Madeline Hodgman-Korth, MSSA, LISW

What Is Cognitive Behavioral Therapy (CBT)? Cognitive behavioral therapy (CBT) is a form of talk therapy that focuses on reducing or eliminating harmful thoughts, feelings, and behaviors that lead to or reinforce substance use.1 It was originally created to help prevent relapse of problematic drinking behaviors.1,2 Today, CBT is widely used to help  treat substance use disorders, as well as co-occurring mental health disorders, such as depression, anxiety, eating disorders, and personality disorders.2 The goal of CBT is to help people develop new ways of responding to difficult thoughts and feelings by replacing their harmful thoughts and feeling with healthy thought patterns. In doing so, CBT can teach people coping skills that help them change their behaviors, including substance misuse.1 [accordion title="Other Types of Therapy for Addiction"] Dialectal Behavior Therapy (DBT) Contingency Management (CM) Family Therapy Motivational Interviewing (MI) [/accordion] How Does CBT Work? Cognitive behavioral therapy works by helping people change their thinking patterns, which in turn leads to changes in behavior.3 CBT has 3 fundamental principles:3 Mental and behavioral health disorders are caused in part by faulty thinking patterns. Negative learned behavioral patterns also contribute to mental and behavioral health disorders. People can learn coping skills to reduce their symptoms and create positive changes. CBT typically starts with a thorough assessment to identify treatment goals.2 Your therapist will use these to help customize your treatment plan.2 This is important because no two people are the same, and CBT essentially teaches you how to overcome negative thought and behavioral patterns through skill-building and practice.3 Once treatment has started, therapy sessions typically focus on the here and now, rather than the past or future, helping you learn more skillful ways of coping with your situation.3 For substance use treatment, this may involve identifying triggers (the people, places, or things that make you want to use substances), then learning about and practicing new ways to deal with them. In addition, standard CBT practices include the use of homework assignments in between sessions.3 Each therapy session usually involves a check-in and a review of the last session.2 Cognitive Behavioral Therapy Strategies CBT strategies that can be useful to gain greater self-control over the use of substances include:1,3,4 Exploring the positive and negative outcomes of substance use.1 Developing problem-solving skills. Role-playing, in which you rehearse ways to cope with triggers or other difficulties through practice with the therapist. Learning how to calm yourself and release stress and anxiety. Homework assignments, which can include monitoring thoughts throughout the week, journaling, and practicing various skills learned in sessions, such as replacing negative thoughts with realistic ones. Effectiveness of CBT for Addiction CBT has become fairly standard in addiction treatment, and studies show that it has good outcomes compared to treatment as usual.5 Research also shows that the CBT skills that people learn in treatment tend to remain after treatment ends, and it may be even more helpful when combined with other addiction therapies or medications.1 There is also evidence that CBT helps to regulate the prefrontal cortex, which generally becomes less active during addiction.5 The prefrontal cortex is responsible for impulse control, attention, and other functions essential to decision-making. During active addiction, this part of the brain is blunted, or inhibited, making these functions less accessible, but CBT can help to change it over time to a more adaptive function.5 Benefits of CBT for Addiction CBT is found to have multiple benefits for treating addiction, including:1,4,5 Reducing cravings and urges to use or drink. CBT helps patients to cope more effectively with internal triggers, such as difficult emotions or memories, as well as external triggers, like being around people who drink or use. Increasing resilience and confidence. CBT increases cognitive flexibility (the ability to change your thoughts or take in new information) and self-efficacy (the belief that you can successfully make necessary changes). Fortifying relapse prevention skills. This may include learning to recognize and avoid high-risk situations or using other coping skills to manage cravings and urges. Flexible and widely available. CBT can also be used in