Links

VA Alcohol and Drug Treatment

Find VA Locations | Veterans Affairs (va.gov)

Every VA healthcare system offers specialized individual and group counseling for Veterans with substance use disorders.

Community-based Alcohol and Drug Treatment

Find Help and Treatment | SAMHSA (samhsa.gov)

The Substance Abuse and Mental Health Services Administration (SAMHSA) provides information and links to treatment and other resources. There is a section that is specific to Veterans.

Find Your Way to Alcohol Treatment (nih.gov)

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has a treatment navigator with resources for both individuals with concerns about their drinking and for their loved ones.

Understanding treatment for substance use disorders (cdc.gov)

The Centers for Disease Control and Prevention (CDC) has information about treatment for substance use disorders and how to access it.

Mutual Support Options

Alcoholics Anonymous (aa.org)

Narcotics Anonymous (na.org)

Self-Management and Recovery Training (smartrecovery.org)

LifeRing (lifering.org)

Women for Sobriety (womenforsobriety.org)

Celebrate Recovery (celebraterecovery.com)

Moderation Management (moderation.org)

VA Developed Digital Supports

Vetchange (vetchange.org)

Vetchange is an app for people, whether they are Veterans or not, who are concerned about their drinking and would like to develop healthier behaviors relating to how they drink.

My Recovery Plan (va.gov)

My Recovery Plan is a web-based VA general recovery tool that can be adapted for all sorts of situations, including when someone wants to make changes in their alcohol or drug use.

VA Safety Plan: Mobile App (va.gov)

The Safety Plan app is for anyone who has experienced thoughts about suicide or self-harm. You can download this and any other app on iTunes and Google Play to your phone, for free.

Because of the high risk of deadly overdose with opioid use – whether prescribed or not – it is important to know the signs and to have Naloxone (Narcan®) on hand.

If people use stimulants, like cocaine or methamphetamine, they should have Naloxone available because stimulants can be contaminated with opioids, leading to overdose risk.

Naloxone (Narcan®) through VA

Choose Before You Use: Opioid Overdose Prevention (va.gov)

This handout from the VA covers Opioid Overdose Prevention and Reversing an Overdose with Naloxone.

Opioid Overdose (va.gov)

This VA link provides life-saving information about preventing and reversing opioid overdoses and has information on how to get Naloxone.

Naloxone (Narcan®) in the Community

Lifesaving Naloxone (cdc.gov)

People who do not use the VA for care can get information about accessing Naloxone here.

Non-prescription "Over-the-Counter" Naloxone Frequently Asked Questions (samhsa.gov)

Naloxone is available over-the-counter (i.e., without a prescription). This link offers more information.

National Association of County Health Officials (naccho.org)

Reach out to your local city/county health department for information on other ways to get Naloxone in your community at this link.

VA Tobacco Use Treatment Resources

Quit VET - Mental Health (va.gov)

1-855-QUIT-VET (1-855-784-8838), VA’s free telephone quitline, offers tobacco cessation counseling to any Veteran who receives their health care through VA.

SmokefreeVET Text Message Program: SmokefreeVET - Mental Health (va.gov)

Stay Quit Coach 2.0 VA Mobile App: Stay Quit Coach | VA Mobile (va.gov)

VA Mental Health – How to Quit Tobacco: How to Quit - Mental Health (va.gov)

Chaplain Services

National VA Chaplain Service - Patient Care Services (va.gov)

Many Veterans view their spiritual and/or religious needs as being central to their well-being. The VA has services available to provide this type of support.

Housing

VA Homeless Programs (va.gov)

VA is motivated to end homelessness for Veterans.This link is the VA's central hub for homelessness services.

Employment

Veteran Readiness And Employment (Chapter 31) | Veterans Affairs (va.gov)

VA is motivated to end homelessness for Veterans.This link is the VA's central hub for homelessness services.

