In 2019, the United Nations Office on Drugs and Crime (UNODC) reported that 35 million people struggle with some form of substance use disorder, including drug or alcohol use disorders, during their lifetime . That’s around 13% of the world’s population.
Substance use disorders can greatly impact a person’s ability to lead a productive and fulfilling life. Given the prevalence of these disorders and how impactful they can be, adequate and appropriate treatment plans are necessary for full recovery from substance dependence.
They are many ways in which substance use disorders can impact behavior, so it’s necessary to develop individualized treatment plans that address specific symptoms, including the underlying causes of those symptoms. Treatment plans should also address the negative consequences substance use can have on different aspects of a person’s life—diminished physical and mental health, strained relationships with family and friends, inability to maintain work, or other issues.
Thankfully, many treatment options are available for patients with substance use disorder. This allows for the use of a combination of treatments, including different types of behavioral interventions [2, 3]. The different focuses of these interventions (for example, increasing motivation, improving self-efficacy, providing new coping mechanisms, etc.) all uniquely contribute to the rehabilitation of this disorder.
Importantly, people may need to use different combinations of these treatments depending on varying factors, such as the intensity of their substance use dependency. Thus, taking an interdisciplinary approach holds a lot of value and is key to an efficient and successful treatment plan [4, 5].
Many treatment options have proven successful for treating substance use disorder. These include:
Counseling can take different forms depending on what the patient needs [2, 3]. There are many variables that should be considered when choosing the right method, including:
When choosing a counseling method, it’s important to consider which combination of approaches will provide the best outcome for the patient based on their individual needs.
Counseling can provide patients with several ways of coping with drug cravings, depending on the type of counseling received. These coping mechanisms can include:
Counseling and behavioral treatments are shown to be effective when utilized in an interdisciplinary way [2, 3, 6-8]. Just some of these approaches include: *
However, it is important to note, we use a number of other approaches in addition to the above when working with clients in order to ensure we meet everyone’s particular needs as they evolve in a treatment process.
It is important to note that not every approach is developed for each individual patient. It is common for many patients to be given the same, generic treatment without much thought. This is something we don’t do at The Beekeeper. To improve chances for success, treatments should be developed around a patient’s individual needs. A variety of approaches are available, and it’s vital that patients are matched with those that will be the most beneficial to them. At the Beekeeper we take an eclectic approach, which means our clinical staff are trained in variety of different ways that equip us to meet the client where they are and develop treatment strategies according to their unique needs. We don’t take a single approach, and we might lean on different therapeutic approaches or techniques when working with clients. Our clinical staff are trained and qualified to be able to deliver such services, making sure we are adaptable and agile when working with clients.
The goal behind self-help support groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) is to provide a support network with others who can relate to the struggles associated with substance use disorder. These commonly use a 12-step program for the rehabilitation process. An additional aim of these programs is to teach that substance use disorder should be viewed as a chronic illness, and to decrease feelings of shame and isolation experienced by people in this community .
Medications and Medical Devices
Medications and medical devices in some circumstances are the first wave of treatment, and provide many uses, such as [4, 5, 7]:
Medications are a significant aspect of the treatment and recovery process and are most effective when used in combination with counseling and behavioral therapies.
Alternative therapies for managing symptoms and mental health can be used to supplement the more common treatment options [7, 9-11]. Adding holistic medicine to your therapy plan promotes stress management and overall wellbeing. Examples of this include:
Although they can be used independently, these treatments are most effective when used in an interdisciplinary manner and part of the patient’s overall treatment plan.
Around 13% of people worldwide struggle with some form of alcohol or drug dependence during their lifetime. These statistics equate to nearly 35 million people struggling with a substance use disorder. 
One of the most beneficial and necessary factors in drug or alcohol abuse recovery is the degree of support the person in need of help is receiving. The strength of a person’s support system is incredibly important and influential for their recovery; if you’re a friend or a family member of someone currently in treatment for drug or alcohol misuse, your interactions with them can have a huge influence on their progress. Show them you are available to support them in any way you can.
