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Addiction Treatment: How Can We Make Things Better? A Q&A with Maia Szalavitz, Part IV
Thursday, April 25th, 2013

When it comes to addiction treatment, too often there is a disconnect between what people with an addiction need and what they get. Combine that with the stigma, desperation and fear that accompany the disease of addiction, time and again, present seemingly insurmountable odds for the addicted person to overcome. In this, the final installment in a four-part series of my Q&A with award-winning journalist Maia Szalavitz, Ms. Szalavitz weighs in on “Addiction Treatment: How Can We Make Things Better?”

JERRY OTERO: Most of the media stories about addiction are often tied to something sensational, like a celebrity death. What will motivate journalists to pay more attention to this issue and, in turn, create more awareness and education among their readers/viewers? What kinds of stories would you like to see?

MAIA SZALAVITZ: Hard to say how to get more attention to this (if I knew how, I’d do it!), but I would like to see reporters who cover this area question their own ingrained beliefs and not just assume that traditional treatment is the only way to recovery, that police are any kind of experts on the effects of drugs, that treatment providers are impartial experts (use academic sources who know the data; you wouldn’t go to a pharmaceutical company for unbiased perspective on its own products) or that current policies are the most effective way to deal with problem.

JERRY OTERO: What’s your biggest wish for change in the addictions field?

MAIA SZALAVITZ: That addiction be seen as a health problem and truly treated that way, with evidence-based treatment in which the traditional harsh approach would be as unacceptable as it would be for doctors to treat cancer patients as immoral malingerers.

JERRY OTERO: Anything parents can do to bring about this change?

MAIA SZALAVITZ: Advocate for evidence-based treatment and policy change that recognizes that addiction problems cannot be solved by the criminal justice system and treat people with addiction with compassion.

This concludes our Q&A with Maia Szalavitz. I want to thank Ms. Szalavitz for sharing her insights with our readers, and for weighing in on topics that are important for parents and other caregivers.

Are you a parent or caregiver of a teen or young adult struggling with a substance abuse problem? Please visit the online community at The Partnership at Drugfree.org’s Time To Get Help.

Maia Szalavitz is a health writer at TIME.com and writes about addiction-related issues for The Fix.com . Find her on Twitter at @maiasz. She is co-author of Born for Love: Why Empathy is Essential — and Endangered, (Morrow, 2010), The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007), and Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (John S. Wiley, 2000) and the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

Posted by Jerry  /  Filed under Addiction, Dealing with an Addicted Child, Drugs, Finding Treatment, Substance Abuse, Treatment, Writing About Addiction  /  Comments: 1



Medication-Assisted Treatment and Other Changes in the Addiction Field: A Q&A with Maia Szalavitz, Part III
Tuesday, April 16th, 2013

Opioids (heroin and prescription pain relievers) are powerful drugs that act on specific receptors in the brain that are important in regulating pain. While prescription opioids can be highly beneficial if used as prescribed, as a class of drug, they have a high potential for abuse. In fact, the National Institute on Drug Abuse estimated that 1.9 million people in the U.S. were addicted to prescription opioid pain relievers in 2010 and 359,000 were addicted to heroin.

Medication-assisted treatment for opiate dependence generally refers to the use of the medications buprenorphine, methadone or naltrexone to treat opiate dependence, in combination with counseling and recovery support services.  

In this, Part 3 of a 4-part series of my Q&A with award winning journalist Maia Szalavitz, Ms. Szalavitz shares her views on the dominance and effectiveness of traditional AA/12 Step based rehab programs, as well as the changes she has seen in the addiction field with a special emphasis on medication-assisted treatment for those struggling with opioid dependency.

JERRY OTERO: What’s been the biggest change in the addictions and treatment field since your book, Recovery Options  publication in 2000? What are the implications for teenagers?

MAIA SZALAVITZ: The biggest change is the widespread use of buprenorphine for opioid addiction treatment and the acceptance of the need for maintenance medication in some cases by abstinence-focused providers like Hazelden.  There has also been a decline in harsh and confrontational treatment, but unfortunately, some is still out there.

I wish there had been more changes though:  it’s still hard to get care that doesn’t present the idea that the 12-steps are the best way and that really meets people’s needs.

Teen treatment is unfortunately still very problematic, particularly in programs that sell themselves as “troubled teen” programs, i.e., emotional growth boarding schools, boot camps, therapeutic boarding schools, behavior modification programs and wilderness programs.  None of these have any controlled evidence supporting their effectiveness for addictions or other teen drug problems and yet lots of teens with drug problems are sent to them.  These programs tend to use tough, harsh tactics that are known to be harmful.

