The 10th step is a vital part of the recovery process for program veterans, emphasizing personal responsibility, accountability, and mindfulness. To stay committed to their sobriety, program veterans seek support from their peers by calling or meeting to “do a 10th step.” This process involves discussing any negative emotions or resentments that have arisen during the day and identifying any patterns of behavior that may lead to addiction.

By reflecting on their actions and behaviors, program veterans stay mindful and make conscious decisions that support their sobriety. They use journals or other tools to track their progress and identify any recurring patterns that need to be addressed. The 10th step promotes accountability and encourages individuals to take ownership of their actions, building upon their 9th step to make amends for any harm they have caused to others. 

The sense of community and support fostered by the 10th step is crucial for maintaining sobriety and staying accountable. The 10th step is a reminder that recovery is an ongoing journey, and individuals must remain vigilant to avoid negative patterns of behavior that may lead to addiction.

The daily rigor of the 10th step provides a strong foundation for the 11th, which involves daily prayer and meditation to develop a stronger connection with their higher power. This spiritual connection provides a source of guidance, strength, and comfort throughout the recovery journey. It also allows for a better understanding of one’s place in the world, and of the means to live a purposeful and meaningful life.

“Doing a 10th step with my sponsor is a crucial part of my recovery process. It’s where I can honestly reflect on my day, make amends for any harm I caused, and gain perspective on any negative emotions I may be experiencing.” – Sarah, AA member with 10 years of sobriety

“The 10th step is a way for me to stay connected to the program and my fellow members. By discussing my daily inventory with my sponsor or group, I feel supported and accountable in my recovery journey.” – Tom, AA member with 15 years of sobriety

“The 10th step is a way for me to stay in touch with my spiritual principles and practice them in my daily life. By taking inventory and making amends, I am living a life of honesty, integrity, and humility.” – Mark, AA member with 20 years of sobriety

“The 10th step is a reminder that I am not perfect and that I must continue to work on myself and my sobriety. It’s a way for me to stay humble and focused on my recovery journey.” – Laura, AA member with 8 years of sobriety

“The 10th step has helped me overcome my tendency towards self-centeredness and selfishness. It’s a daily reminder to be of service to others and live a life of generosity and compassion.” – Michael, AA member with 12 years of sobriety

“The 10th step is about progress, not perfection. It’s a tool that helps me stay accountable and keep moving forward on my recovery journey, one day at a time.” – Karen, AA member with 6 years of sobriety

“The 10th step has taught me the importance of self-reflection and self-awareness. By taking inventory and making amends, I am constantly growing and evolving as a person and in my sobriety.” – David, AA member with 18 years of sobriety

Sleep is important for mental health, and poor sleep habits increase the risk of mental health problems, including substance abuse disorders. A study published in the Journal of Substance Abuse Treatment found that insomnia is linked to a history of substance abuse and higher relapse rates after treatment. 

Individuals in recovery from alcohol use disorder who receive poor quality sleep have higher rates of anxiety, depression, and relapse, as shown in a paper from the Journal of Addiction Medicine. Addressing sleep problems can improve mental health outcomes and increase the chances of long-term sobriety.

Emotional regulation is crucial for individuals in recovery from substance abuse disorders. A study published in the Journal of Affective Disorders found that insomnia increases the likelihood of mood and anxiety disorders, including PTSD. Treating insomnia improves symptoms of mood and anxiety disorders, highlighting the importance of addressing sleep problems in mental health treatment.

Good sleep hygiene improves cognitive function. A Journal of Substance Abuse Treatment study found that individuals with better sleep quality and duration had better cognitive function, including attention, memory, and decision-making skills.

A study published in the Journal of Sleep Research indicated that individuals in recovery from substance abuse disorders who received treatment for sleep hygiene had higher abstinence rates from drugs and alcohol than those who did not. 

