As Sports Fans, Let’s Look at Performance-Enhancing Drugs

By Richard Taite

The Department of Psychiatry at the University of Wisconsin School of Medicine and Public Health, Madison, WI, recently published a review discussing drug abuse in athletes. Drug abuse occurs in almost all sports and at most levels of teen and adult competition. Doping, defined as use of drugs or other substances for performance enhancement, has become an important topic in sports.

Athletic life may lead to drug abuse for many reasons. Often first experimented with in high school or college for performance enhancement, athletes later continue use to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sports.

Performance-enhancing drugs (PEDs) are not restricted to illegal drugs or prescription medications, such as anabolic steroids. They include questionable dietary supplements and a variety of compounds that are available at grocery and health food stores and online. These substances may negatively affect hemoglobin, glucose and kidneys if misused, and evidence of actual performance enhancement is questionable.

Most if not all doping agents have potential short-term and long-term side effects. Unfortunately, given the high doses of the substances often used by athletes, it is difficult to confirm such effects. It would be unethical to give dosages as high as those used by athletes to participants in research studies. Information about side effects has come from empirical observation, reports of admitted users, and effects in patients prescribed specific medications for medical conditions. Research on this topic is extremely limited.

Athletes may receive comprehensive treatment and rehabilitation for physical injuries, but less often for mental illness, such as anxiety or depression due to extreme stress, possibly because of social views of mental illness as a sign of weakness. Untreated mental illness is often associated with substance use, perhaps in an effort to self-treat. Alternatively, substances of abuse may cause mental illness. This can certainly be true of performance enhancing drugs.

Athletes who use drugs are often skeptical of discussing this fact with their doctors. This may be partly with good reason, as many health care professionals are unfamiliar with the mentality of athletes or common drug abuse patterns in this population. Athletes also try to hide their drug abuse. Referral networks or team assistance programs consisting of health care professionals familiar with these issues should be established for the benefit of athletes, teams, trainers and coaches.

Co-occurrence of physical dependence and mental illness is commonplace.  The first level of addressing the problem of drug abuse by athletes should be prevention. Providers should assess for co-occurring mental illness and drug abuse in athletes with preventive measures, education, motivational interviewing, and other evidence-based interventions.

No athlete should ever have to consider PED use to succeed in sport. Simply put, PEDs have the potential to harm the human body and biological functions. These drugs can be extremely dangerous and, in certain situations, deadly. No matter how you look at it, using performance-enhancing drugs is risky business that does not benefit the sport, the athletes or the fans. Remember the film “The Wrestler?” That’s the true end result of PED use.

There are safe alternatives to PED use, including optimal nutrition, weight-training strategies, and psychological approaches to improving performance, all of which may help with athletes’ confidence in their natural abilities. It’s time we stop sullying athletic accomplishment with PED abuse. Talk to a professional for more information on substance use or addiction treatment options.

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Carefully Designed Drug Monitoring Programs Help Keep Addiction in Check

By Richard Taite

Carefully Designed Drug Monitoring Programs Help Keep Addiction in Check

Despite challenges, prescription drug monitoring programs are essential tools in ensuring opioids and other addictive medicines are prescribed and used appropriately.

The field of medicine is being pulled in two directions. On one hand, doctors are becoming more aware of the consequences of pain, leading to the prescription of more and more aggressive pain medicines; and on the other hand, we are also becoming more aware of the addictive potential of many of these drugs. We see the necessity of using opioid painkillers for people in pain, but we see the destructiveness of these painkillers when mis-prescribed and/or misused.

One response to this dilemma has been the growth of prescription drug monitoring programs (PDMPs). PDMPs allow doctors to know who is getting what drugs from whom. That’s the promise of a PDMP – it can keep track of the doctors who are prescribing drugs, the pharmacists who are distributing them, and the patients who are using them, and will allow people in positions of authority along this chain of communication to ensure that dangerous and addictive drugs are being used cautiously and correctly.

An interesting article in the open access journal BMC Pharmacy and Toxicology explores the pros and also the cons of these PDMPs – and lists the challenges we need to answer as we further refine the use of these important programs.

Here are the “pros” the article lists: Reduce over prescription and doctor shopping; reduce fraudulent prescribing by physicians; improve quality of care (e.g. ensuring there are no accidental drug interactions from legitimate prescriptions); and track geographic trends of use (e.g. discovering geographic trends of misuse and also demographic trends in legitimate use).

