Rewiring the brain against addiction is an idea that holds the key to the answer. Having known suffering drug addicts, its safe to say that “just quitting” is not an answer. The Depression that goes along with addiction, often predicating the need for drugs to begin with is a key area of study. Dual Demons! as it called, continually feeds into the reality of repeated relapse. Addiction is a disease that requires the equivalent focus in dollars and effort of the drug war itself. Once we get big Insurance and big Pharma to play the game of real recovery we can start poking holes in the sails of drug trade. De-criminalizing addiction would cripple illegal drug trade. Imagine a world of compassion, recovery and freedom from addiction. Links by M. Slivinski.
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November 5, 2009 at 6:05 pm
Barbara
Thanks for continuing to post great info that needs to be seen and heard!!!
November 5, 2009 at 8:22 pm
dadonfire
My pleasure. Keeping the fire burning under good information, stories, and resources just keeps the fire burning for more recovery, education and prevention of addiction. So much great stuff out there. The tide is turning.
November 13, 2009 at 5:11 pm
Joe
Maybe they don’t quit because it’s hard to quit and people don’t like to do things that are hard or challenging. And why bother anyway as long as someone else will come along behind and clean up the mess. Can they quit is a better question and the answer is yes. Sure they need help and no one does it alone but that help will start to come out of the woodwork once they reach out for it, once they swallow their pride. The role of the concerned person or family member is to help them want to, not to look at them as victims. How about imagining a little tough love.
November 13, 2009 at 10:19 pm
dadonfire
I am with you on the tough love. If it were not for tough love, some addicts wouldn’t get any love at all. So…what do you do with the constant stream of 8 million or drug addicts that seem to stay “hooked” and that are dragging themselves down and everything they touch – lock them up in forced rehab…what do you think of the impact of dual diagnosis, the impact of hard drugs on brain chemistry, the costs to our communities, etc… looking for solutions, answers, ideas, stuff to post.
November 14, 2009 at 2:48 pm
Joe
I think we have made this much more complicated than it needs to be. Treatment is a great place to begin the journey. Once the person leaves they must follow-up with a support group that meets every day. I do not know of any group that even comes close to the AA 12 Step model. I don’t care if they WANT TO GO or not. The sick person is not in a position to create his or her own treatment program. If my son or daughter were in trouble this is what I would tell them to do. If they don’t like it at first that’s too bad. Imagine a diabetic telling his doctor he just doesn’t want to take insulin. I’ve been in the field for over thirty years and all I’m suggesting is what I have personally seen work the vast majority of the time. Like over 90%.
Co-occurring disorders will often take care of themselves after the person stops poisoning his/her brain. It will take at least a few weeks or maybe many months. Too many people want things fixed NOW so they listen to some “psych” tell them about a special drug and start to play a chemistry game with the brain. In some cases these meds do make a big difference but they are way over prescribed. Nothing will ever take the place of talk therapy, nothing. So let’s try a big dose of that first. I have heard more than a few psychiatrists say that many of these drugs often only make things worse. This should be a last resort.
So how do we stop the ever growing number of people from coming into addiction? In my humble opinion you need to start when they are young, as in small children. Kids spell love T-I-M-E. The more time we invest in our children early in life as a mom or dad will make a huge difference. This is by no means a guarantee but it is something we have been lacking in our culture for quite awhile. Single parent homes and absentee parents who pop in on their weekends for some “quality time” ain’t working. One of the best books I have ever read on this issue is Parenting with Love and Logic by Foster Kline. Also, Before it’s too late, by Stanton Samnow.
So what about the 20 something or 30 something or 40 something who is already in big trouble (or the adolescent for that matter) what do we do for them? Empathy and a mixture of tough love is what seems to be most effective.
Concerned loved ones and family members need to not only read about what works best but then also start doing what’s best. No more enabling the insanity to continue.
Regards, Joe
February 21, 2011 at 11:03 am
Nerano
@Joe, Nov.14 2009, 2.48pm
”I think we have made this much more complicated than it needs to be. Treatment is a great place to begin the journey. Once the person leaves they must follow-up with a support group that meets every day. I do not know of any group that even comes close to the AA 12 Step model. I don’t care if they WANT TO GO or not. The sick person is not in a position to create his or her own treatment program. If my son or daughter were in trouble this is what I would tell them to do.”
