Substance Use Disorder

Treatment for SUD

Treatment for a substance use disorder is extremely important. Without treatment, the disorder lingers, and symptoms may intensify over time. Some individuals with SUDs lose all interest in their jobs, their families, and everything they once most cared about. However, recovery is possible with a combination of therapy, medications, and lifestyle modifications, and individuals with SUDs can lead normal and fulfilling lives.

Treatment goals are best accomplished when there is a sense of connection between the client and the treatment provider, in a supportive clinical atmosphere that is free of judgment and stigma. The relationship between the provider and the patient is essential for recovery. Patients need to feel comfortable enough with their provider to inform them when they have relapsed. If patients don’t feel comfortable admitting that, their providers cannot course correct their treatment plan.

Finding a Therapist

Psychotherapy, often referred to as “talk therapy,” has a range of treatment options. By teaming up with a licensed therapist, people can learn coping strategies and communication skills to help them recover from an SUD. Most therapists have experience working with adults with SUDs.

There are different kinds of professionals who can provide effective therapy:

• Clinical psychologists (PhD)
• Licensed social workers (LSW)
• Licensed professional counselors (LPC)
• Licensed clinical professional counselors (LCPC)
• Licensed Marriage and Family Therapists (LMFT)

Effective types of psychotherapy have been identified in the treatment of SUDs and any co-occurring conditions that may be present.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) has been well researched and is widely used in the treatment of SUDs. CBT focuses on how the distorted ways that we think about ourselves and our lives leads to behavioral choices, including problematic drinking. Challenging old assumptions and beliefs can lead to positive growth and behavioral change. CBT also helps people to identify feelings and situations that may “cue” them to pick up a drink.

Motivational Enhancement Therapy

Motivational Enhancement Therapy is a short-term therapy that was developed specifically for those struggling with addictions or who want to make other lifestyle improvements, such as smoking cessation, improving diet, or getting exercise. The therapy helps people to identify the pros and cons of changing their drinking behavior and to build the skills and self confidence to achieve successful recovery.

12-Step Programs

12-Step Programs are designed to offer a group environment where it feels safe for the person to accept that their problematic drinking has taken control of their life and to give and receive group support to own their life and take back control of their life from the grip of alcoholism. Alcoholics Anonymous, an organization that has existed since 1935, has claimed many successes through these programs. There are AA groups throughout the United States and the world, and meetings are free of charge.

Individuals are encouraged to choose a “sponsor,” who offers support and guidance. There are also 12-Step programs for people who abuse narcotics, and many other drugs. Some people over-use marijuana, and a person who needs marijuana every morning (“wake and bake”) has a problem. Many people who suffer from SUDs report that 12-step programs are an effective addition to professional mental health and addictions treatment.

Mindfulness Therapy

Mindfulness Therapy assists people to prevent relapse by focusing on what is going on for them in the current moment. People can avert substance use by learning strategies and relaxation methods to help increase their awareness of what is going on for them in the present moment.

Eye Movement Desensitization and Reprocessing

Research suggests that a history of trauma may fuel the drive to abuse alcohol and other substances for some people. Eye Movement Desensitization and Reprocessing (EMDR) is a treatment modality designed to help people process trauma and alleviate distressing memories in the form of flashbacks, nightmares and other symptoms of PTSD, which may contribute to self-medicating with alcohol.

There is no need to feel alone in seeking help. Yet there are significant barriers to seeking treatment. Some individuals may be reluctant to seek professional assistance, due to the misguided view that they can solve an SUD on their own. Others may allow shame and self blame to derail their efforts. Still others may have a negative perception of mental health and addiction professionals, and those who seek their care. These are out-dated myths and inaccurate perceptions that serve no one who is trying to achieve wellness and sobriety.

The decision to start therapy

Many people try to cope with their distress on their own, and then feel disappointed when they find that this is very difficult to do. Deciding to start therapy can be hard; it takes courage.

For some people, it can take time to warm up to the idea of sharing one’s intimate thoughts or disclosing details of one’s life, especially for those who grew up in a culture where seeking psychological help was frowned upon.

Psychotherapy is increasingly accepted as not only a way to improve mental health symptoms, but also a means for self exploration and personal growth. No problem is too small for a trained therapist: an individual need not worry that others may have it worse. The willingness to reach out for help is increasing: in 2020, one out of every six Americans (men and women) reported seeing a therapist.

Seeing a therapist with whom one feels comfortable, and a sense of connection, and who also participates in their insurance network, is essential. It may take a couple tries to find a therapist who feels like the right fit. If therapy didn't help the first time around, it can be helpful to give another therapist a try because therapeutic styles vary so much from therapist to therapist.

Where to start

Asking one’s physician to make a referral is often a good place to start. Many health insurance cards have websites or 1-800 numbers to call for a list of in-network providers.

To find a therapist who takes your insurance, the National Institute of Mental Health offers a comprehensive list of resources.

Psychology Today also lists therapists by type, location and insurance.

Medications can play an important role in treatment

The Food and Drug Administration has approved medications for the treatment of some substance use disorders. For example, there are three medications for the treatment of AUD: Naltrexone, Acamprosate, and Disulfiram. Naltrexone is also used to treat opioid use disorder. Note that there are no medications for many types of substance use disorders at this time.