Practicing Recovery

Man in museumCertain personality traits have been proven to be associated with the development of substance use disorders. Exposure to trauma and a lack of a strong support system can also contribute to the development of unhealthy coping mechanisms. In some cases, this can include the development of substitute addictions after completing a drug or alcohol rehab program.

About Substitute Addictions

Substitute addictions are behavioral addictions that are used to replace the void left by no longer abusing drugs or alcohol. They may seem to be harmless coping mechanisms at first glance but can cause many of the same negative consequences as substance abuse.

Just as substance abuse affects people from all demographic groups, anyone can develop a substitute addiction after leaving rehab. However, individuals with co-occurring mental health disorders such as anxiety or depression may be slightly more vulnerable to the development of substitute addictions.

Common substitute addictions include:

  • Food addiction: Food addictions are very common in the early stages of recovery. This typically involves binging on sweets or fast food but can include any form of overeating. Food addiction can lead to weight gain, nutritional deficiencies, and a general feeling of low energy or sluggishness.
  • Shopping addiction: Someone with a shopping addiction compulsively purchases items they do not need or want. They may cause harm to their finances, run out of storage space in their home, or hide their purchases from others out of shame or embarrassment.
  • Gambling addiction: Scratch tickets, online casinos, or sports betting offer instant thrills, especially when you win a prize. However, for someone with addictive personality traits, gambling can quickly become an obsession that leads to significant financial troubles.
  • Work addiction: Being devoted to your career is admirable, but not at the expense of maintaining relationships with loved ones. Work addiction can also cause problems if you’re not sleeping, eating, and engaging in appropriate self-care activities to promote recovery from substance abuse.

Video game addiction, social media addiction, or exercise addiction may also be considered types of substitute addictions for people in recovery. Any activity done to excess has the potential to cause mental distress and negative consequences.

Signs of a Substitute Addiction

The signs of a substitute addiction are quite similar to those of an addiction to drugs or alcohol. Your behavior may be considered a substitute addiction if you agree with the following statements:

  • You feel embarrassed, guilty, or ashamed by your behavior.
  • You lie to friends and family about your activities.
  • You’ve experienced negative consequences, such as health problems or financial difficulty, due to your behavior but feel powerless to stop.
  • You find yourself neglecting other areas of your life to engage in the desired behavior.
  • You’ve engaged in illegal or unethical actions, such as stealing, to support your behavior.
  • You have tried to cut back or change your behavior patterns without success.

A Note About Medication Assisted Treatment

Medication assisted treatment refers to the practice of using prescription medications to manage withdrawal symptoms and reduce the urge to use an addictive substance. MAT is often associated with opioid use disorders but can be recommended for people in treatment for alcohol addiction as well.

A common misconception about MAT is that it promotes the development of a substitute addiction. It’s understandable to be nervous about prescription medication if you developed an accidental addiction to opioids, but MAT is closely monitored. You can’t get “high” from any of the medications being used and counseling is provided as part of the care plan. The goal is to use MAT as a stepping stone to recovery.

A substance use disorder is a biologically-based disease that affects the brain. If your care provider believes you are a good candidate for MAT, this is no different than taking medication to treat a chronic illness such as high blood pressure or diabetes.

Promoting a Lasting Recovery

True recovery involves more than just abstaining from drugs or alcohol. Achieving wellness means breaking negative behavior patterns and building a lifestyle that promotes total body healing. This includes:

  • Learning how to express your emotions
  • Finding healthy ways to cope with stress
  • Building strong relationships with others
  • Engaging in self-care activities as needed

If you are worried that your behavior patterns suggest the development of a substitute addiction, this is a sign that your continuing care plan should be reevaluated. Behavioral addictions can cause significant distress, so your concerns shouldn’t be swept under the rug. Prompt treatment can help you get back on track with your sobriety.

St. Joseph Institute offers a full continuum of care for individuals with substance use disorders, including access to ongoing support to help you address any obstacles you may encounter in your first year of recovery.

By Dana Hinders

To learn more about our programs, please visit our website.

