Nikki Sixx is a raw and unflinching memoir that offers a candid look into the life of a rock star struggling with addiction. Through diary entries, personal reflections, and interviews, Sixx takes readers on a harrowing journey through his battle with substance abuse, offering a glimpse into the turbulent world of addiction and its devastating impact. This gripping book about drug addicts provides a poignant and haunting portrayal of the highs and lows of addiction, as well as the toll it takes on relationships, creativity, and personal well-being. The Heroin Diaries is a compelling and honest account that sheds light on the dark and destructive reality of addiction, making it a must-read for anyone interested in exploring the complexities of this pervasive issue.

Dopesick: Dealers, Doctors, and the Drug Company that Addicted America

By beth macy.

Dopesick: Dealers, Doctors, and the Drug Company that Addicted America by Beth Macy is a gripping exploration of the opioid crisis in America. Macy delves into the lives of those affected by addiction, revealing the devastating impact of prescription painkillers and the pharmaceutical industry’s role in fueling the epidemic. Through in-depth interviews and extensive research, she exposes the interconnected web of dealers, doctors, and drug companies that perpetuated the crisis. The book offers a raw and intimate look at the struggles of individuals caught in the grips of addiction, as well as the systemic failures that allowed the epidemic to flourish. Dopesick is a powerful and eye-opening read that sheds light on the human cost of the opioid crisis and the urgent need for change.

Scar Tissue

By anthony kiedis.

Scar Tissue is a captivating memoir by Anthony Kiedis, the lead singer of the Red Hot Chili Peppers, that delves into his tumultuous life as a rock star and his battles with addiction. This raw and honest account takes readers on a journey through Kiedis’ childhood, his rise to fame, and his struggles with drug addiction. From his early experiences with marijuana to his experimentation with harder drugs, Kiedis paints a vivid picture of the highs and lows of his addiction. The book offers a glimpse into the world of substance abuse, showing the devastating impact it can have on relationships and personal well-being. Scar Tissue is a compelling and thought-provoking read that provides insight into the mind of a drug addict, making it a must-read for anyone interested in the human experience.

The Electric Kool-Aid Acid Test

By tom wolfe.

The Electric Kool-Aid Acid Test by Tom Wolfe is a mesmerizing non-fiction book that delves into the world of the 1960s counterculture and the rise of the psychedelic movement. The book follows the author as he immerses himself in the world of Ken Kesey and his band of Merry Pranksters, who were known for their wild, drug-fueled cross-country trips on a psychedelic-painted bus. Through Wolfe’s vivid and immersive writing, readers are taken on a mind-bending journey filled with colorful characters, mind-altering substances, and a profound exploration of the human experience. This book provides a captivating and insightful look into the lives of individuals experimenting with psychedelics, making it a must-read for anyone interested in the history of the counterculture movement or the experiences of drug enthusiasts.

The Lost Weekend

By charles r. jackson.

The Lost Weekend is a gripping novel by Charles R. Jackson that delves into the harrowing journey of an alcoholic struggling to overcome his addiction. The story follows the protagonist, Don Birnam, as he spirals deeper into the clutches of alcoholism during a weekend bender in New York City. Through vivid and haunting prose, Jackson paints a raw and unflinching portrait of the inner turmoil and destructive behavior of a man consumed by his addiction. The novel offers a stark and unapologetic look at the life of an alcoholic, shedding light on the profound impact of addiction on the individual and those around them. The Lost Weekend is a powerful and compelling read that offers deep insight into the struggles of those battling with alcoholism, making it a must-read for anyone interested in the complexities of addiction.

Fear and Loathing in Las Vegas

By hunter s. thompson.

Fear and Loathing in Las Vegas by Hunter S. Thompson is a wild and chaotic ride through the drug-fueled underbelly of American society. The book follows the misadventures of journalist Raoul Duke and his attorney, Dr. Gonzo, as they embark on a drug-addled road trip to Las Vegas. As they navigate through the surreal and twisted landscape of the city, they encounter a cast of eccentric characters and immerse themselves in a haze of drugs and madness. Thompson’s unique and electrifying writing style captures the disorienting and hallucinatory experience of a drug-fueled journey, making Fear and Loathing in Las Vegas a must-read for anyone interested in the counterculture of the 1960s and 1970s. This book about drug addicts is a gripping and unforgettable exploration of the darker side of the American dream.

A Scanner Darkly

By philip k. dick.

A Scanner Darkly by Philip K. Dick is a mind-bending journey into the world of substance abuse and paranoia. Set in a dystopian future, the story follows an undercover cop who becomes addicted to a powerful drug known as Substance D. As he delves deeper into the drug underworld, he grapples with his own identity and reality, leading to a harrowing exploration of addiction, surveillance, and the nature of truth. This gripping novel offers a unique perspective on the struggles of those caught in the grip of addiction, as well as the societal and psychological implications of drug abuse. A Scanner Darkly is a haunting and thought-provoking read that will leave a lasting impression on anyone interested in the complexities of addiction and deception.

The Big Fix: Hope After Heroin

By tracey helton mitchell.

The Big Fix: Hope After Heroin by Tracey Helton Mitchell is a powerful and candid memoir that sheds light on the struggles of addiction and the journey to recovery. In this book on drug addicts, Mitchell shares her personal story of heroin addiction and the harrowing experiences that come with it. She takes readers on a raw and honest journey through her darkest moments and the challenges she faced while battling her addiction. Through her compelling narrative, Mitchell offers a glimpse into the world of drug addicts and the impact addiction has on individuals and their loved ones. The Big Fix is a book about drug addicts that ultimately offers hope, resilience, and the possibility of redemption, making it a must-read for anyone seeking insight into the complex and often misunderstood world of addiction.

In conclusion, these 20 best books about Drug Addicts offer a raw and honest portrayal of addiction and recovery. From memoirs to fiction, these books provide a deep understanding of the struggles and complexities faced by individuals dealing with drug addiction. Whether you’re seeking insight into the personal experiences of addicts or looking for stories of hope and redemption, these books offer a diverse and compelling exploration of this challenging subject.

Which Drug Addicts book is best?

The best book on Drug Addicts can vary with personal preference, but three widely recommended titles are:

A Million Little Pieces by James Frey ,
Tweak: Growing Up on Methamphetamines by Nic Sheff ,
Junky by William S. Burroughs .

Each offers valuable insights and could be a great starting point.

What are the best books to learn about Drug Addicts?

For those looking to learn about Drug Addicts, there is a wealth of literature that can provide a comprehensive understanding of the subject. Some of the most highly recommended books include:

Junky by William S. Burroughs ,
Go Ask Alice by Anonymous ,
Permanent Midnight by Jerry Stahl ,
Trainspotting by Irvine Welsh ,
Beautiful Boy: A Father’s Journey Through His Son’s Addiction by David Sheff ,
Crank by Ellen Hopkins ,
The Basketball Diaries by Jim Carroll ,
Smack by Melvin Burgess

These books offer a range of perspectives on Drug Addicts, covering various aspects and approaches to the subject.

What are the best books on Drug Addicts?

The best books on Drug Addicts include:

In My Skin: A Memoir by Kate Holden ,
The Night of the Gun by David Carr ,
Trainspotting by Irvine Welsh .

Each offers unique insights into the subject. While these books on the topic of Drug Addicts are highly regarded, it’s important to note that any list of ‘best’ books is subjective and reflects a range of opinions.

What are the best Drug Addicts books of all time?

Choosing the best Drug Addicts books of all time can vary depending on who you ask, but seven titles that are often celebrated include

Smack by Melvin Burgess ,
and In My Skin: A Memoir by Kate Holden .

Each of these books has made a significant impact in the field of Drug Addicts and continues to be influential today.