However, giving this degree of support can take its toll. Because a loved one’s substance use can be very draining at times, you may not always have the emotional or mental energy, or even the resources needed to provide this fundamental support. When this happens, it’s important that you also get the help you need. Make sure that you value your own wellbeing in addition to your struggling loved ones. There are several types of support that friends and families of addicts can take advantage of in this situation.
Helping a loved one struggling with addiction is not easy. That’s why it’s so beneficial to seek support from peers who are in similar situations. The goal of these support groups is to provide a mechanism for discussing, coping with, and learning more about addiction in an unbiased environment with others going through the same thing [2-4]. These groups can be helpful for:
Family and Individual Therapy
Therapy is a healthy way to deal with stress, especially the kind of stress brought on by helping a loved one with their substance use disorder. Many people who find themselves in this situation tend to be directly affected or harmed by their loved one’s substance use in ways they may not even notice. They may be experiencing feelings of blame, guilt, worthlessness, frustration, anger, or overall unhappiness. Families and individuals may not have the tools they need to help themselves in addition to their loved ones.
Family and individual therapy programmes are designed to help you acknowledge these feelings, understand them, and work through conflict. These sessions take time and effort, but they are worth it and can be vital for improving your mental health.
Make Self-Care a Priority
Detaching yourself from the issue and prioritising your well-being is vital if you want to be able to provide support . There are several ways to check-in with yourself and make sure you are prioritising self-care:
Manage Your Expectations
One of the most important things for maintaining good mental health while providing support for a loved one is to manage your expectations regarding their recovery process. It’s natural to feel a sense of hope and relief when they seek out and begin treatment, and it can be especially frustrating when recovery takes longer than desired, or when a relapse occurs. However, it’s important to remember that addiction is a chronic disease and recovery is a lifelong process that takes a lot of effort from both sides. Managing your expectations will prevent you from feeling too disheartened and losing all hope in the process. It’s important to remember to be patient with both your loved ones and with yourself. Healing takes time, and there may be some knock backs that you don’t expect. However, being present and supportive can be transformational in nature.
One particularly difficult moment in supporting someone in recovery, or those seeking to achieve sobriety, is deciding when to take a step back. This is a thorny, emotionally hard issue to address as there never seems to be a good or opportune moment that doesn’t come with some degree of regret. The organisations below will help you with this process, but do know that there is no shame in taking some time out of a situation that you feel is impacting your own mental health to a degree that you feel is unmanageable. There is no shame in doing so, and it takes great courage. One can only do as much as one can to help another, and if you feel you need take a break then that’s also fine. You can continue to show compassion to a loved one, even from a distance, but use your own wisdom to know when you can help, and when you need to take care of yourself as well.
Organisations that can help
There are several organisations that may be beneficial for you [9-11]. These include:
As of 2020, the World Health Organisation (WHO) reports that about 270 million people worldwide, or more than 5% of the population, between ages 15-64, use illegal and/or psychoactive drugs , including cannabis, opioids and prescription pain medication, and psychostimulants such as amphetamines, cocaine, and heroine . Of these 270 million, as of 2019, it was reported by the United Nations Office on Drugs and Crime (UNODC) that 35 million suffer from drug or substance use disorders.
Substance use disorder is a mental health condition that causes a person to be unable to control their use of substances, such as drugs or alcohol, due to changes occurring in that person’s brain and behavior after use. Many individuals with substance use disorder also have a co-occurring mental health condition, such as anxiety, depression, or attention-deficit hyperactivity disorder (ADHD) .
Statistics surrounding the prevalence of this disorder show that nearly 13% of people who use illegal drugs, will at some point in their lifetime, develop a substance use disorder. Of thesemillions of people, the amount that receive treatment ? is shockingly low; the UNODC reportsonly 1 in 7 people with a substance use disorder will receive treatment . Given the prevalence of this disorder and the degree to which it can negatively impact a person’s life, it is tremendously important to improve the accessibility of care for these individuals. One of the primary barriers to accessing care that contributes to this low rate is the stigmas surrounding substance use disorder and seeking treatment for it.
