Choices in self-help for substance use disorders

(Author’s note: This post follows from the earlier post on new findings about addiction. I had originally added this as a comment to further discuss alternatives to AA and other 12-step approaches. I have moved that comment into this separate post.)

S.M.A.R.T. Recovery (Self-Management and Recovery Training) was started by a group of mental health professionals who were formerly part of Rational Recovery (RR), a non-12-step abstinence based support and self-help organization based upon Albert Ellis’s Rational-Emotive Behavior Therapy (REBT).

RR and SOS (Secular Organizations for Sobriety / Save Our Selves) were the first mutual help organizations to offer alternatives to the dominant AA/12-step approach, at a time when choice was needed. Both groups raised concerns about the legal and ethical issues involved in mandating people into a program that many felt to be religious in nature.Continue Reading Choices in self-help for substance use disorders

New research reports on addiction

The latest issue of the journal Neuron is devoted to research on addiction and how it operates in (and affects) the human brain. This is important research, and the publishers have made this entire issue accessible at no charge to the public. One of the main take-aways is the idea that addiction is not so much as disease as a “hijacking” of the brain systems that ordinarily serve to help us survive and be healthy. The substances themselves produce changes in the functioning of the brain at the cellular level, and those changes unfortunately create a vicious cycle of use, abuse, and withdrawal. They also impair the very processes that ordinarily help people avoid trouble and think their way out of danger. “Executive functioning” is the term loosely used to describe our ability to plan ahead and choose things that may be less pleasurable in the short term but ultimately better for us in the long run. Addictive substances (and perhaps even process addictions) may impair our very ability to think clearly and plan ahead. I’ve certainly never agreed with the old AA chestnut that says, “Your best thinking got you here.” Actually, I’ve always thought it was the opposite – not being able to use your best thinking is what can get you there. (Even in the case of Charlie Sheen!)Continue Reading New research reports on addiction