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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



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



Be Cautious of Boot Camps and Wilderness Programs for Your Addicted Teen
Monday, January 28th, 2013

Earlier this month a few of us attended a Lunch ‘n’ Learn event at CASAColumbia with Maia Szalavitz, a neuroscience journalist who covers health, science and public policy. She discussed the theme of her book, Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006), an exposé of the “tough love” business.

The talk prompted us to revisit and share what we at The Partnership at Drugfree.org know about boot camps and wilderness programs for troubled and/or addicted teens.

First, it is important to note that boot camps and wilderness programs are not included among the levels of care defined by the American Society of Addiction Medicine. Although you may have heard success stories or read about the benefits of boot camps, we strongly suggest you look very carefully into any boot camp or wilderness program before sending your teen for substance abuse treatment.

According to a government report, these programs are not subjected to federal oversight, and there have been thousands of reports of neglect and abuse at privately owned and operated boot camps and wilderness programs for troubled youth.

Ms. Szalavitz explained that a person with the disease of addiction is already in a lot of pain. To get better, that person doesn’t need more pain and abuse, but rather a kind and supportive approach to treatment. One that’s comprehensive, respectfully addressing the individual’s physical, emotional and social issues. One that makes the person feel better.

We suggest that if you are seriously considering a boot camp or wilderness program, you check with the Better Business Bureau for any complaints against the program. You should also call the program and ask a lot of questions, including:

1) What specific substance abuse and mental health licensing and accreditation does the program have? (If the providers are not licensed, do NOT send your child to the program.)
2) Has a child in the care of the program ever died, and if so, why?
3) What specific training (particularly survival skills training for outdoor programs) do the counselors have?
4) Have there have been any complaints of abuse or neglect at the camp?
5) Can you put me in touch with a few families that have a child who have completed the program so that I can hear about their experience?
6) Who is responsible for medical care? (It should be a licensed medical doctor.)

Remember, addiction is a serious health issue and requires appropriate treatment by licensed professionals so that addicted persons can learn how to manage drug and alcohol problems, how to handle relapse and how to live a life free of drugs and alcohol.

For more questions to ask programs when looking for treatment for your child, here are some helpful resources:

To find the best assistance option for your child with an alcohol or drug problem, see our Treatment e-book.

To connect with other parents about your child’s drug and alcohol problem, join our online support community at TimeToGetHelp.drugfree.org.

To speak to a trained specialist, call our toll-free helpline at 1-855-DRUGFREE (1-855-378-4373).

Have you sent or considered sending your child to a boot camp or wilderness program? Comment below to share your thoughts or experiences.

Posted by Intervene Staff  /  Filed under Addiction, Books about addiction, Dealing with an Addicted Child, Finding Treatment, parenting, Scare tactics, tough love, Treatment, Uncategorized  /  Comments: more



The Mindful Addict: Tom Catton’s Spiritual Road to Long-Term Drug Recovery
Friday, March 9th, 2012

The Partnership is excited to introduce our new blogger, Tom Catton. Tom has been in long-term recovery since October 20, 1971 is the author of The Mindful Addict: A Memoir of the Awakening of a Spirit, which highlights Tom’s relationship with meditation in combating his addictions. Tom is on the advisory board at the Buddhist Recovery Network and is trained in Mindfulness Based Stress Reduction.

The following excerpt from my book “The Mindful Addict” gives a hint of the adventures that occurred during forty years of placing recovery above all else and learning to follow my heart through the practice of meditation each morning. If “The Mindful Addict” were summed up in a few words, I would say it is a miraculous adventure story about what can occur when meditation is coupled with service to others.

I used alcohol and drugs from 1959 until October 20,1971. I always say that I’m a blessed addict because I did all my using in the 60’s.

Growing up in Southern California and traveling to Hawaii as a teenager in 1962 to further my surfing endeavors seemed like that natural movement of the times. I lived the lifestyle that invited the use of drugs and alcohol. We were summoned by Tim Leary to turn on, tune in and drop out.

I went from drinking alcohol to sniffing glue, experimenting with LSD and other mind expanding drugs. Soon I was using needles to inject any substance for a quicker response. If a drug could be dissolved in a spoon, I used it.  

I went to my first 12- Step recovery programs meeting on the North Shore of Oahu in 1968.   I proceeded to bounce in and out of recovery for three years until I was sick of being “sick and tired.” The gift of recovery often waits for this opportune time to enter our lives when we see our own best thinking brought us to a veritable skid row in our mind, body and soul.

Excerpt from The Mindful Addict:
3:45 a.m., February 10, 1968, Kaneohe, Hawaii. A tall, thin woman looking much older than her fifty-two years sits up in bed meditating. A cup of coffee rests on her nightstand, and a cigarette glows in the dark. She listens, in silence, to the small voice within, her shadow standing guard as she sits in the stillness, becoming one with the calm. Flobird meditates for several hours every morning, a habit she picked up in 1960 while getting into recovery in twelve-step programs.