The last thing I would do to a loved one of mine who was in trouble would be to point them in the direction of a 12-step group whose whole philosophy is that recovery is equvalent to heaven and such a state is only attainable through the practice of the 12-steps. Not only that but the 12-step philosophy teaches that failure to practice the spiritual principles of the steps will result in either jails, institutions or death.
February 26, 2011 at 10:36 am
Doug
…If a chemically-dependent person continues to drink they are likely to end up in jail, institutions or death.
Alcoholics Anonymous is one path to stop drinking.
November 14, 2009 at 5:11 pm
Polly G
No more enabling the insanity to continue -sums it up. That plus tough love – mean what you say and say what you mean. No more appeasement. Change is imperative. The brain is addled – thanks to the Toxic impact of substance abuse. Heartbreak won’t change or fix.
January 30, 2011 at 2:46 pm
susan lea
Joe makes some good points but I wanted to comment on a couple:
“you need to start when they are young, as in small children”
This made me think about the DARE program that was in the local elementary schools. They taught the children that drugs were bad. But, once the kids hit 12 or 13, the schools figured they had covered the subject. But there were classmates in my daughter’s middle school that wore DARE T-shirts while they smoked marijuana at lunch break. They thought it was a big joke. Honest discussions and education all through school, K-12, are really needed.
And there is also the comment that Joe makes regarding absentee parents and reading excellent books on the subject:
Absentee parents aren’t interested in reading books on parenting. It’s the concerned parents who read these books. And if single parents are doing their best to provide for, love, educate and discipline their children by themselves, they have a difficult job ahead. Communities really need to provide support to these parents. Too many parents are blamed for their children using drugs. Then when they go to an Alanon meeting they are told it wasn’t their fault.
We need to get the story straight. I’ve seen bad parents with great kids who never use drugs. And I’ve seen great parents with kids who start using drugs at 13.
Tough love is usually a good thing. Love and support are essential. But I would like to see the blame game stopped. I’ve never seen a bad parent blamed for having a kid that stays clean and studies hard and goes to college.
January 30, 2011 at 3:13 pm
Joe
Thanks for the comment Susan. Yes this is a very perplexing problem. And playing the blame game gets us nowhere.
I think the family members could benefit from just deciding ‘what’s best concerning the addiction problem?’ Stay focused on doing the next best thing to help the person by allowing the consequences. Consequences are meant to bring pain. Pain is meant to take the “fun” out of continued substance abuse. Addicts, like myself, seem to learn things through pain that we can’t or won’t learn in any other way. Easier said than done? Yes. Very effective? Yes.
Joe
February 21, 2011 at 2:53 am
kevincody
the statistics for AA/NA are NO WHERE NEAR 10%…facts are facts.
And thanks to all the post for the doctors here who present the idea depression shouldn’t be treated (as in co-occuring) IN CONJUNCTION with the ADDICTION, that shouldn’t kill anyone-tough love in deed.
And while your at it tell us all to pray and work the fourth step over and over and over…please.
AA didn’t really work for its two founders so, bill was a monster and so was bob ?
I am glad the realigious AA/NA support group works for some…like maybe 5% of people (a couple hundred thousand-the rest of the “millions” is churn in my opinion) but it obviously has failed considering the addcition problem is now epidemic and the big book thumpers have had 75 years.
My opinion, this article points that out but not very well. Hoepfully we’ll find non-cookie “programs” which address each individual in a scientific-proven methodolgies and not leave medical advice up to brainwashed legions of laypeople who may OR MAY NOT BE sober at all.
February 21, 2011 at 3:21 am
Fred
What I’ve noticed with the addicts I’ve interacted with is that they manipulated any solution they are faced with actually doing to recover. They will pick apart what the therapist said and be critical of a line or two taken out of context. Or ridicule some facet of SMART recovery as being beneath them, poking holes in it to be able to reject the whole program.
It’s a common addict trait to avoid doing something to change, and an error for any family member to start to buy into their rationalizations.