Prioritizing good sleep hygiene can reduce the risk of relapse and increase the chances of long-term sobriety by improving emotional regulation, cognitive function, and overall mental health outcomes. Seeking professional help is essential for individuals struggling with insomnia or other sleep-related issues. 

According to the National Sleep Foundation, there are several tips to improve sleep quality, including sticking to a consistent sleep schedule, avoiding caffeine before bedtime, establishing a relaxing bedtime routine, keeping a comfortable sleep environment, and limiting daytime naps. In addition, studies have shown that reducing screen time before bed can improve sleep quality. For example, a study published in the Journal of Clinical Sleep Medicine found that individuals who read on an e-reader before bed experienced less REM sleep and took longer to fall asleep than those who read a physical book.

Meditation has emerged as a practice with manifold mental health benefits, especially for those recuperating from substance abuse disorders. Recent research has established that meditation can effectively mitigate symptoms of anxiety and emotional dysregulation, leading to enhanced feelings of well-being. For those grappling with substance abuse disorders, meditation has proven to be a powerful tool in reducing cravings and the possibility of relapse.

A paper published in the Journal of Addiction Medicine found that individuals who participated in meditation-based interventions had significantly lower rates of substance use in comparison to those receiving standard treatments. The study also found that participants practicing meditation reported lower levels of stress and depression, along with elevated levels of mindfulness and well-being.

In another study published in the Journal of Substance Abuse Treatment, mindfulness-based interventions, which frequently incorporate meditation practices, were found to be effective in reducing substance use and cravings in individuals with substance abuse disorders. The study revealed that participants receiving mindfulness-based interventions had significantly fewer days of substance use and lower relapse rates compared to those who received standard treatments.

Research has shown that meditation can help minimize the harmful effects of chronic stress on the brain, which can increase the likelihood of developing a substance abuse disorder. Meditation has emerged as a useful tool in managing stress and minimizing its impact on the brain.

Meditation can also help individuals in recovery to develop greater self-awareness and self-compassion, which can be crucial for those struggling with feelings of shame and guilt related to their substance use. A paper published in the Journal of Substance Abuse Treatment discovered that mindfulness-based interventions were effective in reducing shame and guilt among individuals in recovery.

Oprah Winfrey has been a long-time advocate of meditation and has even offered her own meditation resources through her network. Hugh Jackman credits meditation with helping him remain centered amidst his hectic work schedule. Actress Emma Watson practices mindfulness meditation and has credited it with helping her cope with anxiety. Paul McCartney has been practicing meditation since the 1960s and has spoken about how it helps him maintain balance and creativity. Other notable individuals who have spoken publicly about their meditation practices include LeBron James, Jennifer Aniston, and Jerry Seinfeld. 

The link between proper nutrition and good mental health is well established, with research illustrating that a healthy diet can have a significant impact on mood, cognition, and overall mental well-being.

A study published in the American Journal of Psychiatry found that individuals who followed a Mediterranean-style diet, characterized by fruits, vegetables, whole grains, and lean proteins, had a lower risk of developing depression compared to those who followed a Western-style diet. Another study published in the Journal of Psychiatric Research found that a diet rich in these foods was associated with lower rates of anxiety and improved cognitive function.

Secondly, proper nutrition is essential for brain health and function. Omega-3 fatty acids, found in fatty fish and nuts, have been linked to improved mood and cognition. A study published in the Journal of Clinical Psychiatry found that omega-3 supplements were effective in reducing symptoms of depression. Additionally, B vitamins, found in whole grains and leafy greens, are essential for proper brain function and have been linked to improvements in mood.

Thirdly, proper nutrition can help improve sleep, which is essential for good mental health. A study published in the Journal of Sleep Research found that a diet high in fiber and low in saturated fat was associated with improved sleep quality. Avoiding caffeine and large meals before bedtime can also help promote better sleep, which in turn can improve mood and cognitive function.