combination with other therapies, medication, or computer-based approaches. It is also one of the most common therapy types. In short, there are numerous benefits to pursuing CBT for substance abuse treatment. By choosing an addiction treatment program that utilizes CBT techniques, you will learn to challenge unhelpful thought patterns, manage your emotions more effectively, and ultimately alter the behavior that contributes to addiction. How to Find Cognitive Behavioral Therapy for Substance Use If you or a loved one is struggling with a substance abuse disorder, you are not alone. Treatment can help you start to heal from addiction. Many treatment centers, including American Addiction Centers (AAC), offer cognitive behavioral therapy as part of treatment. Contact our free, private helpline at [phone] for more information. We can help you review different treatment options to find the program that is right for you. [vob-aktify-cta title="Does your insurance cover cognitive behavioral therapy?" subtitle="Check your benefits online or text us for more information."] [accordion title="Detox at American Addiction Centers (AAC)"] Detox Centers: Laguna Treatment Hospital Adcare - Rhode Island Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks Immediate Service Areas: Aliso Viejo, CA Kingstown, RI Worcester, MA Lafayette, NJ Las Vegas, NV Grand Prairie, TX Etta, MS Hollywood, FL Riverview, FL [/accordion][accordion title="Treatment by location"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title ="Insurance Articles"] Aetna Ambetter Blue Cross Blue Shield Humana Kaiser Permanente Medicaid Medicare Tricare Without Insurance Veterans Insurance [/accordion][accordion title ="Treatment articles"] Detox services: Inpatient detox Outpatient detox Medical detox Rehab services: Rehab Inpatient rehab Outpatient rehab Same-day rehab State-funded rehab 30-60-90 day rehab Free rehab Choosing rehab Co-occurring Disorders PTSD Aftercare services: Aftercare Sober Living Support Groups Alcoholics Anonymous (AA) Narcotics Anonymous (NA) [/accordion] [sources] National Institute on Drug Abuse. (2020, June 1). Cognitive-behavioral therapy (alcohol, marijuana, cocaine, methamphetamine, nicotine). Chand, S., Kuckel, D., and Huecker, M. (August 26, 2021). Cognitive behavioral therapy. National Center for Biotechnology Information, Stat Pearls. American Psychological Association. (2017). What is cognitive-behavioral therapy? National Alliance on Mental Illness. (n.d.). Psychotherapy. Zamboni, L., Centoni, F., Fusina, F., Mantovani, E., Rubino, F., Lugoboni, F., & Federico, A. (2021). The effectiveness of cognitive behavioral therapy techniques for the treatment of substance use disorders: a narrative review of evidence. The Journal of Nervous and Mental Disease, 209(11), 835­–845. [/sources] ...

Acamprosate is a medication commonly use in the treatment of alcohol use disorder (AUD).1 Acamprosate works by helping to reduce cravings and uncomfortable symptoms of alcohol withdrawal, such as insomnia, anxiety, and restlessness.1 Due to these effects and acamprosate’s low potential for misuse and addiction, it is a common medication for addiction treatment (MAT) for those struggling with alcohol addiction. Understanding what acamprosate is, how it works, and how it can be part of a comprehensive treatment program can help you understand and find an addiction treatment program. What Is Acamprosate? Acamprosate, sometimes called by the brand name Campral, is one of three medications approved by the FDA for the treatment of alcohol use disorder (AUD).1 Acamprosate is commonly used to help manage or reduce cravings in those struggling with AUD.1 Many people are prescribed acamprosate after detoxing from alcohol to help reduce their cravings and urges to drink in early recovery.1 Acamprosate is non-addictive and carries very little risk of overdose, making it a safe medication when prescribed by a healthcare provider.1 How Does Acamprosate Work? The mechanism that makes acamprosate effective in reducing cravings is still not fully understood. Research indicates that it normalizes brain activity that is disrupted by chronic alcohol use.1 More specifically, it appears that acamprosate counterbalances a lack of the neurotransmitters GABA and glutamate in the brain, which then produces fewer cravings for alcohol.2 Acamprosate has been proven effective in people who have completed detoxification. However, its effectiveness has not yet been studied in people still using alcohol or not yet fully abstinent.2 What Are the