The Addiction Psychologist

Substance use often initiates in adolescence, and an earlier age of first use is associated with a higher likelihood of lifetime problems. But, do risky behaviors carry the same risks for everybody? Dr. Tammy Chung discusses social determinants of health and racial health disparities in young people and highlights how factors in our society create disparities, resulting in more risk from substance use and other health behaviors for people in some groups than others. Dr. Tammy Chung is the Director of the Center for Population Behavioral Health and a Professor of Psychiatry at Rutgers University. Find out more about her work here.

Alcohol impairs motor activity and cognitive functioning that is critical for effective and safe driving, increasing risk of accident. In fact, approximately 1/3 of all traffic fatalities are alcohol-related. Why do some people drive after drinking despite these risks? Dr. Denis McCarthy discusses the history of impaired driving and policy, theories of impaired driving-related decision making, and pathways to prevention, intervention, and treatment. Dr. McCarthy also discusses cannabis-impaired driving and important distinctions between cannabis and alcohol. Dr. Denis McCarthy is the Middlebush Professor of Psychology at the University of Missouri. Learn more about his work here.

People attempting recovery face formidable challenges to successful sustained remission. Return to use depends upon the individual's access to recovery capital, or the collection of resources available that can bolster or improve recovery. In this episode, Dr. Emily Hennessy discusses the science of recovery capital and how improving recovery capital can enhance recovery and save lives. Dr. Emily Hennessy is the Associate Director of Biostatistics at the Recovery Research Institute and an Associate Director at the National Center on Youth Prevention, Treatment, and Recovery at Massachusetts General Hospital, as well as an Assistant Professor at Harvard Medical School.

People range in their readiness to make changes to different behaviors. Processes occurring naturally in each stage differ across the spectrum of readiness to for behavior change. In this episode, we talk with Dr. Carlo DiClemente about the origins and development of the Transtheoretical Model of Behavior Change. This model has become a standard and common language for a generation of behavior change specialists working with people experiencing addiction, in addition to many other health-related behavior changes. Dr. DiClemente is an Emeritus Professor of Psychology the the University of Maryland Baltimore County and a former President of the the Society of Addiction Psychology.

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.