In part 1 and part 2 of the Power of Music series, we shared our observations and experiences of how music affects the emotions and behaviors of clients with substance use disorders and adolescents who might be at risk of substance use. We discussed how music can trigger substance use, yet, when used consciously as a tool, it can also be a catalyst for emotional well-being. This article explores some of the neurobiological effects of music and highlights a few approaches you can try in using music for treatment and recovery. 

The Therapeutic Benefits of Music

Research has established substance use disorder as a chronic brain disease. Research also confirms that music has a profound effect on brain chemistry, producing many of the same brain changes as substance use (Salimpoor, 2011).

For example, opiate use triggers the brain to release endorphins. Some genres of music engage the brain’s reward system and release dopamine, a “feel good” neurotransmitter that can serve as a healthy naturally-induced high.

According to Alex Damon, TEDx speaker and music and brain expert, listening to certain types of music improves regulation of the biological stress system and expedites recovery when we experience stress. This function reduces the stress hormone cortisol. Music’s impact on the biological stress system is significant because stress is a leading cause of relapse.

Singing also has an impact on the brain. In her TEDx Talk, Tania de long AM mentions a recent study that found group singing lessons enhance the release of oxytocin, a neurochemical associated with pleasure, love, and bonding. This is an important factor regarding the neurobiology of the brain, as neuroscientist Markus Heilig states, “social epidemiology has established a strong link between poor social integration and behaviors that result in alcohol and [substance use].”

Using certain genres of music in substance use disorder treatment and recovery offers several additional benefits. Music, as a form of therapy, has been found to:  

• Help clients have a more positive attitude toward treatment and recovery
• Improve mood and increase motivation to change
• Reduce stress and anxiety for clients seeking recovery (Aldridge & Fachner, 2010)
• Potentially help clients increase social connectivity with others

How to Use Music Therapy

Now that we have discussed some of the positive neurobiological impacts of music upon the brain, here are seven ways music can be used therapeutically in addiction treatment and recovery: 

1. Analyzing song lyrics. Many clients relapse repeatedly as a result of unhealthy relationships in recovery. These patterns are often repeated as clients struggle to understand their relationship patterns. Songs describing healthy and unhealthy relationships can be used in treatment to help clients better understand and break unhealthy relationship patterns.
2. Meditation. Meditation can reduce anxiety and regulate the nervous system. In addition, combining guided meditation with music through an app or video can help clients seeking recovery learn stress and craving management skills.
3. Dancing to music. Many clients with substance use disorders learned to party, socialize, and dance under the influence of drugs. Music in therapy can also be used to help clients relearn how to dance drug-free. Dance and movement have also been found to reduce the impact of trauma for individuals seeking recovery. For example, one successful component of the Native American Wellbriety Movement involves a return to Native American dance to facilitate recovery.
4. Writing song lyrics. Clients can create song lyrics to express feelings before and during an active substance use disorder. Autobiographical songwriting can be therapeutic for clients seeking recovery. Encouraging clients to label or name an emotion during songwriting can enable downregulation of uncomfortable emotions.
5. Understanding triggers. Clients can analyze the types of songs that trigger urges and cravings to use drugs and make plans to distance themselves from such music in recovery. According to one study, “individuals can learn to recognize, retrain and integrate state-specific emotional responses to music as part of their lifestyle.”
6. Learning relaxation techniques. Music can be used as a tool to teach relaxation techniques in recovery.
7. Increase group cohesion. Earlier in this article, we referenced de Jong AM’s TEDx talk where she mentioned that singing together in community has been found to increase oxytocin, a hormone associated with empathy, trust, and community relationship building. When substance use disorder groups are cohesive, clients make more progress.

Conclusion

This article highlights ways counselors can use music therapeutically as a tool in substance use disorder treatment and recovery. Working one-on-one with your client using these techniques could make a difference in client outcomes.  A next-level approach could involve hiring a music or experiential therapist to strengthen your program’s ability to incorporate music, art, movement, and other approaches to help clients seeking recovery. Taking this next-level approach could help clients with their recovery. Whether your clients work with you or with a music therapist, they can experience the positive power of music in treatment and recovery.

