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Tag: Addiction

  • HHS Asks the Public What Works for Addiction Treatment in New Federal Request for Comment — Here Is Why It Matters

    HHS Asks the Public What Works for Addiction Treatment in New Federal Request for Comment — Here Is Why It Matters

    The U.S. Department of Health and Human Services published a Request for Information in the Federal Register on June 10, 2026, inviting public comment on which research, programs, and policies have been most successful in treating addiction, improving mental health outcomes, and supporting long-term recovery. The comment period runs through July 5, 2026, and is framed as part of HHS Secretary Robert F. Kennedy Jr.’s broader initiative, the administration has called the “Great American Recovery.”

    The RFI arrives at a sobering moment for American public health. Opioid overdose deaths have remained above 70,000 annually since 2017 and exceeded 80,000 in 2024, making drug overdose one of the leading causes of death among Americans under age 55. Fentanyl and other synthetic opioids now account for the vast majority of these deaths. The toll extends far beyond mortality statistics — addiction devastates families, communities, workforce participation, and the children of people with substance use disorders.

    The notice explicitly invites input from patients, people with lived experience of addiction and recovery, healthcare providers, community organizations, and researchers. The framing reflects a genuine uncertainty about the best path forward at the federal level — and, depending on how the administration responds to the comments received, could foreshadow significant shifts in federal drug and mental health policy.

    What the Science Says About Addiction Treatment

    The research base for addiction treatment has expanded substantially over the past two decades, and several evidence-based approaches have demonstrated consistent results. Medication-assisted treatment (MAT) for opioid use disorder — using buprenorphine (Suboxone), methadone, or naltrexone (Vivitrol) — remains the most extensively studied and most effective approach for reducing overdose deaths and helping patients maintain recovery. A landmark 2023 study in the New England Journal of Medicine found that patients receiving buprenorphine had significantly lower rates of overdose death than those who did not.

    Despite this evidence, access to MAT remains severely limited. Fewer than 20 percent of people with opioid use disorder receive it, partly due to stigma, provider reluctance to prescribe, geographic disparities, and insurance barriers. Advocacy groups and harm reduction organizations have consistently pushed for more accessible prescribing, expanded availability in emergency departments, and removal of administrative barriers to buprenorphine.

    Residential treatment, peer support specialists, contingency management (which uses positive reinforcement to promote drug-free behavior and is especially effective for stimulant use disorders), and community-based case management have all shown benefit in specific contexts. Mental health co-treatment is also increasingly recognized as essential, given that the majority of people with substance use disorders have co-occurring anxiety, depression, trauma, or other psychiatric conditions.

    Harm reduction strategies — needle exchange programs, naloxone distribution, fentanyl test strips, supervised consumption sites — have a strong evidence base for reducing overdose deaths and HIV transmission, though they remain politically controversial and are not universally available.

    What Advocates Want the Administration to Hear

    Public health advocates are watching this comment process closely. Many are hoping the RFI signals a genuine commitment to expanding evidence-based treatment access rather than a pivot toward approaches that lack a strong scientific foundation. Questions about how the Kennedy-led HHS will address the scientific consensus on MAT, harm reduction, and the role of abstinence-only models will shape the federal response for years.

    The comment process is open to all members of the public at federalregister.gov. Comments submitted by the July 5, 2026 deadline will inform HHS policy development.

    Frequently Asked Questions

    Q: What is the HHS asking for in this public comment request?

    A: HHS is seeking input on which addiction treatment programs, policies, and research approaches have been most successful — to guide future federal policy and funding priorities.

    Q: What are the most effective treatments for opioid use disorder?

    A: Medication-assisted treatment (MAT) using buprenorphine, methadone, or naltrexone has the strongest evidence base. Combined with counseling and support services, MAT significantly reduces overdose deaths.

    Q: How many Americans die of opioid overdoses each year?

    A: Opioid overdose deaths exceeded 80,000 in 2024. Fentanyl and synthetic opioids now account for the vast majority of these deaths.

    Q: How can I submit comments to the HHS RFI?

    A: Comments can be submitted at federalregister.gov by the July 5, 2026 deadline.

    Q: What is harm reduction and why is it controversial?

    A: Harm reduction includes strategies like naloxone distribution, needle exchanges, and fentanyl test strips that reduce the risks of drug use without requiring abstinence. Evidence strongly supports their effectiveness, but they remain politically controversial in some settings.