Here are the “cons” the article lists: Physician concerns (e.g.  concern that legitimate, high prescribers will be unfairly flagged); tagging of “psuedo addicts” (e.g. patients who have legitimately moved between doctors searching for real pain relief); patient concerns about refusal of prescriptions; loss of privacy; interference of law enforcement with health care; and mandatory use of PDMPs forcing unnecessary demands on doctors’ already stretched time.

In my opinion, these prescription drug monitoring programs are somewhat similar to asking police officers to wear video recorders; prescribers who are doing their job well have nothing to worry about and, in fact, an extra layer of careful oversight may help many providers answer concerns about their legitimate prescribing patterns. When you’re doing a good job, it can be supportive to have someone watching. Physicians who are in hospice or palliative care, some of the fields that prescribe opioids more than other specialties, will also have support through tracking of their prescribing practices.

Of course, answering the remaining concerns becomes a challenge of doing the most good compared to the least bad. A carefully designed PDMP should flag more doctor-shopping addicts and patients at risk for addiction than it flags patients receiving legitimate prescriptions for chronic, debilitating pain, palliative care, or acute situations. In these cases of inappropriately flagged patients, individual reviews can ensure that people who are in pain receive the drugs they need. We need also to ensure in these processes that reviews are quick, made by medical professionals (not non-medical administrators), and that patients have access to critical medications during the review process.

Are prescription drug monitoring programs worth their drawbacks? What’s your opinion?

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Research Results on Food Addiction

By Richard Taite

Research Results on Food Addiction

Recent evidence suggests that palatable, high-calorie foods, think comfort foods like mac & cheese or burgers with fries or steaks cut half the size of your head, may have an addictive potential that can contribute to overeating. Impulsivity, obesity and overconsumption of such foods have been associated with addiction-like eating behavior. (I say addiction-like, because as of present, food addiction is not fully recognized as an addiction by treatment professionals.)

Current data demonstrates that impulsivity is a trait that predicts the development of food addiction-like behaviors, including excessive intake, heightened motivation for food, and compulsive eating of foods with high fat, salt, and/or sugar content. Is the problem then impulsivity or lack of impulse control, or does something in the food cause impulsivity? Compulsivity is a behavioral trait frequently seen not only in drug-addicted individuals, but also in individuals who pathologically overeat. In this study, researchers hypothesized that a high impulsivity trait precedes and confers vulnerability for food addiction-like behavior.

Working with 4000 food addicts over twenty years, research scientist Philip Werdell found “bingeing clients reported “having to eat” and “bingeing on” the same foods scientists find most “addictive”: sugar, fat, flour, wheat, salt, artificial sweeteners, caffeine and volume.” Food-addicted individuals reported more frequent food cravings, higher eating disorder psychopathology and more depressive symptoms than non-addicted people. Furthermore, evidence indicating food abstinence relieves physical craving, enables sustained weight loss and supports internal recovery, provides a strong argument for the existence of both physical craving and food addiction.

A large 2013 study using a US-based population of women, documented the prevalence of food addiction by using a novel measurement scale in middle-aged and older women. Overall, 7839 (5.8%) of the women surveyed met the criteria for food addiction. The prevalence of food addiction was 8.4% in the younger cohort of women aged 45–64 years and 2.7% in the older cohort of women aged 62–88 years. The scientists hope the results may provide insight into the strong association between behavioral attributes of food consumption and the development of obesity.

Out of control consumption of food is related to pain reduction centers, which focus on the serotonin mechanisms in the brain, according to another study. This research showed malfunctions in serotonin processing correlates with an addiction to sugars and flours. Therefore, struggle with food addiction may have biological influences.

Existing evidence needs critical evaluation and food addiction should be considered for recognition as an addiction, no different than drugs or alcohol. There is now sufficient evidence to suggest that addiction, at least to sugar, is real and deserves treatment. Many holistic approaches help control other addictions, and food addiction warrants a more in-depth discussion for appropriate treatment options, to help those who struggle with this issue and the comorbid diseases of obesity, diabetes, and other disorders. Discuss concerns you may have with a medical professional for advice and development of a personal treatment plan for any addiction.



Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.