Legal

Veterans Treatment Court Program | Overview | Bureau of Justice Assistance (ojp.gov)

When Veterans are involved in the legal system, the VA can help. Information about the Veterans' Treatment Court Program can be found at this site.

Justice-Involved Veterans and Treatment Court - Office of Health Equity (va.gov)

Information about how VA supports justice-involved Veterans can be found here.

Veterans Justice Outreach Program - VA Homeless Programs (va.gov)

Information about how to contact the Veterans' Justice Outreach Program can be found here.

Legal Services for Veterans Programs - VA Homeless Programs (va.gov)

Information about legal services for homeless Veterans and those who may be at risk for homelessness can be found here.

Fact Sheets

Drug Fact Sheets (dea.gov)

To help keep the public informed, the government keeps up-to-date fact sheets with information on known and emerging drugs.

Because of the high risk of deadly overdose with opioid use – whether prescribed or not – it is important to know the signs and to have Naloxone (Narcan®) on hand.

If people use stimulants, like cocaine or methamphetamine, they should have Naloxone available because stimulants can be contaminated with opioids, leading to overdose risk.

Naloxone (Narcan®) through VA

Choose Before You Use: Opioid Overdose Prevention (va.gov)

This handout from the VA covers Opioid Overdose Prevention and Reversing an Overdose with Naloxone.

Opioid Overdose (va.gov)

This VA link provides life-saving information about preventing and reversing opioid overdoses and has information on how to get Naloxone.

Naloxone (Narcan®) in the Community

Lifesaving Naloxone (cdc.gov)

People who do not use the VA for care can get information about accessing Naloxone here.

Non-prescription "Over-the-Counter" Naloxone Frequently Asked Questions (samhsa.gov)

Naloxone is available over-the-counter (i.e., without a prescription). This link offers more information.

National Association of County Health Officials (naccho.org)

Reach out to your local city/county health department for information on other ways to get Naloxone in your community at this link.

Smoking and Tobacco Use Treatment

You Can Quit Tobacco PDF (samhsa.gov)

This brochure is designed to support people who are making changes in their alcohol or drug use who also want to quit using tobacco and nicotine products.

Smokefree.gov

Smokefree.gov has information geared specifically to Veterans, women, teens, Spanish speakers, and people 60 years of age and older.

Call to speak with a quit coach

1-800-QUIT-NOW (1-800-784-8669)

How to Quit (cdc.gov)

Information on Alcohol and Drugs for Loved Ones

Warning Signs of Unhealthy Alcohol and Drug Use | Veterans Affairs (va.gov)

This VA resource provides information about the warning signs that an adult may be having difficulties with alcohol or drugs.

Ways to Give Support and Take Care of Yourself

CRAFT: Community Reinforcement And Family Training (va.gov)

Community Reinforcement and Family Training or CRAFT is a free resource for family members who are worried about a loved one's alcohol or drug use.

Family Member or Friend - Mental Health (va.gov)

VA has several resources and tools to help family members and friends with concerns about a loved one's mental health. This information is available for anyone, not just Veterans.

Relative-Supporting-Recovery.pdf (va.gov)

This is a guide on how to support a loved one struggling with their mental health, including having problems with alcohol or drugs.

Resources for Family and Friends | Videos & Info for Military Veterans (maketheconnection.net)

Make the Connection is a VA resource that focuses on Veterans' stories about their mental health challenges.

Al-Anon Meeting Search - Al-Anon Family Groups (al-anon.org)

Family members and loved ones can access mutual support through free Al-Anon/Nar-anon meetings. There are Al-Anon/Nar-Anon meetings online and in-person in most cities and towns in the US.

Nar-Anon Family Groups (nar-anon.org)

Family members and loved ones can access mutual support through free Al-Anon/Nar-anon meetings. There are Al-Anon/Nar-Anon meetings online and in-person in most cities and towns in the US.