Drug Addiction Recovery Stories_ Inspiring Accounts of Triumph and Transformation

Overview of Addiction Recovery Stories

An overview of addiction recovery stories via the stages of the change model of addiction provides valuable insights and inspiration for individuals seeking recovery from drug addiction. Here are key points to consider:

Inspiration: Addiction recovery stories inspire and motivate individuals struggling with addiction. These stories showcase the resilience and courage of those who have overcome their addiction, offering hope for others in similar situations.
Personal growth: Addiction recovery stories highlight the journey of personal growth and transformation experienced by individuals on the path to recovery. These stories demonstrate the power of self-reflection, determination, and the ability to change one’s life.
Sharing experiences: Addiction recovery stories allow individuals to share their experiences and provide support to others. They create a sense of community and foster understanding by connecting those in recovery and showing they are not alone in their struggles.
Promoting understanding: Addiction recovery stories challenge and break the stigma surrounding addiction. They offer a societal perspective on the complexities of addiction, promoting empathy, compassion, and a more inclusive approach to recovery.

By understanding the overview of addiction recovery stories, individuals gain valuable insights, find inspiration, and feel supported on their journey to recovery.

Inspiring Accounts of Triumph and Transformation

Get ready to be inspired as we dive into the captivating world of triumph and transformation . In this section, we’ll delve into the mesmerizing personal stories of individuals who have conquered their battles with addiction . Brace yourself for tales of resilience , courage , and redemption as these brave individuals share their journeys of overcoming addiction. Get ready to be moved, uplifted, and amazed by their incredible stories of transformation. This is a section you won’t want to miss!

Personal Stories of Overcoming Addiction

Personal stories of overcoming addiction are incredibly impactful and inspiring. They serve as a testament to the remarkable resilience and unwavering determination of individuals who have triumphed over addiction. When reflecting on these narratives, it is crucial to consider a few significant factors.

Inspiring stories: These personal accounts offer a beacon of hope and inspiration to those currently grappling with addiction. They serve as living proof that recovery is not only attainable but within reach for all.
Courageous individuals: The individuals who bravely share their personal stories demonstrate immense courage and strength . By exposing their vulnerability, they provide solace to others who may be feeling isolated in their own arduous journeys.
Personal growth: Those who have successfully conquered addiction underscore the incredible personal growth they have undergone. They candidly discuss the valuable lessons learned, the daunting obstacles confronted, and the transformative positive changes experienced.
Fostering connections: These personal narratives establish meaningful connections among individuals who have shared similar experiences. By offering solace and support, they serve as a catalyst for seeking assistance and embarking on the path to recovery.

By immersing ourselves in these narratives, we gain valuable insights, encouragement, and the necessary drive for our own recovery endeavors. They serve as a poignant reminder that with unwavering commitment , unwavering support , and unwavering belief in oneself , overcoming addiction and embracing a fulfilling, sober life is entirely attainable.

Pro-tip: Consider joining support groups or online communities to discover a plethora of personal stories recounting the triumph over addiction. Hearing from a diverse range of individuals will provide you with a broader perspective and unwavering support throughout your own recovery journey.

Why Are Drug Addiction Recovery Stories Important?

Drug addiction recovery stories hold tremendous significance in society. They serve as powerful reminders of the triumphs and transformations that individuals can achieve in their battle against addiction. In this section, we will delve into the importance of these stories, focusing on two impactful aspects. Firstly, we will explore how drug addiction recovery stories help in breaking the stigma surrounding addiction . Secondly, we will discuss how these stories provide a much-needed source of hope and inspiration to those on their own recovery journey. Let’s dive into these compelling narratives of strength and resilience .

Breaking the Stigma Around Addiction

Breaking the Stigma Around Addiction is crucial in addressing the challenges faced by individuals struggling with addiction. Challenging societal perspectives and promoting understanding and compassion for those affected are important. Addiction recovery stories offer unique insight into the experiences of individuals who have overcome addiction, inspiring hope and transformation. These stories highlight the transformative effects of recovery and renew motivation for those who may be struggling.

By sharing personal experiences, addiction recovery stories help humanize addiction and shift the focus from judgment to empathy. They showcase the courage and strength of individuals who have faced the challenges of addiction and emerged victorious. Through their stories, they demonstrate that recovery is possible and that individuals should not be defined by their addiction.

Breaking the stigma around addiction also involves challenging misconceptions and stereotypes about addiction. Addiction recovery stories create opportunities for open and honest conversations by providing a platform for individuals to share their stories. They help educate the public about the complexities of addiction and the journey of recovery.

Providing Hope and Inspiration

Drug addiction recovery stories serve as a source of hope and inspiration for those who are struggling with addiction. These stories not only demonstrate that recovery is achievable, but they also shed light on the possibility of overcoming addiction. By hearing these stories, individuals are motivated to seek assistance and implement positive changes in their lives.

Throughout the recovery journey, it is common to encounter setbacks and experience doubt. However, stories of triumph and transformation act as a vital source of renewed motivation, reminding individuals of their inner strength and resilience .

Moreover, drug addiction recovery stories play a significant role in fostering understanding and empathy , as they help to dismantle the negative perception surrounding addiction. Through the sharing of personal experiences, these stories prompt society to perceive addiction as a treatable condition rather than a moral failing.

Common Themes in Drug Addiction Recovery Stories

Drug addiction recovery stories are a powerful testament to the resilience and strength of the human spirit as you work with leading experts like Greenville’s Lantana Recovery . In this section, we will explore the common themes that emerge from these compelling narratives. From the gripping rock bottom moments to the transformative turning points, and the importance of support and community , we will delve into the essential elements that pave the way for triumph and transformation in the face of addiction. Get ready to be inspired by the shared experiences and remarkable journeys of individuals who have reclaimed their lives.

Rock Bottom Moments

Rock bottom moments are crucial in overcoming drug addiction. These Rock Bottom Moments represent the lowest point in someone’s struggle with substance abuse and often involve intense despair, loss, and self-destruction. During these Rock Bottom Moments , individuals may realize the negative effects of addiction and become motivated to seek help and change.

Rock Bottom Moments can include setbacks and relapses, illustrating the cyclical nature of addiction. Severity can vary depending on factors like substance use, personal circumstances, and support systems. These Rock Bottom Moments can serve as wake-up calls, inspiring individuals to seek treatment and embrace recovery.

Though challenging, Rock Bottom Moments also offer opportunities for growth and transformation. They allow individuals to reflect on their choices, face the consequences of addiction, and commit to turning their lives around. These Rock Bottom Moments can mark a turning point toward sobriety, healing, and personal development.

Support from loved ones, support systems, and support group meetings plays a crucial role in navigating Rock Bottom Moments and maintaining recovery. These networks provide a safe space to share experiences and offer guidance, helping individuals rebuild their lives, develop healthy coping mechanisms, and build resilience.

Rock Bottom Moments are not the end, but rather a starting point to reclaim lives from addiction’s clutches. With commitment, perseverance, and the right support, individuals can rise from their lowest point, embrace sobriety, and build a future filled with hope, purpose, and fulfillment.

The Turning Point

The turning point in drug addiction recovery is a pivotal moment that brings about transformation , leading individuals to heal and recover. It occurs when individuals realize the destructive nature of their addiction and decide to make a change. This turning point can stem from hitting rock bottom , experiencing setbacks and relapses , or witnessing the consequences of their actions.

During the turning point, individuals undergo a transformative experience that goes beyond physical healing . It involves a spiritual and emotional journey where individuals confront the underlying issues contributing to their addiction. It is a profound self-realization that prompts them to seek support and make necessary changes.

One inspiring example of a turning point is John’s story. He struggled with substance abuse for years until a life-altering event made him realize he had hit rock bottom. With the support of a rehabilitation program, John embarked on a spiritual and emotional journey of self-discovery. Through therapy, counseling, and the guidance of peers, he was able to heal from his addiction and rebuild his life.

The turning point in drug addiction recovery serves as hope for others facing similar struggles. By sharing these stories, we promote understanding , inspire change, and provide renewed motivation for those seeking recovery. These stories encourage individuals to take the crucial step towards healing and empower them to overcome challenges on their journey.

