Category Archives: Addiction

How Does Social Media Influence Drug Use?

Social media plays an ever-growing role in our lives on a daily basis. For many of us, we use social media every day, but understand very little of how it affects us.

Social media and drug use are closely related issues for teenagers. This is because substances and social media affect the brain in similar ways. They can both cause of release of high levels of dopamine which can lead to produce addictive behaviors.

Social media has a huge impact on how we interpret others, ourselves, and the world around us. For this article, we are going to focus on social media’s relationship with dopamine and the brain’s reward system.

What is Dopamine?

Dopamine is a neurotransmitter that can be released in the brain and is commonly associated with pleasure, satisfaction, enjoyment, and reward. This system is in place to reward us when we take positive healthy actions in order to ensure we keep taking those actions, and it’s also one of the primary ways that drug use affects the teen brain.

Drug Use and Social Media

The greater the reward, the greater the chance we become addicted. For most of human history, this risk has been mitigated by the fact that high-reward activities took hard work and long periods of time to achieve.

In today’s world of fast food, door dash, and internet food channels, we can access more food in an hour than our ancestors could access in a lifetime. The same is true for most other resources, and social media provides a convenient shortcut to receiving that reward.

Unearned Highs

As we discussed above, our brain’s reward system is in place to motivate us to take healthy actions. We have two routes to achieving these rewards;

We can earn these highs through action and actually putting in the work required, or
We can cheat the system and trick our brain into experiencing unearned highs.

For as long as the brain’s reward systems have been in place, humans have been finding ways to cheat the system, so to speak. Lying, stealing, cheating, fantasy, overconsumption, and manipulation are just a few of the tools we can use to try to cheat the system and experience rewards we did not earn.

The big tradeoff to our mental health becomes short-term pleasure for long-term pain (unearned highs), or short-term pain for long-term pleasure (earned highs).

Social media platforms play into this balance by offering an endless source of unearned highs, capable of tricking the brain into more dopamine “hits” than would normally be possible.

The Disadvantages

Through the internet and social media, people now have access to more information in an hour than what was available in a lifetime for previous generations.

There are many obvious advantages to this, but there are also some serious disadvantages. Social media plays a large part in a bigger cultural dilemma today which is dopamine saturation and immediate gratification by:

Using likes, subscribes, comments, and many other measures of approval to feed our desire for attention and human connection. Each “like” gives us a little hit of dopamine, each subscriber gives us a little more.
On top of that, we can live vicariously through others and get a taste of what it’s like to climb Mount Everest, be a millionaire, and get the love interest of our dreams all in a 15-minute window.

It’s no wonder so many people are glued to their phones. There are very few things in life that can provide that many quick fixes in short succession.

Dopamine: Social Media and Drug Use

This is where the connection between drug use and social media comes into play. In a world where quick fixes drive our daily lives and drugs are more available than ever before, the quick fix of drugs isn’t a huge jump from all the other quick fixes we access daily. The most common drugs used by teens all operate the same way on the brain.

Drugs affect the brain in the same way social media does, tricking our brains into huge releases of dopamine. Obviously, drugs are much more detrimental, but the payout is also significantly higher.

Effect of Social Media on Recovery

The connection that we consistently see at The Pathway Program between social media and substance use disorders is that both feed into the negative cycle of addiction in the brain, giving us quick fixes and demanding more and more as time goes on.

It is very common to see a person in recovery completely addicted to popular social media. Many of the teens and young adults we work with, come into addiction treatment with a drug abuse problem; along with an unhealthy obsession with social media.

In recovery, the young people who continue to feed into social media addiction are rarely capable of long-term recovery. The addictive cycle demands more reward, and always leads to relapse, if not broken.

What’s the Solution?

So, how does social media influence drug use? They both involve seeking unearned highs, which is a behavior that only results in further addictive behavior and mental health problems.

The solution for both issues involves finding ways to achieve self-worth, approval, positive relationships with friends and families, and positive experiences through earned highs, and to limit the negative behavior patterns of addiction and rush-seeking behavior.

Top 5 Most Common Drugs Used by Teens: Real world data

By Cassidy Culley on May 25th, 2023 in Addiction, Adolescent and Young Adult Substance Use

As a substance abuse treatment program specializing in working with teens and young adults who struggle with substance use disorders, we are often asked questions about commonly used drugs. Though the data is clear that marijuana is the number one drug used by teens, in this article we’ll discuss the other most popular drugs that teens are using.

The data used in this article was gathered from 281 drug treatment charts between 2020 and 2022 that outline the top five drugs used by teens, and make observations regarding the data that will help with understanding these trends.

Out of the 281 charts from young people admitted into our Arizona Substance Abuse Program, we found that the top 5 drugs that were used overall between 2020-2022 were:

Cannabis – 100%
Alcohol – 90%
LSD – 63%
Xanax – 59%
Cocaine – 44%

Many of the young people were also using other drugs among these top five, but these were the most common.

What are the Top 5 Drugs Used by Teens

Below is a graph of the top 5 drugs that were commonly used by teens. Among the top five were some unsurprising results, but there were also some unexpected appearances mixed in with the usual suspects.

#1: Cannabis

Cannabis ranks as the number one drug used by teens. Out of the 281 people admitted into the program, 100% of the teens we worked with used cannabis.

Though the number isn’t a surprise, we found it interesting that the number was a clean 100%. Additionally, almost every teen we worked with (74%) used cannabis first before they tried any other drugs.

This makes sense as most of the teens we work with report that cannabis is easier for them to obtain than alcohol, and the perception of risk for cannabis use has dropped significantly among teenagers.

#2: Alcohol

Alcohol is the second most widely used substance among teens and young adults. Between 2020 and 2022, 90% of teens admitted into the program were using alcohol.

We also noticed a drop in alcohol use year-to-year. In 2020, 92% of young people admitted were using alcohol; compared to 85% in 2022.

As a substance abuse counselor, I have made a few thoughts as to why this may have occurred:

As more teens label THC as their drug of choice, fewer people have claimed alcohol to be.
As Cannabis becomes more accessible and more potent, decreases in other substances such as alcohol occur, as those substances are less accessible, despite the potency of other substances.

#3: LSD

The third most common drug used by teens currently is LSD, edging out Xanax as the teens’ most preferred drug aside from alcohol and THC.

Over the past few years, we’ve seen teens’ interest in hallucinogens rise; the most common hallucinogen used by teens currently is LSD.

LSD is a hallucinogenic drug that comes in the form of paper tabs, gels, or liquids and has major effects on the function of the teen brain. LSD was one of the most widely used substances in the 60’s and 70’s, as a result of the counterculture hippie movement.

#4: Xanax

Benzodiazepines are a type of prescription drug and the most common of these is Xanax. Xanax is a depressant that suppresses central nervous system activity and helps users to calm down. Individuals who abuse Xanax will often feel a high similar to being drunk.

Between 2020 and 2022, 59% of teens we worked with had used Xanax.

We did note that Xanax abuse dropped from 2020-2022 by 9%.

In our experience, out of all the top five drugs used by teens, Xanax is most widely paired with cannabis. However, it is commonly also paired with Alcohol, a particularly dangerous combination that is infamous for leading to overdoses.