NAMI Family Support Group | NAMI: National Alliance on Mental Illness (nami.org)

The National Alliance on Mental Illness (NAMI) also has support resources for family members and friends, and those meetings can be located through this link.

Fact Sheets

Drug Fact Sheets (dea.gov)

To help keep the public informed, the government keeps up-to-date fact sheets with information on known and emerging drugs.

When to Get Urgent Help Sources

Alcohol Overdose

Understanding the Dangers of Alcohol Overdose | National Institute on Alcohol Abuse and Alcoholism (NIAAA) (nih.gov)

Alcohol Withdrawal

Canver, B. R., Newman, R. K., & Gomez, A. E. Alcohol Withdrawal Syndrome. [Updated 2024 Feb 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:

Alcohol Withdrawal Syndrome (nih.gov)

Delirium Tremens

Rahman, A. & Paul, M. Delirium Tremens. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:

Delirium Tremens (nih.gov)

Opioids

Signs of Opioid Misuse, Opioid Use Disorder, and Overdose (cdc.gov)

Barbiturate Toxicity

Suddock, J. T., Kent, K. J., Regina, A. C., et al. Barbiturate Toxicity. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:

Barbiturate Toxicity (nih.gov)

Barbiturate Withdrawal (and other alcohol/drug withdrawal syndromes)

Gupta, M., Gokarakonda, S. B., Regina, A. C., et al. Withdrawal Syndromes. [Updated 2024 Sep 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:

Withdrawal Syndromes (nih.gov)

Stimulants

CDC-Stimulant-Guide.pdf (cdc.gov) (see pg. 2 for stimulant overdose information)

Benzodiazepines

Benzodiazepine withdrawal (UpToDate.com)

Tolerance and Dependence

Understanding Drug Use and Addiction DrugFacts | National Institute on Drug Abuse (NIDA) (nih.gov)

Routes of Administration

Routes Of Administration For Drug Use And Abuse (AddictionResource.net)

Alcohol and Drug Alternative Names and Short-term Effects Sources

Most of the information is adapted from NIDA’s resource on commonly abused drugs, which can be found here:

Commonly Abused Drugs (nih.gov)

Additional information is from the following online resources:

Synthetic cannabinoids

Synthetic Cannabinoids | National Institute on Drug Abuse (NIDA) (nih.gov)

Ritalin street names

Street Names For Ritalin (Methylphenidate) (AddictionResource.net)

Nitrous Oxide (Laughing gas)

Laughing Gas (Nitrous Oxide): Uses, Side Effects, and Safety (webmd.com)

Barbiturates

Drug Fact Sheet: Barbituates (dea.gov)

Benzodiazepines

Drug Fact Sheet: Depressants (dea.gov)

Xylazine

Xylazine: What Clinicians Need to Know (va.gov)

Xylazine: What You Need to Know (va.gov)

White House warning: What you need to know about xylazine (ems1.com)

Kratom

Kratom (dea.gov)

Prescription Opioids

Prescription Opioids DrugFacts | National Institute on Drug Abuse (NIDA) (nih.gov)

Rates of Substance Use and Substance Use Disorders Across Different Groups of People

SAMHSA General Population Information

Section 5 PE Tables – Results from the 2021 National Survey on Drug Use and Health:
Detailed Tables, SAMHSA, CBHSQ (samhsa.gov)

SAMHSA Veteran Information

2021 National Survey on Drug Use and Health:
Among the Veteran Population Aged 18 or Older (samhsa.gov)

National Guidelines for Safer Levels of Alcohol Consumption

Risky Drinking and Alcohol Use Disorder | Veterans Affairs (va.gov)

Information on Why Drinking Guidelines Differ for Different Groups of People

Differences in how Females and Males Process Alcohol

Information adapted from the following:

Women and Alcohol (nih.gov)

Alcohol and Older Adults

Older Adults and Drinking (nih.gov)

Alcohol and Pregnant and Breastfeeding People

Pregnancy: Alcohol and Your Pregnancy (nih.gov)

Breastfeeding: Alcohol | Breastfeeding Special Circumstances (cdc.gov)

Substance Use Disorder Criteria

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.)