Support and Community

Support and community are crucial in drug addiction recovery. Here are key aspects to consider:

Support systems: A strong support system is essential in the recovery journey. This includes family members, friends, support group meetings, and organizations dedicated to helping individuals overcome addiction.
Support network: Surrounding yourself with individuals who understand and empathize with your struggles provides emotional support and guidance. Connecting with others who have similar experiences can be comforting and inspiring.
Peer support groups: Joining groups offer a safe space to share experiences, gain insights from those with long-term sobriety, and cultivate a sense of belonging. This may also include seeking support from family, church, friends, work, school, and self-help organizations like Alcoholics Anonymous and Narcotics Anonymous to aid in their recovery according to Judith Grant’s study, Rural women’s stories of recovery from addiction .
Accountability partners: Having someone who holds you accountable for your actions and progress in recovery is helpful. An accountability partner offers encouragement, keeps you focused on goals, and provides guidance during challenging times.
Therapeutic communities: Residential treatment centers and therapeutic communities offer a supportive environment where individuals can interact with peers who understand their struggles. These communities provide therapeutic activities and resources to enhance recovery.

By fostering strong support and community connections, individuals in recovery can find the encouragement, understanding, and guidance needed to overcome addiction and live fulfilling lives. Remember that each person’s journey is unique, and finding the right support system may take time, but it is worth the effort.

Transformations and Lessons Learned

Transformations and Lessons Learned – Hear inspiring recovery stories from individuals who have triumphed over drug addiction. Discover how they rebuilt relationships, found self-worth and purpose, and embraced sobriety. These powerful accounts of transformation will inspire and motivate you in your own journey toward recovery.

Rebuilding Relationships

Rebuilding relationships is crucial for individuals recovering from drug addiction. It involves restoring and strengthening connections with loved ones, repairing trust, and building a healthy support network.

Healing past wounds: Rebuilding relationships requires addressing past conflicts with open communication, acknowledging mistakes, and working towards forgiveness and understanding.
Building healthy boundaries: Setting clear boundaries is essential for maintaining healthy relationships. Individuals in recovery need boundaries that support their sobriety and well-being while respecting others’ needs.
Developing healthy communication skills: Effective communication is vital for rebuilding relationships. Learning to express emotions and concerns respectfully can help rebuild trust and foster deeper connections.
Attending family therapy or support groups: These resources provide a safe space for open dialogue, education, and guidance in rebuilding relationships. Strategies for improved communication, understanding addiction, and rebuilding trust are offered.
Making amends: Taking responsibility, apologizing for harm caused, showing genuine remorse, committing to change, and making reparations when appropriate are essential steps in the recovery process.

Rebuilding relationships takes time and effort but is crucial for ongoing sobriety and overall well-being. Actively working on repairing connections allows individuals in recovery to cultivate a strong support system.

In my own experience, rebuilding relationships has been transformative. Through therapy and support groups, I learned communication skills, set boundaries, followed journal prompts for addiction recovery , took responsibility for my past actions, and committed to sobriety. This has allowed me to rebuild trust, strengthen relationships, and cultivate a supportive network. Rebuilding relationships has improved my personal life and contributed significantly to my overall well-being and ongoing sobriety.

Discovering Self-Worth and Purpose

Discovering self-worth and purpose is crucial for drug addiction recovery. It is essential for individuals to rediscover themselves and find meaning and direction in their lives.

Throughout the recovery process, personal growth and transformation occur. Individuals learn to celebrate their strengths and recognize their value. Discovering self-worth helps individuals develop a positive self-image and cultivate self-esteem and confidence .

Having a purpose is equally important. It provides individuals with a reason to continue their recovery journey and inspires positive changes. Finding purpose involves identifying new goals, pursuing passions, and contributing to communities. It allows individuals to create a new identity beyond addiction and establish a fulfilling life.

Therapy and counseling can greatly benefit individuals in recovery. Through therapy, they can explore their values, beliefs, and desires, which help them uncover their true passions and align their actions with their values. This further enhances their sense of self-worth and purpose .

By discovering self-worth and purpose , individuals in recovery gain hope and motivation. This newfound self-worth serves as a strong foundation for their ongoing journey of sobriety, empowering them to live a fulfilling life without addiction.

Embracing Sobriety

When recovering from drug addiction, embracing sobriety is crucial. It involves committing to a life free from addiction and actively maintaining sobriety. It begins with acknowledging the need for change and making a conscious decision to break free. It requires determination to overcome challenges and develop effective recovery strategies. Embracing sobriety is an ongoing journey that requires perseverance.

During recovery, individuals may encounter temptations and triggers that can lead to relapse. To avoid pitfalls, cultivating strong support systems and surrounding oneself with supportive people is crucial. Attending support group meetings and seeking professional help from leading rehab centers can greatly enhance the chances of maintaining sobriety.

Embracing sobriety also involves adopting new coping mechanisms and healthy lifestyle habits. This may include implementing stress-management techniques, engaging in regular exercise, and practicing self-care. Therapy or counseling from Lantana may also be beneficial for addressing the emotional and psychological aspects of addiction.

How Can Drug Addiction Recovery Stories Help Others?

Recovering from drug addiction can be a daunting journey, but the power of storytelling can offer hope , inspiration , and practical guidance . In this section, we’ll explore how drug addiction recovery stories have the potential to help others. From offering valuable guidance and practical tips to encouraging those seeking recovery, and providing much-needed support for loved ones, these stories embody the triumph and transformation that is possible. Get ready to be inspired by the transformative impact of these narratives on the path to recovery.

Offering Guidance and Practical Tips

When providing guidance and practical tips for drug addiction recovery, it is crucial to consider several strategies:

Explore treatment options: Research and understand the available treatment options for drug addiction recovery. This includes inpatient and outpatient programs, counseling, therapy, and support groups.
Develop effective recovery strategies: Personalize your strategies for recovery. Set short-term and long-term goals, practice self-care, and find healthy coping mechanisms.
Utilize therapeutic benefits: Therapy, including individual counseling, group therapy, and alternative therapies like art or music therapy, can provide valuable support.
Build a strong support network: Surround yourself with a supportive network of family, friends, and fellow individuals in recovery. Attend support group meetings, share experiences, and lean on others for guidance.
Focus on relapse prevention: Develop strategies to prevent relapse. This may involve avoiding triggers, finding healthy outlets for stress, and creating a relapse prevention plan with your support network. “The goal of treatment is to help individuals recognize the early warning signs of relapse and to develop coping skills to prevent relapse early in the process, when the chances of success are greatest. This has been shown to significantly reduce the risk of relapse” ( Relapse Prevention and the Five Rules of Recovery , Melemis, 2015.)

By following these guidance and practical tips, individuals in drug addiction recovery can increase their chances of success and maintain a healthy, fulfilling life in sobriety.

Encouraging Seekers of Recovery

When it comes to encouraging seekers of recovery, drug addiction recovery stories play a significant role. These stories inspire and motivate individuals on the path to overcoming addiction. Here are some ways in which drug addiction recovery stories provide encouragement:

Instilling hope: Recovery stories showcase real-life examples of individuals who have successfully overcome addiction, demonstrating that recovery is possible and positive change is attainable.
Offering guidance: Recovery stories provide personal insights and practical tips valuable to those seeking recovery. They offer guidance on treatment options, effective recovery strategies, and the transformative benefits of therapy.
Connecting seekers with resources: Recovery stories direct seekers to addiction recovery resources such as support groups, treatment centers, and counseling services. These resources provide necessary support and guidance during the recovery journey.
Promoting change and seeking treatment: Recovery stories encourage individuals struggling with addiction to seek treatment and support. They inspire seekers to take the first steps toward their own recovery by sharing stories of successful addiction recovery.
Fostering understanding: Recovery stories break down the stigma surrounding addiction by promoting understanding. They showcase the challenges faced by individuals with addiction and highlight the importance of support and compassion in the recovery process.

In summary, drug addiction recovery stories are a powerful tool in encouraging seekers of recovery. They provide hope, guidance, and resources, and promote understanding, ultimately inspiring individuals to take the necessary steps toward their own recovery journey.

