If you can’t focus to complete essential tasks you’ll create unnecessary stress - and stress definitely ups your risk of relapse. Safeguard your recovery by learning focus skills that make it easier to stay on task.

An ounce of prevention may be worth a pound of cure - but that doesn’t matter much when you’re focused completely on an ounce of something else…

The addicted life is reactive and chaotic: You run from problem to problem and you only react to the worst of them. This leaves you time to get drunk or high a lot, but it’s not such a great strategy for life-success.

The recovery life, by comparison, is calmer and more focused: Once in recovery you try to stay responsible to prevent small issues from growing into larger headaches.

...or, to put it another way: recovery is like the relaxed breathing-opposite to addiction’s hyperventilation and panic!

In recovery, big problems lead to stress and stress leads to relapse.

So to avoid relapse we avoid problems and stress by staying organized and staying on top of things - which works great… unless you have ADHD!!!

Staying Focused in Recovery - With ADHD

People with ADHD often have trouble sticking with a task to completion, which can result in a failure to handle basic responsibilities; this causes problems, problems cause stress and stress leads to relapse.

So for people with ADHD, an inability to focus is directly linked to an increased risk of relapse (an inability to finish tasks or handle responsibilities can also affect self-esteem, which can also influence relapse risk.)

It's not fair, but people with co-occurring disorders, like addiction and ADHD, have to work harder to maintain recovery.

4 Tips for Finishing What You Start

So once you acknowledge that a failure to complete essential tasks increases your risk of relapse, you have to start looking at how you can improve yourself in this area. Four commonly suggested strategies are:

1. Making visual cues
2. Chunking your time
3. Gaining momentum
4. Creating structure¹

1. Making Visual Cues for Yourself

It’s easy to get sidetracked, especially when distractions are so tempting and essential tasks often aren’t.

So to overcome this problem, set deadlines for yourself and then create visual reminders that you can’t fail to see.

For example, if you have a problem getting work or school assignments finished on time, divide the work up and create milestone deadlines. Then, mark each deadline on a calendar, set alarms on your phone and/or make notes on the fridge and bathroom mirror, etc - all to repetitively remind you of what you need to accomplish, and when you need to accomplish it by.

It’s not real exciting but it’s a good strategy for finishing a project - and when the alternative is a failing grade or reprimand from the boss - it’s an effective, and very recovery-promoting idea to try.

2. Task Chunking

If a large task overwhelms you, try breaking it up into more easily managed steps, and then simply focus on completing these easily managed tasks, one by one, until you have completed the larger project.

For example, if you have difficulty sticking with cleaning your apartment to completion, break it down into small steps, such as:

• Empty waste basket
• Tidy papers on desk
• Make bed
• Vacuum floor
• Etc.

3. Gaining Momentum

Harness the power of momentum for motivation. If you have a list of tasks to accomplish, look for the hardest one first and get it over with right away while you’re feeling fresh and ready - once you’ve got that done, you’ll have an easier time moving on to progressively easier tasks.

Or - if you find starting with a hard task too daunting (so you never get started with any tasks) try the opposite approach, and build up some momentum by starting with a couple of easy tasks and making some good progress right from the start.

4. Live by a Schedule

If you have a hard time finishing basic tasks, you should consider scheduling them into your busy day.

1. First, make a list of all the chores and tasks that need doing on a regular basis.
2. Next, get a weekly planner and mark off unavailable time, such as time at work or time already scheduled for outpatient meetings or self help groups.
3. Then, with the time that’s left, try to create a stable daily routine, where you use similar times each day to accomplish your regular tasks.

If you work from 11 to 7 on weekdays, you might schedule in half an hour for house cleaning and laundry every morning from 9 to 9:30, half an hour for exercise or yoga every day from 9:30 to 10:00 and half an hour for picking up groceries three times a week on the way to work…and so on and so forth

It doesn’t matter how you schedule your time, but it works best when you schedule in your most often overlooked tasks.

And most importantly, once you schedule it - you do it.

More Good Ideas for Getting the Job Done

• Reward yourself for successes - set a goal (clean laundry every day for a week) and a reward for meeting your goal (if successful, will buy new shirt).
• Create artificial deadlines.
• Work at your best - If you’re useless by evening, don’t schedule bill paying for after dinner.
• If TV or radio tend to distract, turn off extraneous noise.
• Prioritize - know that you won’t always get everything done, so make a list of tasks  and prioritize each item from most to least urgent. As long as you cross off most of the urgent stuff by the end of the day, you’ll probably be alright.²

Image Copyright: Auzigog

No matter what you’ve done or who you are, you are entitled to drug addiction treatment that is respectful of your dignity and rights as a human being.

In a discussion paper entitled ‘Principles of Drug Dependence Treatment’^1, the United Nations states that all people receiving drug addiction treatment should be entitled to certain basic rights.

It doesn't matter who you are, what you've done (or are using) and whether or not you are incarcerated. The United Nations suggests the following addiction treatment rights:

~ ~

1. The right to treatment without discrimination

Addiction is a disease and no one should be discriminated against for past or present drug use, or for any other reason, such as race, ethnicity, sexual orientation, gender disability status etc.

~ ~

2. The right to the same ethical standards of treatment as is given to those with physical health conditions

There should be no difference between the ethical standards of care delivered to a cancer patient or an alcoholic or a heroin user. 

~ ~

3. The right to access to treatment during all stages of the disease

People with addictions have a right to access to treatment during all stages of this chronic disease. This includes during periods of incarceration.

~ ~

4. The right to deny treatment

Only in the most exceptional circumstances, such as when a person is an immediate risk to self or others, should any treatment ever be forced on another person. A person with addiction has the right to accept or deny any medical or psychosocial treatment.

~ ~

5. The right to treatment that is never inhumane or degrading

Drug addiction does not diminish a person’s human rights and so practices that would be considered degrading or inhumane for any person are degrading and inhumane for people with drug addictions.

~ ~

6. The right to informed consent and withdrawal from treatment

All people receiving drug addiction treatment have the right to full information about any treatment procedures and must provide their informed consent before receiving any treatments. Even after consenting to treatment, any person has the right to withdraw from treatment at any time, for any reason.

~ ~

7. The right to privacy of information

Your treatment and medical records must remain confidential and be released to outside parties only with your written consent.

~ ~

8. Your right to medical services should not depend on your participation in addiction treatment

You have the right to access all medical services whether or not you choose to comply with recommended addiction treatments.

