Substance Abuse Counseling For Addiction Recovery

Substance-Related and Addictive Disorders is a category of mental health disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) that encompasses several different disorders, including alcohol use disorder (also known as alcohol addiction) and opioid use disorder. Substance use counseling (previously called substance abuse counseling) can help individuals with these mental health conditions address their symptoms and foster emotional wellness.  

Substance use disorder counselors, addiction counselors, and mental health centers provide treatment for those experiencing substance use disorder. Professionals like substance use disorder counselors work to develop individualized treatment plans and treatment goals to address issues related to alcohol addiction and substance use disorder and prevent relapse.

Understanding substance use disorder 

SUDs can affect all areas of a person’s life, including social relationships, family and love life, work, education, physical health, and mental health. 

Substance use addiction treatment 

Substance use disorder can escalate into dependence and addiction. These two words are often used interchangeably, but they both pertain to aspects of substance reliance. Substance use disorder counseling and related mental health counseling can address all various aspects of substance use and related behavioral disorders, helping individuals overcome addiction and avoid relapse. 

According to the Substance Abuse and Mental Health Services Administration, more than 40 million Americans lived with an SUD in 2020, including 14.5 million who lived with alcohol use disorders. While studies indicate that most people living with substance use disorder maintain full-time jobs, the U.S. Bureau of Labor Statistics reports that unintentional drug overdoses are steadily rising in the workplace.  

The hopeful news is that recovery can be possible, and there is help, including in-person and online therapy, for those living with substance-related and other addictive disorders. Substance use disorder counseling professionals work to provide support in all areas of a person’s life to assist in managing substance use disorder. This may include both crisis and non-crisis interventions. 

How to know if it’s time to get help

Everyone experiences symptoms of addiction differently. Understanding the possible symptoms of a substance use disorder may help you decide if you need care from a licensed counselor.

Common warning signs

Here are some potential symptoms and signs of SUDs:

• Difficulty cutting down on or quitting the use of a substance despite wanting to do so
• Changes in performance at work or school
• Withdrawal symptoms upon attempting to discontinue the use of a substance
• Personality changes, such as secretiveness, irritability, or agitation
• Changes in sleep patterns (i.e., difficulty sleeping or oversleeping)
• Mood swings
• Outwardly visible symptoms, such as trembling or shaking, bloodshot eyes, and difficulty with personal hygiene
• Slurred speech
• Unexplained financial problems or needs due to spending money on substances
• Legal problems related to the use of substances
• Social changes due to the use of substances (i.e., social isolation, or changing friend groups and hangout spots based on to substances)
• Difficulty or problems in interpersonal relationships related to the use of substances
• Cravings for the substance

It’s never too soon to ask for help or start the recovery process from addiction. If you notice these symptoms in yourself, it may be time to reach out and ask for help from a counselor or mental health professional.

When to seek emergency help

When you’re dealing with substance use disorder, it can be crucial to know the difference between noncrisis situations and emergencies. If you’ve noticed some of the warning signs above in yourself or someone you love, it’s advisable to seek treatment as soon as possible. However, there may be times when emergency treatment is required, such as in the case of an overdose. 

In case of an overdose

Signs of an overdose may vary depending on the type of substance being used. It may be crucial to familiarize yourself with these warning signs. In fact, it could make the difference between life and death. Generally, if someone you care about has been using alcohol or other substances and becomes non-responsive, call 911 right away or go to the nearest emergency room. 

What are some addiction treatment options?

There are several different types of treatment programs available for addiction and SUDs, including substance use disorder counseling services, and combined approaches are used frequently by licensed counselors. It may be expected for some people to go to detox first to prepare themselves for treatment. In detox, counselors work to help clients discontinue the use of substances safely. After they complete detox, a person may enter residential or inpatient treatment, followed by outpatient treatment and ongoing support groups or therapy for addiction. Substance use disorder counseling and addiction counselors, often working in an independent practice, provide addiction counseling and additional resources and counseling services to ensure a comprehensive recovery process.

