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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



5 Things You Need to Know About Relapse
Tuesday, March 19th, 2013

People in recovery and their families are often terrified of relapse. Understanding the following 5 points may help.

1. Relapse is common. Although relapses are not inevitable, they are common. Many people have one or more relapses before achieving long-lasting sobriety or abstinence. This does not mean the end of efforts toward abstinence and recovery. The person needs to get back into treatment and the family needs to continue attending a support group, professional counseling, or both.

2. Work together to prevent relapse. People in recovery may have frequent urges to drink or use drugs, and feel guilty about it, even though these urges are a normal part of recovery. It’s important to work together to anticipate high-risk situations (such as a party where alcohol will be served) and plan ways to prevent them.

3. Relapse can happen during good times, too. Sometimes relapse occurs when the person is doing well with their recovery. He or she feels healthy, confident, and/or “cured” and believes that he or she is ready to go back to casual, regular or “controlled” use of drugs or alcohol. The person may remember the honeymoon period of their use (even though it may have been long ago) — where his or her use didn’t cause problems — and may want to return to that place. But this is often impossible since addiction changes the physical makeup of the brain and the person is recovery is no longer able to use drugs or alcohol in a controlled fashion.

4. If relapse occurs. Medical professionals, particularly those who specialize in substance use disorders, are an extremely important asset during a time of relapse. They can help the person learn techniques for containing feelings, focusing on the present, and making use of support from others. Relying on group support from Twelve Step programs, engaging in prayer or meditation, and finding other ways to stay on an even keel can also be extremely helpful.

5. Learn from relapse. Experts have found that a relapse can serve as an important opportunity for the recovering person and other family members to identify what triggered the relapse in the first place — and find ways to avoid it in the future.

Posted by Intervene Staff  /  Filed under Addiction, Alcohol, Drugs, Family Therapy, getting help, parenting, Recovery, Recovery & Relapse, relapse, Substance Abuse, Twelve Step, Uncategorized  /  Comments: more






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