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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



Addiction Is a Disease
Tuesday, March 1st, 2011

You may think: I drink alcohol and I know my limits.  Alcoholics just don’t know how to control themselves.  It’s their choice that they don’t want to stop drinking.  Just as easily, you probably infer the same thought process for other drugs out there… heroin, cocaine, methamphetamine, etc. Drug use is a choice.

Yes, drug use is a choice.  It’s free-will to pick up that joint, light it and smoke it.  But what’s going on behind the scenes (i.e. in your brain) isn’t a choice.  Unless you can control your brain structure. In that case, who are you and where are you from?

Since I began working at The Partnership at Drugfree.org, I’ve often asked myself: Why is there such resistance to acknowledge addiction as a disease. The media is so quick to call the person with an addiction irresponsible, reckless, selfish and troubled.  And the majority of online commenters fuel the fire by honing in on the behaviors of the disease, rather than acknowledging the disease itself. It makes me wonder two things: Are people really that cruel? Do people understand what addiction really is?

Maybe, maybe not.   My inclination is sensationalized news sells more magazines and drives traffic.  That’s why news sources play up what’s going on with the Charlie Sheens and Lindsay Lohans of the world, but why do so many of you?  It’s easy to blame someone for the choices they make in life, but when it comes to drug addiction, there is little choice involved.  Although everyone has the potential for addiction, some people are more predisposed to addiction than others.

When a person is addicted they’re suffering continuously; their brain chemistry changes causing distortions of cognitive and emotional functioning; and, even in the face of death, they continue to harm themselves. Family and friends of addicts claim erratic changes in mood, behavior and perception.  Many say their addicted loved one becomes an entirely different person.

Just like schizophrenics can’t control their hallucinations… Parkinson’s patients can’t control their trembling… clinically depressed patients can’t control their moods… once a person is addicted to drugs it’s not that different than other brain diseases.  No matter how someone has developed an illness, once the person has it, they’re in a diseased state and need treatment. 

Moreover, like any other illness, it affects family and friends, too.  There are moms who stay up all night waiting for their child to come home.  There are dads who fear that dreaded phone call telling them that their child has overdosed.  There are siblings who try to remain strong as their family is slowly falling apart. There are friends who feel like their hands are tied, but are clinging to that small ounce of hope that the friend they once knew will accept help. 

Ask the parents, family and friends of the addict if drug addiction is a choice.  Go ahead and ask the addict himself as well.  They will tell you from their experiences that addiction is not a choice.

Knowledge is power. (Sorry for the cliché).  When we bash something that we don’t really understand, and we do it in the numbers, it sways public opinion – intended or not.  With this mindset, the stigma that is attached with the disease of addiction will never go away unless we all change how we view it.

Posted by Community Manager Olivia  /  Filed under Addiction, Cocaine, Heroin  /  Comments: more



Been There, Done That: How Personal Stories Can Help Fight Teen Pressure to Use Drugs
Tuesday, November 23rd, 2010

Over the last year I have been making an effort to speak with parent and student groups about the effects of addiction on a person and all of those associated with a person who is suffering from addiction.

While my son was actively using drugs, my activity concerning this subject irritated him. It made him uncomfortable and angry.  For some reason he did not want me speaking to groups. Maybe it made him feel embarrassed or ashamed.

For nearly six months my son has been working on his recovery and is not using. For me this is quite an accomplishment to see a heroin addict make such a huge turnaround in his life. It’s hard to believe that only six months ago he was speedballing and his mother and I were discussing the fatal outcome of those engaged in this activity. Hope springs eternal.

Recently I was asked to speak to students at our local high school about the effects of drugs on young people. When I told my son I was going to speak he asked if he could go with me and speak to them first-hand about what drugs have done to him. This is a HUGE step for anyone in recovery. Facing their addiction head on and in front of a group takes courage.

We spoke to about 50 students that were in the age group of 14-15 years old.  My son is only 22. When he began to talk and answer questions about drugs and his addiction those students were riveted by him. You could almost feel an electric connection between him and those students. His message was direct and in a language they understood. He showed them scars on his arms caused by infections from dirty needles. He talked about what it is like in jail, going through detox in a cell. He spoke of all his lost opportunities with college, jobs and relationships. Maybe his most powerful statement in response to a question about why he started using was, “I started because I wanted to be cool, this is not cool, this is the worst thing you could ever do in your life. Using leads to becoming addicted and I can’t even describe how horrible that is.”

