Rehab Treatment for Self-Harm and Drug and Alcohol Addiction

Self-harm, also called self-injury, is defined as an act of people deliberately hurting themselves. People who resort to this behavioral pattern practice self-harm as a way of dealing with unrecognized urges. In most cases self-harm is a reaction to real-life developments that a person is unable to come to terms with. Individuals who self-harm are usually adolescents or young adults who are struggling in their everyday lives. With the right form of treatment that deals with their underlying mental health or behavioral issues, most people will overcome their urge to self-harm.1

Self-harm often goes hand in hand with various forms of addiction. It can be said that addiction in itself constitutes a form of self-harm, since people who resort to substance abuse also resort to behavioral patterns that are harmful for their health. But, it’s generally accepted that substance use and eating disorders shouldn’t be thought of as self-harm. Overlapping of self-harm and addiction can lead to serious consequences if left untreated because it endangers a person’s physical and mental wellbeing.2

Although in most cases self-harm isn’t a life threatening condition, it can lead to unwanted and dangerous consequences when things get out of hand. Most cases of self-harm include individuals who have no intention of committing suicide. But, in its most severe forms it can be diagnosed as a suicidal behavior. Available research shows that if left untreated, almost half of people who engage in self-harm end up developing suicidal thoughts which could lead to suicide attempts.3


What Classifies as Self-Harm?

Any act of people deliberately hurting themselves falls under the category of self-harm. Self-harm is a clear sign that a person has problems coping with overbearing emotional distress. It’s not a mental illness in itself but a way of coping with emotional challenges in everyday life. Several mental health conditions are connected with self-harm, such as anxiety, depression, borderline personality disorder, eating disorders, and posttraumatic stress disorder.4

People get the urge to hurt themselves as a consequence of not being able to properly channel or deal with emotional pain or unchecked anger. Sometimes it’s a sign of a deep seated sense of frustration. Certain people never acquire the proper coping skills that would enable them to deal with intense emotions and life disappointments. In other cases, others learned how to hide or suppress their true emotions from a young age which made them unprepared for the complexities of daily life.4

Rejection can also play a major influencing role when it comes to self-harm. This is especially pronounced in adolescents who may resort to self-harm after being rejected by their peers, friends, or other social groups. Being abandoned by a partner can also lead individuals to feel angry, lonely, or unworthy, which makes them more likely to resort to self-harm.5

Statistics on Self-Harm and Addiction

Gathering statistics on self-harm is not an easy thing to do since people aren’t always open about their self-injury episodes. But a very thorough meta-analysis looked at international research data for the 1990-2015 period which encompassed 41 countries and more than half a million participants who reported engaging in self-harm. The researchers were able to come to certain conclusions and found that:6

  • Almost 17% of people resort to self-harm at least once during their lives.
  • Roughly 47% of responders reported only one or two episodes of self-harm.
  • Girls were 72% more likely to self-harm than boys.
  • The mean starting age for self-harm was 13 years.
  • Some 45% of responders reported cutting themselves which made cutting the most common form of self-harm.
  • Hair pulling disorder is 4 times more common in girls than in men.
  • Most frequently cited reason for self-harm was people looking for relief from feelings or thoughts they were unable to cope with.
  • Suicidal thoughts and attempts were more present in adolescents, with the risk being more pronounced in people who admitted to harming themselves more often.

Different Types of Self-Harm

There are various behavioral patterns that are classified as different types of self-harm, such as:2

  • Pulling out one’s hair or twisting it until it breaks off, also called hair pulling disorder or trichotillomania.
  • Cutting oneself with a sharp or pointed object, usually a knife or a blade.
  • Burning oneself with cigarettes, candles, or a lighter.
  • Punching oneself or deliberately hitting one’s head against the wall or a table.
  • Bruising oneself and in some cases breaking bones.
  • Stuffing objects into various bodily openings.

