Recovering from a Substance Use Disorder – What You Need to Know

Consuming substances is a common part of the human experience. Most people ingest some form of substance, whether it’s a cup of coffee in the morning or an evening cocktail with friends. But for those who struggle with their substance intake, learning how to navigate recovery proves a challenge. Fortunately, there are ways to go about recovering from a substance use disorder. Here’s what you’ll learn in this article:

• What makes substances addictive
• How to know if you need recovery
• Different types of recovery

What Makes Substances Addictive?

Before we get into how to recover from a substance use disorder, let’s talk about what makes substances addictive.

All addiction starts in the brain. Brains evolved over thousands of years, going all the way back to when humans had a harder time navigating basic survival in their environment. For example, foods that are high in fat and carbohydrates would give us enough energy stores to survive the winter. However, these foods were fewer and farther between, so our brains started to release dopamine whenever we  would get these items. Dopamine activates the reward centers in our brains, giving us a pleasurable feeling and motivating us to find more of what we had consumed.

The brain also rewards us with dopamine when we perform certain actions, such as cultivating meaningful social connections. In fact, there are even addictive actions, such as exercising too much or gambling.

Dopamine can be wonderful, but unfortunately, it doesn’t discriminate between healthy behaviors and ones that are bad for our health. Just like certain types of food, drugs like alcohol, cocaine, heroine, opioids and opiates, and even caffeine release dopamine. So, our brains attempt to motivate us to get more of these substances, even when we start to experience health complications.

So, if you suspect you may have a substance use disorder, take a deep breath and relax. You’re not inherently broken. In fact, your brain is operating the way everyone’s brain does. But if your substance use is starting to negatively impact you, you might want to consider getting a substance use disorder diagnosis and seeking out help.

How to Know If You Have a Substance Use Disorder

Many people who use a substance sometimes wonder if they qualify for a substance use disorder. Any substance that causes the brain to produce dopamine can lead to a disorder, but not everyone who uses them will develop these conditions.

However, the DSM-5, which is the manual mental health professionals use for diagnosis, has similar diagnostic criteria for the different substance use disorders. Here are the requirements:

Specify current severity based on the following guidelines:

Mild: Presence of 2 or 3 symptoms
Moderate: Presence of 4 or 5 symptoms
Severe: Presence of 6 or more symptoms

Symptoms include:

1. Substance is taken in larger amounts or over longer periods than was intended.
2. There is a persistent desire or unsuccessful effort to cut down or control substance use.
3. A great deal of time is spent in activities necessary to obtain substance, use substance, or recover from its effects.
4. Craving, or a strong desire or urge to use substance.
5. Recurrent use of the substance is resulting in a failure to fulfill major role obligations at work, home, or school.
6. Continued use of substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
7. Important social, occupational, or recreational activities are given up or reduced because of substance use.
8. Recurrent substance use in situations in which it is physically hazardous.
9. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
10. Tolerance, as defined by either of the following:
    • A need for markedly increased amounts of the substance to achieve intoxication or desired effect.
    • A markedly diminished effect with continued use of the same amount of the substance.
11. Withdrawal, as manifested by either of the following:
    (Withdrawal does not apply for every substance.)
    • The characteristic withdrawal syndrome for that substance (see additional criteria in DSM-5).
    • The substance is taken to relieve or avoid withdrawal symptoms.

There are many substance use disorders (far more than this article can get into in detail). Here are some common ones:

• Alcohol Use Disorder
• Cannabis Use Disorder
• Opioid Use Disorder
• Sedative Use Disorder
• Caffeine Use Disorder

This is by no means an exhaustive list. If you suspect your use of a substance might be negatively impacting your heath, your social life, or your quality of life–or if you experience distress because of it–contact your doctor or see a therapist.

Recovering from a Substance Use Disorder

So, you’ve decided to seek help for a substance use disorder. First of all, let’s pause to congratulate you. Choosing to reach out to someone for help is a huge step, and in many support programs (more about them below), recognizing that there is a problem is the first, crucial step.