5 Myths about Healthcare Data Privacy from an Addiction Center CEO

By Richard Taite

Privacy.2It happened to Target and recently we learned it happened to UPS stores, too. It went on for a year at the Montana Health Department and it happened to millions of customers of Kaiser Permanente Northern California. It’s the theft of customer or patient data, and it can take place in many ways – a laptop goes missing, an employee downloads malware to an internal computer, someone on the inside intentionally leaks the data.

When this happens at a retail outlet like Target, customers can lose their credit card information, leading to a lengthy process of sorting out with the credit card company what you did and didn’t authorize. When this happens with a healthcare organization, the consequence can be the loss of your privacy, maybe even a social security number that links you with your identity in ways that are terribly difficult to disentangle.

In late July, Becker’s Hospital CIO published an article describing 7 HIPAA myths that hospitals, clinics, and other healthcare organizations need to keep in mind when trying to stay on the right side of privacy concerns. But there are things patients can do to safeguard their data, too. One of these things is simply knowing what healthcare organizations are and are not required to do to keep your data safe. Unfortunately, there’s HIPAA and then there’s what people think is true about HIPAA.

Following are 5 myths that I hear from patients in respect to their privacy. Of course many if not most healthcare settings, absolutely including my addiction treatment facility, have set their own best practices to answer these concerns. We go far above and beyond HIPAA requirements. But it’s still best to know what healthcare facilities have to do and what they choose to do with patient data. Knowing your rights can keep you safe. Be sure to ask your doctor, hospital, or addiction treatment center what they do to go beyond HIPPA’s basic privacy requirements.

1. HIPAA Requires a Consent Form before Treatment or Billing

Not only can a healthcare facility treat or bill you without a signed consent form, but it can pass along your information to another healthcare provider without signed consent, so that you can be treated and billed. When you move between healthcare institutions or even between some departments within an institution, another medical record may be created. The same is true of billing. Make sure you trust the clinic you are referred to as much as you trust the data security at the hospital where you started.

2. Healthcare Providers Can’t Tell Your Family about Your Medical Treatment

Believe me, I see this all the time; there is some information you might want to withhold from your family. But when it is in the “best interest” of the patient, healthcare providers are allowed under HIPAA to share your medical information. It’s even easier to share information with a family member that a patient has identified as a caregiver.

3. The Fact of Your Admission Is Confidential

This depends on the treatment facility. At my facility and most addiction centers, the fact of admission is confidential. But many hospitals list patients in an online directory and anyone that calls may be given your phone and room numbers. In most healthcare facilities, if you want your stay to be confidential, you have to request it specifically.

4. Your Sensitive Medical Information Won’t Be Emailed

What sits on the top of a fax machine tray may not stay on the top of a fax machine tray. And unless you have expressly communicated how you prefer to be communicated with, your healthcare provider can use email or even text. Most doctors and mental health providers are careful to offer disclaimers of non-confidentiality on all emails. Still, it’s easy to overlook what is and what is not secure.

5. Healthcare Providers Can’t Leave Messages on Answering Machines

In this day of personal smartphones, perhaps there’s less chance that an unsuspecting spouse or child will listen to the message describing the prescription that is ready for you at the pharmacy. Sure, providers are discouraged from leaving the specifics of medical information, but I’m sure you can imagine many cases in which a message leaving the provider’s name and the request to call back could raise privacy concerns. And providers are certainly within their rights to do so.

I don’t mean to sound like a conspiracy theorist. In most cases, healthcare providers will use your information to provide the best possible care – and this information will stay within the walls, or at least within the database, of your treatment provider. And again, most healthcare providers have internal policies that go above and beyond the bare-bones requirements of HIPAA. But it’s worth knowing your privacy rights – not just guessing that your information will be kept safe. At least if you know enough to be uncomfortable with the way your records have been handled, you will be able to request they be handled in a more secure way.


Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.

Image: Flickr/ cc license

Ecstasy by the Numbers: 869,000 New Users of an Impure Drug

By Richard Taite

Ecstasy.2According to the 2012 National Survey on Drug Use and Health, about 16 million people have used ecstasy at some point in their life, and during the 2012 year, 869,000 people used ecstasy for the first time, far higher than the number of new LSD and PCP users combined. The number of new ecstasy users is also greater than the number of new users of cocaine, stimulants, and inhalants. The percentage of people who will use ecstasy sometime in their life is between 2 percent and 3.5 percent. The average age for first-time users was 20.3 years old, smack dab in the middle of the college years.