Also, it is important to note that the withdrawal from Xanax is also very similar to the withdrawal from alcohol. It is one of the only drugs of abuse that can lead to seizures and death upon withdrawal.

#5: Cocaine

One drug that has made a comeback in recent years is cocaine. According to our data, cocaine use amongst teens and young adults ranks fifth on the list with 43% having used cocaine.

Teenagers are drawn to cocaine’s ability to provide a euphoric high and increase energy and confidence. Its popularity among this age group is a cause for concern due to its addictive nature and detrimental effects on physical and mental health.

Teen drug abuse overview

The top five commonly used illegal drugs among teenage and young adult populations include marijuana, alcohol, LSD, Xanax, and cocaine.

Runner-ups included cough syrups, synthetic marijuana, psylocybin (mushrooms), and the ever-popular stimulant adderall.

We will continue to update this post year-to-year as new data becomes available to us.

Real World Data: What is the Number One Drug Used By Teens?

By Cassidy Culley on April 21st, 2023 in Addiction, Adolescent and Young Adult Substance Use, Marijuana

As substance abuse counselors who specialize in working with teens, we get a lot of questions about trends in teen drug use. In this article, we’ll dive into the actual drugs that teens are using based on data we have gathered from 281 patient charts between 2020 and 2022.

We gathered data from all the charts from our Arizona substance abuse program over the last three years (2020-2022), representing 281 individuals who have received substance abuse treatment in our program. We found that the number one drug used by teens is marijuana. Most of these young people were also using other drugs at the time of admission, but not all.

So, what is the number one drug used by teens?

Below, is a chart of the top 5 drugs used by teens. Among the top drugs are some of the usual suspects, marijuana, alcohol, xanax, etc. However, we found that 100% of the young people we worked with were using marijuana:

Most common drugs used by teens between 2020 and 2022:

Substance	2020	2021	2022	Average
Marijuana	100%	100%	100%	100%
Alcohol	92%	93%	83%	90%
LSD	64%	65%	57%	63%
Xanax	63%	58%	54%	59%
Cocaine	44%	45%	38%	43%

Shown another way:

What drugs cause the most problems (substance use disorders) for teens?

Astute readers may observe that the number of teens who have used marijuana being 100% doesn’t necessarily mean that 100% of the young people in our program had a specific problem with marijuana. We felt the same way, so we took a look at the specific substance use disorders treated.

We took a secondary look at the charts from our California substance abuse program to determine what percentage of each drug was responsible for specific substance use disorder diagnoses, and here’s what we found:

Top substance use disorders in teens between 2020 and 2022:

Substance Use Disorder	Percentage
Cannabis	100%
Alcohol	65%
Cocaine	16%
Benzodiazepines	16%
DXM	9%

Note that many of the individuals were admitted for more than one substance use disorder. Only 14% of the individuals were treated for cannabis use alone.

In graphic form:

At least in the case of our programs, it appears conclusive that marijuana is the top drug of choice among young people, and it’s also the drug that is responsible for the most substance use disorders, by a long shot.

Alcohol came in second, and we noted that 58% of the young people we treated had both a cannabis use disorder AND an alcohol use disorder.

Though other illicit substances, like prescription pain medications and opiates, are responsible for many of the tragic deaths, their frequency of use didn’t even crack the top five!

The top prescription drug used was benzodiazepines (most frequently Xanax).

What drugs do teens try first?

While the data above seems to be painting a picture, we also gathered the data from our California program on which drugs the teens used first. Taken from the same data set:

Drugs that teens tried first:

	Percentage
Cannabis Alone	37%
Cannabis & Alcohol	35%
Alcohol Alone	26%
All Other Illicit Drugs	0%

The most common answer to the question was cannabis (37%), followed by alcohol and cannabis (35%). Not a single drug other than cannabis or alcohol was mentioned as a “first drug” by any young person entering our program.

Though the “gateway effect” of marijuana is under constant debate, it seems clear at least that marijuana is the drug that teens most commonly try first.

What about alcohol?

In years past, it wasn’t uncommon for every young person we met to be using alcohol as well as marijuana.

In recent years, this number has declined. Most notably, the number of teens who used alcohol between 2021 and 2022 dropped from 93% to 83%.

In future updates of this article, we will continue to monitor this number to see if the trend continues.

Potential limitations of the data

One thing we want to acknowledge is that this data was collected from young people who entered our substance abuse program. It is, of course, possible that the data would be different if we looked at data for teens who did not require a drug abuse program, then the numbers could look different.

Why is Marijuana so Prevalent Among Teens?

There are several factors that make Marijuana so popular among adolescents, but there are 3 main reasons that stick out among the others:

1. The Perception of Marijuana

The most recent Arizona Youth Survey (2022) data points out that around 49.1% of students between grades 8-12 do not believe that smoking marijuana regularly poses a significant risk.

Marijuana is one of those substances that are often perceived as harmless, and according to an article by the NY Post, about 57% of Americans believe that Marijuana is harmless. Pro-marijuana messaging is everywhere. It can be seen on billboards, on our favorite shows, glorified in music, and it’s all over popular media.

Society, social media, and the Marijuana industry are asserting that marijuana use is safe.

2. Accessibility

Marijuana has become one of the most accessible substances on the market for teens since the rise in concentrated or synthetic marijuana also known as wax pens, carts, and THC vapes.

The legalization of recreational marijuana in many states has caused a rise in accessibility, and teens may find it easier to purchase than alcohol. However, even in states where marijuana is still illegal, teenagers can purchase it through their friends, dealers, and even through social media.

The rise of online sales has also opened up avenues for teens to purchase through social media, without much difficulty. With its social acceptance and easy accessibility, it is concerning how easily teens can obtain marijuana without any safety measures in place and the effect that it may be having on teen drug abuse.

3. Peer Pressure

Peer pressure is one of the biggest factors that contribute to the popularity of drug and alcohol use among teens and young adults. Many young people feel the need to fit in with their peers and may use THC or other illicit substances as a way to do so. Being part of a group that abuses drugs, especially marijuana can give teens a sense of belonging and can help them to feel accepted.

This kind of pressure can also be harmful, as it can lead to drug use becoming a regular part of their lives, even if they know it is not good for them.

Summary

Our data shows that marijuana is the most commonly used drug among teenagers in the United States. The prevalence of marijuana use among teenagers has been on the rise in recent years.

It is important to address substance use among teens through education, prevention, and early intervention programs. Parents, educators, and healthcare providers play key roles in helping teens make informed decisions about drug use and seeking treatment if necessary.

9 Benefits of Residential Substance Abuse Treatment

By Jeremy Wachter, ICADC on July 1st, 2022 in Addiction, Alcoholism

Though other levels of care have their benefits, there are distinct advantages to residential substance abuse treatment when a client’s substance abuse problem is severe enough.

Residential substance abuse treatment provides the distinct advantage of being a much more closely monitored around-the-clock substance abuse treatment solution. Residential substance abuse treatment program benefits include more counseling hours, more 12-step meetings, and more accountability. Residential treatment also offers substance users the chance to attain sobriety in a safe, sober environment where they are free to focus solely on recovery, with very few distractions.

Residential treatment is particularly appropriate for those who have shown that they have a tough time staying sober in their home environment, or those whose substance use disorder or post-acute withdrawal symptoms are severe enough to warrant around-the-clock supervision.