The gut-brain axis plays a crucial role as well, with research showing that the gut microbiome can have a significant influence on mood and cognitive function. A diet high in fiber, fruits, and vegetables can promote a healthy gut microbiome, which may improve mental health outcomes. A study published in the journal Nutrients found that a diet high in fiber and fermented foods was associated with lower rates of depression and anxiety.

Proper nutrition also plays a significant role in the recovery process for individuals with Substance Abuse Disorder (SAD). A study published in the Journal of Clinical Psychology found that individuals who received nutritional counseling as part of their addiction treatment had a higher rate of abstinence from drugs and alcohol compared to those who did not receive nutritional counseling. 

Additionally, poor nutrition can lead to a weakened immune system, nutrient deficiencies, and other health problems that can make it more challenging for individuals to overcome addiction. Furthermore, substance abuse can often lead to poor dietary choices, such as consuming high amounts of sugar and processed foods and few essential nutrients. This can further exacerbate the negative physical and mental effects of substance abuse, making it harder for individuals to recover. 

A diet rich in fruits, vegetables, whole grains, and lean proteins can help restore the body’s physical and mental health, providing a foundation for successful recovery. Proper nutrition should be viewed as an essential component of everyone’s lifestyle, but particularly of those individuals who are reestablishing their daily habits within comprehensive addiction treatment programs.

Physical fitness plays a very important role in the recovery process for individuals with a substance abuse disorder (SAD). A study published in the Journal of Substance Abuse Treatment found that incorporating exercise into addiction treatment was strongly associated with reduced cravings and improvements in mood. Another study published in the Journal of Consulting and Clinical Psychology found that exercise was an effective treatment for anxiety and depression in individuals with SAD.

Exercise effectively reduced withdrawal symptoms in patients undergoing opioid detoxification, according to a study published in the Journal of Addiction Medicine. Another study published in the Journal of Substance Abuse Treatment found that regular exercise reduced withdrawal symptoms in those undergoing detox from alcohol. 

Physical fitness also plays a crucial role in better mental health overall. Multiple sources of data show that physical fitness has significant benefits for mental health, including reducing symptoms of depression and anxiety, improving cognitive function and memory, and boosting self-esteem.

One type of physical fitness that has been strongly associated with better mental health is aerobic exercise. A review of 49 studies published in the journal Sports Medicine found that aerobic exercise (running, cycling, swimming, etc) was associated with significant improvements in symptoms of depression and anxiety. A study published in the Journal of Psychiatric Research found that regular aerobic exercise can increase the size of the hippocampus, a part of the brain associated with memory and learning.

When we exercise, our body releases endorphins, which are natural mood-boosting chemicals that reduce nervousness and promote feelings of well-being. Exercise can also help lower the levels of cortisol in our system; cortisol is a stress hormone linked to anxiety. 

Strength training is another type of physical fitness that can have mental health benefits. A study published in the Journal of Affective Disorders found that resistance training was associated with reduced symptoms of anxiety in adults. Strength training was also strongly associated with improved self-esteem in adolescents, according to a study published in the International Journal of Behavioral Nutrition and Physical Activity.

Yoga and mindfulness practices have also been shown to have significant mental health benefits too. A study published in the Journal of Alternative and Complementary Medicine found that practicing yoga was highly correlated with improvements in overall quality of life. Another study published in the Journal of Clinical Psychology found that mindfulness meditation can reduce symptoms of neurosis and improve cognitive function.

12-step programs such as Alcoholics Anonymous and Narcotics Anonymous provide a structured program for recovery from addiction. The process of working through the steps with others helps individuals to address past mistakes, repair relationships and rebuild trust with themselves, leading to stronger family and social connections. Those who have had success in the program credit its spiritual foundation for their development of newfound coping strategies and self-management skills.