Providing Support for Loved Ones of Those in Recovery

When supporting loved ones in recovery, keep these considerations in mind:

Stay informed : Educate yourself about addiction and the recovery process. Understanding the challenges and stages of recovery helps offer better support .
Maintain open communication : Listen without judgment and encourage the expression of feelings and concerns.
Be patient : Recovery is a journey that takes time. Offer support and encouragement during difficult times .
Establish healthy boundaries : Set limits and communicate your own needs and limitations.
Encourage self-care : Remind loved ones to prioritize their well-being and seek professional help if needed as studies like Mapping the recovery stories and drinkers and drug users in Glasgow by Best et al., have found that better functioning and quality of life were linked to increased involvement in meaningful activities, followed by the number of peers in recovery within the social network.
Offer practical assistance : Provide rides to support group meetings, help with household chores, or aid in finding job opportunities.

Remember, supporting loved ones in recovery is crucial. By offering understanding, empathy, and practical assistance, you play a significant role in their ongoing recovery process.

Frequently Asked Questions

What are addiction recovery stories.

Addiction recovery stories are personal accounts of individuals who have struggled with drug or alcohol addiction and have successfully overcome their addiction. These stories highlight the challenges, setbacks, and triumphs of the recovery journey, offering hope and inspiration to others who may be struggling with substance abuse.

How do addiction recovery stories inspire change?

Addiction recovery stories inspire change by showcasing the possibility of healing and happiness after addiction. These stories provide hope to individuals who may feel trapped in their addiction, showing them that recovery is attainable. By sharing their experiences and insights, those who have overcome addiction encourage others to seek help, develop healthy coping strategies, and embark on their own journey of recovery.

Where can I find addiction recovery stories?

There are various online platforms where you can find addiction recovery stories. Social media communities, blogs, podcasts, and websites dedicated to addiction recovery often feature personal accounts of triumph and transformation. These platforms provide a space for individuals to share their recovery journeys, offering support, inspiration, and a sense of community.

What lessons can be learned from addiction recovery stories?

Addiction recovery stories teach important life lessons. They highlight the significance of self-reflection and accountability in the recovery process. These stories emphasize the value of finding support and treatment, as well as developing healthy life skills and coping mechanisms. They also underscore the role of building a support network and embracing spirituality in maintaining sobriety.

How can addiction recovery stories promote emotional healing?

Sharing personal addiction recovery stories can promote emotional healing in multiple ways. For those who have struggled with addiction, sharing their story can be a therapeutic experience, allowing them to reflect on their journey and find closure. For others, reading or hearing these stories can provide a sense of hope, validation, and connection, and help in their own healing process.

How can I give back and help others through addiction recovery stories?

If you have overcome addiction and want to give back and help others, sharing your recovery story is a meaningful way to inspire and support others. You can use online platforms such as social media, blogs, podcasts, or local support groups to share your story. By offering your experiences, insights, and advice, you can provide hope, encouragement, and guidance to those who are still struggling.

Warren Phillips

Warren is a Licensed Master Social Worker, who specializes in substance abuse and mental health treatment. Clinically, Warren has developed a therapeutic skillset that utilizes a strengths-based perspective, Twelve Step philosophies, Cognitive Behavioral Therapy and Motivational Interviewing.

Understanding Work Stress and Addiction

Understanding the Acceptance Stage of Recovery

Psychologically Damaging Things You Can Say to Someone in Recovery

Understanding What Is Drug Addiction: Causes, Consequences, and Recovery

Exploring the List: What Is a Schedule 1 Drug and Its Implications?

Examining the Evidence: Does Rehabilitation Work in Reducing Recidivism?

Contact Information

Main Number: 866-997-2870 [email protected] Monday to Friday, 9am – 5pm

Lantana Recovery Rehab

65 Gadsden St Charleston, SC 29401 (843) 281-7964

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“Want to try some of this?” he asked.

They rolled up the windows in the Dodge Dakota and crushed the drug on a mirror. Jacob held it up for his friend to snort while driving, then snorted some himself.

Soon Jacob couldn't go a day without it. His constant quest for heroin replaced even things he loved, like fishing trips with his boys.

Jacob lost his job and blew through savings. Water and electricity to his trailer were cut off and he couldn’t flush the toilet. Mold grew on the carpets. Bugs crawled on the furniture. Stephanie was in prison at the time, so the boys had to move in with her mother.

Jacob abandoned the trailer, sleeping on friends’ couches. He let his body go, unconcerned by his haggard face and rotten teeth.

Part 1: An angel of Austin, music teacher lifts kids amid town's drug recovery

His rock bottom coincided with the early months of Austin's HIV outbreak in 2015, when cases skyrocketed every month, reaching 184 by early December. Day and night, Jacob roamed the streets of his hometown with other suffering souls, single-mindedly chasing heroin.

“Finally," he said, "I couldn’t face my boys.”

In desperation, he went to his father.

“I need help,” he told Wilbur. “I’ve got a problem.”

Howell, right, gets a hug from his son Colten Coomer, 9, during a late night at the church where Jacob filled in as the sound man for the choir. Sept. 12, 2018

Wilbur took him in and helped him get treatment with the addiction medicine Suboxone. He brought Jacob to services at Northside Church in New Albany, where a couple invited him to a series of Bible studies in Scottsburg.

Jacob went to the first one but didn’t like it. He skipped the second.

On the night of the third, he returned to his father’s house to find all his belongings piled on the porch. Jacob hadn’t been there for a few days, and Wilbur thought he was using drugs again.

“I wasn’t,” Jacob assured him, trying to explain that he was staying with his boys. “I really wasn’t.”

His dad stood firm.

Jacob wondered where to turn. Two clear choices emerged: the nearest dope house or Bible study.

His whole body cried out for heroin’s oblivion.

But a small voice within him cried out for God’s salvation.

“God, give me faith; give me hope,” he prayed, sobbing on Wilbur’s porch. “Help me, Lord. I’ve dug my hole so deep I can’t get out of it on my own. I need you to help me, oh Lord.”

And help came.

Student and teacher

At Bible study that night, Jacob sat with two strangers, Paul and Becky Thomas.

Paul offered Jacob a ride home and Jacob shared his story on the way, mentioning that he didn’t have a job. Paul told him he was pouring concrete the next day and invited him to help.

Church of the New Covenant pastor Jacob Howell, from left, with former pastor Harold White and associate pastor Paul Thomas. Nov. 4, 2018

Like Jacob, Paul almost didn’t go to Bible study that night. The first one had seemed too much like a self-help group, and he only kept going because Becky urged him to.

Everything suddenly made sense when he met Jacob: “God meant for me and him to connect.”

Just as Jacob was seeking a teacher, Paul was seeking a student.

In 2012, Paul had left his job as part-owner of Thomas Plastic Machinery in Scottsburg, finding money a hollow pursuit. He did mission work in Africa and tried unsuccessfully to help start a church.

“I always thought God had more for me to do than just sitting on a pew,” Paul said. "(Jacob) was crying out to God. I was wanting to make disciples. … And that’s when it started — that night.”

Part three: After the crush of a meth arrest, an Austin teacher finds her light

Two weeks after meeting Jacob, Becky and Paul got a call from Dr. Will Cooke, Austin's lone physician at the time, asking if they could take over a community dinner program. Debbie Ousley, the woman who started it, was ill and had to stop. Paul and Becky agreed to step in.

Senior Pastor Harold White of the Church of the New Covenant agreed to host the dinners. Jacob helped paint the room, then served food alongside Paul and Becky three days later.

From that week on, Jacob and Paul spent many of their waking hours together. When they finished the concrete work, they took on other construction jobs — always talking about God while they worked.

Paul advised: “Take a year and focus on Jesus.”

Gradually, a craving for faith and service replaced Jacob’s craving for drugs. Wanting to shed parts of his old image, he quit smoking and began wearing false teeth.

Howell puts in his fake teeth in the bathroom at the Church of the New Covenant. Nov. 8, 2018

He and Paul formally joined the Church of the New Covenant, where Paul asked Jacob to lead a Bible study.

The two helped add a kitchen, bathrooms and a huge closet for donated clothing to the church's youth center. People often interrupted them to ask for food, clothes or a prayer. Paul got annoyed until he realized that building community was more important than building that addition.