Support services that strengthen recovery

For many people in recovery, substance use counseling is only one piece of the puzzle. Learning to live without alcohol or other substances can sometimes require additional support services. 

Community support

After inpatient treatment, many people in recovery progress to a residential rehabilitation facility where they live with others who are also fighting addiction. Here, they may receive peer and community support while they learn how to live independently without relying on substances. Those in outpatient treatment programs may also benefit from community support networks like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). 

Job placement services and vocational support

Substance use disorder can rob people of their jobs and careers. That’s why many treatment programs include a vocational support component to help people identify opportunities to earn a livable wage. This support can come in the form of job training, job placement services, career planning, and more.

Complementary therapies for substance use disorder

Some common complementary therapies that may effectively treat substance use disorder include:

• Motivational interviewing (MI) — Also known as Motivational Enhancement Therapy, MI is a counseling approach that seeks to alleviate any doubts an addicted person may have about pursuing therapy. It’s listed as an evidence-based therapy by the National Institute on Drug Abuse. Motivational Interviewing as a counseling approach is often done by counselors for the treatment of substance use disorders.
• The Matrix Model —The Matrix Model combines the principles behind various therapeutic techniques, such as CBT, MI, and CM, implementing them in a mixture of individual and group therapy sessions. It’s especially useful for the treatment of alcohol misuse and other substance use disorders.
• Step Facilitation Therapy —STP is a type of behavioral therapy intended to promote engagement with 12-step programs. It provides interventions for substance use disorders.
• Contingency Management — Contingency management is a type of cognitive-behavioral therapy used by licensed counselors and therapists. It involves using tangible rewards to incentivize treatment engagement on the part of the patient. These rewards may involve gift vouchers or small cash prizes in exchange for meeting small and achievable treatment milestones (e.g., attending sessions every day for a month). It’s been successfully used to treat opioid use disorder.
• Rational Emotive Behavior Therapy (REBT) — Another form of behavioral therapy utilized by counselors and therapists, REBT aims to replace irrational or limiting beliefs with more positive thought patterns. It’s an effective treatment for a large variety of co-occurring disorders, such as depression, anxiety, substance use disorders, as well as various phobias and sleep issues.

In treatment for addiction, you often learn about and create a plan for coping with various related matters, including relapse prevention, problem-solving skills, and interpersonal relationships. You may also address any prevalent legal or social issues or comorbid or co-occurring concerns and conditions.

Family therapy sessions and emotional support for families and family members may also be provided by counselors and therapists. There is no shame in seeking care for problem behaviors associated with SUDs and addiction, and it could be important to destigmatize these issues so that more people can get the life-saving support they need.

Addressing co-occurring concerns in treatment for SUDs

Addressing co-occurring or comorbid concerns is often a vital part of treatment for SUDs.

Common comorbidities seen in those living with SUDs may include:

• Post-traumatic stress disorder (PTSD). It said that roughly half of those living with a SUD meet post-traumatic stress disorder or PTSD criteria. PTSD can be treated with a combination of psychotherapy, counseling, and medication.
• Eating disorders. People with eating disorders are five times more likely to live with a SUD when compared to the rest of the general population.
• Anxiety disorders. Anxiety disorders are a significant risk factor for the development of a SUD, especially alcohol abuse. Anxiety disorders can be addressed through medication, therapy, and counseling with a licensed counselor.
• Almost a third of those living with major depressive disorder or MDD meet the criteria for a SUD. Substance use can also pair with other types of depression, like persistent depressive disorder.
• Attention-deficit/hyperactivity disorder (ADHD). People with ADHD are more likely to live with a SUD when compared to those without ADHD.

Other conditions can play a role in the development of SUDs for some people. In cases like these, addressing other concerns is often highly beneficial and is an important part of treatment for SUDs. Other risk factors, like environment, may also be addressed in treatment. When a person receives care that acknowledges their needs as a whole person and does not shy away from the role the substance may play in a person’s life, it may mean that a person can speak openly about their experiences, find healthy coping mechanisms to use when triggers arise, learn how to advocate for themselves, and gain other skills that may be beneficial for them as a unique person in recovery.

