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Before an Overdose Happens: 15 Critical Lifesaving Resources

The illicit drug supply has changed dramatically in recent years. Fentanyl, fentanyl analogs, xylazine, and other substances can now appear in drugs without a person knowing they are there, making it increasingly difficult to predict what someone is actually taking. For people who use drugs, and for the people who care about them, having accurate information can mean the difference between life and death.

Harm reduction is not about judging why someone uses drugs or demanding that they stop. It is about keeping people alive. Simple measures such as carrying naloxone, using fentanyl or xylazine test strips, recognizing the signs of an overdose, and making sure someone knows when and where you are using can reduce the risk of a fatal overdose.

This guide brings together practical overdose-prevention information and resources, including free naloxone by mail, fentanyl test strips, overdose warning signs, information about xylazine and fentanyl analogs, and services that can help make drug use safer. You do not have to be ready to quit using drugs to deserve information, support, and the chance to stay alive.

Never Use Alone

Never Use Alone is the U.S. National Overdose Response Line for people who are using drugs alone and may not have anyone nearby to help in an emergency. When you call, a trained volunteer (a peer) will ask for your location and stay on the line with you. If you stop responding after using, the volunteer will contact emergency medical services and send help to your location.

Call 800-484-3731 or 877-696-1996, 24/7 – 365 days a year.

Free Naloxone by Mail

If you need naloxone, you may be able to get it for free through NEXT Distro’s Naloxone for All program. This mail-based naloxone distribution program can send naloxone directly to your door or connect you with a local organization that can provide it, all at no cost.

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Fentanyl Test Strips

Fentanyl has made drug use significantly more dangerous because people often have no way of knowing whether fentanyl is present in a drug or how much it contains. For people who use opioids, this uncertainty has increased the risk of overdose compared with the risks associated with prescription opioids or heroin alone. The danger can be even greater for people who use cocaine, methamphetamine, or other non-opioid drugs because they may have little or no opioid tolerance. Even a small amount of fentanyl can cause a fatal overdose, and people may not realize that the drug they are using contains fentanyl at all.

Fentanyl test strips are small strips of paper that can detect the presence of fentanyl in many types of drugs, including cocaine, methamphetamine, and heroin, as well as different drug forms such as pills, powders, and injectables. Because fentanyl cannot be reliably seen, tasted, or smelled, there is no way to know by appearance alone whether a drug contains it. Fentanyl test strips offer a simple way to check for the presence of fentanyl before using a drug and can help reduce the risk of an accidental overdose.

Signs of an Overdose

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Signs of an opioid overdose may include:

Very small, constricted “pinpoint” pupils
Extreme sleepiness, loss of consciousness, or inability to wake up
Not responding to voices, touch, or other stimulation
Slow, shallow, irregular, or stopped breathing
Choking, snoring, or gurgling sounds
A limp or unresponsive body
Cold or clammy skin
Pale, gray, or bluish skin, especially around the lips, fingertips, or nails

If you suspect an opioid overdose, treat it as an emergency. Administer naloxone if available and call 911. A person who is making choking, snoring, or gurgling sounds may not simply be “sleeping it off.”

Xylazine (Tranq)

Xylazine, commonly known as “tranq,” is a powerful animal sedative that is increasingly being found in the illicit drug supply, particularly in combination with fentanyl. Xylazine is not an opioid, but it can cause profound sedation, slowed breathing, and loss of consciousness, increasing the risk of a fatal overdose. Because it is not an opioid, naloxone does not reverse the effects of xylazine itself. However, naloxone should still be given during a suspected overdose because xylazine is often found alongside fentanyl or other opioids.

The most reliable way to determine whether a drug contains xylazine is to use a xylazine test strip. Because xylazine may not be evenly distributed throughout a drug sample, testing each batch you plan to use can help reduce risk. Xylazine test strips can indicate whether xylazine is present, but they cannot tell you how much is present or how concentrated it may be.

For more information on xylazine, see Xylazine | Overdose Prevention | CDC.

Fentanyl Analogs

Fentanyl analogs are drugs that are chemically similar to fentanyl but have been modified in ways that can change their potency and other effects. Like fentanyl, they act on opioid receptors and can dangerously slow or stop breathing, leading to a fatal overdose.

The potency of fentanyl analogs varies widely. Some are less potent than fentanyl, while others are significantly more powerful. Carfentanil, for example, is estimated to be about 100 times more potent than fentanyl and 10,000 times more potent than morphine. Fentanyl analogs can also be difficult to distinguish from one another, and some standard drug tests may not identify exactly which analog is present. This makes an already unpredictable drug supply even more dangerous.

Carfentanil

Carfentanil is one of the most potent fentanyl analogs found in the illicit drug supply. It is estimated to be approximately 100 times more potent than fentanyl and 10,000 times more potent than morphine. Originally developed for use as a tranquilizer for very large animals, carfentanil has no approved use in humans. Even extremely small amounts can be deadly.

In the United States, carfentanil has been detected in the illicit fentanyl supply and linked to clusters of fatal overdoses. After becoming less commonly detected for several years, it has more recently reemerged in the drug supply, raising concerns about an increased risk of overdose and death.

Acetylfentanyl

Acetylfentanyl is a fentanyl analog estimated to be about one-third as potent as fentanyl and approximately 16 times more potent than morphine. Despite being less potent than fentanyl, it can still cause severe respiratory depression and fatal overdose. It has been identified in numerous overdose deaths and may be found alone or mixed with other drugs.

Acetylfentanyl can also be difficult to detect using routine drug screening methods. Standard immunoassay tests may not reliably identify or distinguish fentanyl analogs such as acetylfentanyl, meaning specialized laboratory testing may be needed to determine exactly which substance is present. This adds another layer of uncertainty to an already unpredictable illicit drug supply.

Fluorofentanyl

Fluorinated fentanyl analogs have become increasingly common in the illicit drug supply. One example, para-fluorofentanyl, is believed to have a potency similar to or somewhat lower than fentanyl. Like other fentanyl analogs, however, it can cause severe respiratory depression and fatal overdose.

These substances also present challenges for drug testing. Fluorinated fentanyl analogs can be difficult to distinguish from fentanyl and from one another using routine testing methods, and identifying the specific substance may require specialized laboratory analysis. Their presence adds to the unpredictability of the illicit fentanyl supply.

Medication for Opioid Use Disorder (MOUD)

Three medications are approved by the FDA to treat opioid use disorder (OUD): buprenorphine, methadone, and naltrexone. These medications can reduce opioid use and support long-term recovery, and medications such as buprenorphine and methadone substantially reduce the risk of overdose and death. Treatment can be tailored to the individual, and medication may be combined with counseling and other recovery supports based on a person’s needs and preferences.

Buprenorphine

Buprenorphine is a medication used to treat opioid use disorder (OUD) by reducing opioid cravings and withdrawal symptoms. Unlike methadone for OUD, which generally must be dispensed through federally certified opioid treatment programs, buprenorphine can be prescribed in office-based and other healthcare settings, making treatment more accessible. It can be used as part of a broader treatment plan that may also include counseling, behavioral health services, peer support, and other recovery resources based on each person’s individual needs.

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Methadone

Methadone is a long-acting opioid medication used to treat opioid use disorder (OUD). When taken as prescribed, it reduces withdrawal symptoms and cravings and can lessen or block the effects of other opioids. By providing a stable, controlled dose, methadone can help people reduce or stop illicit opioid use and remain engaged in treatment. Methadone treatment for OUD is provided through federally certified opioid treatment programs, with take-home doses available to eligible patients under applicable rules.

Naltrexone

Naltrexone is a non-opioid medication used to treat opioid use disorder (OUD). It works by blocking opioid receptors in the brain, preventing opioids such as heroin and prescription pain medications from producing their usual euphoric effects. Unlike methadone and buprenorphine, naltrexone does not cause physical dependence or withdrawal when discontinued. Because opioids must be cleared from the body before naltrexone treatment begins, patients generally need to complete a period of opioid abstinence first. Naltrexone is available as a daily oral medication or a long-acting monthly injection.

Overdose Prevention and Harm Reduction Resources

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1. DanceSafe DanceSafe is a drug checking, earplug slinging, party servicing nonprofit that was founded on social justice principles. Programs include drug education, sexual health and consent deep-dives, political advocacy, and event outreach, where volunteers distribute information and resources at the fabled DanceSafe Booths.

2. Education — NEXT Distro The NEXT Distro Resource Library is an extensive collection of practical harm reduction resources for people who use drugs, their loved ones, and those who support them. The library covers safer drug use and injection, overdose prevention, wound care, specific drugs and emerging substances, HIV and hepatitis C, treatment, sexual health, stigma, and more. It also highlights timely resources on substances appearing in the changing drug supply, including carfentanil, nitazenes, and medetomidine.

3. Grassroots Harm Reduction Grassroots Harm Reduction Network is a national nonprofit that supports peer-based harm reduction organizations across the United States. Its online store provides low-cost drug-checking reagents and test strips, with 100% of proceeds distributed back to local harm reduction groups. Organizations that provide free harm reduction supplies can also join its Buyers’ Club for reduced bulk pricing, making the site a particularly useful resource for grassroots programs working directly with people who use drugs.

4. Harm Reduction Fundamentals CATIE’s Harm Reduction Fundamentals offers free, self-directed courses on substance use and harm reduction. Topics include the principles of harm reduction, reducing substance-related harms, supporting people who use drugs, stigma and discrimination, and Canada’s drug toxicity crisis. The courses are designed to provide practical, evidence-informed knowledge for individuals, frontline workers, and service providers.

5. Harm Reduction – Recovery Research Institute The Recovery Research Institute’s Harm Reduction resource provides a research-based introduction to harm reduction and explains how these strategies can reduce overdose, infectious disease, and other risks associated with drug and alcohol use. It covers practical approaches including naloxone and overdose education, syringe access programs, safer consumption spaces, connections to treatment, and safer-use education, while also addressing common misconceptions about harm reduction.