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  • Addiction, Recovery, and How Mindfulness Can Support Emotional Sobriety

    Addiction, Recovery, and How Mindfulness Can Support Emotional Sobriety

    As someone who has been sober for 26 years, and in my work as a recovery coach, I’ve come to understand there is more to recovery and wellness than being substance- free. While it may begin there, what is equally, if not more important, is our emotional sobriety.

    When I first heard the term emotional sobriety, it sounded like an unattainable, distant experience reserved for Buddhist monks. Heroines of mine like Tara Brach and Pema Chödrön seemed like they might have it nailed, but it felt well out of reach for someone like me. It wasn’t until I went through a particularly emotionally challenging time —one that ultimately became a portal—that I truly came to understand its significance and have since been able to share this important facet of recovery with my clients.

    When I first heard the term emotional sobriety, it sounded like an unattainable, distant experience reserved for Buddhist monks.

    One day my son announced he was moving from New York City to Los Angeles. On the surface his decision seemed exciting and full of promise, but he didn’t have a job or a place to live; he was going to figure it out once he got there. The ongoing uncertainty around his well-being pitched me over the edge. I was an anxious, nervous wreck. For weeks, I checked my phone to see if he had texted me, and scrolled through Instagram and Facebook, furtively scanning for little snippets of his life, trying to confirm if he was okay.

    His life had been my favorite TV show, and I couldn’t get my fix. I couldn’t stop thinking about him, couldn’t stop worrying, and I felt emotionally hijacked.

    Noticing When Your Past Shows Up In Your Present

    As the saying goes: When it’s hysterical, it’s historical. When I took a deeper dive in therapy, I began to understand why his departure had hit me so hard. It mirrored something much older. When I was in college, my mother abruptly moved to Switzerland. No long goodbye, no gradual adjustment — she was simply gone. Decades later, my nervous system didn’t know the difference between then and now.

    My body was grieving an old loss through a new one. I knew enough to attend Al-Anon meetings to try to unhook emotionally, but my peace of mind remained elusive.

    My body was grieving an old loss through a new one. I knew enough to attend Al-Anon meetings to try to unhook emotionally, but my peace of mind remained elusive.

    The shift came when I learned to meditate. As a novice, I was first encouraged to turn my attention to my breath, and to notice the moment, the pause, between my in-breath and my out-breath.

    As I practiced that awareness, an insight bubbled to the surface. My breath, the singular most subtle physical experience, was my life force. This quiet activity that happened without my making it happen—it was the defining characteristic between life and death. I felt a reverence for my breath that I had never had before. Slowly but surely, I developed the ability to observe how my mind, like a cricket, jumped from thought to worry to thought—and eventually, it began to settle.

    For many, substances helped to numb their feelings and had been a type of escape hatch. So when we put substances down, and come into a more intimate relationship with ourselves, being still and quieting our minds might not feel safe. We no longer have something to shut off the noise or dampen the fears.

    Over time, I felt at peace—I felt emotionally sober. I wasn’t scrambling for something outside of myself to ease my discomfort.

    Making the Mind a Quieter Place

    In my work with people who struggle with substance use disorders and/or eating disorders, many clients share with me that they continue to struggle with quieting their minds. For many, substances helped to numb their feelings and had been a type of escape hatch.

    So when we put substances down, and come into a more intimate relationship with ourselves, being still and quieting our minds might not feel safe. We no longer have something to shut off the noise or dampen the fears.

    In my coaching sessions, we discuss the concept of emotional sobriety, and I offer a variety of entry points, like: 

    • Breath work or a body scan
    • The “notice and name” technique
    • Practicing recruiting a sense of stability from the room and immediate surroundings
    • A short, guided meditation
    • Journaling for twenty minutes

    In all these small practices, I am gently guiding them to reconnect with themselves through curiosity rather than judgment. Given there is no single path to stillness, we find one that fits, and we go at the client’s pace.

    Being emotionally un-sober can look like checking out, endless distraction, mindless scrolling. Mindfulness practices help us, over time, to understand that we can be with our uncomfortable emotions without lurching for that escape hatch.

    What I’ve come to understand is that insight and self-awareness are essential, but even with the best intentions we can still get emotionally hijacked, triggered in an instant—and suddenly the urge to escape those uncomfortable feelings feels overwhelming.

    And while we might not reach for the substance or the activity that brought us to recovery in the first place—which is in itself, of course, a marvelous accomplishment—we might reach for other, perhaps more innocuous activities that serve a similar purpose. Being emotionally un-sober can look like checking out, endless distraction, mindless scrolling. Mindfulness practices help us, over time, to understand that we can be with our uncomfortable emotions without lurching for that escape hatch.

