By Tom Horvath, PhD This weekend SMART Recovery is celebrating (a few months early) its 30th anniversary by holding a conference in Salt Lake City. What has SMART achieved? How well is it functioning? What might its future hold? What follows is my personal perspective on some highlights of SMART’s first 30 years (from someone who has been part of that process), and my hopes for the years ahead. Growth and influence The good news is that in 2018 SMART Recovery expanded into SMART Recovery International, which has a world-wide presence. The US based organization is now an affiliate of the intern ..read more

By Tom Horvath, PhD Stanton Peele suggested this idea in one of his recent blogs. As we await Super Bowl Sunday (2/11/24) the question seems worth re-visiting. It would require a careful analysis of outcomes from pro football and substance use to provide an accurate comparison. The data about substance problems is easy to find. Pro football’s data is harder to find, but generally we know that playing football can result in concussions, broken bones, chronic traumatic encephalopathy (CTE), and other injuries. For further details search for the NFL concussion settlement. However, it seems unlike ..read more

By John de Miranda Innovation does not come quickly or easily to the addiction treatment sector. For example, harm reduction strategies had been employed in the public health sector for decades before their recent adoption by the federal government as a latecomer to fighting our nation’s opioid epidemic. Similarly, the Minnesota Model of addiction treatment, which emerged in the 1950s, still accounts for the model preferred by the majority of treatment programs. At its core, this approach draws heavily from 12-step ideology and requires a commitment to abstinence as the key focus of treatment ..read more

By Kenneth Anderson, MA The history of alcohol treatment since the 1960s has been a history of practitioners ignoring science and the scientific method and forming conclusions based on observations of clinical populations without testing hypotheses, then self-publishing these hypotheses or publishing them in the popular press rather than in peer-reviewed scientific journals. Some of the most notorious examples of this are Hazelden and the Johnson Institute, which will be discussed in later blog posts. Another notorious example is Lakeside Milam, founded by James Robert Milam (Mar 3, 1922 - May ..read more

By Tom Horvath, PhD How well can I calm myself or energize myself using my own abilities? How much do I need to use a substance for help? Although at times a mild sedative (one drink) or mild stimulant (a cup of coffee) can be a helpful tool, the more we rely on such tools the more our internal abilities diminish (atrophy). Daily low doses of sedatives or stimulants can be helpful. As the doses get higher, problems can emerge. In cases of substantial addictive problems, it is common to see someone bouncing between “downers” and “uppers,” sometimes even multiple times per day. At that level of ..read more

By Kenneth Anderson, MA The Wegscheider-Cruse Family Roles Theory is one example of how “chemical dependency” treatment does not have the firm scientific foundation that it is suggested to have. Despite this lack of foundation, to become a certified addiction counselor today one must study Wegscheider-Cruse's theory. Below I present the history of the development of this theory, and some of the specific problems with it. Sharon Wegscheider-Cruse Behind the Wegscheider-Cruse Family Roles Theory was Sharon Wegscheider-Cruse (Nov 16, 1938 - living), born Sharon Rae Roelandt in Jasper, Minnesota ..read more

By Tom Horvath, PhD Although you can embark on a new habit at any time of year, the New Year remains a popular starting time! Here are some suggestions on how to maximize your project. Decide whether to start small or start “big.” Even though your end point may evolve over time, decide at the beginning what your endpoint is (and write it down). If you start small, build over time. What is the smallest step you are confident you can consistently take? Then wait until that pattern is well established and add another step. This approach may be more realistic and comfortable than starting big. If ..read more

By Tom Horvath, PhD This month the Substance Abuse and Mental Health Services Administration (SAMHSA) of the federal government released a 15-page document entitled Advisory: Low Barrier Models of Care for Substance Use Disorders. The document summarizes the difficulties associated with reaching and providing care for individuals with substance use disorders. Less than 10% of individuals who might benefit from treatment participate in it. A “low barrier” approach to treatment attempts to reduce the difficulties that might reduce treatment attendance. Although not primarily intended as a list o ..read more

By Tom Horvath, PhD The Thanksgiving dinner table will provide many opportunities for conversation, and perhaps nearly as many opportunities for disagreements and fights. That level of tension can easily motivate us to overuse substances! Let’s look at some ways to prevent the tension from getting that high. Tips for Listening at Thanksgiving Is it essential that you provide your opinion? If you are talking with someone whose opinion (based on your experience with them) is unlikely to be open to examination, stating your different opinion will likely not lead to a meaningful conversation, and ..read more

Kenneth Anderson, M.A. First, it is important to define our terms. A stimulant is a drug which raises levels of physiological or nervous activity. A depressant is the opposite of a stimulant, i.e., a depressant is a drug which lowers levels of physiological or nervous activity. A depressant is not a drug which causes depressed mood; the correct term for a drug which causes depressed mood is a depressogen. A depressogen is the opposite of an antidepressant, just as a depressant is the opposite of a stimulant. Although alcohol can act as a depressogen and cause depression in some people, alcohol ..read more