Skip to main content
Headway

Mental health conditions

How to manage an addiction

Living with an addiction is hard. Learn how treatment supports recovery, addiction psychology, and safe ways to manage cravings and withdrawal.

April 10, 2026

By Ryan DeCook, LCSW • Clinically reviewed by Dr. Naiylah Warren, DCFT, LMFT

7 min read

By Ryan DeCook, LCSW • Clinically reviewed by Dr. Naiylah Warren, DCFT, LMFT

You’ve thought about it many times. You’ve maybe even tried to make changes. In the back of your mind there are lingering questions: Can I change? Can I manage my addiction? 

You're not alone in asking these questions. According to the National Survey on Drug Use and Health (NSDUH), 48.4 million Americans ages 12 and older experienced a substance use disorder in 2024. That’s nearly one in six people. 

For many people, addiction feels confusing, isolating, and like a loop they can’t escape. Repeated use can further condition the brain to depend on substances and make a path forward feel impossible.

And yet, addiction is treatable. With the right tools and interventions, individuals can find a path forward in recovery.

What is an addiction?

Addiction is described by many leading health organizations as a chronic dependence on substances or behaviors that cause harmful consequences. The World Health Organization notes that there’s an ongoing desire for these addictive actions and a difficulty stopping them, despite the damaging effects. This can apply to substances that are consumed, or a variety of different behaviors.

What are the types of addiction?

Substance addiction 

Drug and substance addiction develops when repeated use leads to physical or psychological dependence, progressively altering the brain and daily life. Examples may include but are not limited to:

  • Alcohol
  • Cannabis
  • Nicotine
  • Opioids (pain pills, heroin)
  • Stimulants (cocaine, methamphetamine, amphetamines like Adderall)

Behavioral addiction

Behavioral addictions don't involve substances, but they can be just as disruptive, consuming time, straining relationships, and proving difficult to control. Many aren't formally diagnosable, but the impact on daily life can be significant. Examples include:

  • Gambling (one of the few behavioral addictions that can be officially diagnosed)
  • Sex and pornography
  • Eating
  • Dieting or exercising (Note: Eating disorders are a distinct clinical category and are best assessed separately)
  • Shopping
  • Video games
  • Internet use

What causes addiction?

There are several factors that can influence a person’s likelihood of developing an addiction, and it’s often difficult to identify a single cause. For any person, there may be a single cause of addiction or a mix of several different causes. The risk factors for addiction are complex, however research points to these main causes:

Genetics

The National Institutes of Health (NIH) estimates that 50 to 60% of a person’s vulnerability to alcohol use disorder is related to genetics. Research consistently shows that substance use disorders have a significant genetic component. 

This confirms what has often been thought — that addiction can be hereditary — which is why many intakes in recovery centers will ask about family history of addiction. 

Adverse childhood experiences (ACEs) and trauma

Early experiences in childhood that are traumatic or highly stressful can significantly increase the likelihood of addiction. The ACE assessment measures specific difficult or traumatic experiences experienced before the age of 18. 

Research studies, including this one, have shown that high ACE scores increase the risk for addiction. Trauma disrupts the stress response and brain development in ways that increase vulnerability to addiction later in life.

Some ACEs, such as exposure to substance use at home and emotional abuse, tend to show especially strong links with later substance problems, while others (like witnessing violence) are still associated with increased risk but may have somewhat smaller effects in some studies.

Environmental exposure and access

Beyond genetics and childhood trauma, a person's broader environment plays a significant role in addiction risk. Early exposure to substance use, whether at home, through peers, or in the community, can normalize use, reduce perceived risk, and provide direct access to substances. Other factors, including low socioeconomic status, adolescent use, and social circles where substance use is common, can further increase vulnerability.

Mental health conditions

Genetic components and environmental factors can both impact mental health. About 20 million people in the U.S. struggle with a co-occurring disorder of mental health and addiction. Mental health disorders and substance use disorders share overlapping genetic risk factors. 

Childhood disorders of ADHD, conduct disorders, and depression seem to be correlated with a risk for later addiction. Mental health disorders can lead to a desire to self-medicate the related emotional and mental challenges. 

Changes in brain chemistry

There are several different changes in the brain that continue to fuel addiction.

  • The reward system in the brain gets flooded with dopamine and pleasure. Over time the brain gets used to this and expects more. With repeated use, the brain's reward system can begin to prioritize the substance similarly to how it signals for basic needs, making cravings feel urgent and difficult to override.
  • The stress and emotion management systems in the brain become impaired. There becomes more intense and frequent negative emotions, which can make the substance become more desired as a relief from those negative emotions. This can parallel the experience of returning to an addictive substance or habit to avoid the struggle of withdrawal symptoms.
  • Repeated addictive behaviors strengthen neural pathways associated with those habits, making them increasingly automatic over time — and harder to quit.

Ways to help you overcome addiction

Managing and overcoming addiction is possible, but it typically requires motivation, the right combination of support, and treatment tailored to the individual. Recovery looks different for everyone, but these approaches consistently support it:

Acknowledge that there’s a problem

It is almost impossible to move forward without this. When someone with an addiction fully acknowledges that it is a problem and that they are ready to seek help, this lays the necessary groundwork for recovery. 