Ecstasy has been and remains primarily a college drug. Not only is it a college drug, it’s a college party drug. It is a hallucinogen, and users report increased energy and feelings of connectedness to others.

An article in the Suffolk Journal quotes a student, Steve, saying, “It’s everything. In your head, you’re happy with the position you’re in. Physically, things around you feel good, familiar. You feel what it is and enjoy it.”

Perfect for a party, right?

According to a fact sheet from The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention, ecstasy also creates short term effects including severe anxiety, paranoia, teeth clenching, and sweating. Longer term effects include impulsivity and damage to areas of the brain involved in thinking and memory. Additional dangers include the frequent combination of ecstasy with other drugs including heroin and methamphetamines, which can cause physical harm to long-term overall health.

In 2001, there were 76 deaths attributed to ecstasy use, most due to heatstroke associated with dancing to the point of dehydration and exhaustion. Additional deaths are attributed to hyponatremia—drinking too much water without accompanying salts, due to the fear of heatstroke while taking ecstasy.

The risks of the drug extend far past use of the drug itself. Ecstasy is commonly known as the “love drug” and consequences of this love drug include everything you might expect when young people have sex without the use of their best judgment, from unplanned pregnancies to the spread of sexually transmitted diseases to legal problems due to unclear consent. College-aged ecstasy users are more likely to have unprotected sex. This population also has a higher rate of sexually transmitted diseases including HIV/AIDS and herpes. Finally, ecstasy use leads to a higher rate of unwanted sex, especially in young women who take the drug.

Additionally, the use of ecstasy increases suicide risk. Also quoted in the Suffolk Journal article, a student named Ryan says, “It gives you a feeling of euphoria for four or five hours, but then you feel like shit when it’s over. You feel depressed. You shouldn’t take it if you’re already depressed. You’ll just feel worse.” A study from the National Institutes of Health confirms this observation, finding almost double the risk for suicide in young adults that had used the drug in the past year and writing that, “Adolescent ecstasy users may require enhanced suicide prevention and intervention efforts.”

No matter its name—ecstasy, X, E, molly, or others like love drug, dancing shoes, skittles, or beansthe fact of the drug is that it is an unpredictable mix of lab chemicals produced in uncontrolled labs around the world, likely designed for stimulation and hallucination. With ecstasy, you simply don’t know what you’re getting and so you can’t predict its effect. Every time you take ecstasy is a roll of the dice. Is it really worth it?


Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good

Image via Flickr by Vix Walker

Study Shows Addicts are Lower in Mindfulness

By Richard Taite

Mindfulness.3Studies have shown the benefit of mindfulness training added to substance abuse treatment. Now a study from the National Institutes of Health shows that lack of mindfulness may be one of the causes of substance abuse, in the first place.

The study calls mindfulness, a “way of being that is focused on the present moment in a non-judgmental, non-reactive, compassionate manner.” The researchers looked for mindfulness in a population 107 adults in residential treatment for substance abuse. At the center, addicts filled out a 13-question survey called the Toronto Mindfulness Scale. Really, the scale looks at two components of mindfulness: decentering and curiosity. In decentering, a person can “step back” to observe their thoughts and feelings, rather than being absorbed by them. And in this case, curiosity isn’t just being generally curious about the world around you, but instead is a kind of curiousness about yourself – “the desire to know more about what you are experiencing,” the authors write.

Because the Toronto Mindfulness Scale has also been used to measure mindfulness in people not seeking treatment, the researchers could make an interesting comparison. For non-addicted people, the average score on the decentering part of the scale is 11.93; for people in residential treatment for addiction, it was 6.78. For non-addicted people, the average score on the curiosity side of the scale was 13.72; for people in residential treatment for addiction, it was 5.58.

Overall addicted people had about half the mindfulness as non-addicted people.

The authors point out that low mindfulness scores in addicts may mean that addicts, as a group, have lower tolerance for distressing experiences. “It is possible,” the authors write, “that the substance abuse group employed alcohol/drugs as a way to cope with, or to distance themselves from, distressing emotions and thoughts that they were over-identified with; in essence, substance use may be a form of coping with these distressing experiences.”