1. The Residential Treatment Environment is Safe and Monitored

It’s not uncommon for drug and alcohol users to be approached by using peers in early recovery, or to discover a secret stash they had forgotten about while in a blackout. Additionally, family dynamics in early recovery can present many challenges before either side has had much of a chance to sort out their resentments, guilt, and fears individually. The early recovery process is a major life transition, and it’s not easy.

Residential treatment programs offer the benefit of 24-hour monitoring by trained staff, technicians, or counselors. Additionally, they are surrounded by peers whose goals are the same – to sober up. 24 hours a day, there will be someone who is capable of providing love, support, and objective feedback on a client’s struggles and progress. Family relationships improve as loved ones receive counseling, and self-esteem improves as the resident gains more confidence and time sober.

2. Residential treatment provides a distraction-free environment

Aside from the obvious live-in element of residential substance abuse rehabilitation programs, most require residents to give up electronics capable of outside communication, such as texting, social media, and phone calls. Residents are usually allowed communication with family members, supportive loved ones, and peers in recovery (such as 12-step sponsors), but that’s about it.

Some of the most common risk factors for relapse are contact with using peers, exposure to pro-drug social media communities, and even pro-drug music or movies. For a time, residential treatment centers completely eliminates these potential triggers.

Though this can be a big hurdle for some individuals who enter residential treatment, it provides a few unique benefits:

It allows residents to have some objectivity as they sort through which peers in their lives are helpful, and which ones are not.
It allows residents to make progress in treatment without undoing their treatment progress in the evening times.
It helps residents determine whether they are truly committed to the recovery process before they enter treatment.

3. Residential treatment provides appropriate separation of family members

We often observe in our substance abuse treatment programs that family members and substance users are usually at odds with each other when the treatment process begins. Though the substance user is usually the one that family members initially feel is “the problem,” family members are often surprised after a few weeks when they discover that they have fears, guilt, and resentments of their own.

Residential treatment programs allow for substance users to focus on recovery and mental health issues in an environment away from their family members, while family members seek counseling or support for issues they discover they have.

This allows the family to come back together in a cohesive way as the treatment program progresses. When the newly recovered substance user returns home and begins their IOP or PHP program, the entire family finds they have tools to respond to the new dynamics in the family.

4. Residential treatment programs provide a singular focus on recovery

Participants in outpatient or intensive outpatient treatment programs are in a unique position. They must learn to manage early recovery while also juggling family relationships, home environments, and resisting the classic temptations associated with early recovery. If the individual is also juggling work or school, then a number of other layers are present, each with their own unique temptations.

For some individuals, this is simply too much to deal with.

A benefit of residential substance abuse programs is that they eliminate the need to focus on anything other than just sobering up. Meals are provided, transportation is provided, and events are planned out. For 30, 60, or even 90 days in some cases, clients’ sole focus is to process emotions, learn the basics of the 12 steps, and develop strong bonds with peers in recovery. These early days in residential treatment often prove invaluable.

5. Community and positive peer relationships are formed in residential treatment centers

We know that connection to a community of positive peers is one of the most important factors in recovery. This is one of the fundamental principles behind programs like Alcoholics Anonymous or Celebrate Recovery.

We also know that one of the most common ways to derail a newcomer’s recovery is through regular contact with negative using peers (or sometimes well-intentioned peers who don’t understand recovery).

Is it necessary to only spend time with peers in recovery forever? Of course not – but in the beginning it’s extremely valuable. Residential drug addiction treatment approaches allow for a period of time in the newcomer’s life where all of their social interactions and emotional support come from peers in recovery who understand what they’re going through.

6. Residential treatment centers offer more counseling and more meetings

When comparing levels of care in drug treatment, it’s immediately apparent that residential and inpatient rehab options have the advantage of a much higher intensity of counseling and 12-step support than outpatient or even partial hospitalization programs. Residents often receive up to 6 hours per day of counseling or therapy, in addition to daily 12-step meetings, process groups, and more.

7. Self-sabotage is much tougher in a residential treatment environment

Substance users are masters of self-sabotage, and this often takes the form of “undoing” their progress in treatment as the process unfolds. Recovering from drug or alcohol addiction is a massive step, and there are many uncomfortable challenges along the way. Substance users will often have an important breakthrough in a treatment session, only to drive by their dealer’s house on the way home or pick a fight with a family member later that evening.

Newly sober substance users also are often faced with challenges such as driving by an old liquor store or ex’s house on the way to and from work, IOP, or school day after day.

Residential substance abuse treatment eliminates all those variables for a while, which makes self-sabotage much harder. This allows residential clients to make progress more quickly in the early stages of their recovery.

8. Residential treatment programs provide thorough aftercare planning and goal setting

It’s important to remember that residential substance abuse treatment is just the beginning – it can take anywhere from 18-24 months for newly sober individuals to fully integrate into their new life as a sober individual. This process involves patience, diligence, and many ups and downs.

Residential programs will all have some sort of “hand off” process into the next phase of recovery. Typically, this involves some sort of IOP program, but will sometimes include a PHP program as well. Ideally, every program would culminate with a thorough Aftercare plan that involves check-ins with counseling staff and sober peers, 12-step meetings, and social activities.

Residential programs allow newly sober individuals the space and time to think through every step of this process, including developing specific plans and tools to respond to situations that arise at work, school, home, social time, and time spent alone.

9. Residential substance abuse treatment is a great beginning to the recovery journey

As stated above, residential programs represent a beginning. They are a chance for substance abusers to begin recovery in a safe, sober, and supportive environment. However, it’s important to remember that recovery is an ongoing process and that a robust Aftercare program is of critical importance.

If you or a loved one has been struggling with addiction or substance abuse problems alone, please reach out to a professional. We’d be more than happy to answer any questions you have and help you develop a plan to start your recovery journey today!

Inpatient vs Outpatient Rehab: Which to Choose?

By Bob Hicks, CRADC, CRPS on June 29th, 2022 in Addiction, Alcoholism, Family Support for Addiction

Realizing that ourselves or a family member has a substance use disorder is a big step – and many times comes as a shock. The next logical question we ask is: what should we do about it? Whether you’ve already discussed your options with a professional done some research on the topic, you may have heard the terms inpatient treatment and intensive outpatient rehab pop up more than a few times.

Inpatient rehab is done in a live-in environment, where treatment groups, social activities, and 12 step meetings are closely monitored. This level of care is more appropriate for those who have found it extremely difficult to stay sober in their typical home environment. Outpatient rehab is generally done in the evenings or afternoons, where participants are free to go home and are encouraged to seek their own outside 12-step meetings. It is also often recommended for those who have been through an inpatient or residential treatment program but are looking for a bridge into their long-term recovery process.

Though there isn’t a one size fits all answer to this question, we hope to offer some helpful guidance on this topic to maximize your chances of success.