Stigma refers to negative thoughts, words, and views that are placed on a person or a specific situation . They are a form of prejudice, often based on misconceptions and false assumptions, that leads to misjudgment, discrimination, and often the mistreatment of those being stigmatizsed [5, 6]. People with substance use disorders are some of the individuals most affected by stigma [5, 6]. Stigmas create challenging obstacles for those afflicted, making it difficult to get support from family and friends, and access other necessities for the recovery and management of their illness. There are several common stigmas and stereotypes placed on people with substance use disorders.
A study from 2005 asked people who have current, or had past substance use issues, what the words ‘stigma’ and ‘stereotype’ meant to them . They responded:
These stigmas have various negative effects on a person’s life and overall wellbeing. Just some of them include [5-7]:
In addition to this, there are very specific experiences of stigma and stereotypes people with substance use disorder tend to have. Some of the most damaging occur in medical settings, which in many cases results in people with substance use disorder not seeing the value in seeking treatment, directly contributing to this low 1:7 treatment statistic .
A common experience for people with substance use disorders is shaming from medical doctors and other healthcare providers , including dentists . A frequent occurrence in hospitals and emergency rooms is the wrongful assumption by healthcare providers that the drug or alcohol problems these patients have are their own fault and a result of their own poor choices . Some physicians have lower regard for these patients , leading to substandard care and in some cases, rejection of treatment entirely [8, 10]. People with substance use issues internalise these experiences, resulting in feelings of shame and a refusal to seek treatment in the future. This type of viewpoint and behavior is driven in part by negative labeling, a lack of compassion and understanding, demonising, and a hyper focus on criminalising drug misuse rather than viewing and treating it as a disease. All of these behaviors are driven by underlying stigma.
Reducing the stigmas placed on those with substance use disorder and similar conditions is one of the best and most important mechanisms for improving access to care. By reducing these stigmas through the ways we think about, speak about, and act towards those with substance use disorder, their medical treatment, societal treatment, and livelihoods can improve immensely.
Ways to address and reduce stigma that have been repeatedly recommended by both researchers and policymakers alike include [5-7, 10-13].
Taking these actions is one of the most impactful ways to improve life for those struggling with substance use disorder.
By Robert Common, Managing Partner, The Beekeeper
The latest in a series on addiction
One year. It can seem like a drop in the bucket of life, or like an entire lifetime lived in 365 days.
What if one year ago you began your sobriety? What changes have happened after being one year sober?
Recovery always involves growth, and a lot of growth can happen in a year. Without the blunting effects of addicting behaviours, every day has involved facing life with a much more realistic outlook.
At some point in the past year, you’ve experienced a sudden appreciation of something that’s been unnoticed in your life for a long time. Perhaps it’s how good it feels to have the sun’s warmth on your face, or to hear the sound of your daughter’s uninhibited giggle as she watches her favourite TV show. Maybe it’s the refreshing tang of lemon sorbet without the interruption of nicotine, or tender pillow talk with your partner after an outing that didn’t end in being drunk.
Whatever that first moment of awareness was, it held the hesitating promise of more moments to come. Because in that first year, there are many times when you weren’t certain of your recovery. When you questioned the possibility that you could get to that one year of sobriety. And then you experienced the next good moment, and then the next.
After one year sober, your body has been through some major changes. At first, there were some horrible days (or even weeks) as your body slowly processed and released the toxic substances it was carrying. For many people, the physical withdrawal symptoms were agonizing, and the first few weeks left them feeling exhausted and disheartened. But as those toxins left your body, you began to feel healthier.
You might have been pleasantly surprised when you started sleeping better. And, of course, better sleep led to more energy and mental clarity. As your body stopped struggling to find balance during the constant exposure to toxic substances, you may have found yourself feeling recharged—without even taking a day off! It may have been your first year without coming down with every cold and flu virus that went around.
During the past year, you had to find new ways to spend your time that didn’t involve activities associated with your addiction. Maybe you reconnected with things that used to bring you joy. Often recovering addicts rekindle their joy in running, swimming, playing instruments, and cooking.
