The Addiction Psychologist

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.

Epidemiological surveys suggest that prevalence of harmful patterns of substance use is greatest among Multiracial populations relative to other racial demographic groups. Yet, most studies either do not report full racial demographics or under-sample people who identify as multiracial. In this episode, Tessa Nalven illuminates the importance of studying multiracial populations, discusses theoretical mechanisms for disparities, and provides recommendations for research with multiracial populations. Tessa Nalven is a currently finishing her doctoral degree in clinical psychology at the University of Rhode Island. She is completing her clinical internship year at the Boston VA. Tessa was the recipient of the 2022 Division 50 DEI Student Recognition Award.

In recent years, there has been a dramatic rise in methamphetamine use among people who use opioids. What is driving this effect? How do these drugs interact? Do they serve substitute or complementary functions? Dr. Justin Strickland summarizes the state of the science and outlines potential solutions. Dr. Strickland is a psychologist and assistant professor of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine. You can learn more about his work here.

During the past several decades, the United States has experienced several distinct waves of opioid epidemic, prompting those providing services to think of novel ways to provide services. to those in need. Dr. Rachel Winograd found her passion for community-based harm reduction services in St. Louis, a city ravaged by wave after wave of the opioid epidemic, and quickly found her place within a network of harm reductionists, community-based providers, and policy makers in Missouri with a common goal. In this episode, Dr. Winograd teaches us about the opioid epidemic and shares about the work she and her team has done to test and disseminate evidence-based harm reduction services in the greater St. Louis area. Dr. Winograd is an Associate Professor in the Department of Psychological Sciences and the Missouri Institute of Mental Health at the University of Missouri-St Louis. To learn more, please visit www.mimhaddisci.org.

For many, the onset of substance use occurs in adolescence. A subset of adolescents who use substances develop substance use disorders later in life, and some even develop harmful patterns of drinking while still in the developmental stage of adolescence. Why is substance use initiation likely in this age group, and what is the developmental function of substance use behavior? What are the interpersonal processes that influence substance use, and how do relationships with friends and family change during this critical developmental stage? Is it possible to leverage these interpersonal processes to bolster treatment initiation and success? Dr. Sam Meisel answers these questions and more as he discusses the complex social environment of the adolescent and it's pertinence to understanding substance use. Dr. Sam Meisel is a Research Scientist at Bradley Hospital and the Center for Alcohol and Addiction Studies in the Brown University School of Public Health.

Dr. Bill Stoops provides an overview of the pharmacology, effects, and prevalence of cocaine, in addition to treatments for cocaine use disorder. Dr. Bill Stoops is an Associate Director for Clinical Science in the Substance Use Priority Research Area, and a Professor in the Departments of Behavioral Science, Psychiatry, and Psychology, and in the Center for Drug and Alcohol Research, at the University of Kentucky.

Alcohol and other drugs are sometimes accompanied by harms from use. However, use only accounts for some of the variance in substance use harms, and their are strategies, and harms can be reduced through other means aside from reductions in substance use. This is particularly important because many who use substances do not have a desire to quit or cut down on their use, even if they do experience harms. In this episode, Dr. Mark Prince discusses the literature on protective behavioral strategies, or any behavioral strategy that may reduce the harm of substance use, often through reduction of risky behaviors while using (i.e., drinking and driving) or through changes in the way the substance is consumed (i.e., drinking water in between alcoholic drinks). Dr. Prince is an Associate Professor and the Associate Director of Addiction Counseling in the Department of Psychology at Colorado State University. Click here for Dr. Prince's paper quantifying the variance unexplained by alcohol consumption alone.

Sexual assault is a massive problem on college campuses, and alcohol is involved in some form or another in more than half of cases reported. Dr. Jen Read talks about her work to understand the complex social environment within which sexual assault often takes place, and her work to design interventions to reduce the rate of sexual assault. Unfortunately, the evidence suggests that intervention and prevention approaches targeting the perpetrators do not work. However, sexual assaults often take place in complex social environments, and interventions may be able to leverage friendships to create more explicit conversations about how to protect one another during a night out. Dr. Jen Read is a renowned scientist known for her work illuminating harms and developing intervention approaches to reduce drinking among college students. Dr. Read is a Professor and Chair in the Department of Psychology at the University at Buffalo.