Get a professional assessment

A great first step can be to reach out to a trained professional to get an assessment. This might be at a recovery center, treatment program, or reaching out to an individual behavioral health provider. This step can often take a lot of courage and support, but can be the launching point to recovery. 

Prioritize your safety, including medical support when needed

Beginning recovery often requires more than motivation. It also requires a safe and supportive environment. Look for care settings that feel structured, respectful, and aligned with your goals, where you feel physically and emotionally safe and where exposure to triggers or destabilizing situations is minimized. Early care should feel like a stable place to land, even if you feel nervous or unsure at first. Medication-assisted treatment (MAT) and medical support may be necessary, especially during detox or withdrawal, and having consistent, supervised support during this stage is important to reduce risk and support your safety.

Choose a treatment setting that fits your needs

Treatment programs can be expensive, especially if insurance won’t pay for it. Unless you are in an emergency, or in urgent need of detox services, make sure that you’ve found a place that meets your needs. 

You want to make sure the treatment setting specializes in your addiction, provides evidence-based treatment to support recovery from that addiction, and offers programs that are long and intensive enough to help your recovery. 

There are many different levels of care offered across treatment facilities. Make sure to ask about the details of these levels of care, as well as about the length of time and the cost. Work with a professional and loved ones to determine what level of care best suits you. 

Start evidence-based therapy

Once you have committed to treatment, you should start evidence-based treatment. The most commonly recommended evidence-based treatments include: cognitive behavioral therapy (CBT), contingency management (CM), motivational enhancement therapy (MET), and family behavior therapy (FBT). 

Other interventions such as mindfulness-based cognitive therapy (MBCT), acceptance and commitment therapy (ACT), and dialectical behavioral therapy (DBT) have also shown benefits for addiction treatment. If you have a co-occurring disorder, other treatments may also be needed to help with symptoms that are impacting the addiction.

Identify triggers and plan for cravings

Early work in evidence-based addiction treatment involves identifying the triggers for cravings. It may be a relationship, criticism, driving past a liquor store, or a range of other possibilities. Awareness of triggers and a plan for when they arise form a foundation for recovery. 

Develop replacement coping skills

For many, substance use or addictive behaviors are used to cope with triggers, difficult moments, and intense emotions. It is a way they seek being more calm or less sad, anxious, or angry. To manage addiction and overcome it, a person needs to develop coping skills that replace what addiction does for them.

Learning to reduce emotional intensity, reframe negative thinking, and tolerate discomfort without substances is essential to learning how to fight an addiction.

Consider medication when appropriate

Medication may be needed as part of recovery treatment. There are medications recommended by the American Society of Addiction Medicine (ASAM) that can help with opioid recovery such as buprenorphine (Suboxone) and methadone. 

NIDA guidelines recommend nicotine replacement therapy (NRT), bupropion, and varenicline for nicotine. There are also several medications they recommend to help with alcohol recovery including naltrexone and acamprosate. If you are struggling with co-occurring disorders of mental health, using medications for your mental health condition may also be an important part of treatment. If you’re considering medications, you should consult with a prescribing provider who specializes in addiction. 

Keep going if you slip or relapse

For many people, slips and relapses are part of their recovery journey. If you’ve been working on overcoming your addiction and have a relapse, it does not mean all is lost. In one large national study, the typical person (median) reported about two serious recovery attempts before sustaining long‑term recovery, though many people need more tries. 

If this happens to you, take the lessons from the relapse and keep working towards recovery. A relapse can be a source of information; about triggers, gaps in support, or what needs to adjust in the treatment plan.

FAQs

What is the most common addiction?

Alcohol and nicotine are among the most prevalent addictions, in part because they’re legal, widely available, and socially accepted in many settings. Cannabis use disorder is also very common, especially among people who use it regularly.

For behavioral addictions, sex addiction (around 2 to 5%) has the highest prevalence, with gambling occurring much less frequently. 

How long does it take to overcome an addiction?

There are many factors that can impact the timeframe for recovery including the type of addiction, level of support, other co-occurring disorders, and the person’s commitment to a recovery process.

Research suggests that cravings and relapse risk decrease significantly after the first year of sustained recovery, and drop considerably lower after five years.

How can I help someone with an addiction?

Supporting someone with an addiction is hard, and it's rarely straightforward. When someone is in active addiction, direct confrontation can sometimes lead to defensiveness rather than openness. Change ultimately has to come from them. 

What tends to help more: listening without judgment, encouraging professional support without pressure, and setting limits that protect you from enabling harmful behavior. Taking care of yourself in the process is necessary. CRAFT offers a research-based framework specifically for family members, and programs like Al-Anon provide peer community support for those affected by a loved one's drinking.

Find in-network addiction support with Headway

Managing and overcoming addiction requires a great deal of desire to change and willingness to commit to a plan. It is hard to do alone and finding the right support is often the most important first step. Headway makes it easier to find in-network therapists and psychiatrists who specialize in addiction and substance use, so you can see what's available and what it will cost before you book. Search Headway to find a provider who accepts your insurance.

This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.

Mental health conditions