    What mindfulness and meditation offer, and what my clients tell me again and again, is a way to reset the emotional thermostat, regardless of what’s happening around them.

    A pause between the in-breath and the out-breath. A moment of choice where there used to be none.

    That is emotional sobriety.

    Stephanie Hazard is a certified peer recovery specialist (CPRS) as well as a certified Carolyn Costin Institute eating disorder recovery coach (CCIEDC). Her debut book, Making Sobriety Stick: A Recovery Coach’s Guide to Sustainable Change, will be released September 22nd during National Recovery Month, and can be pre-ordered at www.pathtowardrecovery.com.



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  • Addiction, Trauma, and the Problem of Being Present

    Addiction, Trauma, and the Problem of Being Present

    The Power of Then

    I remember one day in rehab, after a particularly gruelling day of group therapy, the facilitator decided to end with a mindfulness meditation. Feeling exhausted and overstimulated, I welcomed the chance to close my eyes and shut out the world for a little while.

    But as she guided our awareness through the body, I became painfully aware of what was happening inside mine—the tightness in my jaw and throat, my heart pounding, the knot of fear twisting in my stomach. My body didn’t feel like a safe place to be; it felt like a war zone.

    When the meditation ended, she reminded us of how important it is in recovery “to live in the now.” And that left me with a burning question that I didn’t dare ask: What if my now feels unbearable?

    When the meditation ended, she reminded us of how important it is in recovery “to live in the now.” And that left me with a burning question that I didn’t dare ask: What if my now feels unbearable?

    For many people in recovery, being in the body can feel like stepping onto enemy territory. It’s where we hold the emotional pain, unresolved trauma, and survival responses we’ve spent years trying not to feel. Mindfulness invites us to tune in—to become aware of our bodies and minds, to sit with our emotions and thoughts. 

    To many people, this is a neutral concept. However, for the addict in recovery, it’s also being asked to return to the danger our addiction once protected us from.

    I once heard someone say, “You can’t feel the power of now until you’ve healed the power of then.” That statement really stuck with me. 

    When the nervous system is carrying trauma—when we’re dysregulated, overwhelmed, or trapped in a state of fight/flight/freeze—mindfulness doesn’t always feel supportive. Sometimes it simply heightens our awareness of the pain and discomfort within, without giving us the resources to cope.

    The Root of Addiction

    Many experts in the trauma and addiction field believe trauma sits at the root of addiction. Gabor Mate, one of the most influential voices in this work, invites us to shift the question from, Why the addiction? to, Why the pain? 

    Many of us are working from an outdated idea of what trauma actually is. Trauma isn’t defined by the event. It’s defined by what happens inside of us as a result of the event, the imprint it leaves on our body and mind.

    That reframing, turning the attention toward the suffering beneath the behavior, was one of the most powerful turning points in my recovery.

    You might be reading this and thinking, “This doesn’t apply to me. I don’t have trauma.” Yet many of us are working from an outdated idea of what trauma actually is. Trauma isn’t defined by the event. It’s defined by what happens inside of us as a result of the event, the imprint it leaves on our body and mind.

    Trauma expert Pat Ogden describes trauma as “any threatening, overwhelming experience that we cannot integrate.” When understood this way, it becomes more relatable. It’s not limited to catastrophic events; it also includes the undigested life experiences most of us carry in varying degrees—the moments that shape how safe we feel in the world, in our relationships, and in our own bodies.

    If substances became a way to soothe, regulate, or find relief from the imprint of those experiences, that is the link between trauma and addiction. Addiction doesn’t manifest without reason. It’s your body and nervous system attempting to restore balance—to escape an unbearable now—when nothing else seems to work.

    The Challenges Mindfulness Presents

    Mindfulness isn’t inherently problematic for everyone living with trauma; for some, it’s deeply supportive. The difficulty for some people living with symptoms of trauma is that mindfulness can sometimes intensify those symptoms, and in some cases even cause re-traumatisation.

    Mindfulness eventually became one of my greatest resources. But in the early days, before I was trauma informed, I often pushed through discomfort, believing that was part of the practice. I remember one meditation in particular where I forced myself to sit with an increasingly uncomfortable sensation in the pit of my stomach. I was convinced that if I just stayed with it long enough, I’d eventually reach some blissful state of transcendence. Instead, it sent me into an intense dissociative state which lasted for weeks—something I later learned is not uncommon for trauma survivors. 

