Wednesday, February 1, 2012

Do You Need Help? Treatment and Recovery Options for Alcohol and Drug Use Disorders

By: Cindy Levy, EdD, Ph.D.

How do you know if you or someone you care about has been drinking too much alcohol or taking too many mood altering drugs? How do you know when and where to get help? What is the best treatment for alcohol/drug problems?

Problems with alcohol/drug use can arise slowly over time or seemingly overnight. There are many reasons people say their use is fine despite others’ concerns. But, when your alcohol/drug use is associated with problems at home, work, health, and/or the law; then the use itself is a problem.   Problems typically start small but continue to grow if we don’t check them. The American Society of Addiction Medicine issued an excellent updated definition of addiction based on current research completed in April. Interested readers can review at the new definition in its entirety here:

Briefly, addiction is a primary, chronic disease of the brain with bio-psycho-social-spiritual aspects. It includes biological conditions such as genetics and physical predispositions; psychological conditions such as thinking distortions and emotional defense mechanisms; social conditions such as problems with interpersonal relationships and coping skills; and spiritual conditions such as distortions in the meaning, purpose, and values guiding their life.

If you are concerned about someone’s drinking and/or drug use, the best you can do is to learn everything you can about addiction and your local resources, and to let them know your belief that the situation is serious enough for further investigation, that you want them to get help, and that you are in this with them. The two most common errors are (1) enabling, or ignoring the facts around the use and associated problems, making excuses for them, providing financial aid, allowing them to avoid their responsibilities; and (2) persecuting, or being judgmental, demeaning, nagging, and focusing on moral/character defects. Both approaches tend to result in failure to help the individual, and possible victimization if they don’t keep their promises, fail to pay back your financial aid, etc.  

Places to go for help include local Alcoholics or Narcotics Anonymous meetings, various church recovery groups such as Celebrate Recovery, peer support recovery centers, and substance use disorder treatment centers. For help finding a meeting location, visit:

Levels of treatment include:
  • Outpatient - usually 1-2 times per week participating in group, individual or possibly family counseling
  • Intensive - typically 3 times per week for 3 hours each session followed by a step-down program of less intensive treatment
  • Inpatient – social or medical detox to help reduce withdrawal symptoms, and inpatient rehabilitation programs when less intensive levels of care have been unsuccessful.

Treatment involves trained counselors helping individuals move through the stages of change. It is tailored to the characteristics of the disease being treated and to the individual’s readiness to change. Individuals in the initial, or precontemplation stage of change, need information and feedback to raise their awareness of their substance problems and possibility of change.  Individuals in the second, or contemplation stage, are ambivalent and vacillate between reasons for concern and justifications for unconcern.  In this stage, counselors help them tip the balance in favor of change and strengthen their self-efficacy.  In the preparation, or determination, stage individuals are motivated to make changes and counselors help them find acceptable and effective clinical strategies. In the action stage, individuals act to bring about change and counselors help ensure these actions are effective.  Finally, in the maintenance stage, counselors help individuals learn to sustain changes already made, and to identify and use strategies to prevent relapse.


Cindy Levy, EdD, has a Doctorate in Agency Counseling and is a Licensed Professional Counselor and Licensed Substance Abuse Treatment Practitioner. She is the Adult Outpatient Services Coordinator for Colonial Behavioral Health where she oversees a variety of substance abuse and mental health treatment. She has over 30 years experience providing substance abuse treatment.