Image Copyright: Astragony

The occurrence of a dual diagnosis of mental health problems and addiction will require additional pharmacological intervention beyond the scope of description within this article, and the as follows drugs are the drugs most commonly used to treat a single diagnosis of addiction or dependency.

Although some homeopathic or philosophical interpretations do not allow for the use of pharmacological interventions during drug treatment, the legacy of addiction carries with it acute physical changes within the body and brain, and appropriate medication during drug treatment eases the pains of withdrawal and increases the safety of the process. Medications in drug treatment can also increase mental ability and outlook for a responsive and beneficial participation in drug treatment and cognitive programming, and reduce the physical and psychological cravings that can lead back to temptation during short to medium term recovery.

Much research is underway to increase the efficacy of medications in drug treatment, and there are some current and very promising studies of new medications that have real promise to better the drug treatment experience for recovering addicts.

Medications in drug treatment have to be used with an awareness of the complex interactions of the legacies of abuse with the potential side effects of the medications, but when properly and appropriately prescribed they can reduce the pains of withdrawal, increase the psychological outlook of the recovering addict throughout treatment, and decrease the experienced cravings to relapse after the completion of intensive treatment

Medications have a valid place within any drug treatment program.

Anti Craving Medications

There are two categories of anti craving medications used in drug treatment. Substitution style medications are commonly used for the treatment of opiate dependency, and these types of medications in drug treatment transfer addiction from a harmful abused drug, to a safer and less intoxicating drug.

The other types of medication used in drug treatment are medications that reduce the experienced cravings for drugs, reduce the pleasure of consumed drugs, or make the consumption of drugs very uncomfortable.

Opiate substitution drugs like Methadone, and much more recently Buprenorphine, are used as a substitute for an addiction to opiates. Addicts switch from harmful addictions to heroin or other pain killers to non intoxicating and safe opiate substitution medications and are able to better participate in society; they are gradually encouraged to reduce their dependence to these non intoxicating drugs.

The most common anti craving medication is the dopaminergic acting anti abuse drug Naltrexone, which reduces the effects of consumed drugs by blocking the effects of dopamine. This has been found to reduce cravings and improve sobriety rates. For alcohol abuse, the drugs Disulfiram and Acamprosate have also shown efficacy.

An alternative method for induced alcohol sobriety is use of the drug Antabuse, which reduces the temptation to abuse alcohol, as recovering addict know that if they consume alcohol concurrently with Antabuse, they will become violently ill.

Anti Seizure Medications

Psychiatric Medications

Pain Medications

As addictions professionals recognize and promote the benefits of more holistic programs of recovery, the value of meditation in drug treatment is increasingly recognized and offered as adjunct therapeutic programming in comprehensive drug rehabs.

Meditation has served an essential metaphysical link in eastern spiritual cultures for millennia, but only recently have western medical practitioners recognized its value in the therapeutic treatment of addictions. Meditation is not offered as a cure all for dependence and drug seeking behaviors, but when included in a comprehensive drug treatment program, meditation offers increased self awareness, a renewed spiritual religious connection, increased creativity, and a decrease in negative emotional responses to the stresses in life.

Because meditation induces increased peace of mind, increases a self awareness of negative behaviors and emotions, and reduces relapse provoking stressors, it offers therapeutic benefit to patients in recovery from substance abuse and dependence.

How meditation is used in drug treatment

Meditation is a personal endeavor and is not something that necessarily needs to be expressedly taught, but for accelerated learning, trained professionals guide recovering addicts through the process of meditating.

Although there are literally hundreds of unique philosophical approaches and methodologies to meditation and spirituality, there is a general commonality in the techniques used to promote a meditative state, especially amongst beginner meditators. A straight backed and upright seated position is attained, often with a crossed leg seating, and patients are encouraged to concentrate on slow and steady breathing, gradually attaining a more relaxed state. To clear the mind of extraneous thought, participants are asked to focus exclusively on a certain object, and to strive to think of nothing other than this object.

For the beginner, the cleansing of the mind through focus on a single thought can be very challenging, and as students learn the art of meditation, there will be a continual effort needed to recognize when focus has been lost, and to bring focus back to the singular object of attention. With practice, greater proficiency and focus is attained, and eventually students learn to slip quickly into a free and meditative state.

What are the benefits of meditation in drug treatment?

Meditation allows for a greater self awareness, a greater connection with internal spirituality and a greater internal peace in life.

When a truly blank and meditative state of mind is achieved, memories, emotions and behaviors can be examined introspectively and objectively. Through meditative introspection, recovering addicts often come to a better understanding of the things in life that cause them to abuse drugs or alcohol, and to better understand what they need to do to maintain an avoidance of substance use and abuse. Meditative awareness also illustrates the true destruction of substance use and abuse, and does not allow for any denial of self inflicted harms.

Many people report that through meditation they have achieved, or reawakened, a greater sense of spiritual connection. Although meditation as performed in most drug treatment environments is inherently non religious, the process often awakens spiritual sensations and beliefs.

Through an analytic and unemotional awareness of our behaviors, the stresses in our lives become less emotionally provoking, and this sense of tranquility tends to expand beyond the period of meditation and induces greater calm in all of our dealings. The normally stressful and upsetting events in our lives can often become less upsetting with a better internal awareness. A reduction in the influence of external stress reduces the power of the environment to lead us to relapse and substance use or abuse.

In Summary

As drug treatments become more holistic in nature, and with an increasing awareness that what works for one may not work for another, the inclusion of programming like meditation into treatment gives each and every recovering addict another tool towards recovery and sobriety. Most recovering addicts enjoy the process and benefits of meditation and a majority report it helpful in their battle to abstain from further use.

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Programs that offer sauna treatments as a core component are likely Scientology-related. This treatment is not backed by any legitimate medical organization.

Do not go to a drug or alcohol rehab that advertises saunas as a core component of the addiction treatment or detoxification process.

Many unreputable addiction treatment programs offer treatment that is based on an underlying philosophy of sweating out toxins and drug metabolites through long sauna-sessions, and then replacing what’s perspired with vitamin-heavy liquids.

While this may sound surface-reasonable, there is no reliable research evidence to support this practice and it is not endorsed or recommended by any reputable medical group…not any.

Originating in Scientology

For the most part, rehabs offering this service as a primary treatment (not as something nice to relax in occasionally) are basing their treatments on the thinking and philosophy of Scientology founder, L. Ron Hubbard.

And although supporters of these treatments may offer up 'research' results that ‘prove’ the efficacy of intensive sauna regimens for detoxification, these studies do not meet basic clinical standards, nor were they reviewed prior to publication in any reputable scientific or medical journal.