JERRY OTERO: What are your thoughts on medicated-assisted treatment (such as methadone, suboxone, vivitrol) for patients with opioid addictions? What are things parents should know about this treatment for their older teens/young adults?

MAIA SZALAVITZ: For opioid addiction, medication-assisted treatment is the safest and best option, the one most likely to preserve life and health.  It’s trickiest to determine when it should be used with young people:  obviously, it’s preferable not to have to be on lifelong maintenance of anything, whether blood pressure medication or buprenorphine.  So, young people should be aiming for abstinence at first, but maintenance should not be ruled out or seen as failure and parents should not pressure kids who are doing well on maintenance to come off, simply because they feel that drug-free is better.

Stay tuned next week for Part lV of our Q&A “How Can We Makes Things Better?”

To learn more about prescription medicine abuse, please visit The Partnership at Drugfree.org’s The Medicine Abuse Project.

And look for The Partnership at Drugfree.org’s free Medication-Assisted Treatment e-book coming out next month.

Maia Szalavitz is a health writer at TIME.com and writes about addiction-related issues for The Fix.com. Find her on Twitter at @maiasz. She is co-author of Born for Love: Why Empathy is Essential — and Endangered, (Morrow, 2010), The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007), and Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (John S. Wiley, 2000) and the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

Posted by Jerry  /  Filed under 12-Step, Addiction, Books about addiction, Dealing with an Addicted Child, Finding Treatment, getting help, Heroin, Medication-Assisted Treatment, Substance Abuse, Treatment, Twelve Step, Uncategorized, Writing About Addiction  /  Comments: more



Finding Addiction Treatment for Your Child: A Q&A with Maia Szalavitz, Part II
Tuesday, April 9th, 2013


Recognizing that your child needs substance abuse treatment can be emotional and overwhelming; and you may feel that your child’s addiction has taken over your family’s life. Here, we present Part 2 of a 4-part series of my Q & A with award-winning journalist, Maia Szalvitz. Today, Ms. Szalavitz shares some advice on how parents can find the right addiction treatment for their teens and young adults — and what they should avoid.

JERRY OTERO: What do parents need to know about the differences between girls and boys when dealing with substance abuse issues?

MAIA SZALAVITZ: Mainly that everyone has individual needs and some of them relate to gender, like the fact that girls may be more likely to be depressed or that they may feel uncomfortable discussing issues of sexuality in mixed gender groups.  Mostly, it’s critical for everyone to be thoroughly evaluated before treatment is sought so that an independent assessment of these needs can be done by someone who doesn’t have a particular treatment in mind.  Note:  independent assessment should be done by a psychiatrist or psychologist, not an educational consultant who refers people to residential care.

JERRY OTERO: What should parents be cautious of when looking for the right treatment for their child? What about programs that “whip kids into shape?” And, is there a difference between boot camps and wilderness programs?

MAIA SZALAVITZ: Any treatment that wants to cut off or control communication between parent and child (outside of obvious abusive parents) for longer than a week or two should be viewed with extreme skepticism.  There is no therapeutic reason for this: love and support from family help treatment, they do not hinder it.

Any program that tells parents to expect bizarre complaints or reports of abuse and ignore them should be avoided.  A program that goes on about children being manipulative liars is not safe because health complaints will be ignored and this can and has been deadly.

Programs that require 12-step work for teens— admissions of addiction and powerlessness— are not the best; programs which suggest and support them are fine.

Programs that use physical punishment or restraint or isolation should be avoided; you can’t whip someone with heart disease into a cure, nor can you do this with addiction.

Wilderness programs are different from boot camps in that the harsh treatment takes place in the woods or wilds rather than in a more military style but both have had serious abuses and there is no evidence supporting the idea that they are better than safer alternatives.  If a child likes the woods, a voluntary Outward Bound program may be healing, but forcing someone into camping and hiking isn’t addiction treatment.  If a child goes to a wilderness camp for normal teens, he also will be believed when he has a health complaint — but in “troubled teen” programs the complaints are dismissed so callously that it has lead to dozens of deaths.  They’re also either unregulated or not well regulated.

JERRY OTERO: Thank you so much, for your insights, Maia.

Readers, for more information about adolescent and young-adult alcohol and other drug abuse treatment and how to find the most appropriate care for your child and family, download The Partnership at Drugfree.org’s Treatment e-book. This e-book will provide helpful and realistic information and advice to aid you in steering your child — and your family — toward recovery. Here, you will learn what alcohol and drug abuse treatment is, how to find the right type of treatment for your child, how to pay for treatment and the importance of taking care of yourself and your family.