The study also suggests why mindfulness-based addiction treatment and mindfulness-based relapse prevention programs work. These programs teach non-judgmental acceptance of and curiosity about experiences that are naturally more positive and more negative. By doing so “each experience can be viewed… as something to be explored and understood, rather than something to be removed or pushed away.”

Of course, the way many addicts “push away” these experiences that currently overwhelm them is through using their substance of choice.

Interestingly, this article supports the idea of treating co-occurring and underlying issues along with addiction. In other words, just as depression and anxiety can cause and reinforce addiction, so too can lack of mindfulness be seen as a “condition” that leads to addiction. By treating anxiety or depression along with addiction, innovative treatment centers are improving recovery rates. And now it seems as if low mindfulness can be added to this list of issues for which directed treatment should be provided. By helping addicts discover the curiosity and decentering of mindfulness, we can treat this condition of low mindfulness that underlies addiction.


Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.

Image: Flickr/Mindfulness cc license

Robin Williams: A Devastating Loss

By Richard Taite

robin-williams-300x199In Patch Adams, he made me cry. In Mork and Mindy, he made me laugh. In Good Will Hunting he made me believe. In absolutely everything he ever did, Robin Williams was a wizard and a trickster and about four steps ahead and beyond everyone else on the screen. I am personally devastated by his loss. Especially when it was so preventable.

Reports suggest that Mr. Williams was in rehab in early July. As is often the case with individuals who have been in recovery for a long time and then relapse, accidental overdose and suicide are major risks. Mr. Williams needed more support than he got and tragically, the world has yet again lost a brilliant actor and comedian.

Addiction treatment and all co-occurring disorders such as clinical depression deserve the latest, best treatment available in 2014. Why did Mr. Williams check himself into a 1980s-style, 12-step, bare-bones rehab? Was it just because of name recognition?

The thing is, depression and brilliance and addiction can so often be part of the same package. When they are, it becomes a skilled dance to disentangle the aspects of brilliance that a person wants to keep from the depression and addiction that will almost inevitably pull that shining light down too soon. These are not 1980s skills. This is the cutting edge of today’s addiction treatment.

You can’t treat addiction without treating the underlying mental health conditions that cause it. All the evidence points to the same thing; you have to treat co-occurring psychiatric disorders, such as depression, at the same time as you treat addiction. Failure is almost inevitable if this treatment is not simultaneous. The same is true of anxiety or PTSD. These things can’t be compartmentalized because if you leave one, the others grow.


Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.

Study Shows 4 Reasons for Increased Suicide Risk in Addicts

By Richard Taite
Suicide risk in addicts shows necessity of treating underlying causes. Image: Flickr/DarcyAdelaide cc license

Suicide risk in addicts shows necessity of treating underlying causes. Image: Flickr/DarcyAdelaide cc license

Substance abuse doesn’t sit in a neat little package, tied up with a bow, waiting for treatment. Instead, imagine this little box…with octopus tentacles coming out of it. That’s addiction: it may start as overuse of a substance, but then it spreads to all areas of an addict’s life – family, career, and the way an addict sees him- or herself in the world. One area to which addiction spreads is the addict’s concept of self-worth. As we’ve known (and as you probably could have guessed), addiction increases suicide risk.

An article just published in the Journal of Affective Disorders looks inside this overall risk to discover what it is, exactly, inside addiction that puts people at risk for suicide. The study interviewed patients at a drug abuse treatment center and found that 68 percent of patients had major depressive disorder; 28 percent had attempted suicide within the last year. Here are the characteristics that predicted which patients had attempted suicide:

1. Alcohol/Marijuana as First-Used Drugs

Patients who dove into heroin or methamphetamines were less likely to be suicidal than patients who had started with alcohol or marijuana. Also, suicide risk was highest when people who started with alcohol moved to marijuana and when people who started with marijuana moved on to cocaine. The researchers suggest that perhaps people who start with alcohol or marijuana may also be most likely to use these substances (as opposed to others) in the attempt to self-medicate for depression, or as a result of depression, and that it is this association with depression and not characteristics alcohol/marijuana themselves that push suicide risk past that of other drugs.

2. Depression Before Addiction

Depression is a risk factor for substance abuse. When depression comes first, addiction also comes with increased suicide risk. When substance abuse acts like a symptom of depression, it is essential to treat the underlying cause of depression along with the addiction.