AA was founded in 1935 by Bill Wilson and Dr. Bob Smith, both of whom struggled with alcoholism. Their approach, based on the 12 steps, emphasized surrender to a higher power, personal reflection, and service to others. The program spread globally, with meetings becoming a space for those struggling with addiction to share experiences and support one another on the path to sobriety. Today, AA remains a respected resource for those seeking to overcome addiction in all its forms.

A study published in the Journal of Substance Abuse Treatment found that those who participate in AA have significantly higher rates of continuous abstinence compared to those who do not; it also found that those who attend AA regularly have improved mental health. 12-step programs are not a magic solution and success depends on many factors, particularly the participant’s level of willingness to work the program. 

The 12th step of Alcoholics Anonymous, in which a participant sponsors an alcoholic just beginning their own journey through the steps, is a crucial part of the recovery process. A study published in the Journal of Studies on Alcohol and Drugs found that AA sponsors report greater satisfaction with their own recovery and a stronger sense of purpose compared to those who do not sponsor others. Sponsoring allows individuals to give back to others what was freely given to them, providing a sense of fulfillment that is essential for maintaining long-term sobriety. In a survey of AA members, nearly 80% reported that their sponsor had a positive impact on their sobriety. 

Elizabeth Taylor, the legendary actress, credited AA for saving her life and helping her overcome her struggles with alcohol addiction. Musician Eric Clapton also credited AA with helping him overcome his addiction to alcohol and drugs. Actor Russell Brand has been open about his experience with addiction and recovery through NA. Late actor and comedian Robin Williams credited AA with helping him maintain sobriety and rapper Eminem credited AA with helping him overcome his addiction to prescription drugs. Actor David Duchovny has spoken about how AA helped him overcome his addiction to alcohol.

Actor Robert Downey Jr., has credited AA with helping him turn his life around and overcome his struggles with addiction to drugs and alcohol. The singer Pink has credited AA with helping her overcome her addiction to pain medication and maintain sobriety. Actress Lindsey Lohan has sought treatment for addiction through AA and credited the program with helping her maintain sobriety. 

It is important to note that recovery is a personal journey and what works for one person may not work for another. However, these programs can provide a valuable resource and support network for those seeking to overcome addiction.

Medically, ketamine is used for the induction and maintenance of anesthesia; it is also abused as a recreational drug. Ketamine is a novel compound, derived from PCP. Ketamine may additionally be utilized for acute pain management.

Ketamine was first synthesized in 1962; in 1970 it was approved for use in the United States. It has been regularly applied in veterinary medicine and in the Vietnam War it was widely used for surgical anesthesia. 

At sub-anesthetic doses, ketamine produces a sense of detachment from one’s own body that is known as depersonalization. When abused as a recreational drug, it is found both in powder and liquid form, and is often referred to as “Special K” for its hallucinogenic and dissociative effects. 

Ketamine is a promising agent for treatment-resistant depression; however, the antidepressant action of a single administration of ketamine decreases with time. The long-term effects of repeated use are largely unknown, and an area of current investigation.

Because of its ability to cause confusion and amnesia, ketamine has come to be known as a “date rape drug.” At high doses, users may experience what is called the “K-hole”, a state of dissociation with both visual and auditory hallucinations. 

Recreational ketamine abuse has been implicated in deaths globally, with more than 90 deaths in England and Wales from 2005 to 2013. These included accidental poisonings, drownings, traffic accidents, and suicides; the majority were among young people. 

At anesthetic doses, 10–20% of adults experience adverse reactions during emergence from anesthesia, ranging from hallucinations to emergence delirium. 

Dizziness, blurred vision, dry mouth, hypertension, nausea, and feeling flushed are the most common (>10%) side effects. All these adverse effects are dramatically reduced 40 minutes after the injection, and completely disappear within 4 hours.

At very low, sub-anesthetic doses, most people feel strange, spacey, woozy, a sense of floating, or have visual distortions or numbness. Also very frequent (20–50%) are difficulties speaking, confusion, euphoria, drowsiness, and trouble concentrating. 