6. National Harm Reduction Coalition National Harm Reduction Coalition is a national organization dedicated to improving the health and dignity of people who use drugs. The site offers harm reduction education, training, advocacy, and practical resources, including information on naloxone, safer drug use, overdose prevention, and syringe access.

7. NEXT Distro NEXT Distro is an online and mail-based harm reduction organization that helps people access lifesaving supplies and information. The site provides naloxone, syringe-access resources, drug-testing information, educational materials, and other harm reduction services designed to prevent overdose and reduce health risks for people who use drugs.

8. North American Syringe Exchange Network | NASEN: NASEN Directory Founded in 1992, NASEN was created to support syringe services programs (SSPs) and to grow a strong, connected network of organizations and individuals working to ensure that people who use drugs receive the highest quality care, tools, and support available. NASEN is the first and largest low-cost distributor of harm reduction supplies in the United States.

9. Opioid Overdose Prevention and Reversal | SAMHSA SAMHSA’s Overdose Prevention hub brings together reliable, evidence-based resources for preventing and responding to drug overdoses. Visitors can find practical guidance on naloxone, recognizing and responding to an overdose, reducing overdose risk, and connecting people with treatment and recovery services. The site also includes toolkits and resources for families, communities, and professionals who want to help prevent overdose deaths.

10. Overdose Prevention | HHS.gov The U.S. Department of Health and Human Services Overdose Prevention hub brings together trusted federal resources for preventing overdose and finding help. Visitors can access treatment locators and crisis services while learning about overdose prevention, evidence-based substance use treatment, recovery support, safer prescribing, and federal efforts addressing the changing drug supply. It’s a useful starting point for finding reliable, nationwide overdose information and services.

11. The People’s Harm Reduction Alliance People’s Harm Reduction Alliance (PHRA) is a community-based organization that provides practical, judgment-free services for people who use drugs. PHRA offers free safer-use supplies, naloxone, drug checking, syringe services, wound-care supplies, safer-sex supplies, and connections to health and social services. Its approach centers the dignity and autonomy of people who use drugs, with a simple goal: give people the tools and support they need to stay safer and stay alive.

12. Remedy Alliance / For The People Remedy Alliance/For The People is working to put lifesaving naloxone directly into the hands of people most likely to witness an overdose. The organization supplies low-cost and free naloxone to harm reduction programs across the U.S., prioritizing community-based groups and people who use drugs. Its website also offers practical overdose-prevention resources and information on expanding naloxone access, making it a valuable resource for anyone interested in preventing overdose deaths.

13. The SOAR Initiative The SOAR Initiative is a harm reduction organization offering practical tools to help prevent overdose and make drug use safer. One of its most useful nationwide resources is a state-by-state directory showing where people can obtain free drug test strips across the U.S. The site also provides free naloxone, educational information on substances such as xylazine and medetomidine, instructions for using test strips, and overdose-prevention resources. SOAR also operates a Bad Batch Alert system in Ohio that warns people when overdose spikes or dangerous drugs are detected in their area.

7 Signs of Emotional Avoidance & 5 Healthy Coping Strategies

Guest Post: How Emotional Avoidance Fuels Addiction and Mental Illness

Clinically reviewed by Cassie Jewell, LPC, LSATP

Emotional avoidance, or the tendency to push away, numb, suppress, or escape difficult thoughts and feelings, has been associated with a range of mental health concerns and may play a role in maintaining addictive behaviors and psychological distress.

For many people who develop substance use problems, the goal is not simply to chase a high. Sometimes, it is to get away from something that feels unbearable. It might be a painful memory that keeps returning uninvited, a sense of worthlessness that surfaces without warning, or anxiety so persistent that it begins to feel like a permanent part of who they are.

Substances can offer temporary distance from these experiences by quieting intrusive thoughts, dulling painful emotions, or providing a brief sense of relief. Over time, however, using substances to escape emotional distress can become a deeply ingrained pattern. The focus shifts from seeking pleasure to seeking relief, and avoiding pain can become increasingly difficult without the substance.

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Understanding how it works can help anyone struggling with substance use, anxiety, depression, or just a nagging sense that they are never quite present in their own life. The goal isn’t to stop feeling hard things, it’s to stop needing to run from them.

What Is Emotional Avoidance?

Emotional avoidance refers to the tendency to push away, suppress, or escape from uncomfortable internal experiences such as thoughts, feelings, emotions, memories, and physical sensations.

Emotional avoidance is a common human response. Most of us instinctively want to move away from pain, not toward it. When difficult emotions become overwhelming, behaviors such as drinking, doomscrolling, staying chronically busy, overworking, or mentally checking out can provide temporary relief by creating distance from what we are feeling. The problem is that relief is often short-lived.

Avoidance does not resolve the emotion or the experience behind it; it simply postpones having to face it. Over time, relying on these strategies can intensify distress, reinforce the belief that certain emotions are unbearable, and make it increasingly difficult to tolerate uncomfortable feelings when they arise. What starts as an attempt to escape emotional pain can ultimately keep that pain going.

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7 Common Signs of Emotional Avoidance

Emotional avoidance doesn’t always look like avoidance, and it’s something that many of us do unconsciously. Some patterns include:

1. You feel a difficult emotion and almost immediately reach for your phone, food, a drink, or something else to distract yourself

2. You find it hard to sit in silence or be alone with your thoughts for more than a few minutes

3. When someone asks how you are feeling, you default to just “fine,” “tired,” or “stressed” without being able to say much more

4. You notice that you are always busy but rarely feel satisfied

5. You use substances to relax, sleep, socialize, or manage any emotional state that feels uncomfortable

6. Certain topics, people, or memories feel completely off-limits to think about

7. You describe yourself as not really an emotional person but find that emotions sometimes erupt out of nowhere

Common forms of emotional avoidance include:

Using drugs or alcohol to numb stress or emotional pain
Staying busy to avoid sitting with difficult feelings
Avoiding people, places, or conversations that might trigger certain emotions
Ruminating and worrying as a way to feel in control rather than feeling the underlying fear
Scrolling, bingeing, or any repetitive behavior used to stay checked out
Intellectualizing emotions rather than actually feeling them

None of these behaviors are signs of weakness. They are strategies that often develop because, at some point, they worked. Avoiding, suppressing, or distracting yourself from difficult emotions can provide immediate relief when those feelings seem too painful, overwhelming, or uncomfortable to face.

The problem is that what works in the short term can create bigger problems over time. When avoidance becomes the default response, difficult emotions never really go away. Instead, they can build beneath the surface, influence our choices and relationships, and make it harder to cope when new challenges arise. What begins as a way to protect ourselves from emotional pain can eventually become a pattern that keeps us stuck.

How Emotional Avoidance Connects to Addiction

Higher levels of emotional avoidance are consistently linked to higher rates of substance use, particularly alcohol, tobacco, cannabis, and other illicit drugs. Emotional dysregulation, trauma exposure, and addictive behavior, along with elevated avoidance, lead to impulsivity, psychiatric comorbidity, and poorer treatment outcomes.

People with fewer tools for tolerating difficult emotions are significantly more likely to reach for substances to manage those emotions. And the more they rely on substances to manage emotions, the less practice they get at developing other tools.

emotional young woman screaming in the dark — Photo by İbrahim Halil Ölmez on Pexels.com

It creates a cycle so that the substance works, and the emotion goes away temporarily, so the next time the emotion shows up, the pull toward the substance is stronger. Over time, substance use further damages the already limited capacity for emotional regulation.

How Emotional Avoidance Fuels Anxiety and Depression

Avoidance does not just drive substance use; it also prolongs and worsens anxiety and depression.

With anxiety, avoidance feels like relief. When you avoid a situation that makes you anxious, the anxiety temporarily drops. Your brain registers this as confirmation that the situation was dangerous and that avoidance was the right call. The next time you encounter the situation, the anxiety is stronger, not weaker. The avoidance has preserved the fear over time rather than resolved it.

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With depression, avoidance tends to look like withdrawal or isolation. Pulling back from activities, relationships, and responsibilities that feel too hard. The problem is that isolation removes the very things that could generate positive experience and connection, both important parts of successful recovery.

5 Healthy Ways to Manage Emotions

The alternative to emotional avoidance is developing the capacity to be present with emotional experience without being overwhelmed by it or immediately acting to escape it.

Here are some practical starting points:

Name the feeling before you respond to it. When discomfort shows up, try to label what you are actually feeling before you do anything about it. Fear. Shame. Loneliness. Grief. Naming an emotion has been shown to reduce its intensity. It is also the beginning of actually processing it rather than just reacting to it.

Delay the avoidance behavior by a few minutes. If you notice yourself reaching for a substance, your phone, or any other avoidance strategy, try setting a brief timer before you act. You are not eliminating the behavior immediately; you are creating a small gap between the impulse and the action, which is where choice begins to live.

Practice tolerating discomfort in low-stakes situations. Emotional tolerance is a skill that builds with practice. This can look like sitting with physical discomfort for a few minutes before relieving it, staying with a difficult conversation slightly longer than you would naturally, or pausing before responding to a frustrating email. Small tolerances build larger ones over time.

Try Acceptance and Commitment Therapy (ACT) techniques. Interventions explicitly targeting experiential avoidance, most notably Acceptance and Commitment Therapy, showed promising effects in reducing avoidance and substance use. ACT focuses on accepting internal experiences rather than fighting them and on taking values-directed action even in discomfort. Many ACT workbooks are available online even if you are not currently in therapy.

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Get support for what you have been avoiding. Emotional avoidance often develops around specific experiences, traumas, or unprocessed emotional material that feels too big to approach directly. Working with a therapist who understands the connection between emotional avoidance and mental health or substance use can make the difference between managing symptoms and targeting their source.

A Note on Recovery

If substance use has become the primary way you manage emotional experience, recognizing the role of avoidance is an important first step. It reframes the addiction not as a moral failure but as a predictable response to emotional pain that was never adequately addressed.

Recovery that works with emotional avoidance alongside substance use is more likely to hold. Emotions serve a functional and regulatory role, and treatment approaches need to incorporate this understanding.