Side Effects of Acamprosate? Common acamprosate side effects include:1, 3 Diarrhea and cramping of the intestines. This is the most common side effect of taking acamprosate and is present in about 10% to 17% of all patients. Skin itchiness Dizziness Headache Flatulence Nausea Anxiety Insomnia Muscle weakness Increased sexual desire3 Overall, acamprosate is generally well-tolerated with a low incidence of side effects in most patients.3 In rare severe cases, some people may experience depressive symptoms and suicidal thoughts.1 If you are uncertain if you are experiencing side effects of acamprosate or if your side effects worsen, seek the guidance of your healthcare provider. Acamprosate for Addiction Treatment Acamprosate is typically prescribed five days after the cessation of alcohol use, at which point a patient is most likely done with the detoxification process.2 Acamprosate usually reaches its full effectiveness within 5 to 8 days after initiating therapy, and patients typically take acamprosate for up to a year after becoming abstinent from alcohol.1, 2 Treatment providers need to be knowledgeable about acamprosate, its uses, and potential side effects for the purpose of educating their patients and continuously assessing their needs.1 Providing education about acamprosate and helping patients to make informed decisions can be part of a clinical treatment program with their prescribing professional, as well as with a mental health therapist, as motivation for change is a powerful factor in the effectiveness of acamprosate.1 For example, if patients are not motivated to change their drinking behaviors, they may be less likely to take acamprosate as prescribed, making it less effective. As such, Acamprosate is generally considered as part of a larger addiction treatment plan, and typically paired with comprehensive counseling and behavior therapy programs.1 How to Find Treatment for Alcohol Use Disorder If you are considering taking acamprosate for an alcohol use disorder, it may be a good idea to start by consulting with your doctor or another healthcare provider. It is important to assess your physical and mental health and identify treatment options that are individualized based on your needs. Your doctor will also help you determine whether medication-assisted treatment is right for you and recommend what level of care you may need. After you have talked with your doctor, you may be wondering how to find treatment for alcohol use. Tools like SAMHSA’s Treatment Locator can help you to find different treatment facilities in your area. You may also benefit from reaching out to an addiction helpline. American Addiction Centers (AAC) operates a 24/7 helpline that can connect you with compassionate professionals. Our staff can answer questions you may have about acamprosate and addiction treatment, help direct you to suitable treatment facilities, and verify your medical insurance. Don’t delay a life of recovery, get started today by calling [phone]. [accordion title="Detox at American Addiction Centers (AAC)"] Detox Centers: Laguna Treatment Hospital Adcare - Rhode Island Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks Immediate Service Areas: Aliso Viejo, CA Kingstown, RI Worcester, MA Lafayette, NJ Las Vegas, NV Grand Prairie, TX Etta, MS Hollywood, FL Riverview, FL [/accordion][accordion title="Treatment by location"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title ="Insurance Articles"] Aetna Ambetter Blue Cross Blue Shield Humana Kaiser Permanente Medicaid Medicare Tricare Without Insurance Veterans Insurance [/accordion][accordion title ="Treatment articles"] Detox services: Inpatient detox Outpatient detox Medical detox Rehab services: Inpatient rehab Outpatient rehab Same-day rehab State-funded rehab 30-60-90 day rehab Free rehab Choosing rehab Co-occurring Disorders Anxiety Depression PTSD Therapy Aftercare services: Aftercare Sober Living Support Groups Alcoholics Anonymous (AA) Narcotics Anonymous (NA) [/accordion] [sources] Sources Center for Substance Abuse Treatment. (2005). Acamprosate: a new medication for alcohol use disorders. Substance Abuse Treatment Advisory, 4(1). Substance Abuse and Mental Health Services Administration and National Institute on Alcohol Abuse and Alcoholism (2015). Medication for the treatment of alcohol use disorder: A brief guide. HHS Publication No. (SMA) 15-4907. Rockville, MD. Hunter, K., and Ochoa, R. (2006). Acamprosate (Campral) for treatment of alcoholism. American Family Physician, 74(4), 645-646 [/sources] ...