Symptoms of psychosis such as disappearing, feeling as if melting, “experiencing” colors, and hallucinations are described by 6–10% of people. 

Although the actual incidence of ketamine dependence is unknown, some people who regularly use ketamine develop ketamine dependence. The short duration of ketamine’s effects promotes binging on the drug. Ketamine tolerance rapidly develops, even with medical usage, prompting the use of higher doses. 

Cognitive deficits as well as increased dissociation and delusion symptoms were observed in frequent recreational users of ketamine. Some daily users reported withdrawal symptoms, primarily anxiety, shaking, sweating, and heart palpitations, following the attempts to stop.

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Phencyclidine or phenylcyclohexyl piperidine (PCP), aka angel dust, is a dissociative anesthetic mainly used recreationally for its mind-altering effects which may cause hallucinations, distorted perceptions of sounds, and violent behavior. 

As of 2017, in the U.S., about 1% of high school seniors reported using PCP in the year prior. 2.9% of those over the age of 25 reported using it at some point in their lives. Low doses produce a numbness in one’s extremities and an unsteady gait, slurred speech, bloodshot eyes, and loss of balance. Moderate doses will produce analgesia and anesthesia. High doses may lead to convulsions. 

Its most popularly recognized side effects are summarized by the mnemonic device RED DANES: rage, erythema (redness of skin), dilated pupils, delusions, amnesia, nystagmus (quivering of the eye when looking side to side), excitation, and skin dryness.

It is typically smoked (sometimes with marijuana or tobacco), but may be taken by mouth, snorted, or injected. Chemically speaking, PCP is a member of the arylcyclohexylamine class. PCP is most commonly used in the United States. While usage peaked in the 1970s, between 2005 and 2011 an increase occurred in emergency room visits as a result of the drug. 

The drug is often illegally produced under poorly controlled conditions; this means that users may be unaware of the actual dose they are taking. Further psychological effects of the drug include severe changes in body image, loss of ego boundaries, paranoia, depersonalization, psychosis, agitation, blurred vision and euphoria. Additional adverse side-effects may include seizures, coma, and an increased risk of suicide. Flashbacks may occur despite cessation of use. 

Like many other drugs, PCP has been known to alter mood states in an unpredictable fashion, causing some individuals to become detached, and others to become animated, inducing feelings of strength, power, and invulnerability. Recreational doses of the drug appear to induce a psychotic state, with cognitive impairment that resembles a schizophrenic episode. 

Studies by the Drug Abuse Warning Network in the 1970s showed that media reports of PCP-induced violence may be exaggerated and that incidents of violence are unusual, often limited to individuals with reputations for aggression prior to use of the drug. However, events which involve PCP-intoxicated individuals in physical altercations with law enforcement, possibly driven by their delusions or hallucinations, have been highly publicized. 

Other commonly cited incidents include inflicting property damage and self-mutilation, like the pulling of one’s own teeth. These effects were not noted in its medicinal use during the 1950s and 1960s. 

Oxycodone is the most commonly abused opioid in America. More than 12 million people use opioid drugs recreationally in the U.S.A.

Oxycodone was the leading cause of drug-related deaths in America until 2012, when heroin and fentanyl became more widely abused. Oxycodone overdose can cause spinal cord infarction in high doses as well as ischemic damage to the brain, due to prolonged hypoxia from suppressed breathing.

Most common side effects of oxycodone include reduced sensitivity to pain, euphoria, relaxation, and respiratory depression. Other side effects of oxycodone include constipation, nausea, tiredness, dizziness, itching, dry mouth, and sweating. 

Most side effects generally decrease in intensity over time, although constipation is likely to continue throughout use. Oxycodone in combination with naloxone in timed-release tablets have been created to deter abuse and reduce “opioid-induced constipation.” 

There is a high risk of severe withdrawal symptoms if a patient abruptly discontinues taking oxycodone. In a medical context, if the drug has been taken over an extended period of time, it is to be withdrawn gradually. People who abuse oxycodone at higher than prescribed doses are at risk of severe withdrawal symptoms. 

