The Addiction Psychologist Samuel Acuff and Noah Emery

People attempting recovery from addiction are best served when recovery can be achieved through multiple, diverse, pathways that fit their needs and recovery goals. Although the most commonly used recovery support service is Alcoholics Anonymous (or a similar Anonymous affiliated group), some object to core tenets or cultural elements and may benefit from alternative options. SMART Recovery is one example of an alternative mutual help group that was created to meet the needs of those who may benefit from a different pathway to recovery. In this episode, Dr. Horvath discusses the history, core tenets, structure, and evidence base for SMART Recovery. Dr. Horvath is a licensed clinical psychologist and President of Practical Recovery. Dr. Horvath was a founding board member and served as the president of SMART Recovery for 20 years. He has facilitated approximately 1000 SMART meetings and has supported San Diego to become the locality with the greatest concentration of SMART meetings at approximately 40. Dr. Horvath is also a past president of Div 50 (1999-2000).

In the past few years, a novel adulterant, Xylazine, has emerged in the illicit opioid drug supply. Between 2020 and 2021, there was a more than 1000% increase in xylazine-positive overdose mortalities in the United States from 2020 to 2021. What is Xylazine? How does it work? Why has it emerged in the supply? Dr. Cassandra Gipson-Reichardt discusses emerging literature on Xylazine and answers our questions on this episode of the Addiction Psychologist podcast. Dr. Gipson is an associate professor in the department of pharmacology and nutritional sciences at the University of Kentucky.

Many with substance use disorders make recovery attempts, whether through abstinence or reduction goals. However, some level of return to previous levels of use are relatively common, and treatments developed over the past four decades have typically included elements focused on relapse prevention. However, this was not always the case. Dr. Katie Witkiewitz discusses the history of relapse prevention and her work in the space of mindfulness-based relapse prevention. She also discusses recent conversations about the phrase "relapse": what does it mean, and how is it captured in scientific studies? Dr. Witkiewitz is the Director of the Center on Alcohol, Substance Use, And Addictions (CASAA) and a Distinguished Professor in the Department of Psychology at the University of New Mexico.

In general, most people have some degree of ambivalence towards behavior change. Whether reducing television in the evenings, eating less chocolate, or deciding to limit or abstain from alcohol, most people can identify reasons they would prefer to maintain the status quo and reasons to make a change. How can one move from ambivalence to action? Dr. Bill Miller discusses the origins and key tenets of Motivational Interviewing, an approach grounded in Humanistic psychology to help create a safe space for people to explore their ambivalence and consider change. Dr. Bill Miller is an Emeritus Distinguished Professor of Psychology and Psychiatry at The University of New Mexico.

Chronic pain commonly co-occurs with substance use disorder and may get in the way of recovery goals and valued living. Despite this, chronic pain can go untreated and unmanaged in treatment settings, and many people with substance use disorders struggle to get treatment for pain due to addiction stigma. Dr. Jeff Boissoneault provides an overview of the intersection between pain and substance use and makes the case for why scientists and clinicians should prioritize measuring and treating chronic pain. Dr. Boissoneault is an associate professor in the department of anesthesiology at the University of Minnesota Medical School.

Despite some consequences, substances can provide immediate and certain reward in the different forms, including but not limited to euphoria, pain relief, energy, alleviation of emotional suffering, and social connection. These rewards can compete with non-substance activities that are enjoyable and rewarding, and understanding changes in reward processing over the course of substance use disorder severity may provide critical insights into how to bolster recovery. Dr. Stacey Daughters provides an overview of reward processing in substance use disorders, and explores ways in which neuroscience treatment techniques may complement existing evidence-based psychotherapy treatments to bolster outcomes for people recovering from substance use disorders. Dr. Daughters is a professor in the Department of Psychology and Neuroscience at the University of North Carolina, at Chapel Hill.