Stay tuned next week for Part III of our Q&A“Changes in the Field, including Medication-Assisted Treatement”

Maia Szalavitz is a health writer at TIME.com and writes about addiction-related issues for The Fix.com . Find her on Twitter at @maiasz. She is co-author of Born for Love: Why Empathy is Essential — and Endangered, (Morrow, 2010), The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007), and Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (John S. Wiley, 2000) and the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

 

 

Posted by Jerry  /  Filed under 12-Step, Addiction, Assessment, Finding Treatment, getting help, Treatment, Uncategorized  /  Comments: more



Kind Love vs. Tough Love – What’s A Parent To Do? A Q&A with Maia Szalavitz, Part I
Tuesday, April 2nd, 2013


Maia Szalavitz is an award-winning journalist who covers the addiction field, health, science and public policy. She is co-author (with leading child trauma expert Bruce D. Perry, MD, PhD) of Born for Love: Why Empathy is Essential — and Endangered, (Morrow, 2010) and the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

I recently had the opportunity to speak with Ms. Szalavitz about her work. Following is the first in a four-part series. Here, Ms. Szalavitz shares her insights into how parents can better deal with their teens’ and young adults’ drug and alcohol abuse problems.

***

JERRY OTERO: In your latest book, Born for Love: Why Empathy Is Essential — and Endangered ,you explore empathy’s startling importance in human evolution and its significance for our children and our society. Why is empathy essential, and how can parents help to instill it in their children? Are there any lessons here to learn for parents who are struggling to make sense of their teenagers and young adult children’s drug abuse issues?

MAIA SZALAVITZ: Empathy is critical for having a happy, healthy life because it affects all of our relationships and our health — physical and mental — to an enormous degree is determined by our ability to form strong bonds with others.  The best way to teach empathy is to behave kindly:  as one expert put it, empathy can’t be taught, but it can be caught.  However, kids need to learn to understand their own feelings well before they can understand those of others:  good ways of helping them learn this are reading to them and asking them explicit questions about their own and other people’s thoughts and feelings in various situations.

Empathy is also important for preventing and treating drug problems.  In terms of prevention, schools with warm atmospheres where kids feel part of a community have less drug use and less bullying, for one.

Also, part of the reason I got interested in the subject was that I saw how unkind so many counselors and treatment programs were to people with addictions.  And there are all kinds of people out there advocating that being cruel is the only way to help.  The data just doesn’t support that — empathetic treatment is the most effective.  And harsh treatment drives people away from seeking help.

JERRY OTERO:  “Kind Love” vs. “Tough Love”, what’s a parent to do about a teenager’s or young adult’s substance use?

MAIA SZALAVITZ: There is no evidence that “tough love” does anything useful.  Of course, you shouldn’t buy drugs for your children or do things that will help them use easily and if they are a danger to you or your other children, you may have to have them live elsewhere — but don’t put a child on the street with the aim of helping him stop using.  It might do that — but it also might make a temporary problem into a permanent one by entrenching the street lifestyle and putting the child at greater risk for overdose, suicide and disease.  If you need to cut a child out of your life, in other words, do it to protect yourself or others, not to help them.  There’s no evidence that it does help and all of the evidence on treatment and intervention shows that kind, supportive, gradual approaches are more effective than abrupt, harsh, confrontational ones.

This goes back to empathy:  if you want to help your child quit, you need to understand why they use and help them find other ways of getting those needs met.  If the child believes you are on their side and will not place them in an awful place they can’t escape and want them to feel good, not control them, you will be much more successful in motivating change.  It’s a lot easier for a kid to say yes to treatment if he knows his parents will back him up if it’s not right for him; a trial of antidepressants is much more easily done if the teen sees this as a way for her to feel better, not a way for her to be made compliant.

Check back next week for Part 2 of our Q&A, “Finding Treatment for Your Teen.”

Maia Szalavitz is a health writer at TIME.com and writes about addiction-related issues for The Fix.com . Find her on Twitter at @maiasz.  In addition to the books mentioned above, Ms. Szalavitz previously co-authored The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007), and Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (John S. Wiley, 2000).

Posted by Jerry  /  Filed under Books about addiction, Dealing with an Addicted Child, Drugs, getting help, parenting, Substance Abuse, tough love, Writing About Addiction  /  Comments: more






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