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References

Bock, R. C., Baker, L. D., Kalantar, E. A., Berghoff, C. R., Stroman, J. C., Gratz, K. L., & Tull, M. T. (2024). Clarifying relations of emotion regulation, emotional avoidance and anxiety symptoms in a community-based treatment-seeking sample. Psychology and Psychotherapy, 97(2), 393–404. https://doi.org/10.1111/papt.12523

Chrétien, S., Giroux, I., Smith, I., Jacques, C., Ferland, F., Sévigny, S., & Bouchard, S. (2025). Emotional regulation in substance-related and addictive disorders treatment: A systematic review. Journal of Gambling Studies, 41(2), 353–448. https://doi.org/10.1007/s10899-024-10366-8

Meyer, P. J., & Segal, G. (2023). Editorial: The role of emotional dysregulation in addiction. Frontiers in Psychology, 14, 1253541. https://doi.org/10.3389/fpsyg.2023.1253541

Sequeda, G., Durán-Rondón, S., Acosta-López, J. E., Torres-Santos, E. A., & Rivera-Porras, D. (2026). Experiential Avoidance and Psychoactive Substance Use: Systematic Review. European Journal of Investigation in Health, Psychology and Education, 16(2), 22. https://doi.org/10.3390/ejihpe16020022

About the author:

Tim Hayden spent 18 years in corporate IT before co-founding a Christian rehab for men in Prescott, Arizona. He is passionate about breaking the stigma of addiction in faith communities and helping men build lives that do not require drugs and alcohol.

The Science of Having a Reason to Live: Meaningful Purpose

“The two most important days in your life are the day you are born and the day you find out why.”

-Mark Twain

Most people think of purpose as a nice bonus in life. Research suggests it’s much more than that.

Purpose Is Good for Your Health

Studies have found that people with a strong sense of purpose tend to live longer and experience lower rates of stroke, heart disease, Alzheimer’s disease, and premature death. They’re also more likely to sleep better, maintain stronger cognitive functioning, and report better overall wellbeing.

Young woman jogging on a paved path in a green park with sunlight filtering through trees

Purpose isn’t just about feeling fulfilled. It appears to have a measurable impact on both the quality and length of life.

People who report a sense of purpose also tend to have better mental health, including lower rates of depression and anxiety, and they handle stress more effectively.

What Fills the Void?

Research links purpose to reduced substance use. One study found that college students with a stronger sense of purpose reported lower alcohol consumption and fewer cravings. Conversely, a lack of purpose is associated with addiction.

This helps explain why purpose can play such a central role in recovery. Programs like Alcoholics Anonymous (AA), for example, don’t just focus on abstinence; they offer connection and a sense of direction. At their core, they give people something to move toward, not just something to avoid. The program is based on one addict helping another.

A circle of people participating in an Alcoholics Anonymous group meeting in a community room

When drugs or alcohol leave, they take a lot with them—routine, identity, relief, escape… If nothing replaces that, the pull doesn’t go away.

Purpose can fill that space. Not perfectly. Not instantly. But enough to have something to hold onto when everything else feels unstable.

When I stopped using drugs in my early 20s, the absence was immediate. Not just the substances, but everything that came with them. The euphoria, the lifestyle… even the predictability of it. Without those things, there was a gap I didn’t know how to fill. My life was quieter, but not necessarily better yet. I wasn’t waking up with a clear sense of direction or meaning. I was just… not using.

And it turns out that’s not enough.

That’s the part people don’t talk about. Removing something that destructive doesn’t automatically replace what it was doing for you. It leaves space. And if that space isn’t filled with something that holds your attention or gives you direction, it doesn’t stay empty for long.

For a while, I tried to outrun that gap by staying busy. But “busy” isn’t a strategy. It doesn’t give your life direction. What started to change was realizing I needed something to move toward, not just to avoid. That’s where purpose started to matter in a different way.

Treatment helps, but it won’t keep you sober. Meaning might. It gives you something to hold onto when there’s nothing else.

I tell clients this all the time, especially the ones staring down a life without drugs or alcohol and thinking, what now? Long-term recovery isn’t just about removing something. It’s about building something in its place, something that holds your attention, gives you direction, and feels like it’s worth staying for.

That “something” isn’t the same for everyone. For some, it’s the structure and connection found in AA. For others, it’s helping people in similar ways, becoming a counselor, social worker, or advocate. And for many, it’s simpler: building a life that supports recovery through routines, relationships, and habits that make it easier to stay.

Purpose as a Compass

Beyond its health benefits, purpose acts as a kind of compass. It helps you decide what to move toward and what to leave behind. Without it, decisions tend to be reactive and short-term. With it, there is a sense of direction, even when things are unclear.

Purpose also fuels motivation. It gives your effort a point. You are not just pushing through difficulty for the sake of getting by. You are working toward something that matters. That difference is what allows people to stay engaged over time, even when progress is slow or uneven.

Purpose doesn’t just affect how people move through difficulty. It also affects how they experience isolation.

Research has linked purpose to lower levels of loneliness. A 2023 study found that older adults reported more loneliness than younger groups, but those with a stronger sense of purpose were less affected by it. Purpose appeared to provide a form of psychological protection, helping people maintain a sense of connection and direction even when they felt alone.

That finding carries weight. Loneliness is not a minor issue or a passing feeling. It is increasingly recognized as a serious public health concern. In the same year, U.S. Surgeon General Vivek Murthy declared loneliness an epidemic, underscoring its widespread impact on both mental and physical health.

Interestingly, people in wealthier countries tend to report higher life satisfaction, while those in poorer nations often report a deeper sense of meaning. One explanation is religiosity, which may shape how meaning is experienced across cultures.

In exploring your own sense of meaning, you may find that spirituality or religious practice becomes part of that picture—but it isn’t the only path.

Purpose Without Perspective

Before you move forward, there’s something important to understand. Even when something feels meaningful, it’s worth pausing.

Purpose can feel powerful, but it isn’t a cure-all—and not all purposes are created equal.

Take wealth, for example. If you’re convinced that getting rich is your purpose, you may end up disappointed. Even if you achieve it, money rarely sustains a sense of meaning on its own.

Worse, chasing the wrong purpose can pull you further away from one that actually fits. You can spend years moving quickly in the wrong direction and miss what might have mattered more.

Some people invest a significant amount of time and energy into their appearance. There’s nothing inherently wrong with wanting to look attractive. It can build confidence and, in many contexts, it’s rewarded.

But for some, it becomes something else. It shifts from self-expression to self-definition—where appearance starts to determine self-worth.

Social media amplifies this dynamic. It creates constant exposure to curated images, filtered realities, and narrow standards of beauty. Attention becomes measurable—likes, comments, followers—reinforcing the idea that attractiveness equals value.

Over time, this can pull people into a cycle of comparison and validation-seeking. The focus shifts from “Do I like how I look?” to “How do I measure up?” and “How am I being perceived?”

The problem isn’t appearance itself. It’s when appearance becomes the primary source of meaning. It’s difficult to sustain on its own—and it often leaves people feeling like they’re never quite enough.

Building a Purpose That Lasts

The path to meaningful purpose isn’t a single step but a threefold process. It begins with honest self-reflection — the willingness to look at your life without filters or excuses. From there, it requires clarity about what truly matters to you, the values and commitments that make your life feel worthwhile. Finally, it calls for a realistic awareness of both your strengths and your limitations. Finding meaning isn’t about ignoring what you can’t do; it’s about building a life that fits the full truth of who you are. Put together, these three elements form the groundwork for a purpose that is not only authentic but also sustainable.

To start defining your purpose in life, see below for a free worksheet download.

Your Personal Purpose Snapshot Download

Alcohol in Your Brain & Body

What is alcohol? Alcohol is a small, simple molecule that moves quickly through almost every part of the body once it’s consumed. Shortly after consumption, alcohol levels increase in the brain, and signs of intoxication follow.

Classic cocktail with ice, cherry, and citrus peel on wooden bar counter

Your Brain on Alcohol

Alcohol slows brain activity by increasing the effects of GABA, the brain’s primary inhibitory neurotransmitter, while reducing glutamate, its main excitatory signal.

Glutamate helps activate the brain, while GABA helps calm it down.The two work together to keep brain activity balanced. When excitatory signals become too strong, inhibitory signals help bring things back under control.

Alcohol disrupts this balance by enhancing the calming effects and dampening the activating ones, which is why thinking, coordination, and reaction time are affected.

This combination can impair prefrontal cortex function within minutes of drinking. The prefrontal cortex—the part of the brain responsible for judgment, self-control, and decision-making—is especially affected by alcohol. As alcohol increases calming signals in this area, it essentially quiets the brain’s control center, which is why people often make choices while drinking that they wouldn’t make sober.

At the same time, alcohol overstimulates the brain’s reward system, flooding it with dopamine, reinforcing the urge to keep drinking. Over time, this makes everyday pleasures feel less satisfying by comparison.

Synapse showing presynaptic terminal releasing neurotransmitters into synaptic cleft to receptors on postsynaptic neuron

The brain uses chemicals called neuromodulators. Unlike neurotransmitters, which send direct signals, neuromodulators adjust how those signals work—amplifying or dampening activity across larger brain systems.

Alcohol doesn’t just affect one pathway. It interacts with multiple systems at once, including those involved in mood, reward, stress, and relaxation. That’s part of what makes it so powerful—and so appealing.

Depending on the person and the moment, alcohol can feel like it’s doing different things: energizing you, calming you down, easing anxiety, or even changing how you perceive other people (including their attractiveness).

It’s also poison.

glass bottles on shelf — Photo by Davide Baraldi on Pexels.com

It can feel like more than one effect at once. But it’s still one substance acting on multiple systems in the brain.

Although alcohol is classified as a central nervous system depressant, it can feel stimulating at lower doses. Early effects may include increased heart rate and a sense of energy or alertness as inhibitory controls are reduced.

As it is absorbed and enters the brain, alcohol slows the central nervous system, which can feel like reduced anxiety, a lift in mood, and fewer inhibitions. At higher levels, alcohol leads to intoxication—slowed movement, poor coordination, slurred speech, and in extreme cases, stupor or coma. Alcohol disrupts how the brain communicates with itself.

