DBT and Substance Use

How DBT Can Help Treat Substance Abuse (Alcohol & Marijuana)

If you’re struggling with alcohol or marijuana use, know this: you’re not alone, and you don’t have to do this perfectly to move forward.

For many people, substances become a way to cope with anxiety, overwhelm, emotional pain, or even just the stress of getting through the day. Drinking or using might feel like the only way to relax, connect, or feel some relief, but over time, it can start to take more than it gives.

You might feel stuck in a cycle: wanting to cut back or quit, but unsure what else to reach for when things get hard.

That’s where Dialectical Behavior Therapy (DBT) can be so helpful.

What Is DBT?

DBT is a structured, skills-based therapy that was originally developed to help people manage intense emotions and high-stress situations. It’s been adapted to treat a wide range of concerns like anxiety, eating disorders, and yes, substance use.

What makes DBT different is that it meets you where you are. It doesn’t ask you to "just stop" using. Instead, it helps you understand why you turn to alcohol or marijuana in the first place and teaches you healthier, more sustainable tools to cope.

It also emphasizes something that’s often missing in traditional approaches: compassion. DBT balances acceptance and change. You can want to make different choices and validate that what you’ve been doing has been your best effort to survive.

Why Alcohol and Marijuana Become Coping Strategies

Substance use is rarely just about the substance. More often, it’s about what the substance is helping you avoid or soothe. Maybe you drink to quiet your racing thoughts after work, or smoke weed to disconnect from the pressure you feel to keep it all together.

In DBT, we don’t shame you for those choices. Instead, we get curious. What’s underneath the urge? What are you needing in that moment? And what other options could support you—without leading to more pain later?

DBT Skills That Support Substance Recovery

DBT teaches four main skill areas, and each one is designed to help you better understand and manage your thoughts, emotions, and behaviors. Here’s how they can support sobriety or moderation:

1. Distress Tolerance
When you feel triggered or overwhelmed, distress tolerance skills help you ride the wave without reaching for a substance. You’ll learn how to ground yourself in the present moment, distract in healthy ways, and soothe your nervous system.

2. Emotion Regulation
Many people use substances to escape or numb emotional pain. DBT helps you build emotional literacy so you can name what you’re feeling, understand where it’s coming from, and take care of it directly instead of avoiding it.

3. Mindfulness
Mindfulness is the foundation of DBT. It helps you become more aware of your internal experience, recognize patterns before they spiral, and make conscious choices in the moment. This awareness is key to changing habits without judgment.

4. Interpersonal Effectiveness
Substance use is often tied to social dynamics: feeling pressured, unseen, or like you can’t set boundaries. DBT gives you practical tools to communicate more clearly, ask for what you need, and protect your energy in relationships.

You Don’t Have to Do This Alone

Healing your relationship with substances isn’t just about willpower. It’s about having tools, support, and a sense of safety in your own body and mind. DBT offers that structure without shame—and gives you space to build a life that feels more grounded and aligned with your values.

Whether you’re sober-curious, trying to cut back, or in active recovery, you deserve a space that holds both the struggle and the hope.

Curious about how DBT-informed therapy could support you?
I’d love to walk alongside you. Click here to schedule a free consultation and explore what support could look like.