Jacob didn't mind the interruptions. Paul watched as he effortlessly connected with people in need, including those struggling with addiction. Jacob met them with compassion, not judgment, giving hugs and telling them God loved them. In the church and on the street, he offered impromptu prayers.

One Sunday, Jacob testified to the congregation about his own struggle with drugs.

Paul heard the stirrings of a pastor.

“I felt in my spirit that he had the potential and the enthusiasm and the desire” to preach, Paul said. “As a Christian, you’ve got to love people where they’re at.”

With the encouragement of Paul and Harold, Jacob began preaching every couple of months, joining Paul as a junior pastor.

And just as Paul served and guided him, he began serving and guiding others.

Jacob preaches a Sunday sermon at the New Covenant Church on Rural Street in Austin, Indiana. Howell was ordained as an assistant pastor for a year before being voted in as a senior pastor in November. “The word of God has offered me hope in my recovery, hope for what’s to come. It frees me of my past mistakes and let’s me know there’s a new beginning,” Howell said. “I always say I want to preach the gospel with as little words as possible. I’d like my life to be a true reflection of my heart.” Nov. 4, 2018

Brian LaFever met Jacob at the church in late summer 2017, during the depths of his struggle with meth. Jacob asked if Brian wanted to accept Jesus as his savior and led him to the altar when he said yes. Later in the service, Jacob baptized him.

After church, the two got to know each other. Jacob shared his story and asked Brian if he wanted to help him and Paul with some work around the church.

From that day on, Brian vowed to get sober. He'd been to court-ordered recovery meetings before and had gone with no intention of quitting. But at that point, he was ready to commit. He's been clean, and coming to the church, ever since.

"The Lord put us together for a reason," the 54-year-old said. "He saved my life."

Harry Clark said much the same. Harry, 44, used drugs for 25 years — weed, meth, "whatever I could get" during his darkest times. On Thursdays he went to Food 4R Souls for free meals and got to know Jacob. To his surprise, Jacob didn't judge him like other people did; "he was just on my side ... somebody I could talk to.

"... I knew he understood because he did go through that life."

One day about eight months ago, Harry confided he was ready to get well but didn't have money or a ride to Todd's Place, the men's transitional recovery housing in nearby Seymour. Jacob had connections there, so he got Harry in. He found a friend to drive and accompanied them to drop Harry off at Todd's Place. He's been living there, sober, ever since, working in a factory and hoping to regain custody of his son.

"Without Jacob's help, I'd probably still be doing what I was doing," Harry said. "He's helped me get my life on track."

Paul saw God acting through Jacob. So when he was asked if he wanted to be the senior pastor, Paul said he'd rather "push my brother to the front." Jacob replaced Harold when he retired in late October.

Jacob now gives sermons every other Sunday, trading off with Paul. He vacuums the church and cleans the windows, too.

And he still builds whatever needs building.

Faith, family, future

For Jacob’s wedding, the community transformed the youth center gym. Tables covered with blue cloth and gold runners filled the basketball court, facing a regal head table beneath one of the hoops. Bunches of shiny, star-shaped balloons hovered above tables and chairs.

Guests streamed in with potluck dishes, then lined up to write notes of love and congratulations on a wooden cross. Jacob rushed to Paul and Becky, pulling Becky close and announcing: “This wedding wouldn’t have happened without you.”

Tiffanie and Jacob Howell react after wrapping up their wedding ceremony at the New Covenant Church in Austin, Indiana. Sept. 22, 2018

In the church next door, Tiffanie balanced on a stool as friends fixed her hair and makeup. She marveled at how everyone pitched in to give them the perfect wedding.

“We’re simple people,” she said. “I just didn’t think we mattered. People really care.“

Tiffanie met Jacob as a young girl, while visiting an aunt in Austin. Jacob, who lived across the street, would chase the girl from Florida around a tree and try to kiss her.

Part four: I watched disease and despair grip Austin. Now hope is breaking it free

They met again three years ago at her cousin’s funeral. They connected instantly. Both were single parents. Tiffanie was divorced with four kids. Both were trying to overcome addiction. Tiffanie had struggled with the anti-anxiety drug Xanax. A romance blossomed as they traded Facebook messages and leaned on each other. They took things slow.

Last New Year’s Eve, before preaching a service, Jacob got on one knee and proposed in front of 35 parishioners.

Nine months later, Tiffanie walked down the aisle in Jacob's stepmom's white gown to Carrie Underwood's "Look at Me." Jacob wore his dad's suit and a blue shirt from the church clothes pantry. They promised to love, honor and obey. They lit one candle from two.

At the reception, Jacob’s aunt Donna Barger, Wanda Sue’s daughter, teared up watching them.

“My mom’s looking down today,” she said.

Inevitably, wedding bliss gave way to the hectic balance of work and family — and the challenges of sobriety and faith.

One of the first things Jacob does every day is to ask God for help.

Less than a week after the wedding, he arrived at the church for an 8 a.m. prayer group, wearing overalls and a T-shirt from the city’s recent Overdose Awareness Day Fed Up! march.

“I am sorry for all the things I did that were wrong. God, I’m asking you to help us recognize the darkness around us. Let us not be distracted by the things of the world — whether it’s drugs or anything else ...” he said, closing his eyes.

“Thank you for my church. I’m glad to be back here in the trenches. I’m ready to do this work that you have set before me.”

Later Jacob rounded up his kids to help clean their new, rented house. Jacob's son Colten and stepdaughter, 9-year-old Adylin, mostly played as the older kids made their way from room to room with garbage bags, throwing out trash and figuring out where to put the belongings piled in the living room. Tiffanie returned home from work at CVS and pitched in.

Just as Paul and Wanda Sue guided him toward God, Jacob and Tiffanie hope to do the same for their kids. Jacob already sees encouraging signs. Little Adylin has adopted his practice of impromptu prayers, once asking God to lift “our pain” when Jacob’s lymphedema flared up. Fifteen-year-old Tristen sings with the church band, and said his dad’s relationships with parishioners “show me how to think about others.”

Tiffanie was nervous at first about introducing a new man into her children’s lives, but has been pleasantly surprised. “When you both have kids, every man gives you this promise, I’m going to love them the same, and they never do,” Tiffanie said. “Jacob really does. He stops and he thinks about it.” Jacob gives a hug to Tiffanie’s daughter Adylin Robinson, 9, after their bed time prayer. Nov. 18, 2018

Jacob nurtures those relationships through all his roles at the church: ministering and praying wherever he's needed, whether in church, on the streets, even occasionally in homes.

Giving out clothes or food to those who need them.

Running the youth center used for sports teams, a school gym class, community events and funerals.

And every Thursday, Jacob helps plan and run a crucial service in Austin, the “Food 4R Souls” dinners. Between helping serve food when needed, he weaves among the tables, serving prayers.

One evening he stopped at a table where young, tired-looking men hunched over their plates. He knew them. They were living the life he once did. Jacob shared a little of his own story, invited them to church on Sunday and began speaking to God as they bowed their heads.

Another evening he prayed with an ill, elderly woman. She slumped over the table, then collapsed as he helped lead her outside. So he carried her to a couch, praying as they waited for an ambulance. Again he was there when he was needed.

Each day Jacob grows more hopeful that the revival his grandmother once predicted will come to pass in Austin — that faith will pull people out of addiction and pain.

Jacob heard echoes of his grandmother’s prophecy when an older woman walked into the church in late October, crying.

“I haven’t been in a church building in 10 years,” she said. “Something told me to come here.”

Jacob prayed with her in the sanctuary. And he wept when she told him her name:

Howell works on vacuuming and cleaning the church well after dark. “I don’t want to be a pastor that is too afraid to scrub a toilet,” Howell said. Nov. 30, 2018

Laura Ungar: 502-582-7190; [email protected]; Twitter @laura_ungar . Support strong local journalism by subscribing today: courier-journal.com/laurau .

The journey from drug addiction to drug recovery; a case report of an inpatient rehabilitation

Affiliations.