Alcohol also affects the cerebellum, the part of the brain responsible for balance and coordination. Even small amounts can lead to slurred speech, blurred vision, slower reaction times, and impaired hand-eye coordination, increasing the risk of accidents and injury. It affects areas responsible for balance, memory, speech, and judgment, which is why injuries and poor decisions become more likely.

Over time, heavy drinking can actually change the brain, including shrinking the size of its cells. Chronic alcohol use is associated with reduced volume in the prefrontal cortex and hippocampus, compromising neural systems involved in executive functioning, impulse regulation, and memory consolidation.

Alcohol-related changes in the prefrontal cortex can worsen difficulties with stress regulation and emotional processing. Gradually, these changes may show up as patterns of behavior that are often mistaken for personality traits rather than effects on the brain.

Eventually, heavy drinking can physically change the brain, especially in areas responsible for judgment and memory. Brain scans show reduced gray matter in these regions, and the longer and heavier the drinking, the more pronounced the damage tends to be.

The hippocampus is affected in much the same way. This part of the brain helps turn experiences into long-term memories and supports navigation. With long-term alcohol use, it can shrink, making memory and learning more difficult.

Blackouts

Alcohol doesn’t just slow the brain down—it interferes with memory and learning. Glutamate helps the brain form new connections and store memories. When alcohol suppresses it, the brain has a harder time learning from what’s happening in the moment.

Alcohol-related memory gaps, or “blackouts” are not simply instances of forgetting, but periods in which memory encoding is disrupted. During these times, hippocampal functioning is impaired, preventing the formation of new memories. This is why individuals may recall part of an interaction but have no memory of how it concluded.

Alcohol in Your Body

Alcohol begins entering the bloodstream almost immediately. A small amount is absorbed through the mouth and esophagus, with additional absorption occurring in the stomach. From there, it moves into the bloodstream, where blood alcohol concentration (BAC) is measured.

Cross-section of blood vessels showing red blood cells and vessel walls

BAC is expressed as a percentage. A BAC of 0.10% means there is one part alcohol for every 1,000 parts of blood.

Several factors influence how quickly BAC rises and how strongly alcohol affects you.

Body size plays a role. The more you weigh, the greater your blood volume, which can dilute alcohol and slow the rise in BAC. Body composition matters as well. Alcohol dissolves more easily in water than in fat, so individuals with a higher percentage of body fat tend to reach higher BAC levels more quickly.

Age also has an impact. As the body ages, alcohol is metabolized more slowly, which can lead to higher levels of alcohol remaining in the bloodstream. Physical health is another factor. Conditions that affect digestion can increase how quickly alcohol is absorbed.

What you eat—and what you mix alcohol with—matters. Food slows things down, keeping alcohol in the stomach longer so it enters the bloodstream more gradually. Carbonated drinks do the opposite. They speed up how quickly alcohol moves into the small intestine, where it’s absorbed faster, leading to a quicker and stronger effect.

Your emotional state even influences how alcohol affects you. When you’re acutely stressed, anxious, or fearful, the body shifts into a fight-or-flight response. Blood flow is redirected away from the digestive system, which can slow alcohol absorption. Chronic stress, however, has a different effect. Over time, it can disrupt digestive functioning, which may lead to faster absorption and stronger effects.

Gender differences also play a significant role in how alcohol is processed. Women don’t process alcohol as well, leading to increased health risks.

Alcohol is eliminated through the liver. A healthy liver can process approximately 0.5 ounces of pure alcohol per hour, which is about one drink (12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor). The rest of the alcohol circulates through your bloodstream until the liver is ready to process it.

The liver breaks down alcohol through different pathways.

Most of the alcohol you drink is metabolized through the alcohol dehydrogenase (ADH) pathway, which occurs primarily in the liver and involves two main steps.

First, alcohol is converted into acetaldehyde by the enzyme alcohol dehydrogenase (ADH), with the help of NAD⁺ (nicotinamide adenine dinucleotide), a coenzyme derived from B vitamins. During this step, hydrogen atoms are removed from the alcohol molecule, forming acetaldehyde—a highly toxic compound that contributes to many of alcohol’s harmful effects.

Next, acetaldehyde is rapidly converted into acetate by another enzyme, aldehyde dehydrogenase (ALDH). This step also uses NAD⁺ and helps reduce the buildup of acetaldehyde in the body.

Acetate is then further broken down into carbon dioxide and water. Unlike the earlier steps, this final stage can occur in many tissues throughout the body, not just in the liver.

NAD⁺ plays a critical role in both steps of alcohol metabolism. As alcohol is processed, NAD⁺ is converted into NADH. When NADH accumulates, it disrupts the body’s normal metabolic balance. This shift can contribute to low blood sugar, increased fat production in the liver, and elevated uric acid levels, which may increase the risk of conditions like gout.

Although the MEOS (microsomal ethanol oxidizing system) is considered a secondary pathway for metabolizing alcohol, it becomes increasingly important with repeated or heavy drinking.

Unlike the primary pathway, the MEOS system becomes more active over time. As it ramps up, the body is able to break down alcohol more quickly. This contributes to tolerance, meaning a person can drink more and feel less of the effects.

This can be misleading. It may feel like the body is “handling alcohol better,” when in reality, it’s adapting in a way that often leads to increased consumption and greater long-term harm.

The MEOS pathway also produces toxic byproducts and places additional stress on the liver, which helps explain why heavy drinking can accelerate physical damage even as subjective effects seem to decrease.

Alcohol Poisoning

Alcohol poisoning or overdose happens when there’s so much alcohol in the bloodstream that the brain starts to shut down the systems that keep you alive—breathing, heart rate, and body temperature.

Signs include confusion, trouble staying awake, vomiting, seizures, slow or irregular breathing, a slow pulse, cold or clammy skin, and a loss of the gag reflex, which increases the risk of choking. Body temperature can also drop dangerously low.

This is a medical emergency. Without immediate help, alcohol overdose can cause permanent brain damage or death.

Paramedics attending to an injured man on a stretcher on a city street with ambulance and police car nearby

Higher blood alcohol concentration (BAC) levels are associated with more severe effects.

At 0.20–0.29%, people may experience confusion, vomiting, and blackouts.
At 0.30–0.39%, there is a high risk of unconsciousness and dangerously slowed or suppressed breathing.
At 0.40% and above, the risk of death becomes extremely high due to respiratory failure.

Conclusion

Alcohol is often marketed as a way to relax, celebrate, connect, or escape, but beneath those experiences is a drug that profoundly alters the brain and body. Its effects can feel pleasant in the moment, which is precisely why it can be so difficult to recognize the harm it causes.

Understanding how alcohol works is not about fear or judgment. It’s about clarity. The more we understand what alcohol actually does—from disrupting memory and decision-making to reshaping the brain over time—the better equipped we are to make informed choices about our relationship with it. Whether you drink occasionally, struggle with alcohol, or are simply curious, knowledge provides a foundation for understanding both the appeal of alcohol and the risks that often accompany it.

References

Ketcham, K., & Asbury, W. (2003). Beyond the influence: Understanding and defeating alcoholism. Bantam.

Nutt, D. (2020). Drink?: The new science of alcohol and your health. Yellow Kite.

Porter, W. (2015). Alcohol explained. Alcohol Explained Ltd.

Why Willpower Isn’t Enough

Guest Post: Willpower in Recovery

A person can deeply want recovery and still feel confused by their own behavior. They may wonder why they keep failing even though they truly want to change.

In my work with clients, I often find that relapse makes more sense when we slow down what happened hours and days before the final behavior. What looked like a sudden failure often had warning signs that were building earlier.

Why trying harder often breaks down

Relapse is often described as a process, not a single event, and many relapse prevention models describe the three stages of relapse⁠ as emotional, mental, and physical.

Willpower often fails because it focuses too much on the final moment, when the person is already overwhelmed, craving, or close to acting on an old pattern. This is one reason it can be helpful to move beyond common misconceptions about addiction⁠ and look more closely at how relapse actually builds.

A downloadable handout at the end of this article walks through the three stages of relapse and offers practical steps for what to do in each stage.

How Relapse Builds Over Time

One helpful way to understand relapse is to look at the timeline leading up to it.

Relying on willpower only at the moment of physical relapse can be like waiting to hit the brakes when the car is already speeding towards the edge of the cliff. The three-stage framework helps people notice when the car is drifting earlier, while there is still more room to correct course.

This does not remove responsibility, but it can reduce shame. When someone sees the chain of events more clearly, they can also begin to see where the pattern could be interrupted earlier next time.

Emotional Relapse: Becoming More Vulnerable

Emotional relapse can be confusing because the person may not be thinking about using at all.

Woman sitting at a café table looking thoughtfully out the window with a coffee cup and open notebook

They may still want recovery, but emotionally, something has started to shift. Stress is building, shame is getting louder, and the person may be pulling away from support or pretending they are doing better than they are.

This is like the warning light on the dashboard. Something may not be broken yet, but it needs attention before the problem gets worse.

In my work with clients, this is often the stage that gets missed. Someone may say, “I was doing fine, and then I just gave in,” but when we slow the story down, it often becomes clear they had not been doing fine for several days.

Signs that stress is building
Emotional relapse can look like:

feeling stressed or at capacity
pulling away from support
sleeping poorly
becoming irritable or resentful
neglecting basic self-care

When you notice this stage happening, it can help to label it clearly: “I am in emotional relapse.”

This is not the time to panic, but it is a time to become more cautious and honest with yourself. It means you are in a more vulnerable state, and your addiction may have more pull than usual over the next few days.

This stage matters because there is often more room to intervene. The person may not need an emergency plan yet, but they may need rest, support, or a way to name what they are feeling before the urge for escape gets stronger.

Mental Relapse: When the Bargaining Starts

Mental relapse is the stage where the person starts looking for a way back to the old behavior.

Man sitting on couch smiling and talking on a smartphone

They may still care about recovery, but their thoughts are starting to move toward permission, relief, or escape.

This is where the car starts drifting toward the shoulder. The person has not relapsed yet, but their thoughts are beginning to pull them closer to the old pattern.