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) (doi.org)

Availability

Dimova, E. D., Lekkas, P., Maxwell, K., Clemens, T. L., Pearce, J. R., Mitchell, R., Emslie, C., & Shortt, N. K. (2023). Exploring the influence of local alcohol availability on drinking norms and practices: A qualitative scoping review. Drug and alcohol review, 42(3), 691–703.

Exploring the influence of local alcohol availability on drinking norms and practices: A qualitative scoping review (doi.org)

World Health Resource on alcohol availability:

Alcohol availability (who.int)

Addictive Properties of Alcohol and Drugs

Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. CHAPTER 2, THE NEUROBIOLOGY OF SUBSTANCE USE, MISUSE, AND ADDICTION. Available from:

The Neurobiology of Substance Use, Misuse, and Addiction (nih.gov)

Peer Groups

Henneberger, A.K., Mushonga, D.R. & Preston, A.M. Peer Influence and Adolescent Substance Use: A Systematic Review of Dynamic Social Network Research. Adolescent Res Rev 6, 57–73 (2021).

Peer Influence and Adolescent Substance Use: A Systematic Review of Dynamic Social Network Research (doi.org)

Substance Use and Military Life DrugFacts (nih.gov)

Culture

Cultural Differences in Substance Use (psychcentral.com)

Trauma (and Stress)

Amaro, H., Sanchez, M., Bautista, T., & Cox, R. (2021). Social vulnerabilities for substance use: Stressors, socially toxic environments, and discrimination and racism. Neuropharmacology, 188, 108518.

Social vulnerabilities for substance use: Stressors, socially toxic environments, and discrimination and racism (doi.org)

Traumatic Stress and Substance Abuse Problems (istss.org)

Poverty

Collins S. E. (2016). Associations Between Socioeconomic Factors and Alcohol Outcomes. Alcohol Research: Current Reviews, 38(1), 83–94.

Associations Between Socioeconomic Factors and Alcohol Outcomes (nih.gov)

Genetics

Gerring, Z.F., Thorp, J.G., Treur, J.L. et al. The genetic landscape of substance use disorders. Mol Psychiatry (2024).

The genetic landscape of substance use disorders (doi.org)

Family Dynamics

Tedgård E, Råstam M, Wirtberg I. An upbringing with substance-abusing parents: Experiences of parentification and dysfunctional communication. Nordic Studies on Alcohol and Drugs. 2019;36(3):223-247

An upbringing with substance-abusing parents: Experiences of parentification and dysfunctional communication (nih.gov)

Monari EN, Booth R, Forchuk C, Csiernik R. Experience of Family Members of Relatives with Substance Use Disorders: An Integrative Literature Review. Creative Nursing. 2024;30(3):232-244.

Experience of Family Members of Relatives With Substance Use Disorders: An Integrative Literature Review (nih.gov)

Pain

Pain Management, Mental Health, and Substance Use (https://psychiatryonline.org/)

Health Effects of Various Substances

Alcohol

Effects of Alcohol on the Body (healthline.com)

Tobacco

Cigarette Smoking | Smoking and Tobacco Use (cdc.gov)

Cannabis

Know the Negative Effects and Risks of Marijuana Use (samhsa.gov)

Opioids

Long-Term Opioid Use: Side Effects, Risks, and More (healthline.com)

Adrenal insufficiency/low cortisol info:

Addisonian Crisis: Risks, Symptoms, and Treatment (healthline.com)

Stimulants

Treatment for Stimulant Use Disorders: Updated 2021 [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 33.) Chapter 3—Medical Aspects of Stimulant Use Disorders. Available from:

Treatment for Stimulant Use Disorders (nih.gov)

Know the Risks of Meth (samhsa.gov)