Differences between outpatient vs inpatient rehab

We often receive questions from parents and family members about what level of care is right for an individual with a substance use disorder (SUD) or potential SUD. This can be an extremely complicated decision for family members to make, and advice on the topic can often be conflicting. Below we have highlighted some average features and benefits of each type of substance use treatment:

Outpatient Substance Use Treatment	Inpatient Substance Use Treatment
6-12 weeks, on average	30-45 days, on average (some programs are up to 90 days in length)
9-15 hours or therapy per week, on average, split over 3-4 treatment days	6-8 hours of therapy per day, on average
Participants must seek their own outside 12-step meetings	6-7 in-house 12 step meetings per week, on average
Participants must provide their own transportation	Transportation to and from outside activities is provided
Participants live at home	Participants live in the treatment center
Typically followed with 6-12 week aftercare programs	Typically followed by PHP or IOP programs

The main difference between any form of outpatient or inpatient program is where the client lives while attending treatment. The other difference between these types of treatment is intensity and time spent in treatment on a weekly basis.

Keep in mind that these are averages. Individual programs can vary wildly on features, goals, and length of stay. For example, a standard outpatient will meet 1-3 days a week for 1-3 hours per session. So, it is possible that one program may only meet for 1 hour once a week, while another meets for 3 hours 3 times a week, and both are referred to as outpatient programs. Obviously, the intensity of these two programs would be vastly different, so it’s important to research each program’s treatment schedules.

When to choose Intensive Outpatient (IOP) Rehab

This is a common starting point for an individual who presents with a substance use disorder but has maintained some level of functionality in their life. It can also be appropriate for individuals who have obligations to meet and cannot afford to take time off.

Intensive Outpatient treatment is most appropriate for individuals who:

Are not demonstrating life-threatening withdrawal symptoms
Do not present with medical or psychiatric symptoms that warrant hospitalization
Are capable of staying sober without being removed from their home environment
Need help learning to stay sober in their home environment
Have demonstrated a willingness to try to stay sober and seek 12-step support outside of the treatment environment

This can be confusing for some families, as they may think that starting with the most intensive option will increase the chances of long-term success. The reasoning behind this comes down to the most crucial elements of successful treatment, client willingness and personal “ownership” over treatment.

The “best” treatment in the world will not work for someone who isn’t committed to their own recovery, and the “worst” treatment will do wonders for someone who genuinely wants to change.

We have seen countless examples of parents who catch a family member using and immediately send them to a residential program, only to have the child return home and repeat the same behaviors. After working with these families later in their recovery journey, it became clear that the individual went through inpatient treatment without fully identifying their problem.

In other words, they thought their problem was that their family members overreacted rather than identifying their own substance use as the problem. They may learn a lot of valuable information in residential treatment, but they lacked internal understanding of why they were there in the first place.

It is for this reason that even if residential treatment or inpatient is available or seems appropriate, when safe, it can be beneficial to start treatment at an outpatient level and then move to a higher level of care if necessary. If utilized correctly, this method allows a individual to begin treatment at a less intensive level, with the knowledge that if they struggle to make progress in treatment or maintain sobriety, they will need to attend a higher level of care.

If the person does not wish to leave home, miss work / school, or miss any other commitments, then those things will serve as motivation to complete treatment goals and maintain sobriety. If the participant can make progress in IOP with these motivating factors, it’s a win-win.

The individual can begin their recovery journey and move towards a healthier lifestyle while avoiding having to put life on hold while in residential. It also allows families to retain financial resources which keeps options open if further treatment becomes necessary in the future.

If, on the other hand, it becomes clear that the person does need a higher level of care, the time spent in IOP should help provide the person with a sense of ownership and willingness. The person will be going to residential with the knowledge that they are going not because their parents caught them, but because they failed to make progress in their IOP program. This gives their counselors a solid place to start when working through issues with patients.

Intensive outpatient treatment also allows the individual and their family to begin utilizing recovery tools in the home setting, which is necessary for long term success. This often overlooked portion of the early recovery process is important, regardless of their level of care.

When to choose Residential Treatment or Outpatient Rehab

Obviously, there is no cookie cutter formula for treatment, and some individuals with SUD’s need inpatient treatment immediately. Because the individual lives in the treatment center, inpatient treatment has the benefit of providing an optimal environment for individuals to focus on their recovery without the distractions of daily life.

Inpatient rehab is most appropriate for individuals who:

Are using more dangerous drugs such as strong opiates or benzodiazepines regularly. (A daily opiate user has a significant chance of overdosing during a relapse, so placing them in a residential may be necessary for safety)
Do not have a home environment is not conducive to recovery.
Have a history of relapse or haven’t had success in IOP programs in the past.
Need around the clock accountability for their whereabouts in order to avoid relapse during the first phase of early recovery.

If their ease of access to drugs and alcohol is too high in the home environment, it can be very necessary to leave the home environment entirely in order to avoid relapse. These situations are often volatile, and require case-by-case planning to ensure the individual has a safe and sober place to live once they leave the relatively safe inpatient environment.

Other factors may include the participant’s willingness to attend treatment, physical access to treatment, or history of defiant behavior (such as running away or violence).

One element of particular importance is that we do not recommend looking at inpatient and outpatient treatment as an either / or choice. Inpatient treatment allows an individual to focus entirely on recovery for a while – extremely useful for those who need it. However, these individuals will often face unexpected challenges once they leave the treatment environment.

It is still important to continue the treatment journey after leaving inpatient rehab. This is often in the form an IOP or PHP (partial hospitalization) program.

Necessary Factors for Successful Treatment

Regardless of the level of care you choose, there are number of elements to seek out in treatment options. For treatment plans to be successful, there are a few requirements, which are as follows.

The counseling programs, therapists, family members, and affected individuals should have consistent and effective communication. This can be a major hurdle for an early recovery journey. If someone is referred to residential for a higher level of care, or referred to an IOP for aftercare, communication between programs and families is essential. Without it, the transition between programs can be disorganized and ineffective.

It is important for the goals of treatment to remain consistent between programs, and this cannot happen without communication. When possible, it is preferable to keep treatment philosophies similar between programs. For example, if an inpatient program uses a 12-step or alternative peer group model, then the follow-up IOP program should also utilize a 12-step or alternative peer group model.

In conclusion

As stated before, there is no perfect answer to which level of care you should choose. If you’re currently weighing the options on outpatient rehab vs inpatient drug rehab, we recommend that you discuss your concerns and weigh your options with a medical provider or therapist in your area.

Those trained in responding to addiction will help you choose the best option for your individual situation. If you are anywhere near the Phoenix or Sacramento areas, give us a call. We would be happy to set up a no cost evaluation with you and your family member in order to help determine a course of action and begin your family’s path to recovery.

Young Adult Rehab vs Traditional Drug Treatment

By Jeremy Wachter, ICADC on March 25th, 2022 in Addiction, Adolescent and Young Adult Substance Use

Why Young Adults Need Age Specific Substance Abuse Treatment

The young adult, or 18-25 year old, is often forgotten in the greater drug / alcohol treatment world. They aren’t teenagers, they have some freedom, and society expects them to act like adults. However, they aren’t truly adults yet, either.

Parents and young people alike often report attempt after attempt at sobriety or treatment. Upon further investigation, we often find that these individuals have been in and out of adult treatment centers. Sometimes these programs work well for young adults, but more often than not they fall flat. While we do not wish to disparage adult treatment programs, they don’t tend to meet the 18-25 year-old’s needs very well.

Why is this? We hope to examine the reasons in this post, as well as offer a few viable solutions for parents, young adults, or mental health professionals seeking guidance on working with college-age individuals in a rehab or treatment setting.