    This is why it’s important to understand the potential challenges of mindfulness for some—so that if you do encounter problems, you know it’s not a sign of failure. It’s simply a signal from your nervous system that more safety is needed.

    Here are some primary signals to pay attention to: 

    Focusing on the body or breath can be activating

    Trauma lives in the body as physical sensations, constriction, tension, and survival responses. When we bring awareness to the breath, or to areas that hold this survival energy—the chest, throat, belly—these sensations can feel overwhelming.

    Mindfulness can trigger traumatic memories or flashbacks

    Turning inward creates space for memories, images, or emotions that were previously suppressed to rise to the surface. When they do, the body and mind may react as if the past is happening again. In other words, we start experiencing the power of then.

    Stillness can feel threatening to a dysregulated nervous system.

    For someone who is used to living in a state of fight, flight, or chronic hypervigilance, stillness can feel unfamiliar and unsafe. Even the feeling of calm can feel threatening when the body is used to scanning for danger.

    Self-observation can activate shame or self-judgement

    Turning attention inward can make self-critical thoughts louder, especially for someone whose trauma involved blame, guilt, or a loss of self-worth.

    None of this means mindfulness should be avoided. Far from it. It simply means the practice may need to be approached differently: with more pacing, choice, and with safety at its core.

    Practising Mindfulness Safely

    Safety is the foundation of trauma recovery and one of the cornerstones of trauma-informed mindfulness. David Treleaven, founder of Trauma-Sensitive Mindfulness, emphasises that mindfulness for trauma survivors must be flexible, and adapted to suit an individual’s nervous system and needs. Instead of pushing through discomfort, this approach supports choice, regulation, and autonomy.

    Here are some adjustments you can make to your mindfulness practice when you start to feel activated: 

    1. Start outward. For many people, beginning with external anchors feels more supportive than turning the attention inward. Noticing sounds, feeling your feet on the floor, or gently orienting to your surroundings can help settle the nervous system.
    2. Switch it up. Once a sense of grounding is established, you can then gently approach your inner experience. It can help to move between inner and outer awareness, so that if anything becomes too intense, you can shift your focus back outward, adjust your posture or pause completely. Having a reliable anchor, something that feels supportive to return to, can be especially helpful.
    3. Get mobile. Movement can also be a powerful bridge to presence. Walking, stretching, or gentle swaying may feel more accessible when stillness feels too threatening. You don’t have to sit motionless in a lotus position to be mindful. 
    4. Open your eyes. For some people, closing their eyes means they can’t scan for danger. As people are learning to find safety, practising with eyes open, or with a soft gaze, can also reduce the vulnerability that may come with closing the eyes.
    5. Be gentle with a noisy mind. It’s also worth noting that the mind—even when busy or critical—can feel safer than the body. Understanding this can help reduce frustration when the mind doesn’t quieten in the way we might expect.

    One of the most important things to remember with trauma-sensitive mindfulness is that you have choice and autonomy. Treleaven says, “We want them to know that in every moment of practice they are in control.” So, if things become too much, return to what feels safe. Stay within your window of tolerance, which allows for some discomfort, but not to where it’s overwhelming.

    When practiced with care, mindfulness can be one of the greatest tools for trauma healing and addiction recovery. For me, the benefits were profound, so much so that I wrote a book about it. But the greatest benefit was reconnecting with that part of myself that addiction and trauma never touched: the part that was always there, quietly watching, peaceful and still. My true self!

    Mindfulness doesn’t rewrite the past, but when we can embody a sense of safety, it helps us to hold it differently. So that the power of then no longer overshadows the power of now.



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  • A 12-Minute A Meditation to Get Curious About Your Cravings 

    A 12-Minute A Meditation to Get Curious About Your Cravings 

    This guided meditation helps your get curious about your cravings so you can break free from unhealthy habits.

    It’s normal to want to overcome those habits that aren’t serving you. But what happens when you get curious about your cravings instead of just trying to willpower your way out of them?

    We often imagine that our actions are the result of choice and awareness, which means that we can be extra critical of ourselves when we’re struggling with habits that aren’t serving us. But researchers in the science of habit and craving have found that much of our decision-making process is the result of unconscious neuro-chemical loops that reinforce themselves over time. 

    In this meditation, author and researcher Judson Brewer introduces a thoughtful way to bring genuine awareness and choice back into the equation when cravings arise. 