Hallucinogens

Drug Fact Sheet: Hallucinogens (dea.gov)

Hallucinogens (dea.gov)

Benzodiazepines

Bounds CG, Patel P. Benzodiazepines. [Updated 2024 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:

Benzodiazepines (nih.gov)

Inhalants

Inhalants DrugFacts (nih.gov)

Kratom

Jentsch MJ, Pippin MM. Kratom. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:

Kratom (nih.gov)

Xylazine

Xylazine: What Clinicians Need to Know (va.gov)

Xylazine: What You Need to Know (va.gov)

White House warning: What you need to know about xylazine (ems1.com)

Health Impacts of Alcohol and Drug Use on Others

Alcohol Use and Pregnancy and Breastfeeding

About Alcohol Use During Pregnancy (cdc.gov)

Breastfeeding Special Circumstances (cdc.gov)

Breastfeeding and alcohol: Is it OK to drink? (mayoclinic.org)

Impaired Driving

Impaired Driving Facts (cdc.gov)

Drunk Driving (nhtsa.gov)

Cannabis and Other Drugs and Pregnancy and Breastfeeding

Marijuana During Pregnancy - Know the Risks (samhsa.gov)

Cocaine and pregnancy (marchofdimes.org)

Methamphetamine - Mother To Baby | Fact Sheets - NCBI Bookshelf (nih.gov)

Substance Use During Pregnancy (cdc.gov)

Cannabis and Other Drugs and Impaired Driving

Drug-Impaired Driving (nhtsa.gov)

Impaired Driving Facts (cdc.gov)

Tobacco and Pregnancy and Breastfeeding

What's In a Cigarette? (lung.org)

Breastfeeding special circumstances | Tobacco and Electronic Cigarettes (cdc.gov)

Substance Use During Pregnancy (cdc.gov)

Tobacco and Secondhand Smoke

Health Problems Caused by Secondhand Smoke (cdc.gov)

Alcohol and Mortality (note: as of 2021, the number is up to 178,000 per year)

Alcohol Use | Facts About U.S. Deaths from Excessive Alcohol Use (cdc.gov)

Years of Potential Life Lost Due to Alcohol-Attributable Causes Among Veterans Served By VHA

Lynch, K. E., Livingston, N. A., Gatsby, E., Shipherd, J. C., DuVall, S. L., & Williams, E. C. (2022). Alcohol-attributable deaths and years of potential life lost due to alcohol among veterans: Overall and between persons with minoritized and non-minoritized sexual orientations. Drug and alcohol dependence, 237, 109534.

Alcohol-attributable deaths and years of potential life lost due to alcohol among veterans: Overall and between persons with minoritized and non-minoritized sexual orientations (sciencedirect.com)

Drug Use and Mortality (Note: the final data shows somewhat lower rates for 2022 than was reflected in the provisional numbers)

Provisional Data Shows U.S. Drug Overdose Deaths Top 100,000 in 2022 (cdc.gov)

Begley, M. R., Ravindran, C., Peltzman, T., Morley, S. W., Stephens, B. M., Ashrafioun, L., & McCarthy, J. F. (2022). Veteran drug overdose mortality, 2010-2019. Drug and alcohol dependence, 233, 109296.

Veteran drug overdose mortality, 2010–2019 (sciencedirect.com)

What Are Mental Health Conditions?