Cutting and Burning of the Skin

Cutting and burning of the skin is the most common form of self-harm. It’s usually done in places that can be hidden by clothing, such as on arms, legs, and upper body or torso. Burning of arms or hands with a lighter or a candle are the most common forms of self-burning. While these injuries are mostly done to the surface of the skin, repeated cutting or burning may leave long term marks which can cause complications due to infections and neglect. The more burn marks a person has the harder it is to hide them from their family and friends.7

Punching Yourself and Banging Against Things

Whereas cutting and self-biting are more common among females, punching and self-burning are more common among males. Typical examples include hitting oneself in the face, guts, chest, or legs and banging one’s head against the wall or table. Face marks and bruises are harder to cover so people might avoid this type of self-harm for fear of ostracism or shame.3

Deliberate Starvation

Eating disorders and self-harm have a high degree of comorbidity because they have similar consequences. In usual forms of physical self-harm, most people report not feeling pain while they were self-harming. Self-injuring gives them a feeling of instant gratification. In comparison to this, deliberate starvation is considered as an indirect self-harm since physical harm doesn’t occur in the moment of self-harm but later on. Eating disorders can take the form of fasting, laxative abuse, forced vomiting, and deliberate starvation.8

Addiction to Drugs or Alcohol

Substance use and self-harm are especially linked and intertwined during the adolescent years. In fact, adolescents who resort to self-harm have a higher risk of substance use and various dependence issues during young adulthood. In fact, individuals who self-harm have four times greater chance of developing multiple dependence syndromes later on. Substance use is also dangerous because it can lower the pain threshold and make people less inhibited and more ready to engage in risky behavior. Combination of self-harm and substance use can be very dangerous with long-term health consequences.9

What are the Common Self-Harm Causes and Risk Factors?

Some people resort to self-harm as a cry for help that is meant to draw other people’s attention to the fact that they are going through a hard time. Self-harm can also be an attempt to deal with upsetting feelings or developments in one’s life. Sometimes, people just feel lonely and rejected, so they resort to self-harm in order to “feel alive”. Another problem with self-harm is that gratification lasts for a short time which then leads to more self-harm. It’s important to react before this situation develops into a behavioral pattern.1

  • Most common reasons why people turn to self-harm as a solution are because:4
  • They want to draw attention from their loved ones.
  • They are trying to deal with feelings that are overwhelming them.
  • They want to feel like they are in control and not the victim.
  • They want to punish themselves for perceived inadequacies.
  • They are trying to come to terms with loss.

What are the Risk Factors When it Comes to Self-Harm?

Self-harm can be a problem for people of all ages but it’s mostly associated with teenagers and young adults. There are several risk factors that may make a person more likely to self-harm, such as:10

Problems related to early age, like:

  • Painful trauma from the past.
  • Experience of childhood illness or surgery.
  • Physical and sexual abuse.

Family related issues, such as:

  • Loss of a parent or a loved one.
  • Substance use within the family.
  • Lack of family support or parental neglect.

Coming-of-age and peer pressure issues, for example:

  • Negative perceptions about their body image or position within the community.
  • As a result of peer pressure or bullying.
  • Neglect, rejection, or ostracism.

Mental health related issues, including:

  • Presence of mental health disorders.
  • Lack of impulse control, which leads to reckless behavior.
  • Having friends that engage in self-harm.
  • Substance use at an early age.

Connection Between Self-Harm and Substance Abuse

Substance abuse and self-harm frequently stem from the same root causes. When people are struggling they might decide to turn to substance use or self-harm, or both. Individuals who have substance use issues are one of populations that are most likely to engage in self-injury. In addition to loss of inhibition, substance abuse clouds people’s judgment, making them more prone to resort to desperate solutions.9

Since addiction alters brain chemistry, people who suffer from substance use disorders gradually lose control over their decision making process. This makes them less aware of what is going on and more willing to engage in risky behaviors that may result in unforeseen consequences, like traffic accidents or unwanted injuries. Addiction also leads to unhealthy lifestyle habits and routines which can reinforce the behavioral aspect of self-harm.9

What are Some of the Signs of Self-Harm?