1 Department of Applied Psychology, National University of Modern Languages, Islamabad,Pakistan.
2 NUST Business School, National University of Science and Technology, Islamabad, Pakistan.
PMID: 36156576
DOI: 10.47391/JPMA.2419

In Pakistan, 64% of the total population is under the age of 30 and unfortunately, the increasing number of young addicts in Pakistan is estimated at the distressing rate of 40,000 per year. By considering the alarming situation and scarcity of literature, this research aims to investigate the recovery phase of drug addiction by introducing a case that highlights drug addiction, recovery, and relapse in the Pakistani context. We designed a case study approach in which face-to-face interviews were used. The case under consideration is a 38 years old patient with a history of chronic addiction with episodes of recovery and relapses. The shift of approaches from the extreme end of the addiction continuum to full recovery poses an opportunity for drug rehabilitation professionals to learn factors associated with drug addiction, the recovery process, and first-hand comments on recovering interventions in Pakistan.

Keywords: Illicit Drugs, Substance-related Disorders, Mental Health Recovery, Case report, Pakistan..

Publication types

Case Reports
Asian People
Behavior, Addictive*
Substance-Related Disorders* / epidemiology

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Teen Drug Use Habits Are Changing, For the Good. With Caveats.

Dr. Nora Volkow, who leads the National Institutes of Drug Abuse, would like the public to know things are getting better. Mostly.

Dr. Nora Volkow, wearing a black puffy jacket, black pants and red sneakers, sits on the arm of a bench, with one foot on the seat and one on the ground, in front of a brick wall.

By Matt Richtel

Historically speaking, it’s not a bad time to be the liver of a teenager. Or the lungs.

Regular use of alcohol, tobacco and drugs among high school students has been on a long downward trend.

In 2023, 46 percent of seniors said that they’d had a drink in the year before being interviewed; that is a precipitous drop from 88 percent in 1979, when the behavior peaked, according to the annual Monitoring the Future survey, a closely watched national poll of youth substance use. A similar downward trend was observed among eighth and 10th graders, and for those three age groups when it came to cigarette smoking. In 2023, just 15 percent of seniors said that they had smoked a cigarette in their life, down from a peak of 76 percent in 1977 .

Illicit drug use among teens has remained low and fairly steady for the past three decades, with some notable declines during the Covid-19 pandemic.

In 2023, 29 percent of high school seniors reported using marijuana in the previous year — down from 37 percent in 2017, and from a peak of 51 percent in 1979.

There are some sobering caveats to the good news. One is that teen overdose deaths have sharply risen, with fentanyl-involved deaths among adolescents doubling from 2019 to 2020 and remaining at that level in the subsequent years.

Dr. Nora Volkow has devoted her career to studying use of drugs and alcohol. She has been the director of the National Institute on Drug Abuse since 2003. She sat down with The New York Times to discuss changing patterns and the reasons behind shifting drug-use trends.

What’s the big picture on teens and drug use?

People don’t really realize that among young people, particularly teenagers, the rate of drug use is at the lowest risk that we have seen in decades. And that’s worth saying, too, for legal alcohol and tobacco.

What do you credit for the change?

One major factor is education and prevention campaigns. Certainly, the prevention campaign for cigarette smoking has been one of the most effective we’ve ever seen.

Some of the policies that were implemented also significantly helped, not just making the legal age for alcohol and tobacco 21 years, but enforcing those laws. Then you stop the progression from drugs that are more accessible, like tobacco and alcohol, to the illicit ones. And teenagers don’t get exposed to advertisements of legal drugs like they did in the past. All of these policies and interventions have had a downstream impact on the use of illicit drugs.

Does social media use among teens play a role?

Absolutely. Social media has shifted the opportunity of being in the physical space with other teenagers. That reduces the likelihood that they will take drugs. And this became dramatically evident when they closed schools because of Covid-19. You saw a big jump downward in the prevalence of use of many substances during the pandemic. That might be because teenagers could not be with one another.

The issue that’s interesting is that despite the fact schools are back, the prevalence of substance use has not gone up to the prepandemic period. It has remained stable or continued to go down. It was a big jump downward, a shift, and some drug use trends continue to slowly go down.

Is there any thought that the stimulation that comes from using a digital device may satisfy some of the same neurochemical experiences of drugs, or provide some of the escapism?

Yes, that’s possible. There has been a shift in the types of reinforcers available to teenagers. It’s not just social media, it’s video gaming, for example. Video gaming can be very reinforcing, and you can produce patterns of compulsive use. So, you are shifting one reinforcer, one way of escaping, with another one. That may be another factor.

Is it too simplistic to see the decline in drug use as a good news story?

If you look at it in an objective way, yes, it’s very good news. Why? Because we know that the earlier you are using these drugs, the greater the risk of becoming addicted to them. It lowers the risk these drugs will interfere with your mental health, your general health, your ability to complete an education and your future job opportunities. That is absolutely good news.

But we don’t want to become complacent.

The supply of drugs is more dangerous, leading to an increase in overdose deaths. We’re not exaggerating. I mean, taking one of these drugs can kill you.

What about vaping? It has been falling, but use is still considerably higher than for cigarettes: In 2021, about a quarter of high school seniors said that they had vaped nicotine in the preceding year . Why would teens resist cigarettes and flock to vaping?

Most of the toxicity associated with tobacco has been ascribed to the burning of the leaf. The burning of that tobacco was responsible for cancer and for most of the other adverse effects, even though nicotine is the addictive element.

What we’ve come to understand is that nicotine vaping has harms of its own, but this has not been as well understood as was the case with tobacco. The other aspect that made vaping so appealing to teenagers was that it was associated with all sorts of flavors — candy flavors. It was not until the F.D.A. made those flavors illegal that vaping became less accessible.

My argument would be there’s no reason we should be exposing teenagers to nicotine. Because nicotine is very, very addictive.

Anything else you want to add?

We also have all of this interest in cannabis and psychedelic drugs. And there’s a lot of interest in the idea that psychedelic drugs may have therapeutic benefits. To prevent these new trends in drug use among teens requires different strategies than those we’ve used for alcohol or nicotine.

For example, we can say that if you take drugs like alcohol or nicotine, that can lead to addiction. That’s supported by extensive research. But warning about addiction for drugs like cannabis and psychedelics may not be as effective.

While cannabis can also be addictive, it’s perhaps less so than nicotine or alcohol, and more research is needed in this area, especially on newer, higher-potency products. Psychedelics don’t usually lead to addiction, but they can produce adverse mental experiences that can put you at risk of psychosis.

Matt Richtel is a health and science reporter for The Times, based in Boulder, Colo. More about Matt Richtel

Pilot program that has police, drug treatment providers work together in Portland will continue

A partnership between police and public health workers in downtown Portland aimed at connecting more people with drug treatment is getting government funding and an office space, state and local leaders announced Wednesday.

Portland Police Bureau’s bike squad members, including Portland Police Sgt. Jerry Cioeta, center, reflected in a downtown business window while awaiting transport for a man on a fentanyl-related charge on Feb. 7, 2024. The work is part of a pilot program by Portland Police Bureau’s bike squad and addiction recovery providers that launched in December 2023.

Kristyna Wentz-Graff / OPB

Starting in December, officers with the Portland Police Bureau’s bike squad and Oregon State Police began to work directly with treatment providers in the city’s Old Town neighborhood. The hope was to create a more immediate path for people who want drug treatment.

Under Ballot Measure 110, Oregon’s drug decriminalization law, police handed out $100 citations for drug use . In lieu of paying the fine, drug users could call a state-run hotline to get assessed for a substance use disorder. They had to make another call if they actually wanted to get treatment. But few did. The whole process proved unrealistic for people actively using substances such as fentanyl and methamphetamine.

Under the pilot program that started last year, police would still issue Measure 110 tickets, and offer an immediate opportunity to connect with a treatment provider. In one case OPB reported, a man named Joseph went from the street , immediately into detox, and stayed in treatment.

Police and treatment workers have connected with more than 150 people during the 10 days they’ve worked together, according to Devon Downeysmith, with the Health Justice Recovery Alliance, key supporters of Measure 110.