Mental Health Conditions (nami.org)

Rates of mental health disorders and co-occurring mental health disorders and substance use disorders in 2022

Results from the 2022 National Survey on Drug Use and Health: A Companion Infographic (samhsa.gov) (see pg. 12)

Co-occurring Mental Health and Substance Use Problems – How People Develop Both

Substance Use and Co-Occurring Mental Disorders (nih.gov)

Information on Co-occurrence of Substance Use Problems and Selected Mental Health Disorders

Depression

Does Depression Lead to Substance Abuse? It's a Complicated Link (healthline.com)

Generalized Anxiety Disorder

Share Favorites Permissions Original Articles Multimorbidity and Correlates of Comorbid Depression and Generalized Anxiety Disorder in a Nationally Representative US Sample (lww.com)

Social Anxiety Disorder

Social Anxiety Disorder and Alcohol Abuse (adaa.org)

Posttraumatic Stress Disorder (PTSD)

Hawn, S. E., Cusack, S. E., & Amstadter, A. B. (2020). A Systematic Review of the Self-Medication Hypothesis in the Context of Posttraumatic Stress Disorder and Comorbid Problematic Alcohol Use. Journal of traumatic stress, 33(5), 699–708.

A Systematic Review of the Self-Medication Hypothesis in the Context of Posttraumatic Stress Disorder and Comorbid Problematic Alcohol Use (doi.org)

McCauley, J. L., Killeen, T., Gros, D. F., Brady, K. T., & Back, S. E. (2012). Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment. Clinical psychology: a publication of the Division of Clinical Psychology of the American Psychological Association, 19(3), 10.1111/cpsp.12006.

Posttraumatic stress disorder and co‐occurring substance use disorders: Advances in assessment and treatment (doi.org) (Describes finding that those with PTSD are apt to have increased negative consequences when using similar amounts or smaller amounts than those without PTSD)

Serious Mental Illness

Key Substance Use and Mental Health Indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (cdc.gov) (Note: see graph on page 45)

Eating Disorders

Eating Disorders (nih.gov)

What are Eating Disorders? (nationaleatingdisorders.org)

Substance Use and Eating Disorders (nationaleatingdisorders.org)

Udo, T., & Grilo, C. M. (2019). Psychiatric and medical correlates of DSM-5 eating disorders in a nationally representative sample of adults in the United States. The International journal of eating disorders, 52(1), 42–50.

Psychiatric and medical correlates of DSM-5 eating disorders in a nationally representative sample of adults in the United States (doi.org)(this article covers all three and includes information on rates of AUD and DUD as well as nicotine use disorder)

Gambling

Gambling Problems: An Introduction for Behavioral Health Services Providers (in.gov)

Other issues associated with Substance Use Disorders

Suicide

Overall annual number of US adults who died from suicide:

Suicide Data and Statistics (cdc.gov)

Sleep

Valentino, R.J., Volkow, N.D. Drugs, sleep, and the addicted brain. Neuropsychopharmacol. 45, 3–5 (2020).

Drugs, sleep, and the addicted brain (doi.org)

Anger

Laitano, H. V., Ely, A., Sordi, A. O., Schuch, F. B., Pechansky, F., Hartmann, T., Hilgert, J. B., Wendland, E. M., Von Dimen, L., Scherer, J. N., Calixto, A. M., Narvaez, J. C. M., Ornell, F., & Kessler, F. H. P. (2022). Anger and substance abuse: a systematic review and meta-analysis. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 44(1), 103–110.

Anger and substance abuse: a systematic review and meta-analysis (doi.org)

Isolation

Although this article only focuses on OUD, the basic information is relevant to other SUDs: Christie, N. C. (2021). The role of social isolation in opioid addiction, Social Cognitive and Affective Neuroscience, Volume 16, Issue 7, Pages 645–656

The role of social isolation in opioid addiction (doi.org)

TBI

General population:

Corrigan, J. D., Yang, J., Singichetti, B., et al. Lifetime prevalence of traumatic brain injury with loss of consciousness, Injury Prevention 2018;24:396-404.

Lifetime prevalence of traumatic brain injury with loss of consciousness (nih.gov)

Service Members/Veterans:

Department of Defense Alcohol and Substance 1 Abuse Disorder Research Program, May, 2017 (from Miller, L.S., Colella, B., Mikulis, D., Maller, J., & Green, R. E. 2013. Environmental enrichment may protect against hippocampal atrophy in the chronic stages of traumatic brain injury. Front Hum Neurosci. 7:506.