Young Adults vs Adults in a Rehab Setting

Much has been written and said about the adult alcoholic or drug addict. For obvious reasons, the treatment and recovery world is designed around the older adult alcoholic. This typically refers to a 45-55 year old individual who has experienced serious consequences – divorces, DUI’s, legal battles, with serious career-related implications.

These individuals may enter treatment on their own or at the behest of a loved one, but they are almost always seeking to alleviate consequences. The classic 30-45 day rehab program is very much designed to serve this type of individual, and the “young adult”, or college-age drug user is often lumped into this group.

It’s important to understand that young adults aren’t in treatment for the same reasons as an adult. They haven’t endured 15-20 years of hard drinking, they haven’t lost businesses, they haven’t been through divorces. They aren’t “fed up” with getting high, even if their lives have been miserable for a few years.

These individuals are over 18, but they haven’t totally started their lives yet. Their brains aren’t fully developed, they are almost always single, and in many ways they think and act like adolescents (more on that later). Their experience is somewhere in between the adolescent and the adult.

They’ve often lived on their own, had jobs, or rented apartments. They may have owned (or wrecked) a car or three. They may have even experienced consequences, such as a DUI, a serious breakup, or expulsion from a college or university program. In many ways their “drug using careers” are just getting started.

Rehab for Young Adults vs Teens

Similarly, much has been written and talked about where adolescents and drug abuse is concerned. We all generally understand that an individual under 18 is a different animal than an adult alcoholic or drug addict. They are (typically) still under the guardianship of a parent, parents, or family members. They are required to go to school, and their drug and alcohol use is almost always motivated by a desire to have fun and obtain peer acceptance. They often haven’t totally crossed the “invisible line” into true addiction or alcoholism, and there are numerous treatment approaches tailored directly to the teen drug user.

Young adults can’t be treated as if they are teenagers, because they are in a different phase of life. Legally, they are adults. Parents don’t have the same leverage over their young adult that they would have over a teen.

Additionally, young adults’ have usually progressed further into their substance use disorders than teens have. They have often been using drugs for more than just a couple years. They’ve progressed into harder drugs and often experience withdrawal symptoms upon cessation of use. When presented with facts about addiction, they usually nod their heads in agreement, rather than glaze over like an adolescent would.

Considerations for Young Adult Specific Drug Treatment

Because young adults often get lumped in with adults, they end up in treatment programs that aren’t designed for them. They usually don’t feel that they relate to their peers in treatment, and upon discharge, they are handed off into various 12-step programs where they continue to struggle to relate.

Consider a few generalizations about the 18-25 year old phase of life:

Young adults have a high social need

Being single and young means these individuals still have a high social need – programs need to incorporate fun, opportunities for social connection with a new peer group, and a clean hand-off into a high quality long-term Aftercare program.

Delayed emotional growth still applies

Parents are often frustrated as to why their 23 year old acts and responds like a 16 year old. We often think of delayed emotional growth with teens, but this applies to young adults as well. Young adults who used drugs through high school and college haven’t experienced the emotional lessons during these years. They often present as “23 going on 16,” and retain the black-and-white logic of a teenager.

Parental involvement is important for this age group

They are often still financially and emotionally intertwined with their parents. It is important that parents of this age group have support as their young person goes through the young adult addiction treatment process.

Parents and young people alike benefit from the parents having tools to manage the high emotions involved in the early recovery process. Parents of young adult drug users often also need family therapy, coaching, and support as they decide when and how to financially disconnect from their young adult.

They feel that they are behind in life

Being college-age means these individuals will be thinking about starting their lives after they sober up. Young adult programs need to consider helping individuals sort through what their goals are, and what steps they can take towards the lives they want to create.

Young adults have also likely gotten in more legal trouble than teens, and may need some coaching and support through the process of cleaning up their past.

A 12-step program with depth is usually necessary

Young adults often have crossed the “invisible line” into being dependent on alcohol or drugs. A strong personal 12-step program will be necessary earlier in the recovery process than it will be for teens.

Is there hope for a young adult alcoholic or drug addict?

Absolutely, yes. We see young adults sober up all the time. They are some of the most fun-loving, smart, funny, and energetic individuals we get to work with.

Though we often say there are no guarantees in the substance use disorder treatment world, we believe that seeking age-appropriate young adult rehab programming is just as important for young adults as it is for teens. Their odds of success improve dramatically when the treatment is age-appropriate, their social needs are met through support groups, and their parents are involved.

If you have any questions about the treatment process for young adults, or would like to inquire regarding a substance abuse evaluation, please reach out to us. We are always happy to answer any questions and assist in developing a plan of action for your family or your young adult.

Is Porn Addictive and How Are We Defining Porn Addiction?

By Kim Miller, LCSW, LISAC on March 24th, 2022 in Addiction, Pornography

While porn addiction overuse continues to appear as a treatment and therapy issue for individuals of all ages, it is still a controversial topic. Most sources agree that porn is addictive, but raise concerns over how to define it. In this article, we’ll explore current attitudes towards porn addiction, as well as examine some of the effects of porn addiction.

Current scientific attitudes towards porn addiction

The World Health Organization (WHO) sets many of the standards for disease and disorder criteria and has recently added a new disorder termed “gaming disorder” as related to internet, screen times, or video gaming (WHO, 2020). The International Classification of Disease (ICD) 11th revision is a classification used by professionals as a basis for identifying health trends (WHO, 2020).

In specific, words such as screen dependent, internet addicted, or problematic digital user are used to describe persons who are losing control due to an addictive process. Addictive viewing of pornographic materials specifically has still not made the cut by the WHO, the American Psychological Association, or the Diagnostic Manual of Statistical Disorders although viewing erotic internet materials certainly seems to be on the rise (APA, 2014).

However, topics like pornography and sex are still hotly debated by healthcare professionals and mental health practitioners due to vastly differing attitudes about the acceptability of certain behaviors (APA, 2014). Multiple social movements and support groups exist that aim to liberate human beings from shame and restrictions from “days in the past”. Other camps have strict and meaningful reasons to abstain from certain behaviors for spiritual reasons or other valued commitments.

Mental health professionals have had their own concerns because of the increasing number of clients experiencing consequences for compulsive sexual behaviors which includes pornography. Opinions run wild and perhaps it has not been clear to date if pornography or sex addictions have clarity in categorization as some of the other addictions. One of the major concerns is the potential to over-diagnose or mis-diagnose due to mere differences in opinion on cultural or religious views (APA, 2014).

Prevalence of pornography addiction

One thing seems clear, the viewing of pornography is on the rise. Major porn sites are receiving more than 115 million hits per day, and the number keeps increasing! People are turning up at mental health and addiction treatment offices and centers at alarming rates. It appears the cut off for problem use or addiction rests on an ambiguous line where occasional use turns into a struggle to control use.

Researchers are beginning to pivot their efforts to exploring behavioral process addictions. Knowledge about substance use disorders have gained a lot of ground over the last few decades. They are more readily seen as mental illnesses in need of treatment. Groundbreaking work from neuroscience has explored the brain’s pleasure pathways and pleasure circuits to lend proof that damage occurs to the way drug users experience pleasure by actually damaging circuitry (NIDA, 2021).