Even though there are multiple ways of self-harming and not all people who self-injure will do it for the same reasons, there are still several signs of self-harm which may indicate that a person is self-injuring. Most common signs of self-harm are:1

  • Behavioral self-harm signs including:
    • Being dressed inappropriately for specific weather conditions (eg., wearing long-sleeved clothing during very hot days).
    • General avoidance of activities which will make most body parts visible, like going to a pool or engaging in sports.
    • Insistence on washing their clothes separately.
    • A drop off in school and a loss of interest in various activities.
    • Handling of potentially dangerous objects, like razor blades, knives, or cigarette lighters.
  • Psychological and psychosocial self-harm signs:
    • Expressing feelings of anxiety or depression.
    • A lack of interest in activities and hobbies that the person previously engaged in.
    • Avoidance of social interactions and crowds.
    • Problems in communication with people within their social circle.
    • Sudden and unexplained mood swings and irritability.
  • Physical signs of self-harm:
    • Physical pain which has no obvious explanation.
    • Overdosing on medicine, alcohol, and illicit drugs.
    • Visible signs of self-harm, like bruises, wounds, cuts, and burn or scratch marks.

How to Help Someone Who Self-Harms?

Since many of these signs may also point to other problems, like substance use or problems with peers, self-harm is not easy to spot. Another problem is the fact that self-harming individuals tend to feel deep shame or guilt, which makes them more secretive and less prone to open up. Most self-harm marks are on the arms making them easy to hide. All of these factors contribute to the fact that in most cases self-harm is recognized once the person admits to self-inflicted injuries.11

If you have suspicions someone is engaging in self-harm or you want to help someone who admitted to self-harm, the best thing to do is to try the following approaches:

  • Do not avoid the subject, especially if the person opens up on their own.
  • Try listening even though it might be hard to understand their actions and reasoning.
  • Don’t be judgmental or dismissive.
  • Try showing sympathy and understanding for their situation.
  • Tell them you will be there for them during this hard period.
  • Don’t be too pushy or aggressive when encouraging them to seek help.

Self-Harm Anonymous Meetings

Since self-harm is a behavioral issue, anonymous meetings offer a successful approach that treats the underlying issues which made people turn against themselves in the first place. Anonymous programs look at the ways people can start to feel better about themselves and ultimately start leading healthier and more fulfilling lives. There are various groups that deal with self-harm, including Self-Injury Recovery Anonymous, Self-Mutilators Anonymous, and Self Harmers Anonymous.12

Dual Diagnosis Treatment for Self-Harm and Substance Abuse

Substance use disorders often overlap with certain mental health or behavioral issues. People who have both of these issues are diagnosed with dual diagnosis, also called co-occurring disorder. Many conditions can co-occur with substance abuse like depression, anxiety, self-harm, or PTSD. In most cases it’s hard to tell which one of these caused the other so treatment has to simultaneously tackle both issues.13

If left untreated, dual diagnosis issues have a potential to become a big problem even for seemingly mild cases. Dual diagnosis issues exacerbate each other, so a person who’s self-harming may become more aggressive towards herself when under the influence of alcohol or drugs. Most substances have a numbing effect which can lead to more serious harm than originally intended. National Survey on Drug Use and Health for the year 2020 shows that some 17 million adult Americans are in need of treatment for dual diagnosis of mental health and addiction issues.14

Residential Inpatient Treatment Centers for Self-Harm

Inpatient treatment is probably the most advanced and intensive form of mental health recovery available. Inpatient self-harm rehab treatment requires that patients sleep inside a dedicated addiction rehab facility. This enables medical professionals to constantly monitor their recovery progress and adjust the type and intensity of treatment accordingly. Another advantage of inpatient treatment is the availability of advanced medical tools and instruments as well as various amenities that will aid in treatment.15