Symptoms of oxycodone withdrawal may include anxiety, panic attack, nausea, insomnia, muscle weakness, fevers, and other flu-like symptoms. Withdrawal symptoms have also been reported in newborns whose mothers had been taking oxycodone orally or injecting it during pregnancy.

In high doses and in people not tolerant to opioids, oxycodone can cause shallow breathing, slowed heart rate, clammy skin, pauses in breathing, low blood pressure, constricted pupils, circulatory collapse, respiratory arrest and death. Opioids were responsible for 49,000 of the 72,000 overdose deaths in the U.S. in 2017.

Oxycodone, sold under brand names such as Roxicodone and OxyContin (the extended release form) is a strong, semi-synthetic opioid used medically for treatment of moderate to severe pain. It is highly addictive, usually taken by mouth, and is available in immediate-release and controlled-release formulations. Onset of pain relief begins within fifteen minutes and lasts up to six hours with the immediate-release tablets. 

The reformulated OxyContin has caused some recreational users to switch to fentanyl, which is cheaper and not as difficult to find (and far more dangerous). In the United Kingdom, oxycodone is available by injection. When taken by mouth, oxycodone has roughly one and a half times the effect of the equivalent amount of morphine. 

Oxycodone was first made in Germany in 1916 from thebaine, an opiate alkaloid. In 2020, oxycodone was the 54th most commonly prescribed medication in the United States with over 12 million prescriptions.

Methamphetamine is a central nervous system stimulant used as a recreational drug and rarely as a second-line treatment for attention deficit hyperactivity disorder and obesity. It is seldom prescribed over concerns involving human neurotoxicity and potential for recreational abuse as an aphrodisiac and euphoriant. 

The highest degree of illegal methamphetamine use occurs in parts of Asia and Oceania, as well as the United States, where it has been classified as a schedule II controlled substance. Levomethamphetamine is available in the United States as an over-the-counter drug for use as an inhaled nasal decongestant. 

Recreationally, methamphetamine’s ability to increase energy has been reported to lift mood and increase sexual desire to such an extent that users are able to engage in sexual activity continuously for extensive periods during binges. At high doses, methamphetamine can induce psychosis, the breakdown of skeletal muscle, seizures and brain bleeding. Chronic high-dose intake can precipitate unpredictable mood swings, stimulant psychosis and violent behavior. 

Methamphetamine is very addictive and there is a high likelihood that withdrawal symptoms will occur when methamphetamine use ceases. Withdrawal from methamphetamine use may lead to a post-acute-withdrawal syndrome, which can persist for months beyond the typical withdrawal period. 

Methamphetamine is neurotoxic at high doses and has been shown to have a higher toxicity toward serotonergic neurons than amphetamine. Methamphetamine neurotoxicity causes deleterious changes in brain structure and function, such as reductions in gray matter volume.

A moderate overdose of methamphetamine may induce symptoms such as abnormal heart rhythm, confusion, difficult or painful urination, high or low blood pressure, high body temperature, over-active or over-responsive reflexes, muscle aches, rapid breathing, tremor, and an inability to pass urine. 

A large overdose may produce symptoms such as adrenergic storm, methamphetamine psychosis, substantially reduced or no urine output, cardiogenic shock, circulatory collapse, pulmonary hypertension, kidney failure, rapid muscle breakdown and serotonin syndrome. A methamphetamine overdose will likely also result in brain damage owing to dopaminergic and serotonergic neurotoxicity. Death from methamphetamine poisoning is often preceded by convulsions and coma.

A Cochrane Collaboration review on treatment for amphetamine and methamphetamine-induced psychosis states that about 5–15% of users fail to recover completely. The same review asserts that antipsychotic medications can aid in the resolution of acute amphetamine psychosis symptoms.