Essentially, they found that users no longer release “feel good “chemicals effectively without the help of the drug itself. Research on brain science with pornography shows problematic use is more like an obsession, compulsion, or repetitive behavior pattern that exists that loop in the brain and may not effect all the same brain areas that substance addictions work on (APA, 2014).

Research is still only beginning to understand the neurochemical processes behind process addictions and this information may be lagging in a complete comprehensive understanding. New emerging areas of research and exploration are beginning to take an interest in the way process addiction hijack behavioral processes. Behavioral addictions are gaining exponential amounts of attention in the last decade and can be reflected in mainstream television shows and intervention episodes.

One thing is evident, porn addiction means that compulsive behavior patterns are present in a persons’ life, which create problems. Compulsive behavioral patterns are often tasked with numbing emotions and often result in a sense of disconnectedness. In other words, porn addicts are likely to feel disconnected from family, friends, hobbies, and enjoyment in life.

More research is needed about porn addiction

Groups of researchers and experts are pushing for pornography and sex addiction to be researched and explored to have more diagnostic credibility. The World Health Organization began to recognize “compulsive sexual behaviors” as a problem in 2018, but pornography use still struggles for a definitive category (Kritz, 2018). Opposing camps still worry that cultural and religious groups or fanaticism may push people to over-diagnose and there seems to be little or no education at all on healthy sexuality especially for emerging youth or young adults. The concern is perhaps pornography use is mired in conflict and confusion in values.

One thing has become clear, clients are continuously turning up at the offices of mental health providers looking for help for symptoms they believe are directly related to their compulsive or problematic pornography use in specific. Erectile disfunction, sexual performance issues, anxiety, depression, isolation, relationship issues, depression, anxiety, and many more stressors are bringing people into treatment centers or offices.

Many clients report that being rigid or fanatic can lead to shame and identify issues, but compulsive patterns can replace healthy connections and relationships leading to problems. If people start to experience unwanted patterns, it may be time to seek support and find a place to flush out beliefs, values, and concerns and come up with a plan to address problematic behaviors.

Defining addiction to pornography

A recent porn addiction article on WedMd.com states that “porn addiction is when you can’t stop looking at porn, even if you want to” and that the obsession “gets to the point that it interferes with work, relationships, and other parts of daily life”. Furthermore, it states that with the widespread availability of internet porn and growing research, that it is hard to pinpoint how much is too much but experts agree that “if it gets in the way of your day-to-day activities, you could be watching porn too much” (Donovan, 2020)

Porn addiction symptoms, signs, and effects

While we don’t yet have a clear definition in the literature of what porn addiction is, we can use signs and symptoms that we observe in problem users as well as other process addictions. The following signs likely indicate that an individual has a porn addiction:

Signs of porn addiction

Intense urges or cravings for distracting oneself from tasks
Stopping regular activities, you enjoy such as hobbies
Lose interest in daily chores or attendance to life details
Less interest in spending time socially with others
Damage is created in intimate relationships
Secrecy and transparency issues resulting in anxiety
Can’t stop even when you try
Enjoyment diminishes, but viewing porn anyway
Crossing the line with types of pornography they are watching
Use to resolve anxiety rather than other methods
Struggles at work or home
Dissatisfaction with relationships
Intense fear or anxiety with intimacy

Side Effects and Symptoms of Porn Addiction

Guilt / shame
Low self-esteem
Depression, anxiety, and suicide attempts
Neglecting partner
Debt
Loss of job
Other addictions increase such as drugs

References

Donavon, J. (2020). Porn Addiction. WebMD. https://webmd.com

Kritz, Fran (2018). Compulsive sexual behavior as a mental health disorder. Everyday Health http://everydayhealth.com

NIDA (2021). Drugs and the brain. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

Weir, K. (2014). Is pornography addictive? Monitor on Psychology, 45(4). http://www.apa.org/monitor/2014/04/pornography

World Health Organization (2020). Addictive behaviors: Gaming disorder. http://Who.int

Is Marijuana A Gateway Drug?

By Jeremy Wachter, ICADC on November 19th, 2021 in Addiction, Adolescent and Young Adult Substance Use, Marijuana

Obviously, the landscape of attitudes toward the use of marijuana has changed dramatically in recent years. One of the pieces of conventional wisdom in the drug world was always that marijuana was the most common “gateway” drug. With the widespread acceptance of THC and CBD products for medicinal and recreational use in various portions of the country, this has become a point of contention in recent years.

Those who argue against the so-called “gateway” theory of marijuana point out that there are no documented marijuana-specific properties that “cause” an individual to use other drugs down the road. While this claim is only partially true (we’ll briefly examine the science later in this post), the argument is fundamentally missing the point.

As an aside, in a recent survey of our patient charts, we found that marijuana is the most common “first drug” used by teens with substance use disorders.

To illustrate what we mean:

We surveyed our opiate users about marijuana use

Our (adolescent and young adult specific) substance abuse program did a year-long quick survey of all the opiate and heroin addicts who went through treatment in our facility.

We asked a simple question – did you start with opiates? The answer, a resounding no. Then we asked the obvious follow up question – which drug did you use first? Almost every response was … marijuana.

Surprised? Neither were we.

Rather than getting into the weeds (pun intended) about the clinical properties of marijuana, we prefer a common sense approach to the question. Is it true that marijuana is often the drug that opens the door to further drug use down the road, and if so, why?

A personal anecdote about marijuana

In other portions of this website, we’ve presented some stories about the teenage experience with drug use. I’ll add a portion of my own story:

As a young teenager, I was decidedly anti-drug. My family did a great job of discouraging me from using drugs as well as providing me with suitable alternatives such as hobbies and sports. Not only that, I went through the now defunct D.A.R.E. program as a kid.

I remember the D.A.R.E. officer talking about how people who used marijuana would inevitably experience serious consequences. Despite having some drug-using friends at school, I stayed clean, mostly because I didn’t want to compromise athletics. Then a curious thing happened:

One summer, I smoked weed for the first time. I took a few puffs of a joint at a concert and enjoyed the light, heady feeling I got from it. I didn’t get very high, but the experiment went so well that I decided to do it again – this time I would make sure to get good and high!

A week or two later, I smoked weed from a bong for the first time with some friends and … I had a great time! That’s right – I didn’t commit any crimes, steal from my grandma, join a gang, or try to jump from a high window. That was the day I realized:

Adults are jerks.

They had lied to me.

Drugs were awesome.

My whole attitude toward drug use changed in an instant. I had believed that doing drugs was stupid, but at that point I “realized” that the joke was on me. Within a few weeks, I repeated the experiment with prescription painkillers, cocaine, and over-the-counter cough medications. I began stashing drugs in my room and I quickly fell in love with getting high.

Unsurprisingly, things did get really dark for me. A few years later I was strung out on heroin, homeless, and on the verge of losing ties to my family.

Turns out the joke was on me. I went through the process of getting sober kicking and screaming. But here’s the point:

It all started at that concert, with those first few puffs of marijuana. An “innocent” moment in time where I went from being a capable, athletic, suburban kid to someone open to the idea of doing drugs.