3. Suicide Before Addiction

This finding is fairly intuitive: patients who had attempted suicide before becoming addicted were also more likely to attempt suicide during addiction.

4. Family Drug Abuse History

Addicts who came from families that included addicts were at higher risk for depression and for suicide attempts. But why? Is it because growing up in an environment that included an addicted family member might not have provided the kindest childhoods for patients in the study? Or is it due to a genetic component of addiction and/or depression in which an addicted family member meant that patients in this study were more likely to have genes that predispose them to addiction and depression, and thus suicide?

All these factors taken together seem to mean that a person’s history before becoming addicted is as important as the addiction itself in predicting major depression and suicide attempts. This underscores the need to treat depression and other conditions along with addiction – addiction may be one of many symptoms of an underlying condition. Addiction certainly doesn’t help a person prone to depression avoid suicide attempts, but treating the addiction by itself may leave tentacles of depression or other co-occurring conditions – these tentacles may be the factors putting addicts most at risk for suicide.


Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.

Mindfulness with CBT May Rewire the Brain Sensitized by Addiction

By Richard Taite

One secret to addiction recovery may be rewiring the brain. Image: Flickr/Geekr cc license.

Why do addicts seek their drug? Why can’t they stop? The 21st century view is that an addict’s brain becomes literally hardwired to crave the drug. It’s called “incentive-sensitization” – the theory has been around since 1993 and was made mainstream by an article in the journal Addictionin 2000. Basically, the incentive-sensitization view of addiction says that drugs tip the scale of how our brains calculate incentives: drugs rewire the brain so that the drug is the brain’s only reward and thus its only motivation.

Now, a new article published online last week in the journal Neuroscience and Biobehavioral Reviews shows that it’s not just addictive substance, but addictive behaviors as well that can rewire the brain in this way. Not just what you consume but what you experience can make your brain crave the experience in the same way it can be taught to crave a drug.

A couple weeks ago, I wrote about whether or not food addiction is real and here’s another piece of evidence that it very well may be: behavioral addictions like gambling, food, sex and others can change your brain, making it hypersensitive to the rewards of these behaviors. For a person addicted to food, chocolate cake acts like heroin in the brain: the brain considers food its only reward and its only motivation, and so seeks food and can’t stop seeking it, even at great consequence to health and wellbeing.

Not only do substance addictions and behavioral addictions make addicts more sensitive to the rewards of their addiction, they make addicts less sensitive to natural rewardslike love or safety or belonging. An addict wants their addiction and nothing else can provide the same fix – it’s true of heroin and it’s likely also true of gambling, sex and food. And check out this powerful point: in the brains of addicts, seeking a substance or a behavior has everything to do with “wanting” and nothing to do with “liking.” You may not even like the thing you’re addicted to…but still, you want it.

Seeing behavioral addictions through the lens of incentive-sensitization can help us treat these addictions. The article points out that if addictive behaviors are written in the brain, the challenge is to rewrite the brain in a way that erases these patterns of behavior. The article points out that treatments with therapeutic drugs can mask the brain’s addictive desires, but don’t tend to lead to the long-term fix of new patterns in the brain. Instead, the authors write that cognitive behavioral therapy can, “increase awareness of cues that trigger craving and teach skills that enable new patterns of thinking and acting.”

Unfortunately, cognitive behavioral therapy (CBT) depends on these cues and cravings being conscious. What about all the unconscious cravings? The article recommends mindfulness-based interventions, which “can potentially target unconscious ‘wanting’ mechanisms by increasing awareness of bodily and emotional signals.”

And so if addiction – substance or behavioral – depends on “incentive sensitization,” the solution may be to make these cravings conscious with mindfulness and deprogram them with cognitive-behavioral therapy. If addiction is written into the brain’s system of incentives and motivations, the secret to addiction recovery may be to rewrite or at least rebalance this system.


Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.

Children Who Experience Family Members’ Trauma at Twice the Risk for Substance Abuse as Adults

By Richard Taite

AbuseWe know the effects of childhood traumas like abuse and neglect on later substance abuse. But what impact does second hand trauma have? A study published in the August issue of the journal Addiction shows that when a child under age 15 is exposed to a family member’s trauma (e.g. a parent or sibling being the victim of violent assault or a parent’s cancer diagnosis), that child has approximately twice the risk of struggling with drug and alcohol problems 6 years later.

Continue reading… »


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