They are most comfortable staying with addictive behavior, and will spend amazing energies fighting any solutions that require them to take actions to become better people.
February 21, 2011 at 8:06 am
james
Well, Joe, I disagree on the 12 steps. Insulin doesn’t tell you you are worthless and only God can cure your diabetes, or at least keep it in check. The spiritual aspect of the 12 steps is simply wrong. If there is a God, he/she doesn’t care about one’s addiction. He gave us a brain to figure things out and make choices and learn from those choices. Addiction is as much behavior as disease. The advances in cognitive behavioral therapy are such that 12 step programs are just dinosaur remnants of the past. We no longer employee rotating tourniquets to rid the body of bad humors, but telling someone that aa is the only way to live with an addiction is tantamount to exactly this. Archaic, rigid, concrete thinking that is based on NO science and NO truth, simply the ravings of a human being withdrawing from ethanol while also under the influence of benzodiazepines and belladona alkaloids. People need to take control of their own situation. When one decides to get abstinent, they will do so. If it is in the setting of aa, they will attribute sobriety to aa. That’s fine, but it can be done in any setting or no setting, but hardline, tough love approach is not the only way. We don’t do one size fits all for ANY other process, behavior or disease in the world. Face it, aa doesn’t have the magic cure anymore than you or I do. We must find our own way and decide on a sober life.
February 26, 2011 at 12:56 pm
Joe
What I’ve noticed lately is that things like clarity and facts makes some people angry. 12 Step recovery has proven to be the best and most successful group ever formed for this problem. Why would dozens of other addiction groups copy it if it didn’t work as well as it does. 31 million copies of the Big Book in print, available in 62 different languages, 4 more translations in the works right now, millions of members, over a 100 thousand meetings world wide!!??
What I have seen in the last thirty three years of experience is that there are two groups that do not like 12 Steps. One is the atheists and the other is those who don’t really want to quit.
But who am I anyway? Just some credentialed addiction professional who has counseled a few thousand individuals and their family members in the past three decades. Some ‘win-gut’ with a few decades of personal recovery from a horrible drug addiction problem.
Yup, clarity and facts make a lot of people upset 😦
February 26, 2011 at 9:30 pm
raysny
Joe writes:
“12 Step recovery has proven to be the best and most successful group ever formed for this problem.”
Joe, you might believe that, but whenever AA is examined, it is found lacking.
AA has about a 5% success rate, the same as quitting without any treatment at all, but that’s not taking into account the higher mortality rate of AA.
George Vaillant, former Harvard professor and AA Trustee set out to prove that AA worked and ran the largest study of the day. He said of his findings, “Not only had we failed to alter the natural history of alcoholism, but our death rate of three percent a year was appalling.”
Not improving on the rate of natural recovery shows that AA, at best, is a placebo, and not a very good one at that.
Thirty years of using the same ineffective, often abusive treatment methods haven’t seemed to teach you anything. Everyone who doesn’t like AA must be an atheist or doesn’t want sobriety? Maybe that helps you sleep better at night.
How many have you seen ‘go back out’? New treatment methods, with better results, have come about in response to AA’s failure. If you don’t know what they are, you’re not doing your job, you’re selling 12step.
February 27, 2011 at 8:25 am
madyson007
I want to imagine that world more than anything in my life.
Joe, I do not believe ANY treatment plan including AA/NA is a one size fits all kind of thing. You say if I had a child with a “problem” that is what I would do. Well I don’t care if you are the new Einstein that graduated from Harvard with a doctorate in behavioral Science/counseling/brain science…you can not have the same perspective of a parent or an addict. The reality and complications are not so black and white. I also would like to see the statistics of where it says 12 Steps is the best and most successful group ever formed for this problem. NA/AA is a fabulous program for those who embrace the philosophy but for those who can not there are alternatives. If NA/AA was as successful as you are telling me…all addicts who wanted to stay clean would join and then be cured and that is just not the case. There is no clarity in addiction it is a fuzzy grey world with a million different circumstances and issues.
February 27, 2011 at 9:29 am
Joe
Dear madyson007,
Please share with me the second best way to maintain long-term sobriety. I really wanna know.