Lowering the barrier to drug use

The 2020 Arizona Youth Survey points out some telling facts about youth substance abuse:

41.3% of students surveyed have used marijuana by the time they are in the 12th grade.
35.8% of students have used marijuana concentrates by the 12th grade.
28.0% have taken marijuana edibles by 12th grade.

The number of 18 year olds who have used marijuana is approaching half.

We also know from this 2014 study that 44.7% of individuals with lifetime cannabis use progressed to other drugs later in life.

Why is this? Is it something “special” about marijuana? Doubtful – we could likely make the same argument about alcohol or vaping. We think it has more to do with perception of risk.

Luckily, the AYS gives us data on this topic as well:

Perception of Risk for Marijuana Use Among Youth

The Arizona Youth Survey goes on to say:

Only 23.3% of 12th graders perceive trying marijuana once or twice to be a moderate or great risk.
87.3% of 12th graders perceive trying illegal drugs other than marijuana to be a moderate or great risk.

There’s two conflicting facts here: while almost all students perceive trying other illegal drugs to be a great risk, almost half of marijuana users go on to use other drugs. That should tell us something – once someone tries their first drug, their perception of the risks of other drug use often gets lowered by default.

Some Common Sense Facts About Marijuana Use

We believe (and see in our drug abuse program every day) that the gateway effect is not referring to a scientific phenomenon – it’s referring to behavioral and social factors that open the door to drug use in general. Consider the following:

A teenager having fun using one drug is more likely to hear from another teenager that another drug is also fun.
As noted above, most teens view other illegal drugs as risky at first. Having a good time using one drug makes other, harder drugs seem less scary to try.
Starting to use drugs plugs teenagers into a social network of drug-using peers, some of whom have access to drugs other than marijuana.
Taking one drug regularly leads to tolerance. This leads to a natural inclination to try other drugs as time goes on.

An overview of the science on marijuana

Earlier we noted that the claim that marijuana doesn’t directly lead to other drug use is only partially true. Here’s an overview of what the science says:

Marijuana’s association with other drug use

This 2014 study found that 44.7% of individuals with lifetime cannabis use progressed to other drugs later in life.
The National Survey on Drug Use and Health found that marijuana users are three times more likely to become addicted to heroin.
A 2018 study found that cannabis use was associated with non-medical opioid use in adults.
This 2004 study found that early cannabis use is strongly associated with use, abuse, and dependence on other illicit drugs later in life.

Cross sensitization, or the “priming” effect

Early-use marijuana has been shown to “prime” the brain, setting the person up for substance use disorders later in life. The term cross-sensitization is used to describe the effect of exposure to one drug leading to hypersensitivity to another drug. It has been shown that marijuana use early in life does lead to cross-sensitization for other drugs, which may help explain the high number of users who switch to other drugs later on.

In their article on cross-sensitization, the Addiction Policy Forum had this to say: “Marijuana is an undeniably powerful drug, like alcohol and tobacco, changing the brain and accelerating drug-reward learning.”
This study from 2004 found that an enduring change to the dopamine system takes place in those who use cannabis early in life. This adaptation led to a long-lasting cross tolerance for drugs like cocaine, morphine, and amphetamine.
A more recent study from 2020 performed on rats found that exposure to marijuana during adolescence led to cross-sensitization for cocaine, but adulthood exposure did not. They also reversed the experiment, finding that cocaine use did not lead to cross-sensitization for marijuana.

What about Alcohol and Tobacco?

As compelling as all of this may seem, it turns out that other drugs may have the same effect. For instance, the cross sensitization effect has also been shown in the literature to take place in those who use alcohol or nicotine.

It appears that it may not matter which drug a person does first. As we’ve already stated, it’s likely just the simple fact that someone tries a drug that helps predispose them to other illicit drug use later in life. In their resource on the “gateway effect” of marijuana, the National Institute on Drug Abuse had the following to say:

“An alternative to the gateway-drug hypothesis is that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs.”

So … is marijuana a gateway drug?

Hopefully this article has painted a clear enough picture. As stated in the beginning, we’ve hardly ever met a drug abuser who didn’t start with marijuana. We believe practical experience speaks louder than words.

There is massive pressure to be dismissive of some of the common sense wisdom concerning marijuana use. The fact remains that marijuana is almost always the first drug kids try.

Even if it weren’t for the well documented physical health and mental health risks of marijuana, it would still be true that using marijuana early in life sets in motion the social, behavioral, and emotional wheels in motion for other drug use later in life.

Is Marijuana Addictive?

By Jeremy Wachter, ICADC on September 10th, 2021 in Addiction, Marijuana

With the proliferation of medical marijuana rolling into the movement for recreational marijuana, this seems to be one of the questions of the day – is marijuana addictive? As a general blanket statement, the answer is yes, at around the same rate that alcohol is addictive. The CDC’s report on the health effects of marijuana states that around one in 10 marijuana users will develop addiction, but points out that the number is much higher among users who are under 18 (details below). Long-term marijuana use is one of the fastest growing forms of drug addiction in the United States.

What constitutes a marijuana addiction

Many people point out that marijuana abuse doesn’t have the same severity of withdrawal symptoms as substances such as heroin or alcohol. However, this doesn’t mean that marijuana isn’t addictive. We would like to point out that many “addictive” substances and behaviors don’t necessarily leave the user in cold sweats like heroin does. Take gambling, shopping, or eating for example. Alternatively, most experts would refer to an addiction as the inability to stop engaging in a destructive behavior even though it is causing some kind of physical or psychological harm to the user.

On a clinical level, the diagnosis “cannabis use disorder” is used. This term is taken directly from the Diagnostic and Statistical Manual of Mental Disorders, Vol 5 (DSM-5). The manual states that a cannabis use disorder is a mental health disorder constituted by use of cannabis for at least a one-year period, with the presence of two or more symptoms. These symptoms can include tolerance for the drug, withdrawal from the drug, or failed efforts to cut back / quit, among others. Withdrawal from cannabis typically includes:

Marijuana withdrawal symptoms

Decreased appetite
Irritability
Sweating or chills
Mood swings or feelings of depression / isolation
Cravings for marijuana
Inability to focus
Insomnia

Yes, marijuana is addictive. With the recent surge in marijuana use in the United States, cases of marijuana / cannabis use disorder are on the rise. However, it appears that the rate at which individuals become addicted to marijuana is not increasing – simply the number of users has gone up.

What the research says about marijuana addiction

Let’s take a deeper look into some of the research and data available on the topic of marijuana addiction:

A 10 year study face-to-face interviews conducted in surveys reported that among marijuana users, almost 3 in 10 developed symptoms of cannabis use disorder.
Data from 7,389 past-year cannabis users showed that the odds of transitioning from recreational use to dependence was just under 1 in 10. This is a similar rate that we expect alcohol users to transition to dependence.
This study broke down the likelihood of developing cannabis use disorder by age and found that past-year cannabis users are 4 to 7 times more likely to develop dependence if they are under the age of 18.
The National Institute on Drug Abuse’s Monitoring the Future survey noted that around 2019, there was a sudden increase in marijuana use among the younger grades, and that teens’ perceptions of the risks of marijuana use has declined in recent years.