Read the first two parts of this series by Mark Sanders and Kisha Freed:

The Power of Music, Part 1: Using Music to Reinforce Culture and Support Recovery From Substance Use Disorders

The Power of Music, Part 2: Using Hiphop to Increase Emotional Intelligence and Prevent Substance Use Disorders in Adolescents and Young Adults

Kisha Freed				Mark Sanders, LCSW, CADC
Kisha Freed is a Program Coordinator at the Behavioral Health Excellence Technical Assistance Center (BHE-TAC) at CHESS. She is also a Success Coach, a certified emotional intelligence assessor, a mindfulness meditation teacher in-training, and she provides coaching services for entrepreneurs, creatives, and career professionals. Kisha lives in Huntsville, AL with her two sons, Benjamin and Joseph, and her dearly beloved granddaughter, Jaana.				Mark Sanders, LCSW, CADC, is the Great Lakes ATTC, MHTTC, and PTTC State Project Manager for Illinois. Mark is an international speaker, trainer, and behavioral health consultant whose work has reached thousands across the globe. He has received numerous awards recognizing his outstanding contributions to the fields of social work and substance use disorder treatment. Mark and his family live and work in Chicago, IL.

Works Cited

Aldridge, D., & Fachner, J. (2010). Music therapy and addictions. Jessica Kingsley Publishers.

American Psychological Association. (2019). Mindfulness meditation: A research-proven way to reduce stress.  https://www. apa. org./topics/mindfulness/meditation. https://www.apa.org/topics/mindfulness/meditation

Blum, K., Chen, T.J.H., Chen, A., Madigan, M., Downs, B.W., et al. (2009). Do dopaminergic gene polymorphisms affect mesolimbic reward activation of music listening response? Therapeutic impact on Reward Deficiency Syndrome (RDS). https://doi.org/10.1016/j.mehy.2009.10.008

Bourdaghs, S. & Silverman, M.J. (2020) A neurological rationale for music therapy to address social connectivity among individuals with substance use disorders. The Arts in Psychotherapy, Volume 70. https://doi.org/10.1016/j.aip.2020.101681.

Damon, A. (2018, August). Your brain is better on music. [Video] TEDx Ogden.

https://www.ted.com/talks/alex_doman_your_brain_is_better_on_music

de Jong AM, T. (2013, April). How Singing Together Changes the Brain. [Video] TEDx Melbourne. 
https://www.tedxmelbourne.com/talks/how-singing-together-changes-the-brain

Ghetti, C., Chen, X. J., Fachner, J., & Gold, C. (2017). Music therapy for people with substance use disorders. The Cochrane Database of Systematic Reviews, 2017(3), CD012576. https://doi.org/10.1002/14651858.CD012576

Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Wampold, B. E., Kearney, D. J., & Simpson, T. L. (2018). Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clinical psychology review, 59, 52–60. https://doi.org/10.1016/j.cpr.2017.10.011

Heilig, M., Epstein, D., Nader, M. et al. Time to connect: bringing social context into addiction neuroscience. Nat Rev Neurosci 17, 592–599 (2016). https://doi.org/10.1038/nrn.2016.67

Keeler, J.R., Roth, E.A., Neuser, B. L., Spitsbergen, J. M., Daniel J. M. Waters, D.J.M. and Vianney, J. (2015). The neurochemistry and social flow of singing: bonding and oxytocin. Frontiers in Human Neuroscience. https://doi.org/10.3389/fnhum.2015.00518/full
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Salimpoor, V. N., Benovoy, M., Larcher, K., Dagher, A., & Zatorre, R. J. (2011). Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature neuroscience, 14(2), 257-262. https://doi.org/10.1038/nn.2726

Volkow, N. D., Michaelides, M., & Baler, R. (2019). The Neuroscience of Drug Reward and Addiction. Physiological reviews, 99(4), 2115–2140. https://doi.org/10.1152/physrev.00014.2018