Thanks, Joe
February 27, 2011 at 12:30 pm
raysny
The “Handbook of alcoholism treatment approaches: Effective alternatives” compared 48 alcohol treatment methods, here they are, ranked by effectiveness:
1) Brief interventions
2) Motivational enhancement
3) GABA agonist (Acamprosate)
4) Community Reinforcement
5) Self-change manual
6) Opiate antagonist (Naltrexone)
7) Behavioral self-control training
8] Behavior contracting
9) Social skills training
10) Marital therapy-Behavioral
11) Aversion therapy-Nausea
12) Case managment
13) Cognitive Therapy
14) Aversion Therapy, Covert Sensitization
15) Aversion Therapy. Apneic
16) Family Therapy
17) Acupuncture
18) Client-centered Counsling
19) Aversion therapy, Electrical
20) Exercise
21) Stress Management
22) Antidipsotropic- Disulfiram
23) Antidepressant-SSRI
24) Problem Solving
25) Lithium
26) Marital therapy- Nonbehavioral
27) Group process pyschotherapy
28) Functional analysis
29) Relapse Prevention
30) Self-monitoring
31) Hypnosis
32) Psychedelic medication
33) Antidipsotropic-calcium carbimide
34) Attention Placebo
35) Serotonin agonist
36) Treatment as usual
37) Twelve-step facilitation
38) Alcoholics anonymous
39) Anxiolytic medication
40) Milieu Therapy
41) Antidipsotropic-metronidazole
42) Antidepressant medication (non-SSRI)
43) Videotape sefl-confrontation
44) Relaxation training
45) Confrontational Counseling
46) Psychotherapy
47) Gerneral alcoholism counseling
48) Education (tapes, lectures, or films)
The mental health program I work for uses Motivational Interviewing. Motivational Enhancement, listed as #2 here, is a time and session limited version of MI. Most of these methods came about in response to the poor outcomes of AA.
I have yet to see any scientific study that claims that AA is #1, it seems as if the only ones making this claim are AA members who are happy with the program.
March 1, 2011 at 12:42 am
Lewis
Alternatives to what????
February 27, 2011 at 3:26 pm
Joe
“Handbook of alcoholism treatment approaches: Effective alternatives”
Amazon ranks this at 395,731. Which means that 395,730 books sell better than it does.
February 27, 2011 at 3:41 pm
raysny
Yeah, I’m sure Snooky’s new book outsells this textbook on recovery. Only professionals and students would own it let alone read it, what’s your point?
February 27, 2011 at 3:28 pm
madyson007
Wow. AA is listed at number 28. I guess that puts it into perspective. Please tell me more about Motivational enhancement.
February 27, 2011 at 3:48 pm
raysny
“Motivational interviewing is supported by over 80 randomized clinical control trials across a range of target populations and behaviors, including substance abuse, health-promotion behaviors, medical adherence, and mental health issues.”
From Wikipedia, it has a fairly good article on Motivational Interviewing with a couple of better links.
February 27, 2011 at 3:46 pm
Joe
In closing I want to add one more thing. Alcoholism and drug addiction are life threatening and fatal diseases. Picking the wrong way to treat it can (and often does) end up with people dying and families suffer greatly. This is not like picking the wrong appetizer on the menu and being a little disappointed. Much is at stake. ~Joe
February 27, 2011 at 3:59 pm
raysny
You’re right and often 12step recovery is the wrong option. Instilling guilt and fear has a lot to do with the mortality rate in AA, I’m sure.
Almost every adult suicide among people I know were AA members. If a person killed themselves without drinking or drugs, members would cluck, “At least he died sober”; if they had relapsed, they’d say, “He just couldn’t get this simple program”, no one ever questioned why the person took their life, they only wanted to comment on the death in a way that reflected positively on AA.
At the last mental health program I worked for, all our clients were dually diagnosed and had been through 12step programs and treatment unsuccessfully. Every single one of them reported being told that they weren’t ‘really sober’ if they took medications. Several of the ones who did stop attempted suicide.
February 27, 2011 at 4:14 pm
Joe
I guess we will just have to agree to disagree. Glad you are in the people helping business. It’s a tough profession.