Others find new activities and hobbies that fill previously unmet needs for physical activity, personal connections, artistic expression, and meaningful contributions. Everyone is different, and that’s why at The Beekeeper we offer a range of activities to help you on this journey, from yoga to tai chi.
Many people in recovery decide to make meditation a part of their daily routine after trying it for the first time in the early days of their journey. Enriching volunteering is another activity that becomes both part of the healing process and part of a healthier happier lifestyle.
The first year sober wasn’t all ‘rainbows and sparkles’. There were some very challenging days and weeks. Times when the journey felt impossible, times when surviving life without addictive substances seemed like too big of a challenge, and times when the consequences of years of addiction felt too heavy to bear.
We hope that these times remain in your memory—not as a negative thing, but as a reminder of each barrier that you’ve survived and overcome. Choosing sobriety will always include remembering where you’ve been while celebrating every new milestone that marks the path you are on now.
In the past year, you’ve seen a change in your relationships. Those based entirely on sharing addictive behaviours are no longer the centre of your personal circle. The superficiality of these became more obvious without that one shared interest. But even losing superficial relationships is still a loss.
You may have spent time in counselling or learning new ways to initiate and experience healthy relationships, and you’ve had to relearn how to be in a variety of situations sober. Maybe you’ve rekindled some of the best relationships from your past—ones that weren’t compatible with addictions, but are very compatible with sobriety.
Having relationships with people and not trying to hide an addiction has given you a new way of relating to others—with honesty and authenticity instead of deception and pretending to put on a brave face. During the past year, you may have had the opportunity to make amends with some of the people you hurt when addiction dictated your choices. Some of those people may be slowly beginning to trust you, perhaps for the first time.
Sometime during the past year, you began to get to know your real self. Without addictions masking who you really are, you started to learn truths about yourself. Maybe you found out you’re an introvert who thrives in one-on-one connections with people. Or maybe you found out you love trying new activities where you’ll interact with people very different from the ones you used to spend all your time with.
You’ve also begun to take responsibility for your own care and maintenance. You’re learning to value yourself. This part of the journey can be pretty challenging. But at one year sober, you are starting to enjoy taking care of yourself and you’re conscious of how good it feels to know you can meet your needs.
Speaking of responsibility, that’s another thing that’s been changing in the past year. While you have taken responsibility for yourself and your choices and behaviours, you’ve also worked on not taking responsibility for others. You’re realising that it’s not your fault when other people make mistakes, and this realisation is life changing.
Most addicts share a history of trauma, and they’ve spent years feeling responsible for other people’s actions. But the more you’ve released that unhealthy attachment to other people’s choices, the more empowered you feel over your own life. After a year of sobriety, you’re getting better at saying no to people and situations that aren’t right for you.
You’re also learning to feel good about the choices you make. What a surprise! After years of regretting or defending your choices, you’re now feeling proud of what you choose! The very act of choosing sobriety every single morning is a reminder of how life-changing (in a good way) your choices are. Speaking of mornings, you’re also waking up every morning with a clear memory of where you are now and where you were last night. One year sober doesn’t mean last night wasn’t an embarrassment (although it often does); it means last night’s choices were made completely by you without substance impairment. That’s a big deal!
Celebrating one year sober marks the sum of hundreds of little changes that you’ve made over the past year. And those little changes really add up. This might be the first time you take an inventory of where you’ve come in the past 365 days, and say, ‘Wow, I didn’t notice how much better things had gotten!’
And one of the best things about one year sober? The mystery and excitement of how many more good things are going to come in the next year!
By Robert Common, Managing Partner, The Beekeeper
The latest in a series on addiction
Since ancient times, healers have performed cleansing rituals for unwanted spirits. This is a tradition that spans many religions, but is particularly important in the practice of Buddhism.
The early physical experiences of recovery are closely related to this spiritual practice. In Western terminology, the initial physical state after removing a drug from the body is known as withdrawal. The wisdom of the ancient understanding of this experience can be combined with the insight of the modern view of it to provide an optimal route for healing and resetting the body during this critical time.
