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A blog for parents concerned about their teens alcohol and drug use




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






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