SMART Recovery In Addiction Treatment

No one doubts that the burden of addiction is considerable, having a profound and detrimental impact on mortality, health, relationships, families, employment, and quality of life. Collectively, the monetary damage from alcohol, substances, and behavioral addictions such as gambling are costly, estimated at over $28 billion per year.

In the United States, over 22 million individuals live with a substance abuse problem. At any given moment, there are approximately 4.5 million individuals who have a substance abuse disorder. In data gathered in 2019 among people aged 12 or older, 60.1 percent (or 165.4 million people) used a substance (i.e., tobacco, alcohol, or an illicit drug) in the previous month, 50.8 percent (or 139.7 million people) drank alcohol in the previous month, 21.1 percent (or 58.1 million people) used a tobacco product in the previous month, and 13.0 percent (or 35.8 million people) used an illicit drug in the previous month.

What Causes Addiction

Having noted the impact of addiction, the question that begs to be asked is “What causes addiction?” Of course, there is no pat answer, but what we do know is that addiction is impacted by the following:

• Genetics, including the effect of environment on gene expression, account for about 40% to 60% of the risk of addiction.
• Environmental factors can increase a person’s risk of addiction. Contributing factors include chaotic home environments, abusive situations, parental drug usage, peer pressure, community attitudes toward drugs and poor academic achievement.
• Age is a factor as teenagers are more at risk for drug use and addiction than other populations.
• Those suffering with mental health disorders are also a high-risk population.

What is SMART Recovery and how does it work?

Drug and alcohol abuse is frightening. What is more alarming is when you are the one battling an addiction and there does not seem to be a solution. While there are many programs designed to help, this article focuses on one in particular: the SMART Recovery Program. What is it and how does it work?

Developed in 1985, Rational Recovery, an addiction recovery program, enjoyed success as an alternative to Alcoholics Anonymous and other 12-step groups. Studies conducted at the time indicated that an individual was more likely to become and remain abstinent if they participated in Rational Recovery meetings. In 1992, the program incorporated the Alcohol and Drug Abuse Self-Help Network and by 1994 the organization had rebranded to SMART Recovery.

Self-Management and Recovery Training, (SMART Recovery) is a global abstinence-oriented program that brings people together to assist in resolving addiction (drugs, alcohol, activities such as gambling or over-eating). The program is free and strives to help participants learn techniques to transition their lives from self-destructive to happy and fulfilling. Many luxury rehab centers are moving towards SMART Recovery.  Retreat at Sky Ridge uses SMART Recovery programs.

SMART Recovery, in contrast to other recovery programs, teaches that those with addictions are not powerless in managing and maintaining their recovery. A basic tenet of SMART Recovery is that science does not support helpless, negative beliefs about accountability. It also emphasizes teaching participants alternative methods for dealing with negative emotions such as anger, anxiety, guilt, and low self-esteem. Participants are encouraged to seek out and engage in activities that replace their addictive behaviors.

It is a peer community, with meetings run by volunteers, that utilizes a science-based 4-point program to guide participants.

• Building and maintaining the motivation to change: Through motivational interviewing, participants can determine which of the six stages of change they are in before beginning the recovery process. For example, if the participant has no intention of changing behavior, then they are in the first stage, the pre-contemplation stage. Here, the participant does not see their addiction as a problem and think those who see it as such are exaggerating. On the other hand, if the participant is engaged in treatment and maintaining sobriety, they are in the fourth stage, the action stage – sticking to the plan and determined to make it work.
• Coping with urges: SMART Recovery is based on a combination of three scientific methodologies: Motivational Enhancement Therapy, Cognitive Behavior Therapy, and Rational Emotive Behavior Therapy. However, the fundamental inspiration behind the scientific and philosophical framework of SMART Recovery is Albert Ellis’ Rational-Emotive Behavior Therapy. Ellis (1913-2007) was an American psychologist whose therapeutic approach focused on changing negative thoughts and unhealthy behaviors into positive alternatives.
• Managing thoughts, feelings, and behaviors in an effective way without addictive behaviors: To manage thoughts and feelings, participants use a cost/benefit analysis to answer the following questions to better understand their addiction. These questions are to be answered on an ongoing basis:
  • What do I enjoy about my addiction?
  • What do I hate about my addiction?
  • What do I think I will like about giving up my addiction?
  • What do I think I will not like about giving up my addiction?
• Living a balanced, positive, and healthy life: More than just a recovery skill, managing life to achieve balance in a healthy way is generally the key to success. Understanding personal values and being aware of the areas where there is an unbalance can shift perspective. Those seeking recovery must be honest with themselves and focus first on their areas of need. Recovery is rooted in creating a plan for how changes are going to be made, then working on making those changes within the proper support network.

In conclusion, as with any addiction recovery program, there are pros and cons:

Pros of SMART Recovery

• The program is totally inclusive with no entrance requirements
• It is based on scientific methodologies of therapy
• It is appropriate for treating a broad spectrum of addictions
• It does not rely on participants believing in a higher power

Cons of SMART Recovery

• SMART Recovery is not as well-known or widespread as 12-step programs like Alcohol Anonymous
• There is no professional accountability since volunteers direct meetings
• To optimize success, participants need commitment, determination, and a willingness for self-reflection. Consequently, the program is not appropriate for everyone
• The program is not life-long, an important component for some participants

Ultimately, success in addiction recovery depends in large part on choosing a recovery program that works for the individual. SMART Recovery is certainly worth considering.