How substance use disorder counseling and group therapy can help you recover

If you’re considering taking SUD counseling and recovery with a licensed counselor, you might wonder how it works, what it will be like, or what the benefits of treatment might be. Substance use disorder counseling can help you:

1. Name and navigate the triggers of your addiction

Learning to name and navigate triggers is often a crucial part of relapse prevention. Your triggers might be specific feelings, specific situations (such as situations where you may be in the same room as a substance or be offered a particular substance), or something else. Once you name or identify your triggers, you will likely make a plan for how you can navigate them, helping you engage in more rational thinking. This might be turning to a support system, leaving the room or event, finding ways to cope after the fact, or something else.

2. Work on life goals

A big part of counseling or treatment for SUDs can be thinking about what you want your future to look like. This could include learning skills that’ll help you build and maintain healthy friendships, job or work-related skills and goals, and implementing positive daily routines into your life.

3. Challenge negative thoughts

It’s can be common to experience depression, negative thoughts, and other challenges when new to sobriety. Learning to challenge negative thoughts effectively may be something that we can all benefit from, and in time, your general thought patterns can become more positive and balanced if this is something you’re working on.

4. Improve your overall mental health for recovery

Because mental illness often coincides with substance misuse, one of the key principles of substance use disorder counseling may be addressing mental health holistically. In other words, most often, you can address everything (or most things) that is impacting your mental health rather than the SUD diagnosis and the behaviors that might come with it alone. Many patients learn coping skills, communication skills, and other strategies that positively impact their lives and well-being overall.

5. Find solidarity and fight stigma

You will likely come to find a sense of solidarity in SUD counseling or treatment. Whether that is from the healthcare professionals you work with, a support group, a sponsor, or someone else, finding people who take away the stigma of SUDs and provide solidarity for your recovery is something everyone who gets care deserves. 

Other benefits of counseling for substance use disorders include:

• Counseling can help with relapse prevention. Counseling and therapy from a licensed counselor can teach individuals healthy coping skills to resist triggers and prevent relapse.
• Counseling may offer advice to repair relationships that might have been affected by substance misuse.
• Counseling can offer support for individuals dealing with substance use disorder. Counseling can be a safe space for individuals to work out issues that led to substance misuse.
• Counseling could be is good for addressing other mental health conditions that are associated with substance misuse.
• Counseling may be cost-effective for treating substance use disorder. Counseling can provide substantial benefits while being affordable at the same time.
• Counseling may addresse issues that can be associated with substance misuse such as anger management and low esteem. Counseling can improve an individual’s mental health by identifying negative patterns and triggers and replacing them with healthier alternatives.

Counseling for a SUD can help you in many different ways, and it may be the start of what truly feels like a new life for many people.

Support for specific populations

Despite the use of evidence-based therapies, treatment for substance use disorder is not a one-size-fits-all solution. Support services can be adapted to accommodate different populations, including veterans and minorities. 

Veterans and service members

Veterans with substance use disorder can seek treatment and support services from the U.S. Department of Veterans Affairs. The VA provides comprehensive treatment options, including medication, counseling, and relapse support. 

Culturally responsive support

People of certain ethnic backgrounds and specific populations may be at a higher risk for substance use disorder. They may also face unique challenges during recovery. Culturally responsive support in mental health care and substance use counseling can ensure that everyone receives relevant and effective support for substance misuse and addiction. 

Where to find treatment near you: How to get started

Finding local providers

• Ask a professional about treatment for substance use disorders. You can ask a general practitioner or call area hospitals for treatment information. You can also ask a substance abuse counselor, therapist, social worker, or psychiatrist you already work with. 
• Use a treatment locator for substance use disorders such as https://findtreatment.gov.
• Call a resource hotline such as the 211 hotline. 211 is available in most areas in the United States. Dial “211” using any landline or cell phone, and you’ll be connected with an operator. Call substance abuse hotlines and start your recovery from substance use disorders.