This format of an experienced young adult speaking to a group of teens is the most powerful weapon I have seen in waking up young people to the risks of drugs and alcohol. Let’s face it, I’m just another old guy telling these kids not to use drugs, but when someone in their age group stands there and tells a personal story with all the graphic details — that is called bringing out the heavy artillery.

By sharing his personal story he helped the kids connect the hazards of drug usage.  Being close to their age and someone who has “been there done that” I believe deeply resonated with them, inspiring them to  think differently about the consequences of the choices they make.

Education about the dangers of drug and alcohol use is all about being relatable. No matter if it is parents, relatives, friends, professionals or peers, the key to helping your child fight the pressure to use drugs is education. Give them a way out of those pressure situations. Do not be naive and believe that your child will not be exposed to the opportunity to use drugs. Every single young person out there has to make a decision about whether or not to try using drugs or drinking. Parents, take the offensive; do not wait until the monster has entered your home. Slaying this monster is about educating its prey, before he has a chance to attack.

By the way, I want every person that reads this to know; I cannot remember a time when I was more proud of my son. I stood up at the end of the presentation in front of all of those kids and told them with my voice cracking how proud I was of him to come speak with me.

Editor’s Note: Like any relationship, your relationship with your child changes over time.  For ways to talk to your child about drugs at every age, please visit our Parent Tool Kit.

Posted by Ron Grover  /  Filed under Addiction, Dealing with an Addicted Child, Heroin, Recovery, Taking Care of Yourself  /  Comments: more



The Scarlet Letter Revisited
Wednesday, September 8th, 2010

As a teenager I read  Nathaniel Hawthorne’s novel, The Scarlet Letter. For those of that haven’t read it, the book chronicles the trials and tribulations of Hester Pyrnne, a young woman living in a New England Puritan community during the 18th century.  Hawthorne describes a scene where Hester, who has been accused of adultery, is led from the prison carrying her infant daughter borne of her affair.  A scarlet rag, shaped in the letter “A”, is noticeable against the breast of her gown.  It is the symbol of her sin of adultery — her badge of shame.

This story came flooding back into my mind when my husband, Ed, and I were at a neighborhood barbeque. At the time, our son Alex was in an inpatient rehab program.  One of our neighbors, I’ll call him Joe, cornered me to ask how Alex was doing.  I didn’t know Joe well, but my general impression was that he was a gossiper.  I had heard from another neighbor that Joe was looking for juicy details about Alex’s drug use and his incident with the police.

Read the rest of this entry »

Posted by Pat Aussem  /  Filed under Addiction, Heroin, Substance Abuse, Taking Care of Yourself  /  Comments: more



Courage, Change and Acceptance
Tuesday, August 17th, 2010

We’ve heard that necessity is the mother of invention and that change emerges when you can’t keep doing something the same way.  Mental balance is sometimes that necessity.  Positive change and acceptance are more than just talking and coping.  It’s not necessarily as complicated as it sounds.  Change in context to acceptance is powerful and it takes courage to break through the destructive patterns that are in the way.  Change is born of courage.  Acceptance is what we give something we know we are powerless with.  Wisdom is knowing that difference.  In a nut shell, that’s the serenity prayer.  It has served those impacted by the actions of an addict as much as it has any addict.

In a 2007 film about addiction, Things We Lost in The Fire, Benicio Del Toro plays a heroin addict so convincingly you might think you’re right there feeling acceptance and compassion for his struggle.  It works both ways.  The film shows an innocent side to addiction as a disease and the miracle of compassion that is attracted when courage and acceptance meet.  After years of shooting heroin, Jerry (Del Toro) endures a brutal detox in the home of his best friend’s widow, Audrey (Halle Berry). 

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Posted by Bill Ford  /  Filed under Addiction, Heroin, Recovery & Relapse, Taking Care of Yourself  /  Comments: more






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