Outreach worker Ryan Hazlett, with Mental Health & Addiction Association of Oregon, and a representative from Recovery Works NW, right, make calls to find treatment options for a man sick from fentanyl, center, in downtown Portland, Ore. on Dec. 13, 2023. The work was part of a pilot program by Portland Police Bureau’s bike squad and addiction recovery providers that launched in December 2023.

The program will cost $683,000 during the first year, which will come from the city of Portland, Multnomah County and the state. The funding will cover a lease for office space at Mercy Corp, along with a vehicle and five staff members, including four outreach team members who work on the streets to directly connect with people who want to access treatment.

“Through this pilot program, [Mental Health & Addiction Association of Oregon] peer support outreach teams have been able to work collaboratively with law enforcement to connect individuals who are experiencing addiction and mental health issues to the available services they want and need,” Janie Gullickson, the nonprofit’s executive director, said in a statement. Gullickson said this could take the work to “the next level.”

Oregon lawmakers made sweeping changes to Measure 110 during their recent legislative session to add more funding for treatment while also re-criminalizing drugs. Gov. Tina Kotek signed House Bill 4002 this month, making drug possession a misdemeanor crime once more .

“This is a tangible result that has the potential to be a model for other regions,” Kotek said in a statement Wednesday.

OPB’s First Look newsletter

Oregon governor signs bill criminalizing drug possession

On Monday, Oregon Gov. Tina Kotek signed House Bill 4002, which both expands funding for substance abuse treatment and makes possessing small amounts of hard drugs a misdemeanor beginning Sept. 1.

Recovery houses in Oregon provide crucial transition in path toward drug-free life

Senate Bill 1530 would fund new recovery houses and expand those that exist, opening up another 500 to 600 beds for people throughout the state.

Oregon’s new drug penalties would mean surge in convictions, jail stints, state estimates suggest

State estimates show 1,333 people will be convicted of drug possession and 533 could go to jail every year under the bill approved by lawmakers last week.

Oregon’s drug decriminalization experiment appears dead

The voter-approved Measure 110 is nearing its end as the Legislature sends a bill unwinding Oregon's drug decriminalization toward the governor's desk.

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The journey from drug addiction to drug recovery; a case report of an inpatient rehabilitation

2022, Journal of the Pakistan Medical Association

Critics of forced drug treatment say it could lead to more fatal overdoses

Scott Simon

More people suffering from drug addiction are being forced into drug treatment and threatened with prison if they don't comply. Some say it's "tough love." Critics say it's unethical and ineffective.

SCOTT SIMON, HOST:

People with addiction are being forced into drug treatment programs more frequently across the country. Those who refuse are threatened with prison, the loss of welfare benefits or other penalties. Supporters say this tough-love approach may be necessary, but many doctors and addiction experts disagree and say it might lead to more fatal overdoses. NPR addiction correspondent Brian Mann joins us now. Brian, thanks for being with us.

BRIAN MANN, BYLINE: Hi there, Scott.

SIMON: Brian, how common has mandated addiction care become around the country?

MANN: They're really common. And it's noteworthy, Scott, that drug use is one of the few areas of American life where officials use this threat of criminal penalties and prison time to pressure people into accepting medical treatment against their will. With the threat of fentanyl, more states are embracing this idea. Just a few weeks ago, when lawmakers in Oregon were debating a measure to recriminalize hard drug use, this kind of mandated treatment was a cornerstone of the bill. Here's State Representative Kevin Mannix.

(SOUNDBITE OF ARCHIVED RECORDING)

KEVIN MANNIX: The central or core principle here was accountability combined with compassion.

MANN: And that measure passed on a bipartisan vote. California passed a similar law last year, making it a lot easier to detain people and force them into medical treatment for addiction. And voters in San Francisco just approved a measure that requires people on welfare to get drug treatment.

SIMON: What's the argument for forced treatment?

MANN: Well, really, since the 1970s, governments in many parts of the U.S. have used drug courts and other systems to pressure people to first get sober and then accept treatment. Because of fentanyl, as I mentioned, street drugs are more deadly, killing tens of thousands of people a year, so these policies are gaining momentum again. I spoke about this with Tom Wolf. He's a recovery activist in San Francisco, and he says this process, being arrested and threatened with punishment, saved his life.

TOM WOLF: It helped me kick the withdrawals from the heroin and the fentanyl that I had started to use as well. And then I was given an opportunity, a choice. I could continue to sit in jail at that point, or I could go to a rehab.

MANN: So these programs do help some people. Wolf's been in recovery for nearly six years.

SIMON: Brian, you also spoke with some addiction experts who were troubled by this approach. What did they say?

MANN: Well, really, most experts I spoke to, Scott - physicians and researchers - said linking health care and police and criminal punishments is ineffective and can actually scare people away from treatment. Morgan Godvin studies drug policy in Portland, Ore. She was addicted to heroin and says she and many of her friends were forced into these treatment programs. She says they were dehumanizing and dangerous.

MORGAN GODVIN: Psychologically, I associate treatment with handcuffs and strip searches. We were harmed by our contact with the criminal justice system.

MANN: And one of the big concerns here, Scott, that people raise is that people sent into these mandated treatment programs often relapse. They start using drugs again, then they wind up behind bars. And there's strong data showing those people sent to jail or prison are then far more likely to overdose and die when they're released. So experts say these tough-love laws are meant to be compassionate, but often have these really deadly unintended consequences.

SIMON: You also heard concerns, Brian, about medical ethics. What did people say about that?

MANN: Yeah, a lot of doctors I talked to say using police and threats of prison time to coerce people into medical care they don't want is just wrong. I spoke about this with Dr. Stephen Taylor with the American Society of Addiction Medicine.

STEPHEN TAYLOR: We want to help people who have addiction disorders, but we have to respect people's autonomy and their rights to accept treatment if they want to accept treatment.

MANN: And Taylor, who's Black, says this kind of coerced treatment is especially problematic for people of color.

SIMON: And why is that?

MANN: Well, Scott, studies show Black people, Native Americans and Hispanics are arrested far more often when they use drugs, and they're punished more severely. Researchers also say there's bias and stigma against people of color inside many of these addiction treatment programs that people are being forced into. One study published just last year in the New England Journal of Medicine found substantial racial and ethnic disparities. I spoke about this with Kassandra Frederique, who's also Black. She heads a group called the Drug Policy Alliance that opposes drug criminalization.

KASSANDRA FREDERIQUE: Oftentimes when people name the carrot and stick intervention, what they tend to miss is that some people get the stick more than others.

MANN: So again, the idea, the goal of these laws is compassion. But critics say the end result is often more people, especially people of color, winding up behind bars.

SIMON: I don't have to tell you, Brian, fentanyl is a real crisis that harms human lives. The critics of these mandatory treatment programs have other ideas.

MANN: Yeah, everyone I interviewed, Scott, agrees about one thing, that the U.S. needs a lot more drug treatment programs that are more widely available and affordable. People say if that system were in place, more people would enter treatment voluntarily. Right now, a lot of the states adopting these mandated treatment programs don't have enough capacity in their health care systems to treat the people being arrested. A lot of communities are ramping up their health care programs for addiction, but that process is going to take years.

SIMON: NPR's Brian Mann, thanks so much.

MANN: Thank you.

(SOUNDBITE OF MUSIC)

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

News | Gov. Newsom, the drug that kills most Americans…

News | Gov. Newsom, the drug that kills most Americans is on grocery store shelves

Column: inspiration for reshaping addiction treatment, from the experts.

Hey, Gov. Newsom. I’ve been in Dallas with some of the best addiction doctors and researchers in America these last few days. There’s so very much going on here – which we’ll expand on in coming weeks – but we implore you to keep these thoughts at the forefront as California embarks on its plan to spend $6.4 billion helping and housing homeless and mentally ill folks.

What kills most?

We can buy the drug that kills more Americans than any other at the grocery store. Legally. Every day of the week.

While overdose deaths from fentanyl and its sinister cousins have seized the spotlight for years — some 112,000 Americans died from drug overdoses in 2023 — alcohol-related diseases kill many, many more people — 178,000 Americans every year, according to the National Institute on Alcohol Abuse and Alcoholism.