When thoughts start giving permission
Mental relapse can sound like:

“Maybe just once.”
“I can handle it now.”
“I deserve some relief.”
“ I already failed, so what’s the point?”

In my work with clients, this is often where shame and stress start turning into permission. The person is not only having an urge; they are beginning to build a case for why the urge makes sense.

This is where the window starts to narrow. The old behavior may begin to feel more reasonable, more comforting, or more deserved. This is when the alarm bells should start going off in your head.

For many people, this bargaining can happen hours or even minutes before returning to the addiction. This is a strong sign that the relapse process is moving forward unless something changes.

This is the time to slow down and interrupt the pattern. That may mean avoiding people, places, or situations that give you easy access to the addiction. It may also be the best time to ask for help from your support systems and to make your healthy coping systems a priority for the day.

Physical Relapse: Why the Final Moment Is Not the Whole Story

Physical relapse is the stage where the person actually returns to the substance or addictive behavior.

Person preparing white powder on reflective tray with spoon indoors

This may be using the drug, opening the website, or doing the behavior they were trying to stop.

This is the edge-of-the-cliff moment. The behavior is happening or about to happen, so the plan needs to be simple, immediate, and concrete.

When the window is smaller

DBT distress tolerance skills can still help here, but the window is often small. This may mean leaving the room, calling someone, removing access, delaying for ten minutes, or doing anything that helps the person get through the next few minutes without making the situation worse.

Physical relapse also shows why earlier stages matter. If someone only makes a plan for the final moment, they may be waiting until the hardest possible time to intervene.

How DBT Skills Help People Catch the Process Earlier

DBT skills can be useful in addiction recovery because they give people something more specific than “try harder.”

Matching the skill to the stage

Instead of waiting until the final moment and hoping willpower shows up, DBT helps people ask, “What stage am I in, and what skill fits this moment?”

DBT skills can give people concrete ways to manage emotional intensity⁠, tolerate urges, reach out for support, change the environment, or get through the next few minutes without making the situation worse.

This is also why many approaches to substance use treatment⁠ focus on coping skills, support systems, emotional regulation, and relapse prevention planning rather than motivation alone.

The point is not that DBT makes recovery easy. The point is that skills give the person more places to intervene before the pattern becomes harder to stop.

Recovery Is Easier to Protect Earlier Than Later

Relapse prevention is not only about what someone does in the final moment before using or acting out.

It is also about noticing earlier warning signs, such as poor sleep, isolation, shame, bargaining, or secrecy, before the situation becomes more urgent.

Willpower may help someone commit to recovery, but skills help them practice recovery when it gets hard.

A better question after relapse

Instead of asking only, “Why wasn’t I strong enough?” a more useful question may be, “Where did this process start, and what can I do earlier next time?”

For readers who want more perspectives on addiction and recovery⁠, stories and psychoeducation can help reduce shame and make the recovery process feel less isolating.

The downloadable handout included here can help you map your own emotional, mental, and physical relapse warning signs and choose a next step for each stage.

The 3 Relapse Stages Handout Download

Joseph Brooks is a Gainesville, FL counselor who works with teens and young adults navigating ADHD, emotional overwhelm, and addiction recovery. You can learn more about his work with ADHD and DBT⁠ at Brooks Counseling & Wellness.

20 Free Addiction Workbooks for Teens & Adults

Are you or someone you care about looking for support on the journey to recovery? While there are countless paid resources out there, finding reliable and free addiction workbooks can be a challenge. In this post, I’ve rounded up a collection of free addiction resources—workbooks you can access and print without a fee. Each of these workbooks is designed to offer tools, strategies, and reflections to support your recovery or your work as a helper.

Disclaimer:
Please note: These workbooks are shared here for informational purposes only. I’m not responsible for the content, accuracy, or privacy policies of the linked resources. While I’ve tried to include only reputable and helpful materials, always review any resource to ensure it meets your needs and consult with a licensed professional when needed. Additionally, readers are responsible for ensuring they adhere to all applicable copyright laws when using these resources.

free addiction workbooks — Photo by Photo By: Kaboompics.com on Pexels.com

1. A 12-Step Workbook A 72-page workbook

3. The Addiction Recovery Skills Workbook

The Addiction Recovery Skills Workbook (New Harbinger) (2015)

4. Addiction Workbook A 35-page workbook from the site ChoosingTherapy.com

5. Breaking Free of Addiction:42 Therapeutic Tools to Help You Recover from Problem Drug and Alcohol Use A 182-page workbook by Deborah Sosin, LICSW

6. Change: A Self-Help Manual for Drug and Alcohol Users Who Want to Make Changes

Change-A Self-Help Manual for Drug & Alcohol Users

6. The Detox Handbook, A 44-page PDF, published by Exchange Supplies

The Detox Handbook

7. Drugs, Brains, & Behavior: The Science of Addiction, A 36-page booklet, 2014

8. HAMS: Harm Reduction (A printed copy of the book can be purchased on Amazon by clicking the link below.)

9. Mindfulness Skills Workbook for Addiction

Mindfulness Skills Workbook for Addiction (2020)

10. Motivation & Change: Recovery Workbook A 17-page workbook

11. The Outside-the-Box “Free Stuff” Pages | Kim Rosenthal, MD

12. Rethinking Drinking: Worksheets & More

The “official” companion workbook can be purchased here https://amzn.to/4kBC5Em.

16. SUBI Client Workbook-2nd Edition (2007)

SUBI Client Workbook-2nd Edition (2007)

16. Substance Misuse Workbook

Substance Misuse Workbook A 46-page CBT-based workbook from the site http://www.getselfhelp.co.uk/

17. You & Substance Use-Stuff to Think About… & Ways to Make Changes

You & Substance Use-Stuff to Think About… & Ways to Make Changes

18. The Wisdom to Know the Difference

The Wisdom to Know the Difference

19. Your Recovery Workbook-Managing Addiction

Your Recovery Workbook-Managing Addiction

Bonus Section: Supplementary Materials Provided to be Used with Purchased Workbooks

Cravings & Addictions-NEW HARBINGER

Creating Change-A Past-Focused Treatment for Addiction & Trauma

Group Treatment for Substance Abuse

The Emotionally Focused Therapy Workbook for Addiction

The Mindful Workbook for Addiction-2nd Edition-NEW HARBINGER (2022)

Treating Impulsive, Addictive, & Self-Destructive Behaviors

Treating Women with SUD-The Women’s Recovery Group Manual-GUILFORD

How Your Brain Changes When You’re Thriving (Includes PDF Flourishing Scale)

What does it mean to truly thrive? Flourishing goes beyond just getting by—it’s about rewiring your brain for growth, resilience, and fulfillment. Discover how positive psychology and neuroplasticity can help you build a thriving life.

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Key Points

Neuroplasticity & Recovery: The brain has the ability to rewire itself—at any age or health status—meaning growth and change are always possible.
Flourishing & Positive Psychology: Martin Seligman’s PERMA model defines wellbeing through Positive Emotion, Engagement, Relationships, Meaning, and Achievement.
Your Brain on Flourishing: Research shows flourishing changes the brain, enhancing life satisfaction, self-esteem, and motivation.
Practical Steps to Flourish:
- Gratitude practice
- Daily reflection
- Identify & use strengths
Final Takeaway: Healing, growth, and thriving are possible—and they start today, not someday in the future

After having a stroke at 42 as a relatively healthy adult with minimal risk factors and spending three weeks in the hospital and then inpatient physical rehab, I’m not taking life for granted. And I’m not going to wait until I retire to do all the things I’ve been wanting to do. Tomorrow isn’t promised. And I want to spend the rest of my life not just existing but flourishing.

The stroke was a profound shock to me and everyone in my life; I maintain a healthy weight, I don’t smoke, and I have no family history of stroke. (I’m even plant-based!) It came out of nowhere.

Fortunately, the damage was minimal: I experience some balance issues and short-term memory impairment, but fundamentally, I’m still the person I was before. I know that some stroke survivors undergo significant personality changes, depending on which part of the brain is most affected. This post has become deeply personal, leading me to research the brain’s capacity to rewire itself—a phenomenon known as neuroplasticity. Through this, I’m learning how to potentially repair neural pathways or create new ones as I recover.

Research indicates that even individuals with mental illness and substance use, including those with chronic or reoccurring disorders, can fully recover and reach high levels of wellbeing (e.g., flourishing) (Keyes et al., 2022).

Neuroplasticity & Flourishing

“Neuroplasticity can be viewed as a general umbrella term that refers to the brain’s ability to modify, change, and adapt both structure and function throughout life and in response to experience” (Voss, et al., 2017)

Reseeardh indicates that neuroplasticity is possible in brains young and old, as well as brains healthy and diseased (Voss, et al., 2017). So there’s hope for everyone, no matter your age or your physical/mental health.

Understanding the brain’s ability to rewire itself naturally leads to the question: What does it mean to truly thrive? This is where the concept of flourishing comes in.

Flourishing & Positive Psychology

Maslow originally coined the term positive psychology in the 1950s, and the movement gained momentum as psychologists sought alternatives to outdated treatment modalities. Around the same time, humanistic psychology emerged, with Maslow arguing that psychology’s focus on disorder and dysfunction overlooked human potential.

Martin Seligman, a co-founder of positive psychology, became a leading figure in the movement during the 1990s (Nash, 2015). His work centered on authentic happiness, which he defined as a fulfillment achieved not by pursuing momentary pleasures but by making intentional choices that bring meaning to life. According to Seligman (2011), authentic happiness consists of three key elements: positive emotion, engagement (flow)—using one’s highest strengths and talents to meet the world—and meaning—”belonging to and serving something greater than oneself” (p. 11, p. 17).