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Women in a meetingIf you’re struggling to make the 12-Step process work for you, don’t give up hope of a lasting recovery. Although Alcoholics Anonymous and other similar groups play a vital role in keeping millions of people clean and sober, these organizations aren’t right for everyone.

SMART Recovery is one AA alternative that you may wish to investigate as a resource for post-residential treatment support. The program can also be helpful as a supplement to AA meetings if you feel you are in need of additional recovery support.

About the SMART Recovery Program

SMART Recovery is an abstinence-based nonprofit organization offering self-help services for people wishing to overcome alcohol or drug addiction. It was founded in 1994 by a group of mental health professionals that included Dr. Joseph Gerstein, Dr. Tom Horvath, Dr. Philip Tate, Dr. Rob Sarmiento, Dr. Michler Bishop, Rich Dowling, Dr. Jeff Shaler, Ann Parmenter, LCSW, Peter Bishop, Dr. Robert Dain, and Dr. Hank Robb.

SMART is an acronym that stands for Self-Management and Recovery Training. The program is based on a cognitive-behavioral psychotherapy known as Rational Emotive Behavior Therapy (REBT). Developed in the 1950s by psychologist Albert Ellis, REBT teaches that changing your beliefs and emotions empowers you to change your actions in regards to self-destructive behaviors such as substance abuse.

SMART Recovery’s approach to treating addiction is recognized by a number of respected substance abuse treatment experts, including the National Institute on Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the American Academy of Family Physicians.

A 12-Step Alternative

Like Alcoholics Anonymous and other 12-Step programs, SMART Recovery meetings are free and intended to offer both support and information. However, there are some important differences between the two programs.

The SMART Recovery program:

  • Is secular and scientifically based
  • Focuses on the present instead of dwelling on the past
  • Encourages an empowerment mindset to change behaviors
  • Does not encourage individuals to admit to powerlessness over addiction
  • Avoids the concept of a higher power
  • Rejects the disease theory of substance abuse in favor of viewing addiction as a habit that can be overcome
  • Believes certain people have a predisposition towards addictive behaviors
  • Is open to people struggling with drug or alcohol addiction as well as process addictions such as eating disorders or sex addiction

Stages of Change

While AA uses the 12-Steps, SMART Recovery talks about four points that participants need to master:

  • Building motivation
  • Coping with urges
  • Problem solving
  • Lifestyle balance

The program also refers to the stages of change that people go through when gaining control over addiction.

  1. Precontemplation – The person doesn’t realize he has a problem.
  2. Contemplation – The person performs a cost/benefit analysis to determine whether addiction is interfering with life goals.
  3. Determination/Preparation – The person makes the decision to work towards personal change. A Change Plan worksheet may be completed at this time.
  4. Action – The person seeks out new ways of handling addiction-related behavior. This can include self-help, group support, or professional guidance.
  5. Maintenance – The behavior has changed and the person looks for ways to maintain this progress.
  6. Graduation/Exit – The person has been in recovery long enough to feel confident in graduating from the SMART Recovery program.

Under the SMART Recovery model, relapse is considered a side event. The program teaches that relapse is not inevitable, but a relapse does not mean change is not possible. If a relapse is handled well, it can serve as a learning experience that helps the person overcome addiction.

SMART Recovery Meetings

Every group is a little different, but SMART Recovery meetings typically run between 60 and 90 minutes in length. Meetings are open to the public unless they are specifically labeled as private or specialized.

Meeting facilitators receive SMART Recovery training before becoming volunteer group leaders. Some facilitators are mental health professionals, but others are concerned individuals who have overcome drug or alcohol addiction and wish to use their newfound skills to help others.

Meetings typically begin with a group welcome, followed by a check in where each person can discuss the challenges they’ve experienced in regulating their behaviors or the progress they’ve made in reaching specific life goals. New participants can share what brought them to the group, but all participation is optional.

After the check in, the facilitator will determine what issues the group will discuss. Everyone will brainstorm potential ways to use the SMART Recovery program to address the specific issue being discussed. Participants often say this part of the process helps them look at their problems in a new way and boosts confidence in their ability to tackle the challenges of building a sober life.