In California, a record-breaking 11,000 people died of drug overdoses in 2022. But nearly twice that many — 19,335 — die from alcohol-related diseases every year in the Golden State, according to a recent number crunch by the California Department of Public Health.

There are medications that can help treat alcohol use disorder. They’re not fabulous, experts at the American Society of Addiction Medicine’s annual conference said, but they’re a tool in the toolbox that can help address the most widespread and pernicious addiction in America.

“Everything right now is opioids, and it’s great we’re trying to prevent overdoses, but alcohol is not gone. Alcohol causes more related deaths than opioid overdoses,” said Dr. Julio Meza, director of UCLA’s Addiction Medicine Fellowship, who we chatted with before the conference began.

“Before 2020, the main reasons for a liver transplant at UCLA were Hepatitis C, tumors and then alcohol. Now at UCLA, the main reason for a liver transplant is alcohol.”

General practitioners! Family doctors! Talk to your patients about their drinking. More addiction treatment from front-line physicians is critical.

As a founding partner of the PlumpJack Group, the wine, food and hospitality company that includes three Napa Valley wineries, we hope you’ll take this to heart, Gov. Newsom.

What is treatment?

Ask folks on the street what addiction treatment is and they’ll say “detox” or “AA.”

Detox is not treatment. Twelve-step programs like Alcoholics Anonymous are not treatment.

Detox is designed to remove drugs from the system — best done under the watchful eye of medical professionals, unlike how it’s often done in California, sometimes to tragic results. But that’s only the first tiny step. Research has found that some 90% of folks who detox from opioids use again within five days. Overdoses and death are too often the aftermath.

The link between Adverse Childhood Experiences (ACEs) and substance use (SAMHSA)

There are several excellent medications for opioid use disorder that dramatically reduce cravings and subsequent use. But in California, nearly half of treatment centers don’t use them, according to data from the Substance Abuse and Mental Health Services Administration. And only 1 in 5 people diagnosed with opioid use disorder take these medications.

That’s insane! Please fix this! Ensure that the folks we’re trying to help through Proposition 1 (and, really, everywhere else) have access to life-saving medications from the get-go, and for as long as they need them, which might be forever.

If you want to be cold about it, that could save money in the long run. A decade ago, about one of every nine acute care patients at UCSF were substance users, said Dr. Marlene Martín, associate professor of clinical medicine at UCSF. Today, that’s about one of every three.

And please, don’t mistake sobriety for recovery, the experts cautioned. While the peer support of AA and other 12-step programs can be absolutely essential, they are not in and of themselves recovery. Sobriety is a step on what’s often a life-long road. The 30-60-90-day treatment model so prevalent now — largely because that’s what insurance will pay for — has it all wrong.

Serious as a heart attack

We need to stop treating addiction like a heart attack and start treating it more like diabetes, the ASAM experts said.

“Addiction treatment is set up on an acute care model. It works really well for acute conditions, where you go for treatment and are ‘cured.’ This is what we’ve done in addiction for a long time,” Dr. Elizabeth M. Salisbury-Afshar of the University of Wisconsin, Madison School of Medicine and Public Health, told her colleagues.

But chronic conditions like diabetes — and addiction — are not cured in the ER. They require long-term management and, often, life-long medication.

“The way we determine success is by a urine test. Positive or negative. Acute care model. It doesn’t work for chronic conditions,” she said as her colleagues erupted in applause.

Insistence on abstinence

Folks who’ve had long-term success on methadone lose privileges, and have their medication reduced, if they raise a glass of chardonnay to toast a grandson’s graduation. This, too, is nuts.

Harm reduction efforts — clean needle exchanges, fentanyl test strip distribution, supervised consumption sites (a nicer way to say safe injection sites, which might be more palatable in a presidential campaign) – are often gateways to treatment, the experts said.

Substance Abuse and Mental Health Services Administration

But a punitive mindset – which sees users as criminals – dictates punishment rather than compassion. It’s important to remember that folks who turn to substances to cope have often endured terrible trauma – and the more trauma they endured as children, the more likely they are to use, SAMHSA has found.

Homeless people — the people Prop. 1 is supposed to help and house — have high rates of addiction, SAMHSA found.

This is where harm reduction comes in. “Meet them where they are, work like hell to get them somewhere better,” said Dr. Corey Waller, chief medical officer at BrightView Health.

One might argue that’s precisely what our present approach has done.

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From homeless addict to city chief: the unusual journey of Canadian mayor

D an Carter once was a drug addict living on the streets, but now runs a Canadian city and draws from his darkest times to tackle a housing crunch and an addiction crisis.

"I truly believe in my heart of hearts that everyone is worth saving," says the mayor of Oshawa, Ontario, admitting that in the past he himself consumed copious amounts of cocaine and alcohol.

"That's why it matters to me where we are today and the complexities of housing or homelessness, and addiction," he explains.

Carter, 64, was in 2018 elected mayor of this city of 189,000 residents near Toronto, as citizens and authorities began to take notice of soaring opioid overdoses and homelessness.

Today, Carter says, Canada has the "most serious health crisis" ever and is calling for a national state of emergency to focus on affordable housing and battling addiction.

In Oshawa alone, the number of homeless people jumped from 45 before the Covid-19 pandemic to more than 300 today -- a rise echoed across Canada.

"It's expensive (and) it's very hard to find a place you can rent around here," says Chris Harris, a homeless man whose partner died of an overdose.

Carter set up a first-of-its-kind regional reception center in Oshawa which offers meals and temporary accommodations but also medical and psychological care.

He also established a program to increase collaboration between first responders and social workers, and another aimed at collecting used syringes in parks and public spaces. Last year alone, Oshawa emergency services responded to more than 500 overdose calls.

All of these accomplishments were inspired by his own experiences.

"By the time I was 31, I was mentally, emotionally, physically, financially and spiritually broken," says the politician. "Addiction took me to every dark place you could possibly imagine."

- 'Sober up or die' -

Born in New Brunswick in eastern Canada, Carter experienced a difficult childhood marked by the death of his mother and brother, learning disabilities linked to his dyslexia and a sexual assault that he hid for a long time.

As a young adult, he spent a few days in prison for forging a check, an episode that still haunts him decades later.

"I have to travel to the United States regularly and I have to get clearance every single time... because I have a criminal record," he says.

Carter turned his life around in his early 30s thanks to his sister. "She said, 'You got two choices: you can either sober up or you can die today," he recalls.

After a detox treatment, the man whom everyone just calls Dan got back on his feet and by chance landed a job in television despite having "no formal education, no journalism degree and no skills or abilities" and "losing my hair."

His dyslexia continued to dog him, but his progress in reading and his "natural curiosity about people" allowed him to pursue a career in media for more than 20 years.

Grateful for all the help he received at that time, he in turn wants to extend his hand to those most in need.

"Dan is as frustrated as everybody else in that those solutions don't come quick enough," comments Nathan Gardner, director of the Back Door Mission shelter, who described the homeless population as facing "a lot of despair."

But Carter is not losing optimism. "We can do better than what we're doing today," he says.

gen/tib/amc/md

'I truly believe in my heart of hearts that everyone is worth saving,' says Oshawa mayor Dan Carter

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Gov. Newsom, the drug that kills most Americans is on grocery store
In California, a record-breaking 11,000 people died of drug overdoses in 2022. But nearly twice that many — 19,335 — die from alcohol-related diseases every year in the Golden State, according ...
Alcohol Addiction Dug Pipeline Research Report 2024
In the report, a detailed description of the drug is proffered including mechanism of action of the drug, clinical studies, NDA approvals (if any), and product development activities comprising ...
From homeless addict to city chief: the unusual journey of ...
From homeless addict to city chief: the unusual journey of Canadian mayor. Dan Carter once was a drug addict living on the streets, but now runs a Canadian city and draws from his darkest times to ...
Some hospitals are changing their response when babies are born ...
The Comprehensive Addiction and Recovery Act, known as CARA, removed the word "illegal" from the law in 2016 to mandate notification of authorities anytime a newborn is affected by "drugs ...