As Seligman worked to conceptualize wellbeing, he determined that it was comprised of fourth element: accomplishment as in “accomplishment for the sake of accomplishment” (p. 19). As he further developed the construct of wellbeing, he observed that wellbeing has five measurable elements, and introduced the concept of PERMA:

Positive emotion
Engagement
Relationships
Meaning
Acheivement

He observed that “No one element defines wellbeing but each contributes to it” (Seligman, 2017, p.24). Eventually, Seligman concluded that the goal of positive psychology within wellbeing theory is “to measure and to build human flourishing” (Seligman, 2011, p. 29) He suggested several practical exercises for flourishing:

Practice gratitude by expressing it in an intentional and thoughtful way.
Focus on the positive. “Every night for the next week, set aside 10 minutes before you go to sleep. Write down three things that went well today and why they went well” (Seligman, 2011, p. 33). Be sure to stick with it for the entire week.
Identify and use your signature strengths. Start by discovering your signature strengths by taking the free VIA Strengths of Character Survey here: Questionnaire Center | Authentic Happiness. (The assessment is interactive and self-scoring. Registration required.) Examine your top five strengths and determine whether each is a signature strength. Once you’ve determined your signature strengths, carve out a time in your weekly schedule to exercise one or more of these strengths in a new way and then reflect on it through writing. Seligman suggested answering the following questions: “How did you feel before, during, and after engaging in the activity? Was the activity challenging? Easy? Did you lose your sense of self-consciousness? Do you plan to repeat the exercise?” (Seligman, 2011, pp. 39-40).

photo of women hugging each other — Photo by Anna Shvets on Pexels.com

Seligman observed that the exercises were effective even in depressed individuals.

To measure your current level of flourishing, take the short assessment below.

Citation: Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D., Oishi, S., & Biswas-Diener, R. (2009). New measures of well-being: Flourishing and positive and negative feelings. Social Indicators Research, 39, 247-266.

Description: The Flourishing Scale is a brief 8-item summary measure of the respondent’s self-perceived success in important areas such as relationships, self-esteem, purpose, and optimism. The scale provides a single psychological wellbeing score.

Instructions:Below are 8 statements with which you either agree or disagree. Using the 1-7 scale below, indicate your agreement with each item by indicating that response for each statement.

1= Strongly disagree—————————–7=Strongly agree

I lead a purposeful and meaningful life.
My social relationships are supportive and rewarding.
. I am engaged and interested in my daily activities.
actively contribute to the happiness and well-being of others.
I am competent and capable in the activities tf
I am optimistic about my future.
People respect me.

Total your score. The possible range of scores is from 8 (lowest possible) to 56 (highest possible). A high score represents having many psychological resources and strengths.

Click on the link below to download a PDF version of the scale:

The Flourishing Scale

Flourishing & Your Brain

Advancements in brain imaging technology have demonstrated that talk therapy induces measurable physical changes in the brain, including alterations in both neural activity and structural connectivity (American Psychiatric Association, 2020). Research further suggests that flourishing in life is associated with brain changes such as increased activity in specific regions and enhanced connectivity between hemispheres (Goldbeck et al., 2019).

Expanding on this, Waugh (2022) found that brain areas linked to life satisfaction, self-esteem, relationship satisfaction, and goal progress exhibit differences in structure and neural functioning in individuals who experience higher levels of flourishing. Additionally, positive emotions activate key regions of the prefrontal cortex and limbic system, which enhance cognition, behavior, and motivation. This neural activation fosters better decision-making and supports healthier lifestyle choices, ultimately contributing to improved physical wellbeing (Kandel, 2013).

Summary

This journey has taught me that flourishing isn’t about waiting for the perfect conditions—it’s about making intentional choices today. The brain is adaptable, healing is possible, and wellbeing is within reach. Neuroplasticity shows that our brains can rewire and grow, no matter our circumstances. Positive psychology teaches that thriving isn’t about chasing fleeting pleasure, but about cultivating meaning, engagement, and accomplishment. Science confirms that our thoughts, actions, and experiences can reshape the brain, reinforcing wellbeing. I’m not waiting until retirement to do the things I’ve always wanted to do—because tomorrow isn’t promised, but flourishing starts now.

Resources for Flourishing

Action for Happiness Daily actions, community-based well-being initiatives, and science-backed happiness resources

Authentic Happiness | Authentic Happiness

Black Dog Institute | Better Mental Health | Science. Compassion. Action.

Greater Good: The Science of a Meaningful Life

Mind & Life Institute Focused on wellbeing and the mind-brain connection

PositivePsychology.com – Helping You Help Others Articles, research studies, worksheets, and practical tools related to positive psychology

Positive Psychology Center A leading research center on flourishing, resilience, and wellbeing science, founded by Dr. Seligman

Positive Psychology Institute

Self-Compassion by Kristin Neff: Join the Community Now Assesses how self-kindness and mindfulness contribute to flourishing

The Science of Well-Being | Coursera Free course from Yale on wellbeing

On Amazon: Diener, E., & Biswas-Diener, R. (2011). Happiness: Unlocking the mysteries of psychological wealth. Wiley-Blackwell.

On Amazon: Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. Free Press.

On Amazon: Ryan, R. M., & Deci, E. L. (2018). Self-determination theory: Basic psychological needs in motivation, development, and wellness. Guilford Press

VIA Character Strengths Survey & Character Reports

References

American Psychiatric Association. (2020, January 6). Brain imaging shows the impacts of psychotherapy. https://www.psychiatry.org/news-room/apa-blogs/brain-imaging-shows-the-impacts-of-psychotherapy

Goldbeck, F., Haipt, A., Rosenbaum, D., Rohe, T., Fallgatter, A. J., Hautzinger, M., & Ehlis, A.-C. (2019). The positive brain – Resting state functional connectivity in highly vital and flourishing individuals. Frontiers in Human Neuroscience, 12, Article 540. https://doi.org/10.3389/fnhum.2018.00540

Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D., Oishi, S., & Biswas-Diener, R. (2009). New measures of well-being: Flourishing and positive and negative feelings. Social Indicators Research, 39, 247-266.

Kandel, E. R. (2013). The new science of mind and the future of knowledge. In S. H. Koslow & M. F. Huerta (Eds.), Neuroscience in the 21st century (pp. 3–20). Academic Press. https://doi.org/10.1016/B978-0-12-407236-7.00001-2

Nash, J. (2015, February 12). The 5 founding fathers and a history of positive psychology. PositivePsychology.com. https://positivepsychology.com/founding-fathers/

Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. Free Press.

Voss, P., Thomas, M. E., Cisneros-Franco, J. M., & de Villers-Sidani, É. (2017). Dynamic brains and the changing rules of neuroplasticity: Implications for learning and recovery. Frontiers in Psychology, 8, 1657. https://doi.org/10.3389/fpsyg.2017.01657

augh, C. (2022). An affective neuroscience perspective on psychological flourishing: How the brain believes that things are going well. In I. Ivtzan (Ed.), The psychology of flourishing (pp. 33–47). Springer. https://doi.org/10.1007/978-3-031-09786-7_3

Sample Treatment Plan for SUD

A sample treatment plan for SUD (substance use disorder) with suggested goals, objectives, and interventions, as well as a recommended book list

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This is a generic, sample treatment plan for SUD (substance use disorder). It includes a suggested reading list as well as the National Institute on Drug Abuse’s principles of effective substance use treatment.

Photo by John Diez on Pexels.com

Sample-Treatment-Plan-for-SUD Download

CLIENT GOALS

Increase knowledge about addiction and treatment: Individuals should have a basic understanding of addiction, including the signs, symptoms, and the underlying factors associated with developing a SUD. Individuals should be introduced to multiple treatment approaches. (There is no “one-size-fits-all.”)

Develop coping and emotional regulation skills: Individuals should learn how to cope with stress, difficult emotions, and cravings without using substances.

Improve social support and develop effective interpersonal skills: Individuals should develop a strong support network of people who care about them and can help them in their recovery as well as learn how to communicate effectively.

Relapse prevention: Individuals should develop a written plan for how they will maintain their sobriety. Components of a strong relapse prevention plan include the following:

Identify triggers and warning signs: One of the first steps in relapse prevention is identifying triggers. Triggers can be internal (i.e., difficult emotions, thoughts about using, etc.) or external (i.e., people, places, events, circumstances, etc.) Warning signs are behavioral changes or changes in mood or thinking that may indicate the person is in “relapse mode.” Common warning signs include isolation, not attending 12-step meetings, sleeping too much or too little, irritability, etc. (Hint: The individual should consider asking significant others, close friends, or family members for help with identifying their warning signs.)
Develop a coping plan: Once the individual is aware of their triggers and warning signs, they can develop a plan for how they will manage them. This plan might include things like calling a friend, going to a meeting, or taking a walk. The plan should be individualized; things that work for one person may not work for other. The plan should also include coping or distraction techniques for cravings. (Consider this worksheet for tracking urges to use.)
Identify and avoid high-risk situations: If certain situations are likely to trigger the individual, it is best to avoid them if possible. This might mean not going to certain places or not hanging out with certain people. The individual should consider setting boundaries with loved ones who trigger them. If a situation is unavoidable, they may want to bring their sponsor or trusted person with them.
MAT (medication-assisted treatment): A psychiatrist or other licensed provider can prescribe medications such as naltrexone or buprenorphine to reduce cravings. (For locating a practitioner who specializes in MAT, see Buprenorphine Treatment Practitioner Locator | SAMHSA.)
Mental health treatment: If the individual has a mental health diagnosis, it’s important to take mental health medications as prescribed and attend all scheduled psychiatric appointments. It’s also important to understand how co-occurring disorders interact with substance use.
Stay connected to a support network: It is important to stay connected to a support system, such as a therapist, 12-step (or similar) group (e.g., Alcoholics Anonymous, NA, SMART Recovery, Celebrate Recovery, Women for Sobriety, etc.), peer support, or friends and family who are supportive of recovery goals. A recovery network can help the individual to stay on track.
Practice self-care: Self-care and wellness practices are important for everyone, but especially so for individuals in recovery. It’s crucial to get enough rest, eat healthy foods, drink plenty of water, attend to physical illness, and exercise regularly (at a minimum). Nutrition in recovery is especially important for heavy drinkers; the individual should consider seeing a nutritionist if they have a history of alcoholism.
Find hobbies or leisure activities to pursue: A strong recovery program is balanced and includes enjoyable activities. The individual should plan leisure activities or explore new hobbies and engage in them on a regular basis.
Explore spirituality: Many individuals find that spiritual practices such as attending church, seeking guidance from a spiritual leader or shaman, forest “bathing,” etc. enhance their recovery program.
Have patience: Relapse prevention can be a lifelong process. There may be times when slip ups happen. This does not take away from the time the individual maintained their sobriety. The important thing is to get back on track and not give up.