Inpatient rehab is usually reserved for people who have mental health issues that are endangering their everyday existence and rendering them unfit to take care of themselves. Inpatient programs last at least a month but each case differs. Co-occurring conditions and dual diagnosis are best treated in an inpatient setting due to the complexities of dealing with multiple issues at the same time. In severe cases of self-harm dual diagnosis same day admission is a key component of successful rehab.13

Outpatient Treatment Centers for Self-Harm

Outpatient self-harm rehab treatment is a good solution for people who were able to recognize their issues before their condition became too serious. Even though it can’t match inpatient rehab’s level of care, outpatient treatment can in many ways mimic the intensity of inpatient rehab. This can be done through the adjustment in the duration and number of weekly visits to the rehab center. More intensive form is called Intensive outpatient treatment.16

Outpatient rehab could be a good choice for those who are able to motivate themselves to keep regular appointments and avoid triggers in their everyday surroundings. Patients with a stable home situation and a strong support system could also opt for outpatient rehab. In general, outpatient rehabs will cost less than inpatient ones, but this can also depend on the duration of recovery process or whether a patient requires a medical detox procedure.16

Therapy Treatment for Self-Harm

Self-harm therapy may be a good choice for mild cases or those who previously completed some form of treatment but feel like they could slip up and experience a relapse episode. There are multiple forms of self-harm therapy with the most popular form being the Cognitive Behavioral Therapy (CBT). CBT tackles addiction issues and builds a patient’s overall mental health through changes in behavioral patterns and daily routines. Patients can choose between group and individual self-harm therapies depending on their specific medical condition. In certain cases, combination of both is used to achieve the best results.17

How to Find Self-Harm and Substance Abuse Rehab Treatment Centers Near Me

If you’re thinking about rehab options near you, American Addiction Centers (AAC) offers a network of rehab facilities that specialize in dealing with various types of mental health conditions and addiction disorders. Visit their website or call one of their hotlines that are dedicated to substance abuse issues like alcohol, opioid, or heroin abuse. All AAC hotlines are free of charge, available 24/7, and guarantee absolute confidentiality.

The AAC admissions navigators have vast experience when it comes to addiction related challenges and medical knowledge about various treatment possibilities. Many of them have completed successful rehab procedures which enables them to have a true understanding of the complications and challenges addicts are faced with. AAC’s staff can verify the details of your coverage, check your insurance benefits, provide guidance and advice, or help you get to know various payment options at your disposal.

Getting into treatment is only a few steps away and may look like this:

  • Step 1: Reaching out for help is the first step and a clear sign that a person is ready and in need of proven medical solutions.
  • Step 2: Undergoing the pre-screening process that will help professionals get acquainted with your mental and physical condition as well as specific individual characteristics of your case.
  • Step 3: Getting a personalized treatment suggestion about the treatment approach that will be best suited to tackle your specific medical condition and a best fit for your personal situation.
  • Step 4: Preparing for the trip by packing for treatment, sorting out your finances and ways of paying for rehab as well as resolving your schooling or job obligations and commitments.
  • Step 5: Start your recovery by going through the final medical screening and intake assessment process.

Does Insurance Cover Self-Harm and Substance Abuse Treatment?

Since the passing of the Affordable Care Act, all insurers on the Marketplace are mandated to provide coverage for essential health benefits. There are 10 essential health benefits and mental health issues are one of them. Since self-harm falls under the category of mental health conditions as a behavioral issue, insurance providers will have to offer recovery treatment coverage up to a certain point. The exact duration or amount of coverage will depend on the individual healthcare insurance plan.18You can easily inquire about the specifics of your healthcare plan by calling the number that is located on the back of your insurance card. If you don’t have insurance there are several options to look into like, various SAMHSA funded programs, local state funded options, low cost options for those with financial issues, and even free programs for those who can’t afford treatment that they need.


Frequently Asked Questions