A new case study has highlighted how acceptance and commitment therapy (ACT) can support recovery from addiction to crack cocaine and methamphetamine, two of the most damaging and addictive substances in the world. The research offers a rare insight into how one individual, after more than a decade of repeated relapse, was able to use ACT principles to find a way forward. The findings were published in Psychreg Journal of Psychology.
Addiction to stimulants such as crack and methamphetamine often leads to severe psychological and physical harm. Relapse rates remain high, and traditional therapies focused on abstinence or behavioural change have had limited long-term success. ACT, however, is part of a newer wave of psychological approaches that emphasises acceptance, mindfulness, and living in line with personal values. Rather than trying to eliminate difficult cravings or emotions, ACT teaches people to change how they respond to them.
The study followed a 32-year-old man, referred to as John, who had been dependent on crack and methamphetamine since adolescence. Despite multiple attempts at recovery through rehabilitation and behavioural therapy, he struggled to remain drug-free. Over a six-month period of ACT, John’s recovery journey was shaped by learning to accept his cravings rather than suppress them, distancing himself from harmful thoughts, and reconnecting with values that gave his life purpose.
At the start of therapy, John found it almost impossible to tolerate cravings without relapsing. Attempts to resist them often made the urges stronger. Over time, he learnt to let cravings exist without acting on them, reducing the emotional burden that had previously driven him back to drugs. This shift marked one of the turning points in his recovery. Another important development came through mindfulness exercises, which helped him focus on the present rather than being overwhelmed by regret or anxiety about relapse.
One of the most significant aspects of John’s progress was a change in how he saw himself. Previously, he defined his identity by his addiction, using labels such as “junkie” or “failure”. Through ACT, he began to view himself as more than his past behaviour. Reconnecting with core values, such as family and personal growth, gave him renewed motivation to stay committed to recovery. He was able to take meaningful steps, including attending support groups and repairing relationships, even when progress was slow.
The study also revealed how ACT can be adapted to fit personal needs. John found humour to be a helpful tool for managing negative thoughts, a personalised version of a technique known as cognitive defusion. This flexibility reflects one of ACT’s strengths, allowing individuals to apply its processes in ways that feel natural to them.
While this was a single case study and cannot be generalised to all people with stimulant addiction, it demonstrates how ACT can help build resilience and psychological flexibility. Researchers suggest that more large-scale studies are needed, but the findings provide valuable guidance for therapists and treatment providers looking for new ways to support recovery.
ACT is increasingly seen as a promising approach in mental health treatment. By helping individuals accept discomfort, step back from harmful thoughts, and act according to personal values, it may offer a more sustainable path to recovery for those battling the toughest forms of addiction.