Cultural influences play a role in defining normative behavior and definitions of harmful substance use; yet, a great deal of our understanding of addiction comes from privileged populations in American and Western society. Dr. Adrian Bravo talks about his line of research connecting researchers around the world to study differences in substance use, norms, and processes across cultures. Dr Adrian Bravo is an assistant professor in the Department of Psychological Sciences at the College of William & Mary.

Regular exercise confers many benefits: It will increase your mood, decrease fatigue, and increase the quality of your sleep, among others. But how can exercise impact substance use? Is exercise an effective adjunct to treatment? If so, how do we encourage a behavior that, for many, is so hard to maintain? Dr. Ana Abrantes discusses the research on exercise and substance use treatment, with a particular focus on making exercise accessible. Dr. Ana Abrantes is a Professor of Psychiatry and Human Behavior in the Alpert Medical School of Brown University, and the Co-Director of Behavioral Medicine and Addictions Research at Butler Hospital.

Have you ever passed a sign on the road advertising for something called "Kratom"? or, perhaps, a friend or family member has mentioned trying it. What is it? An herbal supplement, or pharmacological drug? As addiction scientists, epidemiologists, and clinicians, do we have anything to be concerned about? In this episode, Dr. Kirsten Smith catches us up on what is known about Kratom, including the pharmacology, effects, and prevalence of this emerging substance. Dr. Kirsten Smith is a Post-doctoral Fellow in the Real-world Assessment, Prediction, and Treatment Unit at the National Institute on Drug Abuse Intramural Research Program, and an incoming Assistant Professor at Johns Hopkins University.

ARE YOU READY FOR CPA 2022? The first in-person CPA conference since 2019 is happening this weekend, April 7-9, in Portland, OR. In addition to amazing networking opportunities, there will be incredible sessions and posters presented by experts ranging from early to late career, studying addiction and related topics. On this episode, we highlight the award-winning work of five early career scholars who will be presenting their research in Portland. Tune in for a sneak preview, and get hyped for CPA! Timestamps and presentation titles below. 1:34 - 10:44: Dr. Jevon Rice - Training in Substance Use Disorders Among Black Emerging Adults for Psychologists 10:44 - 19:27: Victoria Chentsova - Internalizing Symptoms, Rumination, and Problematic Social Networking Site Use: A Cross-national Examination 19:27 - 32:01: Peter Soyster - Personalized Machine Learning Models to Predict Future Alcohol Use 32:01 - 36:30: Madison Smith - Which Types of Substance-Related Legal Problems are Most Predictive of Arrest? 36:30 - 47:51: Melissa Schick - Gender Parity and Homophily in the Drug and Alcohol Dependence Editorial Process

Sleep is a critical function that can be disrupted by substance use. In fact, the majority of people with an alcohol use disorder report insomnia or sleep disturbance. So, what is good sleep, and why does it seem that substance use disrupts it? Can you treat the sleep, even if the drinking doesn't change? Does cannabis actually help sleep? Dr. Mary Beth Miller answers these questions and more, in our latest episode on the relationship between sleep and substance use. Dr. Mary Beth Miller is an Assistant Professor in the Department of Psychiatry at the University of Missouri School of Medicine.

Persistent alcohol use can, at times, interfere with intimate relationships and create conflict. The dynamic of the couple can be a source of tension and may create a loop that can perpetuate alcohol use. However, intimate couples relationships can also be great supports in the recovery from alcohol use disorder. Dr. Barbara McCrady talks about decades of research and development of Alcohol Behavioral Couples Therapy (ABCT), which attempts to target changes in alcohol use by bolstering the couples relationship and using the partner to help work toward behavior change. Dr. Barbara McCrady Professor Emerita of Psychology and the Center on Alcohol, Substance Use, and Addictions (CASAA) at the University of New Mexico. Here she is pictured with her beloved horse, Skylark.

Alcohol use produces changes in the cardiovascular system affecting heart rate. These systematic differences in heart rate can, in turn, function as a biological signature (i.e., biomarker) of dysfunction among those with alcohol use disorder (AUD). In addition to assessing difficulties, understanding heart rate modulation may have important treatment implications. Dr. David Eddie talks about heart rate variability as a biomarker of AUD and his work developing behavioral skills that can target heart rate using biofeedback to improve AUD treatment outcomes. Dr. Eddie is an Assistant Professor at Harvard Medical School and a Research Scientist at both Massachusetts General Hospital’s Center for Addiction Medicine and Recovery Research Institute.