So what happens to the body when you stop using drugs? Science shows that many chemicals in the brain get produced by the experience of using drugs. One of the most well-known of these is called dopamine, and it is responsible for the experience of pleasure and reward that can make drugs so appealing. However, as the brain begins to get used to the presence of these drugs, less and less of this reward chemical is produced. This is known as tolerance, and it is an indicator of addiction. More drug is needed to achieve the same effect, and far more of the body’s distress signals get produced when the drug is not present. These distress signals are hormones called adrenaline and cortisol. They are the same hormones that get produced when you are frightened, in danger (even if you believe you are in danger without an obvious threat). These hormones are also active when you go through a trauma or experience something unpleasant.
During the initial stages of withdrawal, adrenaline and cortisol are produced in heavy amounts. The body is sending out distress calls, and it has come to believe that it is in a fight for its survival.
In a state of withdrawal, there is an unhealthy energy, and the body has knowledge that it must move away from this condition. The body’s input, like food, water, herbs and medicines, become even more critically important during this phase then they are during normal times.
Though the experience of withdrawal is common to many types of drug use, this energy state is most pronounced when a person uses opioids. Frequent use of opioids prevents the body from creating its own natural pain relief, and during the time when you have stopped using opioids, the body has not had enough time to resume producing these pain relievers. Western medicine understands these pain relievers to be endorphins, a combination word for endogenous (internal) morphine.
In the traditional view, this initial physical experience of recovery is often considered part of the process of restoration. Even though it is painful, it allows for balance, for a more sustainable forward and present path. Withdrawal, in its most acceptable form, can be considered as helping reduce an aspect of our lives that has caused us suffering. It gives us the opportunity to reflect on the consequences of our actions, and consider a different course.
Whether you understand the experience of early recovery through a traditional or modern viewpoint, the end experience is the same: you may find yourself after a few days achy, irritable, feverish, nauseated and generally feeling unwell. Even with the knowledge that this state of being is temporary, it can be rather unpleasant.
Many still tolerate the experience of withdrawal because they believe that doing so will help them become more enlightened, or more connected with the suffering of others. Others go through the experience of withdrawal because they believe they must be punished. Some are able to approach withdrawal with a sense of acceptance and openness, acknowledging their fears and the unpleasant reality of it.
The length and severity of withdrawal depend on several factors:
● the type of drug used
● how long it was used
● how often it was used
● how much was used
● individual health status
Both the length and the severity of withdrawal can be reduced with certain medications or certain herbs after assessment by a trained professional. In Western terminology, this is referred to as a “medical detoxification”, or “detox” for short. Detox is often necessary when a person has:
● been using a substance regularly in large amounts
● used a substance over an extended period
● experienced a smaller effect over time from using the same amount of a substance
● required increasing amounts of a substance to achieve the usual effect
● craved a substance regularly when there is no access to it
● tried to quit using a substance and found it difficult to do without help
As withdrawal subsides, the body and brain must restore their natural balances, which have often been highly disrupted. For many people, this is a period where energy is low, but irritability and tension in the body may be high. Soreness in bones and muscles is common, and so are fatigue, sweating and digestive disturbance. The majority of individuals in early recovery benefit from professional and community; community members and therapists must be patient, calm and empathetic during this time to provide helpful support.
Early recovery may not be easy on the body, but it offers a unique opportunity for restoration. If you are well informed about the body’s experience of withdrawal and the early recovery period, you are more likely to be able to utilize a mindful approach to this time. With mindfulness, early recovery becomes an experience that confers wisdom and a renewal for body and spirit.
Harris, I. C. (2008). Cambodian Buddhism: history and practice. University of Hawaii Press.
United States National Institute on Drug Abuse. “Understanding Drug Abuse and Addiction: What Science Says.” February 2016. Accessed August 20, 2020.
Sangkapreecha, P., & Sangkapreecha, T. (2013). The Cave of Healing: The Physical/Spiritual Detoxification and The Distinctive Healing Program for Drug Rehabilitation at Thamkrabok Monastery, Thailand. Humanities, Arts and Social Sciences Studies, 123-138.
National Center for Biotechnology Information. “Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.” 2009.