More than two options

Operation Mallorca, US Drug Enforcement Admini...

Operation Mallorca, US Drug Enforcement Administration, 2005 (Photo credit: Wikipedia)

Mark Kleiman is making sense:

“For every complex problem,” H.L. Mencken wrote, “there is an answer that is clear, simple and wrong.”

That is especially true of drug abuse and addiction. Indeed, the problem is so complex that it has produced not just one clear, simple, wrong solution but two: the “drug war” (prohibition plus massive, undifferentiated enforcement) and proposals for wholesale drug legalization.

Fortunately, these two bad ideas are not our only choices. We could instead take advantage of proven new approaches that can make us safer while greatly reducing the number of Americans behind bars for drug offenses.

Our current drug policies do far more harm than they need to do and far less good than they might, largely because they ignore some basic facts. Treating all “drug abusers” as a single group flies in the face of what is known as Pareto’s Law: that for any given activity, 20% of the participants typically account for 80% of the action.

Thank goodness for commentary that avoids straw men and phony binary choices.

2 Comments

Filed under Jason Schwartz, Policy

Mindfulness and recovery

by Ross Hill

The Addiction Recovery blog at PsychCentral has a very good post explaining how mindfulness can help in addiction recovery.

1 Comment

Filed under Jason Schwartz

Viral recovery


Malcolm Gladwell and Seth Godin have popularized the concept of viral change. Bill White has talked about it for years in the context of transmitting hope for recovery. Now, he’s written a very brief paper on the topic.

Here are some quotes from clients that covey how they became “infected” by recovery carriers:

“He used to freak me out by saying things like, ‘Are you tired of living behind that mask?’ or he would call me when I was back using and ask, ‘How’s that high life working for you?’ He messed with my head, but he hung in with me,and I kept going back to him until I got my head together.”

“I could not write off ___(name) as I had so many other would-be helpers. It wasn’t even like he was helping. Others wanted to drop their pearls of wisdom and run. He was comfortable just being with me.”
“I knew if I wanted to stay out there in ‘the life,’ I needed to stay away from her ‘cause she was the ‘real deal.’”
“He kept telling me with this big smile on his face that I was full of shit but that he still loved me. He was telling the truth on both counts. I was and he did.”
“She kept calling to see how I was and to say she had been thinking about me at a time no one was thinking about me–even while she was going through cancer treatment. How does someone do that?”
“Everyone had threatened me or given me advice; he gave his story and gave me hope. He didn’t have any advice, only experience.”
“Every time I tried to praise her for all she had done, she would just smile and tell me she was just another drunk trying to stay sober and do what was right. I started thinking maybe I could be like her someday.”

2 Comments

Filed under Jason Schwartz

Human rights and coerced treatment

 

Superior Court Judge Jason Deal, right, congratulates one of three graduates, who successfully completed Dawson County’s Drug Court.

A recent article looks at the ethics and effectiveness of coerced treatment:

It has been argued that quasi-compulsory treatment (QCT) may be considered ethical (under some specific conditions) for drug dependent offenders who have committed criminal offences for whom the usual penal sanction would be more restrictive of liberty than the forms of treatment that they are offered as a constrained, quasi-compulsory choice. It has briefly reviewed research that suggests that QCT may be as effective as treatment that is entered into voluntarily. This may help individuals to reduce their drug use and offending and to improve their health, but it is unlikely to have large effects on population levels of drug use and crime.

Leave a Comment

Filed under Controversies, Jason Schwartz, Policy, Treatment

Smoking cessation in treatment

Looks like we still have a lot to learn about helping alcoholics and drug addicts quit smoking, but intensive smoking cessation interventions do not appear to do harm:

The intensive smoking cessation intervention yielded a higher short-term smoking quit rate without jeopardizing sobriety.

Leave a Comment

Filed under Jason Schwartz, Research, Treatment

Group treatment has long term benefits

A photo of a group conducting psychotherapy.

A photo of a group conducting psychotherapy. (Photo credit: Wikipedia)

From the journal, Alcoholism: Clinical and Experimental Research:

Background:  Group psychotherapy (PT) is one of the most common interventions used to treat alcohol dependence (AD), and it is assumed to be effective. Despite its common clinical use, long-term trials that have been conducted to examine the efficacy of group PT in the treatment of outpatients with AD are limited and often lack appropriate comparisons. On that basis, a long-term comparative trial was performed with the main objective of evaluating the effectiveness of continuing group PT for outpatients with AD.

Methods:  Quasi-experimental trial was conducted from January 2004 to May 2010 in 177 AD subjects who had completed an inpatient 10-week alcohol treatment program. Abstinence rates of the combined group (experimental group: outpatient individual PT plus group PT,N = 94) and the standard outpatient individual PT-only group (comparison group, N = 83) were statistically compared using Kaplan–Meier survival analysis. Predictive factors of abstinence rate for alcohol were assessed using Cox regression analysis.

Results:  Abstinence rates of the combined PT group were significantly high relative to those of the outpatient individual PT-only group. Significant predictive factors for the alcohol abstinence rate were outpatient group PT and age. Even after controlling for confounding factors, outpatient group PT was a significant predictive factor for the alcohol abstinence rate.

Conclusions:  Our findings indicate that for AD patients who had completed an inpatient 10-week alcohol treatment, outpatient group PT appears to be an effective form of continuing care or aftercare within the context of an outpatient service delivery system.

Leave a Comment

Filed under Jason Schwartz, Research, Treatment

Youth Recovery Contexts

hands by katerha

Another study brings good news about adolescents and 12 step recovery:

Results

The proportion attending 12-step meetings was relatively low across follow-up (24 to 29%), but more frequent attendance was independently associated with greater abstinence in concurrent and, to a lesser extent, lagged models. An 8-item composite measure of 12-step involvement did not enhance outcomes over and above attendance, but separate components did; specifically, greater contact with a 12-step sponsor outside of meetings and more verbal participation during meetings.

Conclusions

The benefits of 12-step participation observed among adult samples extend to adolescent outpatients. Community 12-step fellowships appear to provide a useful sobriety-supportive social context for youths seeking recovery, but evidence-based youth-specific 12-step facilitation strategies are needed to enhance outpatient attendance rates.

Leave a Comment

Filed under Jason Schwartz, Mutual Aid, Research, Treatment