    This guided meditation was recorded live at the Center for Mindfulness at the University of Massachusetts Medical School

    • First, find a comfortable position. We can begin just by settling into a comfortable posture, whatever that posture is for us right now.
    • Now, tune into body sensations. Check in with your body. What does your body feel in this moment — are you holding tension in any places? Perhaps checking in with the feet and other touch points: the knees, the hips, our hands, our shoulders. Even this breath, breathing itself. Just being really curious: What’s alive for us right now in our bodies.
    • Name the cravings in your mind. For the next few minutes we’ll play with working with cravings. Once we’re settled and anchored in this body, just bring to mind something that really gets our juices flowing, whether it’s a food or something else we really like. We’re also bringing to mind those itches that we feel like we have to scratch. Many of us that are in “Inbox Zero,” which is this constant race to keep our inboxes and our e-mail accounts as small as possible. We can bring this to mind: What does it feel like? When I opened up my computer and I have 58 new e-mails in the last hour. So whether it’s something pleasant, or whether it’s something unpleasant that we feel like we have to deal with, just bringing that situation to mind. Really checking in to see what this urge to do something feels like in our body; this urge to hold onto the pleasant or the urge to make the unpleasant go away.
    • Now, notice how the craving shows up in your body. As we identify where it is in the body, we can dial up the curiosity. What does it feel like? Perhaps even naming to ourselves the physical sensations that are most predominant. We can even explore how this feeling shifts and changes as we bring this curious awareness to it. We can even dial up the curiosity a little bit more. If we had to pick is it more on the right side or the left side of our body? Is it more in the front or the back of our body? And what happens simply by curiously exploring where it is? How long does this sensation last? Is one sensation replaced by another that becomes more predominant? And if we notice that the sensation is fading away that was brought up by imagining that food or the e-mail inbox.
    • Notice what it feels like now just to rest in awareness in the body. Notice what it feels like to know that we can become aware of these sensations — That we don’t have to be slaves to our cravings, we can explore them with curiosity, moment to moment.
    • Finally, explore any other urges or cravings that surface. For the next few minutes. Simply resting in awareness of our bodies. Being on the lookout for these urges: Urges to get lost in fantasies or those urges to beat ourselves up over something that might have happened earlier in the day or in the week. Just diving right in. Exploring. Holding each sensation with this kind, curious awareness.

    This guided meditation provides additional information to a feature article titled “Constant Craving” which appeared in the April 2018 issue of Mindful magazine.



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  • RFK Jr. to End ‘Godsend’ Narcan Program That Helped Reduce Overdose Deaths Despite His Past Heroin Addiction

    RFK Jr. to End ‘Godsend’ Narcan Program That Helped Reduce Overdose Deaths Despite His Past Heroin Addiction

    Despite his own history of overcoming heroin addiction, Health and Human Services Secretary Robert F. Kennedy Jr. is backing plans to end a federal Narcan distribution program credited with helping drive a steep drop in U.S. overdose deaths.

    Narcan, the widely-used overdose reversal drug, has played a major role in reducing opioid-related deaths, particularly amid the fentanyl crisis.

    A $56 million annual grant program through the Substance Abuse and Mental Health Services Administration (SAMHSA) has funded the distribution of Narcan to first responders across the country, training over 66,000 individuals and distributing more than 282,500 kits in 2024 alone. Recent CDC data shows a nearly 24% drop in overdose deaths for the 12 months ending September 2024, the sharpest one-year decline in decades—an achievement partly attributed to widespread naloxone access.

    Speaking at the Illicit Drug Summit in Nashville on Thursday, Kennedy reflected on his personal struggle with addiction and emphasized the importance of community, treatment, and hope in solving the drug crisis, USA Today reported. However, behind the scenes, the Trump administration’s draft budget includes major cuts to addiction programs, including the termination of the Narcan grant, according to The Independent.

    “Narcan has been kind of a godsend as far as opioid epidemics are concerned, and we certainly are in the middle of one now with fentanyl,” Donald McNamara of the Los Angeles County Sheriff’s Department said. “We need this funding source because it’s saving lives every day.”

    Though Kennedy has previously praised interventions like Narcan as critical to saving lives, he now frames the crisis as one requiring deeper, spiritual and societal change rather than relying solely on “nuts and bolts” medical solutions.

    The proposal has drawn swift condemnation from addiction specialists and public health advocates, who warn that cutting Narcan funding could reverse the progress made against overdose deaths. Critics argue that removing life-saving tools while broader societal fixes are slowly pursued would leave vulnerable communities at risk.

    While national overdose deaths have declined, experts warn the epidemic is far from over, especially in states still experiencing surges. Ending federal Narcan support could slow or even reverse recent gains.

    Originally published on Latin Times

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