Below, we’ll get into the different types of help available to people with substance use disorders. You’ll learn what to expect for the different types as well as some pros and cons for each one.

Inpatient Rehabilitation Care

If you’ve seen movies that include recovering from a substance use disorder as part of the plot, you likely think of inpatient care when you think of seeking treatment. Inpatient facilities often employ therapists, psychiatrists, and other professionals to help you through the initial phases of addressing your substance use. During treatment, people live at the treatment centers.

Inpatient care has two major benefits. First, you’ll have direct, sometimes even around-the-clock, care. Second, no substances are allowed in the facility. So, you won’t have any temptations around you as you make it through the withdrawal phase.

However, inpatient care is often very expensive. In general, the cost of these treatments range from $1,400 to $10,000 for a 30-day period. This doesn’t include the cost of any medications the doctors may prescribe.

Outpatient Rehabilitation Care

Outpatient care provides professional treatment and therapy just like inpatient facilities do. However, the major difference is that the person usually spends at least part of the day (potentially the whole day) at the center and then goes home at night.

The major benefits to outpatient care include direct daily access to trained professionals at a lower cost than inpatient care. In addition, it helps people get used to resisting their substance at home or around friends at night, which is a more real-world experience than just staying in a substance-free facility.

At the same time, professionals recommend people who undergo this type of care have a strong support system in place and abstain from having the substance in their home. If you live with people who also consume substances, then, ask yourself if you feel like you could realistically give up the substance while the other people are still doing it. If not, outpatient care might not be the right choice for you.

Substance Use Therapy

Not everyone who uses a substance needs to go to a rehabilitation center for treatment. In fact, many substance use counselors practice separately from these clinics.

These counseling sessions look a lot like regular therapy. You’ll usually meet with the counselor for about an hour each session, and the counselor will use evidence-based techniques to help you identify your goals surrounding your substance use, identify your motivators and strengths, and help you achieve those goals.

Counselors also run group therapy for substance use. During group therapy, you and several other people will meet with a therapist together. Even though you get less one-on-one time with the counselor, you’ll get to know others who are on a similar journey.

Support Groups

There are many support groups for people struggling with substance use, with each group usually targeting a specific substance. One common type of support group is the 12-step group, like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).

These groups are open to the public and commonly follow a series of steps. Usually, the first step is admitting that the substance use is causing difficulty in your life. The groups often provide mentorship and community for people who are resisting certain substances and are led by others who are on their recovery journey instead of professionals. The advantage to this lies in the fact that these people can directly relate to the experiences of others in the group.

However, these leaders don’t have professional training, so they might not be able to provide scientifically-backed help.

Many of these support groups have a spiritual bent to them, too, encouraging participants to call upon a “higher power” for spiritual support. In particular, these programs started in the United States, which has a lot of Christian cultural influences. So, some of these programs have some Christian influence, even if they’re not explicitly Christian. These aspects have left some participants feeling disenchanted and alienated and encouraged others. If you prefer a specific type of spirituality or no spirituality at all, look for 12-step programs that cater to your preferences.

Harm Reduction Therapy

If you choose to see a therapist in an individual or group setting, look for someone who practices harm reduction therapy, especially if you anticipate having a hard time giving your substance up. Harm reduction therapists focus on helping the client reduce or eliminate their consumption. However, they also recognize that quitting is difficult and provide you with tips for safer consumption in case you relapse.

These types of therapists are also less likely to be judgmental about substance use, and you might find yourself more comfortable talking to them.

Keeping Yourself Healthy During Your Recovery

Recovering from a substance use disorder can be a long and difficult process. To help you gain the most success, you need to keep yourself mentally and physically. This includes engaging in self-care and taking part in moderate exercise to keep your endorphin levels (and as such, your happiness) high. If you’re new to self-care, check out these tips!