A Different Path to Fighting Addiction

A Different Path to Fighting Addiction- New York Times – Gabrielle Glaser

I just saw this great piece that takes a realistic view of treating binge drinking in young people by using evidence based methods rather than the old 12 step solutions. Here is a link http://www.nytimes.com/2014/07/06/nyregion/a-different-path-to-fighting-addiction.html?_r=0

The piece is by Gabrielle Glaser who wrote the excellent book “Best Kept Secret” which I found to be a real eye opener on how drinking problems have affected a greater number of people, especially women in the last century. Binge drinking is something that often happens with young people and sometimes they need some help before things get out of hand. I do not think the 12 step environment is a great place for many who are young and vulnerable. The 12 step idea of powerlessness can be quite dangerous when taught to a young person who is likely to not abstain and so a harm reduction method can give more practical help. AA was designed for low bottom male drunks in the 1930’s and not today’€™s teenager.

Here is a section from the article.

When their son had to take a medical leave from college, Jack and Wendy knew they — and he — needed help with his binge drinking. Their son’s psychiatrist, along with a few friends, suggested Alcoholics Anonymous. He had a disease, and in order to stay alive, he’d have to attend A.A. meetings and abstain from alcohol for the rest of his life, they said.

But the couple, a Manhattan reporter and editor who asked to be identified only by their first names to protect their son’s privacy, resisted that approach. Instead, they turned to a group of psychologists who specialize in treating substance use and other compulsive behaviors at the Center for Motivation and Change.

The center, known as the C.M.C., operates out of two floors of a 19th-century building on 30th Street and Fifth Avenue. It is part of a growing wing of addiction treatment that rejects the A.A. model of strict abstinence as the sole form of recovery for alcohol and drug users.

Instead, it uses a suite of techniques that provide a hands-on, practical approach to solving emotional and behavioral problems, rather than having abusers forever swear off the substance — a particularly difficult step for young people to take.

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The center’s pamphlet advises parents on helping children in recovery. CreditKirsten Luce for The New York Times

And unlike programs like Al-Anon, A.A.’s offshoot for family members, the C.M.C.’s approach does not advocate interventions or disengaging from someone who is drinking or using drugs. “The traditional language often sets parents up to feel they have to make extreme choices: Either force them into rehab or detach until they hit rock bottom,” said Carrie Wilkens, a psychologist who helped found the C.M.C. 10 years ago. “Science tells us those formulas don’t work very well.”

When parents issue edicts, demanding an immediate end to all substance use, it often lodges the family in a harmful cycle, said Nicole Kosanke, a psychologist at the C.M.C. Tough love might look like an appropriate response, she said, but it often backfires by further damaging the frayed connections to the people to whom the child is closest.

The center’s approach includes motivational interviewing, a goal-oriented form of counseling; cognitive behavioral therapy, a short-term form of psychotherapy; and harm reduction, which seeks to limit the negative consequences of substance abuse. The psychologists also support the use of anti-craving medications like naltrexone, which block the brain’s ability to release endorphins and the high of using the substance.

A 2002 study conducted by researchers at the University of New Mexico and published in the journal Addiction showed that motivational interviewing, cognitive behavioral therapy and naltrexone, which are often used together, are far more effective in stopping or reducing drug and alcohol use than the faith-and-abstinence-based model of A.A. and other “TSF” — for 12-step facilitation — programs. Results of an updated study have not yet been released.

Researchers elsewhere have come up with similar findings. In 2006, the Cochrane Library, a health care research group,reviewed four decades of global alcohol treatment studies and concluded, “No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems.” Despite that research, A.A.’s 12-step model is by far the dominant approach to addiction in America.

Jack and Wendy’s son, who is in his early 20s, began drinking to alleviate crippling anxiety and ease persistent depression. His drinking, while worrisome, was not an entrenched pattern, his parents believed. Some of Jack’s friends suggested that if their son did not attend A.A. of his own volition, the only thing Jack and Wendy could do was attend Al-Anon.

“The implication was that there was no other solution,” Jack said. “There was a great deal of sadness on their part, empathetic sadness, which in some ways was frightening in itself.”

Read the rest here http://www.nytimes.com/2014/07/06/nyregion/a-different-path-to-fighting-addiction.html?_r=0

 

 

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