She lives each day by the spiritual guidance she receives during meditation and diligently records the messages in her journal. Writing becomes automatic, a prayer in ink, and the spirit guiding her pen to identify her next assignment. At times her dialogue with God is intense, and at times she questions the assignment; but, she always steps into the unknown and does exactly as spirit guides her.

On this particular early morning, Flobird’s meditation leads her to the North Shore of Oahu, about 40 miles from Kaneohe. She hops into “Redbird,” her Fiat, and drives to the Sunset Beach area, just as she has been directed in meditation. Here, she finds a four-bedroom, completely furnished; wood-framed home nestled under the trees right on the oceanfront. Guided by an inner direction, she reaches above the doorjamb, locates the key, unlocks the door, and enters. Coincidentally, I lived next door to this house.

During the winter months, the waves on the North Shore are huge. This is the only time they break with gigantic force and must be at least twenty feet high before they are considered surfable by the locals. The energy from just one such a large wave, as it comes crashing down, is breathtaking, and the salt spray can be seen in the air for miles.

At night, the roaring waves sound like thunder, or an enormous gong echoing across the oceans from some unknown temple. Often they become so enormous they wash over the highway. Sometimes these monster waves can even level houses in their wake.
The North Shore community is relatively small, and everyone knows one another. Back in the 1960s, Haleiwa, the main village, had only two grocery stores and a bank. Today, it is a bustling town sought out by tourists from all over the world to watch or surf the killer waves.

This time and place was magical for those of us fortunate enough to live there. The community was dominated by surfers from around the world who competed in riding the giant waves at the world’s most famous surf spots dotting this five-mile stretch of coastline. There were also many so-called hippies searching for enlightenment through the use of drugs, including LSD and hashish, which were believed to lead to spiritual illumination. Some of these drug-using hippies were in both categories: they surfed, took a lot of drugs, but were ultimately looking for something greater. That was me.

In the early morning hours of this day, I was startled awake by the sound of a car on our street. With a new clarity entirely unfamiliar to me in the breaking dawn, I gazed out the window and saw a tiny red Fiat pull up to the vacant house next door. I watched curiously as a strange woman got out and walked calmly up to the house as if she indisputably belonged, as if placed there by mystical entitlement. I had no idea that this event would change my life forever.

Posted by Tom Catton  /  Filed under Acceptance, Addiction, Alcohol, Books about addiction, getting help, Recovery, Self-reflection, Substance Abuse, Uncategorized, Writing About Addiction  /  Comments: more



6 Noteworthy Memoirs About Parenting a Child with an Addiction
Monday, May 2nd, 2011

Certain parenting memoirs help us feel less alone and provide hope that our child’s drug use problem can get better.  If you’re a parent of a child struggling with drugs or alcohol, here are 6 noteworthy books that offer information and advice, and might even give you comfort and strength during this difficult time.

Teens sharing pillsStay Close: A Mother’s Story of Her Son’s Addiction (2010)
By Libby Cataldi
Stay Close is one mother’s tough, honest, and intimate tale that chronicles her son’s severe drug addiction, as it corroded all relationships from the inside out. It is a story of deep trauma and deep despair, but also of deep hope-and healing.
this riverThis River (2010)
By James Brown
Award-winning author James Brown gained a cult following after chronicling his turbulent childhood and spiraling drug addiction in The Los Angeles Diaries. This River picks up where Brown left off in his first memoir, describing his tenuous relationship with sobriety, telling of agonizing relapses, and tracking his attempts to become a better father.

we all fall downWe All Fall Down (2010)
By Nic Sheff
In his bestselling memoir Tweak, Nic Sheff took readers on an emotionally gripping roller-coaster ride through his days as a crystal meth and heroin addict. Now in this powerful follow-up about his continued efforts to stay clean, Nic writes candidly about eye-opening stays at rehab centers, devastating relapses, and hard-won realizations about what it means to be a young person living with addiction.

Teens sharing pillsMy Daughter’s Addiction: A Thief in the Family – Hardwired for Heroin (2009)
By Marie Minnich
A captivating story of one mother’s journey raising her heroin-addicted daughter. The autobiographical story also chronicles the murder of the author’s mother in 1968; the Youth Culture of the 60s, the author’s experience as a battered wife and the devastating effects on her adult daughter who is a drug addict.

beautiful-boyBeautiful Boy: A Father’s Journey Through His Son’s Addiction (2009)
By David Sheff
With haunting candor, David Sheff traces his oldest son’s Methamphetamine addiction from the first subtle warning signs, the denial, the attempts at rehab and at last, the way past addiction. He shows his readers that whatever an addicts fate, the rest of the family must care for one another too, lest they become addicted to the addiction.  He shows his readers that whatever an addicts fate, the rest of the family must care for one another too, lest they become addicted to the addiction.

Read the rest of this entry »

Posted by Community Manager Olivia  /  Filed under Alcohol, Books about addiction, Co-Occurring Disorders, Dealing with an Addicted Child, Substance Abuse, Taking Care of Yourself  /  Comments: more






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