If you have health insurance, you can also contact your health insurance company directly to see what treatment resources they cover. 

What to prepare before your first appointment

Before your first appointment, your counselor may e-mail you some intake forms to fill out. Some of these forms may be for health insurance or billing purposes. Others might assess your readiness for counseling or the severity of your substance use issues. 

In addition to filling out forms, you may also want to write down any questions you have for your counselor. Knowing what to expect from the counseling process may help you feel more comfortable moving forward. If you’re not sure where to begin, you can find resources at the Substance Abuse and Mental Health Services Administration’s website to help you prepare for your first appointment. 

Choosing the right provider

The relationship between you and your counselor could significantly impact your success in treatment, so it’s important to choose wisely. Whether you choose an online or in-person provider, you may want to do your due diligence to ensure they’re a good fit. 

Licensure and credentials

At a minimum, you may want to ensure your substance use counselor has the proper licensure and credentials to provide treatment services. In terms of substance use and addiction professionals, you can check with your state board or the National Association of Addiction Professionals (NAACP) to confirm a counselor’s qualifications. In some cases, the counselor’s employer or the counselor themselves can provide the documentation you need. 

Questions to ask 

Beyond checking minimum licensing requirements, you may want to ask your prospective counselor some questions to find out whether they’re a good fit for your needs. Some examples could include:

• What experience do you have providing substance use counseling?
• How do you monitor progress?
• Will I have a say in my treatment plan?
• What strategies and techniques do you use?
• What is your philosophy on addiction?
• How do you structure sessions?
• What if I relapse?
• Do you treat comorbid conditions?

What to expect in substance use counseling

Once you find the right substance use counselor, you can schedule your first session. At this initial meeting, your therapist may ask you questions to get an idea of your symptoms and their severity. You might also begin developing a treatment plan together. 

Questions to expect

When you attend your first substance use counseling session, you may want to prepare yourself to answer several questions about your habits and circumstances. Some of these questions may include:

• What types of substances do you use?
• How much and how often do you use these substances?
• When did you first start using substances?
• Have you ever tried to quit before?
• What problems in your life are connected to your substance use?
• Do you have a support system?

You may feel hesitant or nervous to open up to your counselor at first. This is to be expected, but try to answer each question as accurately and honestly as you can. 

How counselors develop treatment plans

To develop treatment plans, counselors rely on their own knowledge of substance use counseling combined with what they know about your specific condition. They’ll likely ask for your participation to complete a personalized treatment plan to guide your progress. When you play a part in designing your own course of treatment, you may find that you’re more invested in the process.

Tips for supporting your loved ones in recovery

If you live with a SUD and want to show someone in your life how to support or better understand what you’re going through, you may send online resources and other sources of information their way. SUD treatment often encourages the involvement of loved ones.

Alternatively, if you’re the loved one of a person with a SUD, you may want to find support for yourself. There are many support groups for loved ones of those with SUDs, including family and romantic partners. 

Therapy and additional support options

Individual therapy with a licensed mental health professional or counselor may also be advantageous if you are the loved one of someone living with a SUD. It can be challenging to watch someone you care about face a SUD or another similar condition. Among the many other reasons people might seek therapy, therapy can be a safe space to talk about your feelings and help you cope with or manage stress when times are hard. In time, you can learn to replace the negative habits and thought patterns that lead to substance abuse with more positive behaviors.

Online therapy for substance use disorder

Online therapy can be a viable option if an individual doesn’t want to meet in person. After assessing readiness, individuals can connect with a licensed professional from their home without a commute, often at a more affordable price than in-person treatment. 

Many halfway houses and correctional facilities may beare willing to accept proof of substance use disorder counseling with an online provider who has a Master’s degree or Bachelor’s degree in their field.