Although meetings are free to attend, a hat is often passed for donations at the end to help with group expenses such as venue fees.

To find a meeting near you, enter your address or zip code in the SMART Recovery meeting locator tool. If you are interested in attending an online meeting, the SMART Recovery online meeting schedule provides a comprehensive list of all live online meetings.

You can visit the SMART Recovery website and use the meeting locator  to find a meeting near you. An online forum is also available to provide supplemental support.

By Dana Hinders

To learn more about our programs, please visit our website.

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Two men talking“Continuum of care” is a phrase that’s commonly used in addiction treatment, but many people seeking help for a substance use disorder find themselves wondering exactly what this means.

Essentially, continuum of care refers to having a detailed plan for what services a person needs to help him or her stay sober after seeking residential treatment. This is a system where clients are guided and monitored over time as they progress through all levels and intensities of care. In some cases, this approach may be referred to as a “Recovery-Oriented System of Care” (ROSC).

There’s No Quick Fix

The most common misconception about addiction treatment is that detox and a quick inpatient stay are all that is needed to ensure lasting sobriety. Unfortunately, treating addiction is much more complex.

Addiction is widely recognized as an illness, but it’s not like getting strep throat and having your doctor write a prescription for an antibiotic. It’s more like being diagnosed with diabetes and having your doctor recommend diet changes, exercise, and blood sugar monitoring in addition to your medication.

You can live a full and productive life after being diagnosed with a substance use disorder, but you need to stay on top of your recovery. If you become complacent, you put your sobriety at risk.

Personalized Care Is Essential

No two people with a substance use disorder are exactly alike. Someone who has been abusing drugs or alcohol for many years has very different needs than someone who has only recently developed an addiction. Exposure to trauma, the availability of family support systems, and the presence of a co-occurring mental health disorder are also examples of factors that can widely influence what services are necessary after residential treatment.

Depending upon the client’s specific needs, some services that may be recommended as part of the continuum of care include:

  • Ongoing outpatient counseling
  • Intensive outpatient treatment that offers a more intensive counseling experience but still allows the client to return home each night
  • Sober living homes that serve as an interim step between residential treatment and living independently
  • Participating in 12-Step groups
  • Participating in alumni events sponsored by the residential treatment center
  • Online recovery education programs

Steps in the Continuum of Care

Every case is a little different, but the general steps in the continuum of care are as follows:

  1. Assessment: Determine the nature and extent of the substance use disorder, as well as any chronic illnesses or co-occurring mental health conditions that would complicate care.
  2. Treatment Plan: Develop an evidence-based plan for addiction treatment.
  3. Treatment: Use detox, counseling, and holistic treatment to build the skills necessary for long-term sobriety.
  4. Evaluation: Determine how successful treatment has been in helping to break old behavior patterns.
  5. Case Management: Develop a plan for ongoing care, such as intensive outpatient treatment or sober living.
  6. Extended Care: Provide the services necessary to ease the transition into independent living while addressing physiological, psychological, and spiritual concerns.
  7. Monitoring: Periodically check in with the individual to make sure there are no areas of concern.

Notice that the level of support gradually decreases as the client becomes more adept at practicing the skills necessary to manage the chronic nature of a substance use disorder.

Easing the Transition to Independent Living

Although the specifics are different for each individual, the goal of continuum care planning is to ease your transition from the structured environment of residential treatment to an independent sober life.

Your care team will help you determine what support you need to practice applying the skills you’ve learned to everyday situations. This includes:

Your continuum of care plan can help address specific goals you may have for yourself as you embrace the possibilities of a life without drugs or alcohol. For example:

Providing a Roadmap to Recovery

It may be helpful for you to think of the continuum of care in addiction treatment as a roadmap to recovery. You still need to do the work of building the skills necessary for sober living, but this approach provides you with a detailed plan and actionable steps to guide the process.

However, this does not mean that your continuum of care plan is set in stone. If you suffer an unexpected setback, the plan can be adjusted as needed. There’s no criticism or judgement, only a sincere desire to help you find the best way to move forward with your recovery journey.

By Dana Hinders


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