Best, Joe
February 27, 2011 at 5:07 pm
raysny
It is, but it’s also very rewarding. I don’t like the idea of people going through the things that I did when trying to get help.
March 1, 2011 at 5:58 pm
madyson007
What an enlightening conversation…and confirms what I have always suspected.
June 5, 2011 at 3:24 pm
susan lea
The thing I noticed right away on the list of “Effective Alternatives” for alcohol treatment, (and I’m assuming we are also applying this to drug treatment) is that the vast majority of treatments cost money. They require either insurance or a hefty savings account.
No doubt many of these therapies and medications are helpful for the addict. But 12 step programs are free. I’ve been to an NA meeting with my daughter who is an addict and I didn’t meet many people there who had insurance or a big bank account. But I did see people giving each other hugs and words of encouragement. I’ve been to Alanon meetings and found that each person attending finds aspects of the 12 step program that can help them. A person can attend a 12 step program and still be an atheist.
I believe that individual addicts need to evaluate what works best. This requires help from family, attorneys, counselors, etc. Some addicts need medication. Some need behavioral therapy, especially in cases of dual diagnosis.
But the one thing that NA meetings provide is community. Most addicts think that only other addicts can relate to how they feel. This means that addicts will hang out with other addicts. So why not have them hang out at a 12 step meeting?
June 6, 2011 at 8:20 pm
raysny
Dr. George Vaillant, former Harvard professor, researcher, and AA Trustee found that AA did not improve on the rate of natural remission and raised the mortality rate.
In other words, the same number of people quit using AA as quit on their own, but more people in AA died. That doesn’t sound like a good option.
June 7, 2011 at 8:59 am
susan lea
I wonder how statistics are gathered on AA and NA when no one at meetings keeps track of who is there. And the people who attend these meetings are there anonymously. I would think this would make percentages of recovery difficult.
Also, there are people who attend a few meetings and it could turn their life around and they don’t come back. And then there would be others that relapse. And then there are people who go every week or for many years.
So even if a statistician could document mortality and recovery rates for anonymous individuals, how would they divide up the addicts and alcoholics who go for a month as opposed to those who go for a year or for a decade?
Obviously this Dr. Vaillant is more knowledgeable than I am. But I wonder what he would say to my questions?
June 6, 2011 at 8:02 pm
msjo101
I have just started a group called ONE MAD MOTHER.and I work together with Heroin, Taking our lives back.
Our goal is to make AWARENESS of the PILL MILLS AND CANDY MEN DOCTORS! I have first hand witnessed!
I am planning a protest at the ALTA MED where the good doc gave my son in front of me scripts for 100 pills! AFTER I notified the nurse that son was shooting up heroin in bathroom, we went directly to Las Encinas where they took his drug kit from him
Son is dual diagnosed….
I AM LOOKING FOR PEOPLE TO WORK WITH ME
I am on wordpress as ONE MAD MOTHER 2001
AND ON FACEBOOK AS ONE MAD MOTHER
ANYONE WHO IS INTERESTED PLEASE CONTACT ME!
I AM ON A MISSION TO PUT TOGETHER A GROUP TO CHANGE LAWS.
June 6, 2011 at 8:16 pm
raysny
What were the pills for? Something to help him with the withdrawal symptoms? Psych meds for underlying problems?
June 6, 2011 at 8:05 pm
msjo101
ANYONE INTERESTED IN HELPING ONE MAD MOTHER!
PLEASE CONTACT ME via focus14841@sbcglobal.net
I update my wordpres it is ONE MAD MOTHER 2011 (my mistake)
June 8, 2011 at 12:01 am
Dadonfire
I would stay committed and active in your work and forward any poignant writings you have for publication. Moms United to End the War on Drugs might me a good start for you. http://www.anewpathsite.org/momsunited1.html – Some very cool ladies just started that alliance. http://www.facebook.com/home.php?sk=group_125162887532951
June 8, 2011 at 3:43 pm
susan lea
I looked up the site http://www.anewpathsite.org and found a wonderful group of people doing some great things for changing the way we look at addiction in the court system. It makes me optomistic about the future. Thank you for this information!