Most of the 'research' papers published to support saunas for detoxification have appeared in the journal Medical Hypothesis.

• This is the only Elsevier journal that doesn't require peer scientific review of articles prior to publishing.
  
• In addition to Scientology science, it also recently accepted an article denying the link between HIV and AIDS (2009) and an article which referred to those with Down's syndrome as Mongoloids.

in 2009, based on its lack of scientific rigor and because it had become a tool by which pseudoscience organizations attempted to legitimize their theories, a group of scientists petitioned The National Institute of Medicine to remove the journal from the Medline database.¹

Choose Evidence Based Therapies

1. There is no one-size-fits all treatment for addiction, different interventions can work for different people.
2. But though not all interventions will work for all people, there is no reason to subject yourself to an intervention never proven to work for any person.

So before you waste your time, money, energy and hope on something that won’t work, and might even harm, do some research on your own and confirm for yourself that what you see on an attractive website really stands up to legitimate scrutiny.

• Why not double check the reputation and practices of any program under consideration with a medical professional you know and trust before committing to anything?
  

If your doctor confirms that treatments meet scientific/medical standards, then you’ll know at least that you’re not putting your health at risk.

Take Home Message

1. If a program advertises long stays in a sauna as core component of treatment, you should be very cautious. This treatment is generally only used in Scientology-related programs.
2. No research evidence from any peer-reviewed academic journal supports this practice. Sweating out toxins for long periods will not shorten or reduce withdrawal severity.
3. Long periods in a sauna combined with large doses of vitamins may do you harm.
4. When choosing treatment, make sure to do your research to avoid dangerous programs using non evidence based therapies.

Image Copyright: Thomaswanhoff

If you drink or smoke marijuana make sure it's a conscious and examined choice - one you've made after looking carefully at the pros and cons of your decisions. You’ve only got one life to live so make it a conscious one and make it count – and if alcohol and marijuana pull you down, have the resolve to make some changes.

“When you change the way you look at things, the things you look at change.” 
― Wayne W. Dyer¹

Ever wonder if it’s all worth it?

Getting drunk and high can be a lot of fun, but sometimes you have to consider if your habits might not take more than they give - and if you don’t take stock every now and again, it’s way too easy to get stuck on autopilot until choices become habits and habits become destructive.

So if you like to drink – drink up! If you want to smoke weed – go on and get high then! It’s your life to enjoy and you should enjoy it as you see fit.

But before you do, take a moment to think about what you’re doing. Do you still choose your behaviors or are they now so ingrained that you act without thinking – stumbling into unconscious intoxication?

Don’t get stuck in a destructive rut. Choose a conscious life; examine your choices and if necessary, make the changes necessary to get you back to the life you want to lead.

Here’s a quick exercise to get you started…

Examine your habits across 7 domains...

Choose a behavior or habit to examine and then consider how your habit affects your life across the following 7 major domains of existence.

If possible, write down at least a couple of the most significant pros and cons below each domain (for illustration purposes we’ll consider how someone with a heavy marijuana habit might respond.

Physical Health

Pros:

• I am better off smoking than doing harder drugs. I’d probably drink a lot more if I didn’t smoke weed

Cons:

• Getting high reduces my motivation to get active, so I am out of shape and overweight
  
• I have a nagging little cough from smoking every day

Finances

Pros:

• None

Cons

• A half ounce a week eats up a large chunk of my disposable income
• Not saving as much money as I want to

Career/Education

Pros

• None

Cons

• Marijuana interferes with my short term memory and general sharpness. Makes it harder to excel at work.

Social/Recreational

Pros

• I enjoy many aspects of getting high with my friends. It’s a lot of fun, my friends are great, movies and music are far more enjoyable high, it gives me something to look forward to every day after work

Cons

• Feeling a bit stuck and bored because I won’t consider recreational activities that I can't do high
  
• Don’t see much of friends that don’t smoke anymore

Close Relationships

Pros

• Some of my closest friends smoke

Cons

• My wife does not approve
• It removes me from the same head-space as my children

Mental Health

Pros

• Gives me an outlet for stress

Cons

• Makes me feel a bit paranoid
• Feel irritable and depressed when I can’t get high (like at work sometimes)

Sexual Health

Pros

• Can increase desire sometimes

Cons

• Sometimes lack the motivation to actually get something going
• Not as connected with wife when high
  

... So How Did You Do?

If, after completing this exercise, you feel good about how your habits and behaviors affect your life - then congratulations and keep up the good work…

If this exercise has raised questions or concerns then consider what changes you could make to better your situation.

Remember:

• You don’t have to change everything all at once – lots of baby steps are a lot easier than one giant leap
• Just because you’re unsatisfied with your life and habits doesn’t necessarily mean you need to quit entirely – you can also consider moderation and harm reduction
• If you decide you want to stop using or drinking, and moderation doesn’t work for you (a lot of people have trouble with this) you might find talking to a counselor or joining a support group really helpful

Have the courage to live the life you want.

Since we started with a quote, lets end with one too…

"No one ever finds life worth living – one has to make it worth living."
― Winston Churchill³

Image Copyright: Chris Zerbes

Should you take an antidepressant during early recovery - or while still drinking/using? Does your substance abuse cause your depression or is it the other way around? Read on for an overview of your options and for more information on when SSRIs will help, and when they won’t.

Antidepressants and alcohol or drug treatment.

Ever heard the saying “you can’t use drugs to treat a drug problem?”

If you have - forget it, because it's based on dangerous and outdated thinking that just blocks you from valid recovery options. Instead, think of depression and addiction as brain diseases - and medications as tools that facilitate brain healing and a return to normal functioning.

Are antidepressants right for you?

Before taking any antidepressant you need to make sure that your substance abuse doesn’t cause your depression, because if it does:

1. You don’t need SSRIs or any other antidepressant – you just need to stop using or drinking and your depression will evaporate
2. Antidepressants won’t help anyway

However, if you suffer with independent depression and addiction issues, then SSRIs may reduce your depression, whether you stop using or drinking or not.

Read on to learn more about:

• Which substances can cause depression and how to know if you’ve got independent or substance-abuse-caused depression.
• What to do if you’re not sure or can’t tell?
• The importance of integrating medications, therapies and other forms of addiction treatments.
• Diagnosing yourself (a self test)  – do your symptoms meet the diagnostic criteria for depression?

Which Substances May Cause Depression?

Are you taking a drug or alcohol capable of pushing you into depression?

With substance abuse and mood disorders, especially pre-abstinence, it’s sometimes hard to tell if the substance abuse caused the depression or if the depression exists independently of the substance abuse.

While addictions of all forms may cause work and relationship problems that increase your risks for depression, the abuse of certain substances can alter brain chemistry to induce a mood disorder directly.

Abusing any of the following substances may result in substance-induced depression:¹

• Alcohol
• Cocaine
• Meth
• Opiates
• Hallucinogens
• Marijuana
• Benzodiazepines
• Other sedative drugs

Is Your Depression Substance-Induced?

Depression and addiction go hand in hand. According to data from the National Epidemiological Survey on Alcohol and Related Conditions, 20.5% of people meeting the criteria for current alcohol dependence also have concurrent major depression – this is almost 4 times the prevalence seen in the general population; and among alcohol dependent people seeking treatment, 40.7% have at least one independent mood disorder.² 

• Depression can lead to self-medicating and addiction 

Or

• Abuse alone can lead to depression (and further self medicating)

And unless one condition came first, it’s often hard to know what’s causing what. Here are some differentiation strategies...

Signs that your substance abuse caused your depression include:³

• You abuse a substance that’s known to cause depression and you take it heavily enough to plausibly induce a mood disorder.
• Your depression evaporates on its own with sustained abstinence (with a period of days to months of abstinence).
• Your substance abuse precedes your depression.

Signs of independent depression include:⁴

• Your depression precedes your substance abuse or feelings of depression precede binges.
• You have a strong family history of depression.
• You stay depressed during periods of sustained abstinence (4 weeks or longer)
• You have severe depressive symptoms and only minor or moderate substance use – your depression is greater than would be expected given your quantity of substance use.

What if You Can’t Tell?

So what do you do if you don’t know what’s causing your depression?

According to the Canadian Addiction and Mental Health Centre (CAMH):⁵

• If you can maintain abstinence for a stretch and you have mild depression it’s best to wait for between 4 to 12 weeks before starting pharmacotherapy (medication therapy). If the depression doesn’t ameliorate over this period, then consider starting medication but realize that it’s very difficult to get an accurate psychiatric diagnosis until at least 3 to 6 months of abstinence.
• If you have severe depression or signs indicate a mood disorder that’s independent of your substance abuse (such as a strong family history of depression) your doctor may want to try antidepressants anyway without waiting for the 4 to 12 week period of abstinence.
• If you can’t or won’t maintain abstinence, and there is reason to suspect primary depression, your doctor may want to try antidepressants or other medications even while you continue to use or drink.
  

In some studies, depressed active-drinking alcoholics provided SSRI antidepressants experience improved mood and show some reductions in their alcohol intake. 

Note – Given the many millions of people dealing with both depression and substance abuse as co-occurring disorders, there is a real scarcity of research on the efficacy of medications to treat mood disorders among this actively using population.  Many studies historically rejected actively using alcoholics or drug users to reduce confounding variables that would cloud the interpretability of data. Fortunately, this situation is now changing for the better.

What Are the Recovery Odds?

If you’ve got depression and addiction, here’s some good news:

• Sustained and integrated treatment will get you feeling a lot better and using a lot less – and you can expect to start feeling better within weeks and continue to improve your quality of life for lasting benefits.

So you should feel optimistic and excited about your chances for a better life, so long as you’re willing to do the hard work of recovery - because the truth is, co-occurring depression complicates treatment and you can’t expect a quick fix. Research shows that if you take a large pool of people with serious mental health and addiction issues, it takes between 3 and 4 years of integrated treatment for half of this pool of dually diagnosed people to attain stable and lasting sobriety.

While this may seem daunting, it’s worth noting that even those people who don’t achieve lasting sobriety by 3 or 4 years typically experience at least some reduced substance use and often substantial improvements in quality of life.⁶

Take Home Message

• Integrated treatment, which may include antidepressants and other medications, works well, even for people with serious mental illness.
• Treatment takes time and is best viewed as an ongoing process, rather than something to finish quickly.
• Even those people who don’t achieve full abstinence or remission usually benefit from treatment and medication – through reduced substance use and decreased depressive symptoms.
• People with less severe mental illness can expect quicker recovery times.

Can You Just Treat the Depression?

Although you could treat the depression alone – and not address the substance abuse/addiction – you are more likely to reduce the severity of the mental illness by addressing the depression and the substance abuse/addiction at the same time or by tackling the substance abuse first.

Here’s why:⁶

• The substance abuse may be the primary cause of the depression, and if you can reduce or eliminate the substance abuse, the depression may go away without need for further treatment.
• Even if the depression exists independently of the substance abuse, drug or alcohol abuse almost certainly worsens the situation and complicates treatments.  The abuse of certain drugs and alcohol can reduce the effectiveness of psychiatric medications and reduce treatment compliance - and people abusing drugs and alcohol often experience behavioral and relationship difficulties that can worsen mood. 
• Studies on antidepressant use among active alcoholics show that medications can help to reduce depression, but even when they do, they don’t have a strong impact on reducing drinking. 

Also, when looking only at alcohol, we can see that:

• Heavy drinking causes longer-lasting depressive episodes.
• Depression during abstinence and recovery is a significant risk factor for relapse.²

So whether or not substance abuse causes your depression, you need to treat your substance abuse as something that’s inextricably linked to your depression.

Of course, in some situations, a person might seek help for their depression but feel unable or unwilling to address their substance use or abuse. In such cases, mental health workers might recommend antidepressants anyway, as a harm reduction attempt that’s better than nothing.

Combining Medications and Therapies

In many situations, when faced with co-occurring substance abuse/addiction and depression, doctors and psychiatrists will recommend a combination model of treatment that includes:

1. Psychosocial interventions, like CBT therapy, motivational interviewing and community mutual self-help group attendance (AA/NA or similar)
2. Psychiatric medications, like SSRI antidepressants
3. Anti-craving medications, such as Suboxone or methadone for opiates, naltrexone or others for alcohol, or nicotine replacement medications, for tobacco

A recent study published in the American Journal of Psychiatry illustrates the value of combination therapies. In this study, researchers gave depressed alcohol dependent study subjects either a placebo, an antidepressant (setraline), an antidepressant and an alcohol dependence medication (naltrexone) or naltrexone alone. All subjects also received weekly cognitive behavioral therapy.

Results

The study results illustrate the synergistic effect of combination treatment.

• After 14 weeks of treatment, subjects given the combination of naltrexone and setraline made greater gains in both reducing depressive symptoms and drinking than subjects given either medication alone.⁷

Matching Treatments to Readiness to Change

Though it’s important to treat addiction and mental illness at the same time, it’s OK to treat each situation at different intensities, depending on your wants and readiness to change.

For example, if you’re ready to treat depression but ambivalent about treating alcohol addiction, it might be better to start with antidepressants and CBT for the depression and motivational enhancement therapy for the alcohol addiction, rather than full-on rehab treatment, which doesn’t really match with your ambivalence about change and which isn’t as likely to produce a positive outcome.⁸

Beyond Medications – Therapies and Social Support

The Value of Therapies

By getting therapy you learn applicable skills that help you maintain your sobriety and manage mental health disorder symptoms.

If you’re dealing with serious depression or any other serious mental illness, therapy alone probably isn’t enough to get you feeling significantly better, for this you need to combine effective psychiatric medications and therapy.⁹

The Value of the 12 Steps for Those with Co-Occurring Depression and Substance Use Disorders

Does AA help with depression?

Although AA and other 12 steps programs are known primarily as abstinence-focused peer support groups they also seem to help alleviate symptoms of depression.

These groups help by increasing the likelihood of abstinence and reduced overall consumption, but they also mediate change by offering increased social support and promoting positive social interactions and feelings of self efficacy.¹⁰

The bottom line – These groups get you out of the house and can help you stay clean and sober, but they also get you socially involved with others, involved in helping others and they increase your sense of hope and self-efficacy.

Aren’t Antidepressants Addictive Too?

Antidepressants aren’t addictive, but they will induce a state of physical dependency and you will experience antidepressant withdrawal symptoms if you stop taking your medication too suddenly.

Though your body becomes dependent on these medications for normal functioning, these pills aren’t considered addictive - since you won’t:

• Have to keep increasing your dose to get the same effects
• Crave them or take more than recommended to get high
• Lose control of your use¹¹

Testing Yourself for Current Depression

So are you depressed?

If you think you might be, it’s well worth talking to your doctor or another qualified mental health professional about getting a diagnosis and for treatment options, but for a head-start on this, take this quick and easy test that may shed some light on your situation.

This test, called the Epidemiologic Studies Depression Scale (CES-D) is a quick and easy questionnaire developed by researchers at the National Institute of Health that can help you self-diagnose:

1. Major depression
2. Moderate depression
3. No depression¹²

The Epidemiologic Studies Depression Scale Test

Match each of the following test statements with one of the following answers:

• Rarely or none of the time
• Some or a little of the time
• Occasionally of a moderate amount of the time
• Most or all of the time

1. The answer you pick should be the one that best describes how you’ve been feeling over this past week.
2. You will need to count your answers at the end of the test, so keep track of how many of each answer you score.

The Test

1. I was bothered by things that usually don't bother me.
2. I did not feel like eating; my appetite was poor.
3. I felt that I could not shake off the blues even with the help from my family and friends.
4. I felt that I was not as good as other people.
5. I had trouble keeping my mind on what I was doing.
6. I felt depressed.
7. I felt that everything I did was an effort.
8. I felt hopeless about the future.
9. I thought my life had been a failure.
10. I felt fearful.
11. My sleep was restless.
12. I was unhappy.
13. I talked less than usual.
14. I felt lonely.
15. People were unfriendly.
16. I did not enjoy life.
17. I had crying spells.
18. I felt sad.
19. I felt that people disliked me.
20. I could not get "going".

Scoring

1. For each “Rarely or none of the time” answer – give yourself 0 points
2. For each “Some or a little of the time” answer – give yourself 1 point
3. For each “Occasionally of a moderate amount of the time” answer – give yourself 2 points
4. For each “ Most or all of the time” answer – give yourself 3 points

If your total score is:

1. 22 or greater - you may have major depression
2. 15 to 21 - you may have mild to moderate depression
3. Less than 15 - you likely do not have current depression

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Suboxone…Get off Those Pills!

Methadone works, but one of the biggest problems with methadone therapy is that because methadone has such a high abuse potential, doctors can only prescribe it in very limited doses - typically only a one day supply to start with.

What Is Suboxone?

Suboxone is different. Firstly, buprenorphine, the active ingredient in Suboxone, isn't as potent an opioid agonist as methadone. This reduces the abuse potential so doctors are allowed to give you a lot more of it at one time. To further reduce the risk of abuse, the manufacturer has also combined the buprenorphine in the medication with a dosage of naloxone.

Naloxone is an opioid antagonist, and if it's taken concurrently with any other opioid, you will go into an immediate full withdrawal.

1. With normal use,you take Suboxone sublingually (under the tongue) and through this administration, very little of the naloxone is ingested, so you have no problems with withdrawal.
   
2. However, if you attempt to dissolve and inject the medication however, the naloxone is absorbed in full, and not only do you not get high, you go into immediate and agonizing withdrawal.

So because it's less abusable, you can, after an initial period of close observation and dosage modification, get a month's supply of pills prescribed and purchasable at a pharmacy.

Two Potential Problems

Because it's so easy to get and take, and because it works well to keep cravings and withdrawal away, the treatment compliance rate is very high.

1. The biggest problem people are having at the moment is just finding a doctor licensed to prescribe the medication, as current legislation caps the number of patients each doctor can prescribe to.
2. The second major problem is cost.

Suboxone Might Be Your Answer

If you are searching for an effective opioid treatment medication, Suboxone may be the solution you have been looking for. Remember however, that Suboxone is not intended as a stand alone treatment and it should be combined with addiction treatment of some form.

The Affordable Care Act (ACA) will start on January 1st, 2014 - and from that day forward, most people will have coverage for essential mental health and substance abuse treatment services. Learn more about how the ACA might affect you.

Starting in 2014, under the Affordable Care Act (ACA), Americans will suddenly enjoy greater coverage for substance abuse and mental health treatments.

How Does the ACA Increase Access to Substance Abuse Treatment?

Under this new legislation:

• Substance abuse and mental health treatments become one of ten ‘essential health benefits’ - no matter what plan you’re covered under, you’ll have coverage.

• The act mandates mental health and substance abuse treatment parity - this means you’ll receive treatment for mental health and substance abuse issues that is equal in scope to the treatments offered for physical health complaints.

• The number of Americans who’ll have at least minimal insurance coverage should increase dramatically.

Essential Health Benefits

As of January 1st 2014, any insurance plan you buy into must offer coverage for 10 essential services and treatments - substance abuse and mental health services being one of these essentials.

So no matter what plan you buy, you will have coverage for substance abuse and mental health services.

Mandated Parity

Under new parity regulations, insurance plans must offer benefits that are equivalent in nature to benefits provided for general medical and surgical treatments.

Parity laws will cover all non-grandfathered individual and small-group plans.

Increased Coverage - Increased Access to Substance Abuse Services

According to the Department of Health and Human Services, under the provisions of the act:

• By 2022, 27 million currently uninsured Americans will receive health coverage.
• By 2020, 62.5 million Americans will enjoy increased substance abuse and mental health coverage, including 32.1 million who’ll have coverage for these conditions for the first time.

An estimated 25% of those currently without coverage have a mental illness or substance use disorder in need of treatment, so from this subset alone, the ACA should provide needed treatment to almost 7 million Americans living with mental illness or a substance use disorder.¹

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If you want to be sure you'll get value and benefit from an addiction treatment program, make sure they offer evidence based therapies - interventions that are actually proven to work!

If you broke your arm you’d probably go to a hospital, and no matter which one you went to, you’d likely get similar treatment (x-ray, pain medications, cast or sling, etc).

Addiction treatment isn’t like this, and this lack of uniformity is mostly a bad thing:

• Go to one residential program and you’ll get pharmacological management of withdrawal symptoms, cognitive behavioral therapy to learn cravings management, an introduction to community self help groups like AA and other useful evidence based interventions.

• Go to another residential program with the same problems and you’ll spend days in a hot sauna ingesting supplements and learning very little.

One provides you a solid base for recovery and the other provides little of benefit (and maybe much of harm), but before you go, when looking at 2 equally attractive websites and when talking on the phone with people who all sound very convincing, how are you supposed to know which one is best for you?

Here's how:

• You can evaluate the potential quality of an addiction treatment program by asking detailed questions about which evidence based therapies make up the curriculum -  which ones get used, how are they used and what kinds of staff members run them?

You probably don’t know much about evidence based therapies for substance abuse treatment, but that’s OK - read on, and by the end of this article you’ll know:

• Why you want a treatment program that uses evidence based therapies
• Some examples of evidence based therapies
• About red flag warning signs of non-evidence based programs
• What to ask when you call up treatment programs on the phone

Characteristics of Evidence Based Therapies

So, what is an evidence based therapy?

Definitions can vary slightly, but basically, a treatment is considered evidence based if:

1. Researchers evaluated the treatment using randomized controlled trials or other experimental means and published their results in a peer-reviewed journal
2. Other teams of researchers replicated the experiments and observed similar outcomes
3. The treatment has proven benefits and works as intended
4. The treatment can be standardized and is usable across multiple sites to produce similar results¹

So when you go searching for addiction treatment, especially if considering a residential treatment program, you’ll have to decide between two types of programs

1. Those that use evidence based therapies
2. Those that choose not to

Do you want to go to a program that uses rigorously studied therapies proven to work as promised, or do you want to go to a program that uses unstudied therapies, or even worse, therapies studied and found ineffective?

Evidence Based Therapies for Substance Abuse

The following are some (not all) evidence based therapies for substance use disorder treatment as of June 2013.

Evidence Based Pharmacotherapies

There is strong evidence that, for appropriate candidates, medications used in conjunction with psychosocial therapies increase the odds of success. According to the American Psychological Association (APA), any alcohol or opiate addicted person deemed an appropriate candidate for medication should receive pharmacotherapy.²

Medications proven beneficial in substance use disorder treatment include:

• Methadone (opiates)
• Buprenorphine (opiates)
• Naltrexone or Vivitrol (alcohol)
• Disulfiriam/Antabuse (alcohol)
• Topiramate (alcohol)
• Varenicline (tobacco)
• Buprion (tobacco)
• Nicotine replacement therapy, such as gum or the patch (tobacco)³

Evidence Based Behavioral Therapies

• Motivational interviewing
• Motivational enhancement therapy
• ‘A Woman’s Path to Recovery’ (an evidence based program of recovery for women only)
• Structured couples or family therapy, or ‘Alcohol Behavioral Couples Therapy’
• Behavioral couples therapy
• Cognitive behavioral therapy
• Contingency management (incentive programs)
• Community reinforcement therapy
• 12 step facilitation therapy (an introduction to the 12 steps)
• The ‘Matrix Model’ (an integrated system of treatment for stimulant abusers)
• 'Brief Marijuana Dependence Counseling'
• 'Strengths Based Case Management' for substance abuse
• ‘Trauma Informed Substance Abuse Treatment’ (a model for women with co-occurring addiction, mental health problems and trauma histories)
• ‘Broad Spectrum Treatment’ (an outpatient program for alcoholics that combines naltrexone and behavioral therapies)
• ‘Contacts, Prompts and Reinforcements’ (an aftercare program that you start during your last week of residential treatment)
• ‘Network Support Treatment’ (a one-on-one program of individual counseling for alcoholics)
• ‘Oxford House Model’ (a model for sober living housing)
• ‘Relapse Prevention Therapy’ (a very common program that teaches behavioral self control)⁴

Red-Flags: Programs that Conflict

While it’s not vital that a treatment program employ only evidence based therapies, programs that boast interventions or policies that contravene what's proven to work may not be the best choice for your treatment experience.

Some examples of policies and interventions that conflict with an evidence based philosophy are:

• Using acupuncture or relaxation therapy as a stand-alone treatment (these types of therapies may serve some purpose as peripheral or secondary programs, but should not serve as first-line treatments)
• Individual psychodynamic therapy
• Unstructured group therapy (not the same as structured - therapist directed - group therapy)
• Confrontational techniques
• Programs that advertise detox without continuing treatment as sufficient (some ultra rapid opiate detox-type clinics may make these types of claims)
• Programs that discharge people from treatment based on relapse

Questions to Ask When Calling Treatment Programs

• Since retention and engagement are so vital to eventual success, how will you keep me encouraged and motivated to continue (to not drop out)?
• Noting that major medical and governmental organizations such as SAMHSA, NIDA, ASAM the APA and others all endorse the use of treatment medications, what is your philosophy on the use of these treatment medications, where appropriate?
• Which evidence based therapies do you use?
• Who runs group therapy sessions? What type of credentials/license does this person have (group therapy is enormously helpful, provided it’s run by a trained counselor or therapist)?

After You Call, Double-Check What You’ve Been Told

Here’s the thing about addiction treatment:

1. Sometimes people tell you things about recovery that aren’t true. Reasons for this include: they incorrectly believe what they’re telling you, they believe that deception serves your best interest - or in more nefarious situations, they may intentionally mislead you as a way to convince you of some fact or to sell you on some program
2. And sometimes, even things that seem to make a lot of sense, aren’t necessarily true.

Here’s an example:

• You can’t solve a drug problem by taking more drugs.

On the surface it sounds pretty sensible, but in reality, research tells us that in appropriate situations, anti-craving or withdrawal management medications can help a great deal and can greatly increase your chances of maintaining recovery.

So what’s the consumer to do?

Check and recheck!

Fortunately, you don’t need a Ph.D to find accurate information. Try this:

1. When you call treatment programs, ask specific questions about which evidence based interventions they use. Tell them you plan on researching these later so you need the precise names of each therapy.
2. Write these names down
3. Check out the Substance Abuse and Mental Health Agency’s Evidence Based Treatment Registry. If the treatment is truly evidence based, you'll find everything you need to know about it on their website. The University of Washington‘s Alcohol and Drug Abuse Institute runs another good resource on evidence based programs for substance abuse treatment, which can be found here.

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While the strengthening of appropriate and encouraging relationships is beneficial in any drug treatment program, participation in a romantic or sexual relationship can impair the ability to recover, and as such the vast majority of drug treatment facilities have no tolerance rules against romantic relationships between recovering drug and alcohol addicts.

Because of the enormous emotional transition occurring during drug treatment, the temptations towards romantic involvements are high, but the costs to recovery are equally high.

Why are romantic relationships so tempting during drug treatment?

Recovering addicts enjoying the companionship and support of a group of people who understand and empathize with the pains and trials of recovery often form lasting bonds and friendships. Although the bonds of friendship can assist in the recovery process, the bonds of romance or sexual relationships turn our attention outwards, away from the focused internal healing that needs to occur.

Because many drug and alcohol abusers have experienced a lessening of sexuality due to the effects of substance abuse, the initial period of recovery, and with recovery a restoration of normal sexuality and desires, can create strong infatuations and romantic feelings for others in the facility.

Additionally, because fellow recovering addicts really understand the pains and heartaches of addiction and share the journey of recovery; many recovering addicts feel spiritual connections of understanding and support that can be interpreted as love or sexual attraction. Whether this initial attraction is real or not makes little difference, as during recovery, these relationships are uniquely damaging and reduce the probability of long term success and sobriety.

What are the dangers of romantic relationships?

Although peer support relationships, relationship strengthening with family, and even professional relationships with therapists and addictions professionals are all beneficial to the process of recovery, romantic and sometimes volatile sexual relationships are rarely helpful.

Firstly, the dangers of STD's are elevated within populations recovering from substance abuse and having often engaged in risky drug or sexual behaviors while using. The last thing a recovering addict needs to complicate their recovery is the addition of a new and destructive ailment.

Secondly, when we get involved in a romantic relationship, there is an inevitable desire to present ourselves in a positive light to the other party. While this presentation is generally harmless, during the healing and introspective days of rehab, when honest and full participation in group and other therapies can make the difference between success and failure, failing to reveal our ugly truths can be very harmful.

Thirdly, rehab is an internal and personal process; and healing towards addiction recovery needs to come from within after great introspection and personal honesty. This process of introspective and meditative healing cannot be assisted when our focus turns outwards to infatuation with another person. Any distraction in drug treatment negatively affects the recovery process, and even a distraction that may feel compelling and right, is ultimately destructive to recovery.

Relationships in drug treatment

Drug treatment facilities actively monitor the interactions of participants in a program, and are aware of the frequent temptations towards romantic feelings and the negative implications of enacted sexual relationships. Addictions professionals working within drug treatment facilities do not police relationships as a matter of prudishness, but out of concern for the recovery process of each and every recovering addict.

The strengthening of family and peer support relationships assists the addict when once again immersed in the environment of temptation, but romantic relationships have no place during a period of introspective rehabilitation, and as tempting as they may seem, they are never a wise idea.

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Biofeedback Therapy is a relatively new form of alternative therapy that uses specialized instruments and technology to measure quantifiable reactions and responses of the body.

Biofeedback - What is it?

Biofeedback is simply monitoring various things that are happing in our bodies such as blood pressure, heart rate, skin temperature, muscle tension and perspiration and seeing the results in real time.

Even things like taking your temperature or weighing yourself on your bathroom scale could be considered biofeedback.

Uses

Biofeedback Therapy is used to treat a wide range of issues, but is commonly used to treat things like hypertension (high blood pressure), incontinence, migraines and chronic headaches, muscle tension and pain, sports injuries insomnia and anxiety.

More recently and with promising, but not proven results, biofeedback has been applied to the treatment of ADHD and also incorporated into addiction treatments.¹

How it Works

The idea behind Biofeedback Therapy is that we can control our body’s responses and behavior by understanding it better. With the help of scientific equipment, patients are made aware of physiological information in real time that they would otherwise not notice, and with the help of a professional, these results can be interpreted and applied to improve the ailment.

With practice and training, biofeedback therapy can put the patient more in control of physical processes of the body - processes that previously were automatic responses of the nervous system or brain. Although results can vary dramatically, the idea is that by having access to this physiological information, you can teach yourself to self regulate better. Essentially, mind over matter.

In terms of its application to addiction, biofeedback is in some aspects the scientific approach to the benefits of meditation. Getting attuned to your body and mind and therefore having greater influence over it. By learning relaxation techniques and controlling respiration rates, biofeedback can improve sleep and help treat anxiety and depression. Many patients say they gain more confidence about their bodies when they realize they can control physiological aspects of themselves.

Some studies have shown that people who have alcohol abuse problems also have different brain wave patterns, yet by observing brain waves and learning biofeedback techniques, one can retrain the brain subtly over time.

For Example

There is a connection between skin temperature and the level of stress someone is experiencing. Therefore, when a biofeedback machine registers a drop in body temperature, then the patient knows that they need to start relaxation techniques.

Another measurement that is often taken is the activity of sweat glands and the amount of perspiration (galvanic skin response) that a patient expels, because this reflects levels of anxiety. One well known application of this is the polygraph machine (lie detector) which takes advantage of this physiological response to find out if someone is not telling the truth.

Brain waves can also be observed using an electroencephalography or EEG. Different types of brain waves reflect different mental states. Beta waves indicate wakefulness, Alpha waves show relaxation and Theta waves reflect calmness.

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EMDR stands for Eye Movement Desensitization Reprocessing Therapy. No one quite understands why it works, but as more practitioners adopt the method, most scientists concede that is does.

EMDR is a therapeutic tool, where patients remember traumatic memories while focusing in on the moving hand or light of a therapist. It is used in the treatment of post traumatic stress disorder, and increasingly, in addiction treatment. It has also shown efficacy in the treatment of chronic pain, depression, eating disorders, stress, recovery from sexual abuse and poor self esteem.

Why Do Negative Memories Haunt Us?

Negative or traumatic memories can cause a psychological and physiological response upon recall. When we remember something very traumatic, the response in the body and mind can be extreme.

Symptoms of PTSD, for example, can include insomnia, depression, irritability, emotional numbness, shame and self destructive behaviors, such as substance abuse.

Most people will try to repress (not think about) the traumatic experience, to minimize these unpleasant reactions; but this repression only exacerbates the severity of the symptoms, and lessens our ability to control them.

A common therapeutic technique for PTSD is cognitive behavioral therapy, in which patients mentally re-experience the traumatic event, and learn healthier ways to deal with the stress that the memory creates. Through this type of exposure therapy, the influence of the memory diminishes, and symptoms fade.

EMDR works in a similar ways, but its proponents argue that it gets the same results as cognitive behavioral therapy, more quickly.

How Is EMDR Used?

During an EMDR session, the therapist will ask the patient to think of a very positive memory, as well as very negative or traumatic memories. The therapist will ask the patient to remember in detail the experience, or memory, and at the same time will ask the patient to visually follow a quickly moving hand or light.

The therapist will alternate between positive and negative memories, and continue to do so until the intensity of the emotional response to a negative memory is significantly reduced. This reduction in the influence these memories has on our bodies and minds is enduring, and EMDR therapy can erase the legacy of traumatic memories forever. You still remember the experience, but no longer is the memory associated with extreme psychological or physical reactions. You can finally move on.

Why Does EMDR Work?

No one knows, not for sure anyway. A relatively new therapeutic technique, EMDR lacks a significant base of scientific study, although preliminary studies do replicate the positive effects of anecdotal reports.

Clinicians hypothesize that EMDR helps the mind to finally process these traumatic memories completely, and once processed, these memories no longer threaten us as we recall them.

Some speculate that the movement of the eyes during EMDR mimics that of rapid eye movement (REM) during sleep, a known informational processing period. Others think that moving the eyes laterally back and forth allows the brain to consolidate the memory between the left and right hemispheres of the mind.

Adding to the confusion though, recent research with blind patients has shown that eye movements may not even be necessary, and that hand clapping may work equally well.

Why is EMDR Used in Drug and Alcohol Rehab?

Therapists love EMDR because of its rapidity of effect. Since time spent in rehab is often limited, a therapeutic tool like EMDR allows for intensive sessions that offer results, quickly.

Many substance abusers drink or drug, in part due to past traumas and EMDR may help these patients to limit the influence these past traumas have on their present reality.

These emotional traumas contribute to relapse, and reducing their legacy and impact increases the likelihood of long term success and sobriety.

Some people enter drug treatment after a DUI conviction to avoid or minimize the legal repercussions of the arrest, and some repeat DUI offenders will be sent to court mandated drug and alcohol treatment programs after a DUI conviction.

For some, the legal complications and public exposure of a DUI can be enough to break through an existing wall of denial, and force a personal acceptance of the need for change, and the need for professional drug treatment.

The good news is that regardless of the motivations for entry into a drug treatment program after a DUI conviction, the therapies and programming of drug treatment prove almost equally effective to all that access them, regardless of their initial motivations for joining.

We can sometimes learn more about ourselves through a few hours of working with horses than we can through months of psychotherapy - and we don't even need to ride horses to do it! Learn the benefits of equine assisted therapy for addiction treatment.

You can't manipulate or bully a horse, a horse knows when you're feeling anxious or scared and horses will respond well to kindly and assertive communication.

Prey and herd animals, and very attuned to the emotional states of those around them, horses have a unique sense about people. They are said to mirror the emotional states of whomever they are interacting with, and provide therapists observing these interactions real insight into the true natures of their clients.

What Is Equine Assisted Therapy?

It's not about riding horses.

Within the realm of addiction treatment, equine assisted therapy normally occurs un-mounted, with clients interacting with horses in the barn, either alone, or in a group, and with a trained equine therapist observing or facilitating the interaction.

It offers both therapists and clients a revealing glimpse at some deep seated problems, problems clients may be unaware of, or reluctant to talk about.

Horses mirror our emotional states. If we approach a horse feeling anxiety, the horse will respond with nervousness. If we show fear, the horse gets skittish. Should we try to bully, the horse responds with a determined stubbornness.

The equine therapist will ask clients to interact with the horse in a variety of scenarios - sometimes grooming the horse, leading the horse, even catching and bridling the horse loose in the barn. The therapist, and in some cases the group, will observe the interaction, and later discuss with the client what the horse's reaction reveals about the client's character.

These interactions provide metaphoric fodder for the challenges of life and of recovery. A person attempting to dominate in life, and in the barn, will quickly learn how ineffective such a strategy is, and the therapist learning this trait about the client can then help the client to better understand how dominance or control issues may be harming real-life relationships.

A person lacking in assertiveness may find it difficult to lead a horse, offering in a few short minutes a peek into the true nature of the client's character, and providing the therapist with insight into the real challenges facing the client.

Horses don't lie, and they expose us openly. They show trained observers quickly our inner truths, and sometimes, teach us the root causes of our problems in life.

Physical/Emotional, Not Intellectual

Working with horses, can be intense, especially for those not accustomed to close contact with the imposing animals. It prompts a physical/emotional reaction – you don't think, you just feel and do.

Many people suffering addictions intellectualize their problems, to their detriment. They trick themselves into believing in denial or they think their way into blaming others for their problems – and these intellectualizations can intrude into conventional "talk-therapy". It can be a time-consuming and sometimes difficult process for a therapist to break through this wall of intellectualization, and have the client see themselves honestly and openly. Warts and all!

Equine assisted therapy leaves no room for intellectualization. You feel, you react – and you reveal. And just as it shows to a trained therapist the truth of your character, it can also help those in recovery to understand their true natures, and face more head-on some of the real obstacles to emotional growth and recovery.

Equine Assisted Therapy is Rewarding

Most people come to enjoy their regular interactions with horses. There is something undeniably soothing about close contact with the animals, and in addition to the therapeutic aspects of the time spent; most participants find the therapy a rewarding change from other conventional therapies.

Most advocates of equine assisted therapy recommend that it be used in conjunction with other therapies, for best effect.

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