Marijuana addiction symptoms & signs

In our drug and alcohol treatment programs for youth, we often describe how marijuana / THC users will “scrape the bottom,” rather than “hitting a bottom” in the traditional sense. We also observe that marijuana is the most popular drug used by teens, by far. Whereas users of other illicit drugs such as heroin or methamphetamine will often experience hard consequences very quickly, marijuana users tend to slowly let their lives slip, such that they themselves are unaware of the effects it’s having on them. Some of the clear marijuana addiction symptoms are:

Unsuccessful attempts to stop using the drug or cut back on marijuana or THC use.
Incrementally giving up activities, hobbies, or endeavors, likely due to a marijuana-induced amotivational syndrome.
Continuing to use marijuana after developing awareness of the destructive consequences. This is one of the most classic signs of addiction.
Tolerance for the drug, or needing to use more and more to get high over time.
Problems with memory and trouble learning.

Treatment options for marijuana addiction and next steps

If you or a loved one are struggling with marijuana use, we recommend that you start with a consultation with a professional. This doesn’t necessarily mean a trip to rehab – it’s simply to get an objective perspective on the level of use, as well as some next steps. Good places to start would be with a healthcare professional trained in addiction, an addiction counselor, or a drug and alcohol treatment program such as our teen and young adult drug treatment programs in Tempe, AZ and Sacramento, CA. As always, feel free to call our program or contact us if you have questions or would like to request an evaluation.

Does AA Really Work? New 2020 Research on AA Effectiveness

By Jeremy Wachter, ICADC on August 13th, 2020 in Addiction, Alcoholism, Articles

A new analysis of research on AA published this year by Keith Humphreys, PhD et al. has sought to answer some long-standing questions about whether or not Alcoholics Anonymous is effective for alcohol use disorder and other substance use disorders.

Alcoholics Anonymous has been considered the gold standard in the treatment and mental health world for decades as a method of helping individuals beat their drinking and drug use problems. There have also been over 30 other free fellowships formed that directly utilize their 12-step program model of recovery. This number doesn’t even include the many fellowships and groups out there that credit AA with influencing their model, such as Celebrate Recovery. However, the fellowship’s insistence that each AA group remains autonomous, that access to the fellowship remains free of charge, and it’s historical resistance to being directly studied may lead one to some very logical questions:

How effective is AA and 12 step treatment?
If it is effective, is it more effective than other forms of treatment such as cognitive behavioral therapy?

AA Research – some quick background

Humphreys is a professor of psychiatry and behavioral studies and a member of the Wu Tsai Neurosciences Institute at Stanford University. For the past 3 years, Humphreys and his co-authors have been reviewing research from over 57 independent studies concerning the effectiveness of Alcoholics Anonymous as a solution to the basic trouble of the alcoholic, drug addict, or substance abuser.

They ran the meta-analysis through the standards set forth by the Cochrane Collaboration, which has long been considered the gold standard for meta-analysis. It is trusted by clinicians and considered to be bias resistant. After holding the 57 studies up to Cochrane Reviews’ standards, it was decided that 27 of them were suitable for inclusion in the meta analysis. The 27 studies represented research on over 10,000 individuals ranging in age from young to old and who either attended AA or received other types of therapy. The average ages of participants in the studies was between 34 and 51. This is quite a large evidence base!

The original abstract of the research can be found in the Cochrane Library by clicking here.

The basics of the AA 12-step approach – a quick overview

Alcoholics Anonymous chips for lengths of sobriety

Alcoholics Anonymous gives out chips denoting various lengths of sobriety.

Alcoholics Anonymous is a grassroots movement that dates back to the 1930’s between two alcoholics who were trying to maintain abstinence from alcohol. They found that when they connected with each other, and attempted to deliver their message of hope and recovery to alcoholics still suffering, they were able to maintain their own sobriety, and even find peace and happiness.

This realization flowered into multiple free support groups in Akron, New York, and Cleveland. They later formed the basis of their recovery process, the well known approach using 12 steps. This process starts with admission of powerlessness over one’s addiction and developing a relationship with a higher power of the participant’s choice. It proceeds to complete a thorough inventory of one’s conduct and life, continues through a process of making amends with those harmed, and culminates with the 12th step – delivering the message to those who still suffer of alcoholism and addiction.

AA’s model is completely free and self-sustaining, denying charitable contributions from outside organizations. AA members are free to consider themselves members if they have a stated desire to stop drinking.

The study’s results – does AA really work?

The study refers to AA/TSF interventions, which means Alcoholics Anonymous and Twelve Step Facilitation. These interventions were compared with other psychological clinical interventions, such as cognitive behavioral therapy. Three areas were studied: rates of continuous abstinence, percentage of days abstinent, intensity of drinking/using, and healthcare cost savings.

It was found that:

AA improves rates of continuous abstinence at 12 months, and that the effect continues at 24 and 36 months. This means that AA meetings and 12 step interventions are particularly better at producing continuous abstinence in the long term.

For percentage of days abstinent (days sober compared to days not sober), AA performs as well as other clinical interventions at 12 months – but AA outperforms other interventions at 24 and 36 months.

For drinking intensity (drinks per drinking day / percentage heavy drinking days), AA was found to perform as well as other clinical interventions at 9 months and 12 months.

3 of the 4 studies reporting on the cost of health care reported that AA and 12-step interventions showed greater health care cost savings. The fourth study concluded that other interventions outperformed AA, but that those with the worst prognostic characteristics showed greater health care savings from AA. While at first this may seem like it should be obvious, keep in mind that things like overdoses, hospital visits, and sickness add to healthcare costs as well. Sober people have lower healthcare costs in general.

The authors’ general conclusions, as quoted directly from the abstract:

“There is high quality evidence that manualized AA/TSF interventions are more effective than other established treatments, such as CBT, for increasing abstinence. Non‐manualized AA/TSF may perform as well as these other established treatments. AA/TSF interventions, both manualized and non‐manualized, may be at least as effective as other treatments for other alcohol‐related outcomes. AA/TSF probably produces substantial healthcare cost savings among people with alcohol use disorder.”

What does this mean for counseling, therapy, and rehab?

Humphreys also addressed the controversy that can surround Alcoholics Anonymous at times. He noted that while physicians tend to support 12 step approaches, psychiatrists and psychologists will sometimes regard the fellowship with skepticism. After all, how can lay people do a better job at facilitating recovery from alcohol and drugs than a trained psychologist with degrees?

Humphreys was quick to point out that while the study has made him a true believer in the Alcoholics Anonymous approach, he isn’t saying that counseling or substance abuse treatment shouldn’t be considered. He recommends that counseling for substance users can be designed as a “an extended, warm hand-off into the fellowship.” He noted in a podcast interview with Stanford Medicine that he felt validated for his recommendation that so many different people try Alcoholics Anonymous over the years. While he does admit that the AA way of life doesn’t necessarily work for every single person, an individual with a substance abuse problem will likely be better off if they give AA a try.

Based on our extensive experience helping young people and teens stop drinking and find sobriety, we would agree with Humphrey’s assessment here. Alcohol and drug treatment programs, whether inpatient or outpatient, in addition to therapy, are all valuable tools, but we see success rates dramatically improve when the participant is willing to make a transition into Alcoholics Anonymous or a similar fellowship (such as those directed at drug addiction) once their participation in our support groups comes to a close.

Further reading on this important research on Alcoholics Anonymous can be found Stanford University and Inverse.com.