CLIENT OBJECTIVES

Client will abstain from or reduce the use of mood-altering substances.
Client will identify the consequences of their addiction.
Client will identify their triggers, high-risk situations, and warning signs.
Client will develop a plan for coping with cravings and triggers.
Client will identify, challenge, and replace destructive thought patterns with positive, reality-based self-talk.
Client will attend 12-step meetings (or other support groups) regularly. (For online support groups, see The 7 Best Online Sober Clubs.)
Client will develop a support system of people and organizations that are supportive of their recovery.
Client will find a job or start school.
Client will maintain a healthy and balanced lifestyle that includes pleasant activities and self-care.
Client will manage their finances.
Client will resolve any legal issues.
Client will maintain healthy relationships with supportive family and friends.
Client will develop a written relapse prevention plan.

THERAPIST INTERVENTIONS

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Assess for the following:

Suicide risk
Cognitive deficits (either as a result of long-term use and/or overdoses or pre-existing conditions that may impair individual’s insight)
Co-occurring disorders
Pregnancy
Trauma – If severe, individual would benefit from evidence-based trauma treatments, such as CBT, EMDR, CPT (cognitive processing therapy), or TF-CBT
Conditions that lead to “self-medicating” (e.g., insomnia, chronic pain)
Recent events (divorce, death of a loved one, etc.) or circumstances (poverty, disability, etc.) that may directly influence substance use
Family of origin problems – Especially in younger individuals, family therapy should be considered as part of the treatment plan
Safety concerns – Screen for domestic violence, unsafe living environment (e.g., staying at a homeless shelter), at high-risk f or overdose, etc.
Stage of change – Consider harm reduction for individuals who are not ready to commit to sobriety (e.g., Narcan, fentanyl strips, etc.) (For an evidence-based guide on enhancing motivation for change, see TIP 35: Enhancing Motivation for Change in Substance Abuse Treatment | SAMHSA.)

Evidence-based therapeutic approaches:

Motivational interviewing
Motivational enhancement therapy
Mindfulness-based therapies
CBT
DBT
MAT (refer to)
Behavioral therapy
Family or couples therapy
Trauma therapy (EMDR, CPT, Seeking Safety, etc.)
Experiential therapies
Contingency management

Therapeutic interventionS:

Complete a thorough biopsychosocial assessment.
Assess for severity of addiction and for the need for medical detox services; refer as needed. (Consider using the ASAM criteria.)
Refer client to a medical provider for a physical/wellness exam and STI testing (as needed).
Refer client to a psychiatrist for an evaluation and medication management, including MAT, (as needed).
Individualize treatment (or refer to a specialist) for co-occurring disorders.
Assess the severity of impairment in the individual’s different life areas to guide a collaborative treatment plan.
Link client to community resources for deficits in education, employment and/or finances and for legal help (as needed/appropriate).
Explore how past events or circumstances (as appropriate) may have impacted the individual’s addiction.
Provide client with education on addiction (risk factors, signs and symptoms, addiction science, long-term and permanent consequences, complications, etc.)
Provide client with education on various treatment options and approaches (i.e., harm reduction, abstinence, moderation, etc.)
Assist client in identifying their risk factors, triggers, high-risk situations, and warning signs.
Help client to identify consequences and benefits of use.
Help client to identify coping skills.
Assist client with the development of a crisis plan (including things they can do, people they can contact, hotlines, etc.)
Teach assertiveness, anger management, and distress tolerance skills.
Teach mindfulness practices, grounding techniques, and self-soothing activities.
Recommend local 12-step and/or support groups.
Educate client on the benefits of peer support and link client to a peer recovery center or a peer recovery support specialist.
Assess for case management needs (e.g., transportation, childcare, etc. that may impact client’s ability to attend outside meetings), and link client to appropriate resources.
Assist client in identifying supportive persons in their life and maintaining a strong support network.
Help client to identify activities they find meaningful and/or pleasurable.
Explore spirituality with individual.
Teach problem-solving and decision-making skills. (For additional problem-solving worksheets, see 10 Best Problem-Solving Therapy Worksheets & Activities (positivepsychology.com).
Explore the role of shame and guilt in addiction.
Explore values and motivation for recovery.
Teach self-compassion and explore self-care practices. (For more on self-compassion, see Homeworks and Handouts for Clients (actwithcompassion.com).)
Explore making amends (including “living amends”), forgiveness, and self-forgiveness.
Assess for self-esteem problems and assign strengths-based homework or review client’s accomplishments and strengths in sessions.
Utilize CBT techniques for irrational thought patterns that impact client’s ability to stay sober.
Teach and role play refusal skills.
Teach conflict resolution skills.
Challenge and develop discrepancy with clients in the later stages of change.
Consider implementing a reward system for attending therapy appointments; this works well with individuals who misuse stimulants. (See Counselor’s Treatment Manual for more on stimulant use treatment.)
Assist client in developing a written relapse prevention plan. (Consider this free workbook from Between Sessions.)
Assign homework to support the individual’s goals.
Use bibliotherapy for addiction recovery. (See suggested reading list below.)
If client relapses, revisit the relapse prevention plan, problem-solve, and amend as needed.

NIDA’S PRINCIPLES OF EFFECTIVE TREATMENT

Addiction is a complex but treatable disease that affects brain function and behavior. Drugs of abuse alter the brain’s structure and function, resulting in changes that persist long after drug use has ceased.
No single treatment is appropriate for everyone. Treatment varies depending on the type of drug and the characteristics of the patients.
Treatment needs to be readily available. Because drug-addicted individuals may be uncertain about entering treatment, taking advantage of available services the moment people are ready for treatment is critical.
Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems. It is also important that treatment be appropriate to the individual’s age, gender, ethnicity, and culture.
Remaining in treatment for an adequate period of time is critical. The appropriate duration for an individual depends on the type and degree of the patient’s problems and needs. Research indicates that most addicted individuals need at least 3 months in treatment to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment.
Behavioral therapies—including individual, family, or group counseling—are the most commonly used forms of drug abuse treatment.
Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs. A patient may require varying combinations of services and treatment components during the course of treatment and recovery.
Many drug-addicted individuals also have other mental disorders. Because drug abuse and addiction—both of which are mental disorders—often co-occur with other mental illnesses, patients presenting with one condition should be assessed for the other(s).
Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse.
Treatment does not need to be voluntary to be effective.
Drug use during treatment must be monitored continuously, as lapses during treatment do occur. Knowing their drug use is being monitored can be a powerful incentive for patients and can help them withstand urges to use drugs. Monitoring also provides an early indication of a return to drug use, signaling a possible need to adjust an individual’s treatment plan to better meet his or her needs.
Treatment programs should test patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling, linking patients to treatment if necessary.

Source: Principles of Drug Addiction: A Research-Based Guide (Third Edition) (nih.gov)

25 Powerful Quotes About Addiction & Recovery

A list of 25 powerful and compelling quotes about addiction and recovery that are relatable, darkly funny, and inspiring.

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This is a list of quotes about addiction, suffering, and hope that spoke to me – as an addictions professional – as well as on a human level.

These quotes about addiction are raw and relatable, with perhaps my favorites being from the memoir Drinking: A Love Story, in which the author, Caroline Knapp, bares her soul so compellingly that she becomes a kindred spirit in her vulnerability. Carrie Fisher also has a way with words, frank and darkly witty on the topic of addiction.

Read on for quotes about addiction from famous actors, singers, writers, sex workers, and more.

Image by mostafa meraji from Pixabay

Quotes about addiction: on why people become addicted…

“And then I realized I was high. I loved the sensation. It felt like medicine to soothe the soul and awaken the senses. There was nothing awkward or scary – I didn’t feel like I had lost control – in fact, I felt like I was in control.”
Anthony Kiedis (Founder & Lead Vocalist of the Red Hot Chili Peppers)

“Drugs don’t really fix anything, except for everything.”

— Ashly Lorenzana (American Sex Worker, Freelance Writer, & Writer of the Memoir Sex, Drugs & Being an Escort)

“The priority of any addict is to anaesthetize the pain of living to ease the passage of day with some purchased relief.”
Russell Brand (English Comedian, Actor, & Author of My Booky Wook)

“To a drinker the sensation is real and pure and akin to something spiritual: you seek; in the bottle, you find.”
Caroline Knapp (American Writer & Author of Drinking: A Love Story)

On what it’s like having an addiction…

“It has been the desperate attempt to escape from torturing memories, from a sense of insupportable loneliness and a dread of some strange impending doom.”
Edgar Allan Poe (American Writer, Poet, & Literary Critic)

“The attempt to escape from pain, is what creates more pain.”
Gabor Maté (Canadian Physician & Author of In the Realm of Hungry Ghosts: Close Encounters with Addiction)

“Imagine trying to live without air.
Now imagine something worse.”
Amy Reed (American Author)

“Drugs are a sort of dusk that grant us the illusion that we’re the ones who decide when the light goes out, but that power never belongs to us. The darkness takes us whenever it likes.”
Fredrik Backman (Swedish Author, Blogger, & Columnist)

“If you have a need to be comfortable all the time—well, among other things, you have the makings of a classic drug addict or alcoholic.”

— Carrie Fisher (American Actress & Writer)

“If you’re one of us, the bottle takes your shit, that’s all. First a little, then a lot, then everything.”
Stephen King (Best-selling American Author, the “King of Horror”)

“I drank when I was happy and I drank when I was anxious and I drank when I was bored and I drank when I was depressed, which was often.”
Caroline Knapp

“I’ve been asleep and I don’t know if it’s the same day or week or year, but who the hell cares anyway?”
Beatrice Sparks (American Author, Mormon Youth Counselor, & Hoaxer)

Dark humor…

“Reality is just a crutch for people who can’t handle drugs.”
Robin Williams (American Actor & Comedian)

“I used to have a drug problem, now I make enough money.”
David Lee Roth (American Singer, Songwriter, & Original Lead Vocalist of Van Halen)

“An alcoholic will steal your wallet and lie to you. A drug addict will steal your wallet and then help you look for it.”
David Sheff (American Author)

Karl Marx:

“Religion is the opiate of the masses.”