Stimulants are a class of substances that are used to increase attention, alertness, and energy levels.1 When they are prescribed by a medical professional, stimulants are used to treat conditions like narcolepsy and attention deficit hyperactivity disorder (ADHD).1 Common stimulants include medications such as amphetamines (Adderall), methylphenidate (Ritalin), or diet pills as well as illicit drugs like methamphetamine, cocaine, or synthetic cathinones (commonly known as “bath salts”).3 While stimulant medications are generally safe when taken as prescribed, misuse can lead to dependence, addiction, and in some cases overdose.2 Stimulant misuse can become addiction, classified in the psychiatric literature as a stimulant use disorder. These might include taking more of the stimulant or for more time than originally intended, or experiencing cravings, urges, or withdrawal symptoms after using stimulants.4 Can You Overdose on Stimulants? A stimulant overdose occurs when a person uses enough of the drug to produce a life-threatening reaction or death.1  At high doses, stimulants can lead to dangerously high body temperature, cardiovascular complications like an irregular heartbeat and heart failure, as seizures.1 Any type of drug overdose generally requires emergency medical treatment. Long-term or regular use of illicit stimulants, or misuse of prescription stimulants, use can be dangerous, not only due to the risk of overdose, but it can also lead to addiction, psychosis, anger, paranoia, heart, nerve, and stomach problems.1, 2 Recent research has also found that opioid and stimulant co-use is also on the rise.6,7,8 Studies indicate that those who use opioids may be at an increased risk of also using stimulants (mostly methamphetamines, although data shows an increase in cocaine usage and overdoses as well). As a result, when overdose and overdose deaths occur in somebody who is using both opioids and stimulants, the overdose may be reported as an opioid overdose. This could suggest an underreporting of stimulant overdoses. Stimulant Overdose Symptoms Symptoms of a stimulant overdose can include: Tremors. Restlessness. Overactive reflexes.1 Rapid or labored breathing.1 Behavioral changes, such as confusion, panic, or aggression.1 Hallucinations. Muscle pain and weakness.1 Nausea, vomiting, diarrhea, and abdominal cramps.1 Difficulty regulating temperature, high fevers, and hyperthermia.3 Convulsions. Chest pain and cardiovascular distress, such as irregular heartbeat and low or high blood pressure.2, When symptoms are ignored or left untreated, a stimulant overdose may result in coma, respiratory failure, cardiovascular failure, cerebral hemorrhage, stroke, heart attack, or death.1-3 [vob-aktify-cta title="Contextual CTA" subtitle="Check your coverage online or text us your questions for more information"] Treating a Stimulant Overdose. Treatment of stimulant overdose typically starts in an emergency setting to provide immediate medical attention and reduce the risk of fatal complications such as a heart attack or seizure.1 If you believe that someone is experiencing an overdose from stimulant use, it is important to call 911 immediately.1 Medical providers will aim to restore blood flow to the heart to prevent cardiovascular effects and reduce the risk of seizure by administering medications.1 [accordion title="Detox at American Addiction Centers (AAC)"] Detox Centers: Laguna Treatment Hospital Adcare - Rhode Island Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks Immediate Service Areas: Aliso Viejo, CA Kingstown, RI Worcester, MA Lafayette, NJ Las Vegas, NV Grand Prairie, TX Etta, MS Hollywood, FL Riverview, FL [/accordion][accordion title="Treatment by location"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title ="Insurance Articles"] Aetna Ambetter Blue Cross Blue Shield Humana Kaiser Permanente Medicaid Medicare Tricare Without Insurance Veterans Insurance [/accordion][accordion title ="Treatment articles"] Detox services: Inpatient detox Outpatient detox Medical detox Rehab services: Rehab Inpatient rehab Outpatient rehab Same-day rehab State-funded rehab 30-60-90 day rehab Free rehab Choosing rehab Co-occurring Disorders Anxiety Depression PTSD Therapy Aftercare services: Aftercare Sober Living Support Groups Alcoholics Anonymous (AA) Narcotics Anonymous (NA) [/accordion] [sources] Sources National Institute on Drug Abuse. (2018, June). DrugFacts: Prescription stimulants. Ciccarone, D. (2011, March). Stimulant abuse: Pharmacology, cocaine, methamphetamine, treatment, attempts at pharmacotherapy. Primary Care, 38(1), 41-58. Department of Justice/Drug Enforcement Administration. (2020, April). Drug fact sheet: Stimulants. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association. National Library of Medicine. (2008). The Search for Medications to Treat Stimulant Dependence. National Institute on Drug Abuse. (2022, January). Overdose Death Rates. National Library of Medicine. (2022). The Rise of Illicit Fentanyls, Stimulants, and the Fourth Wave of the Opioid Overdose Crisis. (2022). A Changing Epidemic and the Rise of Opioid-Stimulant Co-Use. [/sources] ...