Environmental enrichment may protect against hippocampal atrophy in the chronic stages of traumatic brain injury (nih.gov)

Types of TBI:

What Is Traumatic Brain Injury? (va.gov)

Two-way risk of TBI and Substance Use Disorder:

Traumatic Brain Injury and Substance Use Disorders: Making the Connections (attcnetwork.org)

Recommendations for TBI Recovery:

Bombardier, C. H., Alcohol Use After Traumatic Brain Injury, Archives of Physical Medicine and Rehabilitation, Volume 94, Issue 10, 2040 - 2041

Role of Motivation in Changing Substance Use Patterns

Enhancing Motivation for Change in Substance Use Disorder Treatment: Updated 2019 [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2019. (Treatment Improvement Protocol (TIP) Series, No. 35.) Chapter 1—A New Look at Motivation. Available from:

Enhancing Motivation for Change in Substance Use Disorder Treatment (nih.gov)

Natural Recovery

Pathways to Healing and Recovery: Perspectives from Individuals with Histories of Alcohol and Other Drug Problems, November 2010 (samhsa.gov) (see pg. 12)

Overview of Treatment Goals

Paquette, C. E., Daughters, S. B., & Witkiewitz, K. (2022). Expanding the continuum of substance use disorder treatment: Nonabstinence approaches. Clinical psychology review, 91, 102110.

Expanding the continuum of substance use disorder treatment: Nonabstinence approaches (doi.org)

Reduced drug use is a meaningful treatment outcome for people with stimulant use disorder (nih.gov)

Magill, M., Martino, S., & Wampold, B. E. (2022). Goal setting and monitoring with alcohol and other drug use disorders: Principles and practices. Journal of substance abuse treatment, 132, 108650.

Goal setting and monitoring with alcohol and other drug use disorders: Principles and practices (doi.org)

Person-oriented explanation of harm reduction:

What Is Harm Reduction and How Does It Work? (clevelandclinic.org)

Person-centered explanation of moderation goals and how to be successful with them:

Guide to Moderation Management Steps of Change (moderation.org)

Transtheoretical Model of the Stages of Change

Kim, H., Min, M. O., & Han, D. H. (2022). Personal Social Networks and Relapses in Women With Substance Dependence: Application of the Theory of Planned Behavior. Psychiatry investigation, 19(10), 795–802

Personal Social Networks and Relapses in Women With Substance Dependence: Application of the Theory of Planned Behavior (doi.org)

Supporting Wellness and Behavior Change

Creating a Healthier Life, A Step-By-Step Guide to Wellness (samhsa.gov)

Challenges or Barriers to Wellness and Behavior Change

Social Networks With Lots of People Who Use Alcohol or Drugs

Kim, H., Min, M. O., & Han, D. H. (2022). Personal Social Networks and Relapses in Women With Substance Dependence: Application of the Theory of Planned Behavior. Psychiatry investigation, 19(10), 795–802.

Personal Social Networks and Relapses in Women With Substance Dependence: Application of the Theory of Planned Behavior (doi.org)

When Family and Friends Are Unsupportive Of Change Efforts

Tracy, E. M., Munson, M. R., Peterson, L. T., & Floersch, J. E. (2010). Social Support: A Mixed Blessing for Women in Substance Abuse Treatment. Journal of social work practice in the addictions, 10(3), 257–282.

Social Support: A Mixed Blessing for Women in Substance Abuse Treatment (doi.org)

Stigma and Shame

Matthews, S., Dwyer, R., & Snoek, A. (2017). Stigma and Self-Stigma in Addiction. Journal of bioethical inquiry, 14(2), 275–286.

Stigma and Self-Stigma in Addiction (doi.org)

“Testing” Control

Relapse and the Hidden Dangers Behind “One Drink Won't Hurt” (psychologytoday.com)