Carrie Fisher:

“I did masses of opiates religiously.”

— Postcards from the Edge

“Selling my soul would be a lot easier if I could just find it.”
Nikki Sixx (Co-founder, Bassist, & Primary Songwriter for Mötley Crüe)

“People are a lot easier to be around when they’re not tweaking out on meth.”
Joe Exotic (“The Tiger King”)

“And in my mind, this settles the issue. I would never drink cologne, and am therefore not an alcoholic.”
Augusten Burroughs (American Author & Screenwriter)

Quotes about addiction: on quitting and recovery…

“[Crystal methamphetamine] was the hardest boyfriend I ever had to break up with.”
Fergie (American Singer/Rapper, Songwriter, & Actress)

“Your addiction is not your identity, but you won’t know that until you’re in recovery; that’s when the two separate.”
Toni Sorenson (American Author)

“The opposite of addiction isn’t sobriety. It’s connection.”

— Johann Hari (Journalist, Writer, & Admitted Plagiarist)

“Getting sober was one of the three pivotal events in my life, along with becoming an actor and having a child. Of the three, finding my sobriety was the hardest.”
Gary Oldman (English Actor & Filmmaker)

“When you quit drinking, you stop waiting.”

— Caroline Knapp

“Recovery is an acceptance that your life is in shambles and you have to change it.”
Jamie Lee Curtis (American Actress, Producer, & Author)

Share your favorite quotes about addiction and recovery in a comment!

Guest Post: Addiction, Family, & Healing

The battles that come with loving a person with an addiction are deeply painful. Healing takes time, but it is possible to recover and rebuild trust.

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The battles that come with loving a person who struggles with addiction can be extremely painful. One such battle is having to face the dishonest words and behaviors of your loved one.

Image by Marco Wolff from Pixabay

When Trust Falls Apart: A Look at Addiction, Family, & Healing

Families will often come to me, astounded by how their addicted loved one can look them right in the eye and calmly lie that he/she is not drunk or high, when it’s evident that he/she is. This type of interaction feels so very personal to the family.

It can leave the family feeling hurt, disillusioned, or downright furious. We think, “How could they do that to someone they love?!”

In a healthy brain, one that is unencumbered by the highjacking of addiction…they likely wouldn’t. That’s why it’s so confusing and painful. Many families will report that the dishonesty about drug and alcohol use causes more wounds to the relationship than the use itself!

However, with education about how addiction works, we can come to understand how the bizarre nature of this disease can actually be fairly predictable – and why our loved one has deviated in this way from values we hold dear (and maybe they once did too).

Getting High to Survive

As addiction progresses, the addicted person becomes more and more captive to the demands of the disease. Because the disease greatly impacts the “survival circuitry” in the brain, the perceived need for the drink/drug becomes a profound compulsion.

The logic that an addicted person would follow is similar to that of a starving man who easily justifies the theft of a loaf of bread, “I gotta do what I gotta do. I’ll deal with the consequences later.”

Stuck in the Middle

I often envision an addicted person in a tragic tug-o-war. On one team is the Disease, fierce and manipulating them into submission. On the other team are Societal Expectations: the shared belief structure of right vs. wrong, laws, and norms.

The notion of a healthy family structure falls under the umbrella of this second team, holding expectations of mutual respect, consideration, honesty, and the like.

While most addicted people never fully abandon these values in their heart of hearts, the pull of the disease tugs progressively stronger until the person is being yanked between others’ expectations and their own compulsions.

At this point, it can feel to the addicted person that the most adaptive solution is… lie like your life depends on it.

In other words, the addicted person attempts to keep society/family satisfied (or at least at bay) while keeping the disease satisfied by continuing to feed it.

It’s Not Because They Don’t Love You

As personal as the dishonesty can feel, this was never about love. I have come to consider dishonesty as an actual symptom of substance use disorder. It’s an adaptation the addicted person makes to continue surviving in “normal life” in spite of the profound changes that have occurred in their brain.

To be clear, I do not share the above explanation as a justification of hurtful behavior. I share it as a clinician who happens not to have a personal history of addiction.

In my early years as a provider for the substance-misusing population, I too, struggled with the bewilderment, and at times admittedly hurt feelings, when my addicted clients would lie to me about their recent use. After all, I was there to help them, right? Why would they lie to ME?

I’ve come to truly understand however, that dishonesty serves as an odd… but reliable ally that shields the addicted person from their shame, consequences, and need to explain their actions.

While a growing body of neuro-scientific understanding continues to shed light on the “WHY?” many of my clients would admit that on a personal level, they truly don’t understand why they do what they do.

What they do know however is that in order to get to their next fix, they need to evade those that love them the most. A loving family who wants to save you from addiction is the greatest threat to your next high.

Breaking Up & Waking Up

That powerful allegiance between the addicted person and their drug/drink seems only to be broken when they themselves come to understand that this intimate affair they’ve had with their substance has become a nightmarish relationship with a toxic abuser, the kind of abuser that controls their life and takes everything else they love away.

At that point, we hope they can finally reconsider their allegiances.

Recovery: Not Just for Substance Users

When a loved one enters recovery from addiction, it often takes the family a very long time to trust again. Understandably there is skepticism and disillusionment. After all, if a person has looked us in the eye and lied so calmly to us during active addiction, what is our barometer for honesty now?

The notion that “time takes time” is a reality that a recovering person must humbly accept. The addiction caused great damage, and that will take time to heal.

But as the family nurses its wounds, they must also understand that trust-building is a two way street. We must accept that our loved one lied to us because they didn’t trust us to understand the tug-o-war in which they were trapped.

The only way to become a trusted ally is to begin listening and trying to understand. In this, we also hopefully set the stage for them to eventually hear and understand our pain as well.

About the Author: Karen Perlmutter, LISW-CP, has worked as a therapist in clinic, hospital, and private practice settings for 15 years. She specializes in the treatment of substance abuse and mental illness, with a particular interest in supporting the entire family system through the complex journey of addiction. She has developed an evidence-based course for families coping with a loved one’s addiction. Karen also aims to share education, support and hope with the community through a variety of speaking forums which have included universities, treatment programs, support groups, National Public Radio, professional development events, and an upcoming Tedx Charleston talk.

Never Use Alone

Free Naloxone by Mail

Fentanyl Test Strips

Signs of an Overdose

Xylazine (Tranq)

Fentanyl Analogs

Carfentanil

Acetylfentanyl

Fluorofentanyl

Medication for Opioid Use Disorder (MOUD)

Buprenorphine

Methadone

Naltrexone

Overdose Prevention and Harm Reduction Resources

Guest Post: How Emotional Avoidance Fuels Addiction and Mental Illness

What Is Emotional Avoidance?

7 Common Signs of Emotional Avoidance

How Emotional Avoidance Connects to Addiction

How Emotional Avoidance Fuels Anxiety and Depression

5 Healthy Ways to Manage Emotions

A Note on Recovery

References

Purpose Is Good for Your Health

What Fills the Void?

Purpose as a Compass

Purpose Without Perspective

Building a Purpose That Lasts

Your Brain on Alcohol

Blackouts

Alcohol in Your Body

Alcohol Poisoning

Conclusion

References

Guest Post: Willpower in Recovery

Why trying harder often breaks down

How Relapse Builds Over Time

Emotional Relapse: Becoming More Vulnerable

Signs that stress is buildingEmotional relapse can look like:

Mental Relapse: When the Bargaining Starts

When thoughts start giving permissionMental relapse can sound like:

Physical Relapse: Why the Final Moment Is Not the Whole Story

When the window is smaller

How DBT Skills Help People Catch the Process Earlier

Matching the skill to the stage

Recovery Is Easier to Protect Earlier Than Later

A better question after relapse

1. A 12-Step Workbook A 72-page workbook

3. The Addiction Recovery Skills Workbook

4. Addiction Workbook A 35-page workbook from the site ChoosingTherapy.com

5. Breaking Free of Addiction:42 Therapeutic Tools to Help You Recover from Problem Drug and Alcohol Use A 182-page workbook by Deborah Sosin, LICSW

6. Change: A Self-Help Manual for Drug and Alcohol Users Who Want to Make Changes

6. The Detox Handbook, A 44-page PDF, published by Exchange Supplies

7. Drugs, Brains, & Behavior: The Science of Addiction, A 36-page booklet, 2014

8. HAMS: Harm Reduction (A printed copy of the book can be purchased on Amazon by clicking the link below.)

9. Mindfulness Skills Workbook for Addiction

10. Motivation & Change: Recovery Workbook A 17-page workbook

11. The Outside-the-Box “Free Stuff” Pages | Kim Rosenthal, MD

12. Rethinking Drinking: Worksheets & More

13. Self-Awareness for Alcohol Reduction

14. Self-Help Strategies for Cutting Down or Stopping Substance Use-A Guide

15. Staying Sober Without God: A Free Companion Workbook

16. SUBI Client Workbook-2nd Edition (2007)

16. Substance Misuse Workbook

17. You & Substance Use-Stuff to Think About… & Ways to Make Changes

18. The Wisdom to Know the Difference

19. Your Recovery Workbook-Managing Addiction

Bonus Section: Supplementary Materials Provided to be Used with Purchased Workbooks

Key Points

Neuroplasticity & Flourishing

Flourishing & Positive Psychology

Flourishing & Your Brain

Summary

Resources for Flourishing

References

Treatment Plan for SUD

CLIENT GOALS

CLIENT OBJECTIVES

THERAPIST INTERVENTIONS

Assess for the following:

Evidence-based therapeutic approaches:

Signs that stress is building
Emotional relapse can look like:

When thoughts start giving permission
Mental relapse can sound like: