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 veggie
Registered: 07/26/04
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 Does Teen Drug Rehab Cure Addiction or Create It? 
#12906657 - 07/16/10 01:25 PM (2 years, 10 months ago) |
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Does Teen Drug Rehab Cure Addiction or Create It?
July 16, 2010 - Time
Matt Thomas had only recently begun experimenting with marijuana, when he got caught selling a few joints in the bathroom at his junior high school. It was no big deal, Thomas thought, especially considering that his parents — an investment banker and a homemaker — smoked pot, too.
But Thomas' grades had already begun to slip, mostly due to his increasing alcohol and marijuana use; that, coupled with his drug-dealing offense, was enough for the school to recommend that his parents place him in an inpatient drug treatment program. Thomas, then 13, was sent to Parkview West, a residential rehab center located a few miles from his suburban Minneapolis home.
But rather than encouraging sobriety, Thomas says his seven-week stint at Parkview West helped launch a decades-long descent into severe addiction — from regular marijuana user to daily drinker to cocaine and methamphetamine addict. "It was [in rehab] that they told me that I was a drug addict and an alcoholic," says Thomas, a pseudonym. "There was no turning back. The whole event solidified and created this notion in my own mind and in my social status. Who I was was an alcoholic and drug addict."
In treatment, Thomas met other addicts. He attended daily group therapy with older teens, who regaled him with glamorized war stories about drugs he'd never tried. In rehab, says Thomas, your first question upon meeting a new person is: "What's your drug of choice?" And that's often followed by, "What's that like?" Thomas recalls hearing a description of an LSD high so seductive that he pledged he would try it, if he got the chance. He did, not long after getting out of rehab.
Increasingly, substance-abuse experts are finding that teen drug treatment may indeed be doing more harm than good. Many programs throw casual dabblers together with hard-core addicts and foster continuous group interaction. It tends to strengthen dysfunctional behavior by concentrating it, researchers say. "Just putting kids in group therapy actually promotes greater drug use," says Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA).
The exposure can be especially dangerous for impressionable youngsters. "I've known kids who have gone into inpatient treatment and met other users. After treatment, they meet up with them and explore new drugs and become more seriously involved in drug use," says Tom Dishion, director of research at the Child and Family Center at the University of Oregon, who has documented such peer influence in scientific studies.
In academic terms, the problem is known as "deviancy training," or the negative impact of friends on teen behavior — what parents would simply call a "bad influence." In one 2000 study, Dishion found that social exposure to delinquent peers at age 14 (researchers measured how much time teens spent together and how much they encouraged their peers' misbehavior) accounted for 53% of adolescents' life problems five years later — including criminal convictions, sexual promiscuity, relationship issues and drug use.
In another study looking specifically at the impact of group interventions, teenagers who had been identified as being at high risk for drug use and delinquency at ages 11 through 14 were more likely to smoke cigarettes and have disciplinary problems at school three years later if they had been enrolled in a "teen focus" group about drugs, compared with those who underwent private counseling sessions with their immediate families. "Any condition that promotes kids talking about or endorsing drug use [with each other] would increase the likelihood that the treatment would have a negative effect," says Dishion.
In addition, researchers find, the harm of many teen drug treatment programs may come not only from the negative influence of new relationships, but also from the degradation of positive bonds with family. In a 2003 paper, Jose Szapocznik, the chair of epidemiology and public health department at the University of Miami, found that teens who used marijuana but still had healthy relationships with their families saw those relationships — and their drug habits — deteriorate when they were assigned to peer-therapy groups. Among these teens, who were in treatment for a minimum of four weeks, 17% reduced their marijuana habit, but 50% ended up smoking more. "In group, the risk of getting worse was much greater than the opportunity for getting better," Szapocznik says, adding that, in contrast, 57% of teens who were assigned to family therapy showed a significant improvement in drug use, while 19% got worse.
Although teens with fewer problems may be adversely affected by their more dysfunctional peers, the reverse can also be true: teens with severe behavioral problems actually improve when placed in groups with better adjusted youth. The 2004 Cannabis Youth Treatment (CYT) trial, which included 600 teens, found that over the course of a year, marijuana use dropped 25% in teens in both group therapy and family therapy, no matter how severe their behavioral problems were.
CYT's success may be due to the fact that while its participants had varying degrees of behavioral difficulties, they did not differ significantly in terms of substance use — the trial excluded anyone who had used any drug other than marijuana for 13 or more days in the previous three months. That factor alone may account for the across-the-board benefits, but in most teen rehab centers outside of research settings, patients continue to be lumped together with little regard for the severity of their drug problems. (See TIME's health and medicine covers).
It doesn't help either that the philosophy behind many drug-treatment programs can be easily misinterpreted by teenagers. Most programs in the U.S., including the one Thomas attended, are modeled after the 12-step recovery plan used by Alcoholics Anonymous. The first step encourages participants to accept that they are "powerless" over their addiction and to surrender their will to a higher force. For some people, it inspires mutual support and abstinence, but for others — especially teenagers — it can foster a feeling of defeat. "You get these 12-step teachings telling you that you're doomed, that you have this disease and this is the only way out," Thomas says. (Comment on this story.)
Indeed, surrender is not a word that comes easily to teens, and teaching them to believe they are powerless may create a fatalism that leads to relapse, according to Andrew Morral, a senior behavioral scientist at the Rand Corporation. In his studies of teens treated at Phoenix House, one of the largest treatment providers in the U.S., he found that participants who subscribed to the tenet of powerlessness were more likely to return to drugs after treatment, compared with teenagers who did not take the message to heart. (See teens in obesity rehab.)
Still, for an estimated 10% of teen drug users whose addictions are severe enough that they already feel helpless to control them, the 12-step method can help. For example, a study published in July in the journal Drug and Alcohol Dependence, found that teens who had severe addictions to alcohol, marijuana, heroin or painkillers and chose voluntarily to attend 12-step meetings once a week for three months had nearly double the number of sober days than those who did not attend. "People who go to Alcoholics Anonymous or Narcotics Anonymous and stick with it are the most severe cases," says study author, John Kelly, associate director of the Massachusetts General Hospital Harvard Center for Addiction Medicine, while people with milder problems typically don't feel like they "fit" and quit attending.
The problem is that most treatment programs do not give teens a choice about 12-step attendance: it is usually a mandatory part of rehab or is in some cases legally mandated by a court.
Despite the fact that individual and family therapy have shown more success with teen drug users than group treatment, most programs continue to use problematic approaches. One reason is cost. Group treatment allows a therapist to see many more patients in a day than in individual sessions. "If you can have four groups a day, you're going to do a lot better [financially] than if you have seven or eight individuals," says Szapocznik, noting that if insurers would pay for individualized treatment according to patient, instead of services per hour, treatment for single patients or families could be made affordable.
The 12-step model also remains popular in part because such meetings are free and widely available. What's more, given that about half of addiction counselors are recovering addicts themselves, they tend to stay true to the treatment that worked for them — usually a 12-step program — and are not often well-trained in other approaches like family therapy.
Some experts worry that unfavorable treatment strategies may only increase with forthcoming revisions to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of psychiatry. In the current edition of the DSM, substance problems are divided into two diagnoses: "substance dependence," which signifies severe, chronic addiction, and "substance abuse," which applies to the kind of short-term risky behavior that characterizes many teens, but tends to be outgrown.
In the proposed fifth edition of the DSM, however, diagnoses will be divided by drug, then by severity, all under the umbrella category of "addiction." That would mean the label of "addict" may be applied equally to a college binge drinker and a long-term a heroin addict, which would not only reinforce the negative labeling effect on teens but also encourage mixing patients with varying substance problems in group therapy. "Failing to make the distinction at diagnosis will contribute to failing to make distinction in treatment," says Dr. Allen Frances, emeritus professor of psychiatry at Duke University and chair of the DSM task force that was in charge of the fourth edition.
What impact the new diagnostic categories may have remains to be seen. For now, researchers say that the evidence shows the most effective teen drug treatment involves non-group settings, especially for young people whose drug habits have not evolved to include harder substances. Anders Hoff, 23, says he was able to overcome his alcohol problem through individual therapy and by avoiding groups that required him to bear the label "alcoholic." At 18, Hoff left his home in Minnesota to attend college in Vermont. By the end of his first semester, he had developed a drinking habit so severe that he was frequently falling down drunk and suffering concussions. He had powerful headaches and his sense of taste and smell was damaged by brain injury, but he didn't stop binge drinking. Panicked, three days before the end of the term, he says, "With a knot in my stomach, I called my parents, said I had a problem and told them I had to go home."
He began individual counseling for alcoholism with Bob Muscala, a nurse in private practice in Edina, Minn., who has worked in the addictions field for 40 years. Hoff had two slips during his three years of therapy, but unlike with the standard 12-step program, his stumbles didn't force him to go back to zero and start counting his sober days all over again. "It didn't make me shut down and say, 'I'm done, let's start again with my old behavior,'" says Hoff, who is now back in school. "When I admitted the incidents, no one said, 'Well you're an addict, you're never going to stop.'"
NIDA is now funding collaborations with drug treatment programs throughout the U.S., which are aimed at bringing both youth and adult treatments in line with practices that are known to work — for teens, that means family therapy, selective groups or individual therapy that prevents prolonged teen interaction in waiting rooms or other common areas. "There has been an incredible acceptance of evidence-based treatment" in programs that have joined NIDA's initiatives, Volkow says; however, many more community-based programs are still using interventions that have not been proven.
Meanwhile, some individual treatment providers, like Muscala, continue to do their part, reducing drug use in the U.S., patient by patient. Matt Thomas, who has been in counseling with Muscala for about a year, just celebrated 10 months sober at age 41.
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 MushroomMarkk
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Registered: 01/25/05
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Re: Does Teen Drug Rehab Cure Addiction or Create It? [Re: veggie]
#12906833 - 07/16/10 02:13 PM (2 years, 10 months ago) |
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isnt that the idea? so they come back and have to pay for more treatment, thus doubling and tripling the income of the center? I thought thats what all businesses tried to do. Its ridiculous to trust anyone with money as their major motivational factor.. and who runs these centers? previous drug addicts.. and what is almost as good as a drug to a drug addict? cha-ching (its equally as addictive in my experience)
isnt this common sense? ofcourse who isnt ready, able, and astoundingly excited to throw all caution to the wind when someone points out they have a Ph'd before they start talking. Sounds like an excuse to make things up that generate that individual money, but they went to school for so long they deserve it right?
This world man, what the hell
PS: Oh andthen they think to solve the problem they can just wall off the child from reality.. wait a second what were they using the drugs for? to escape? well they sure as hell wont have to escape from reality when they are being taken from it. Andthen fall flat on their faces when they are suppose to move out, seen it many a time.
Arent connection and love the most valuable things in life? when will everyone get the point that inanimate objects cant act? and that drugs are only as negative as how the user uses them. Why dont we just use our brains and trust the coming generations to be even more intelligent than us, and make them aware thats how we believe they are, and that we know they are more capable. What about a generation that can be handed any drug you can think of an use it while having a complete and thorough understanding, instinctually, that it wont help them day to day. They will ask what the point in doing it is, and when there is no real answer besides, "it feels good" (all in the eye of the beholder as this generation will clearly understand), they will quickly turn their attention to improving themselves and their community. Community, the very thing that we seem to be heading in the direction of sacrificing to stop the drug use, so when we're all alone and sad and walled off being told of all the insane euphoria(lies) chemicals can bring we wont want them? holy fuck all this idiocracy makes me want to go numb myself so i can forget how genetically similar i am to these beings.
Wasnt LSD treatment extremely effective? It works for me whenever i need to realize why i cant keep buying heroin, it gives me the ability to stop and start as i please, though the duration of the use is a complete waste of my life, and i sometimes cry myself to sleep knowing of all the hours i wasted. Thank god i didnt start telling myself and everyone around me "its a disease, i cant do anything about it" otherwise id be realll fucked.
How about truth and intelligence and community and embracing and realizing the infinite extent of our wisdom and adaptability as human beings, man.
Edited by MushroomMarkk (07/16/10 02:28 PM)
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aiyobro
Registered: 06/30/07
Posts: 10,436
Loc: Outer Space
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Re: Does Teen Drug Rehab Cure Addiction or Create It? [Re: MushroomMarkk]
#12907508 - 07/16/10 04:13 PM (2 years, 10 months ago) |
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its enough of a reason to do drugs if you got out of that place jeez
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Patient Right
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curenado
73rd Man
Registered: 04/01/03
Posts: 2,601
Loc: North Central Arkansas
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Re: Does Teen Drug Rehab Cure Addiction or Create It? [Re: aiyobro]
#12908376 - 07/16/10 07:28 PM (2 years, 10 months ago) |
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Actually - whether or not it was intended to be a revolving door insuarnce companies have their limits and so lots of places aren't so keen to have revolving door anymore....interesting isn't it? When the money was going that way "All kids are on dope and their precious soul needs our help immediately!"....insurance companies dried up "Sometimes you just have to let them go." seriously...
I am glad to see that the motivation for that $ is causing more venues for those who need them and YES, the right kid in the right circumstance can go from ignorant experimenter to addicted offcianado quickly. Seen that happen...just my opinion that they weren't that interested in dope either, just desperate for peer approval and thinking being the "bigger doper!" would do it, hence more potential for uniformed disaster...
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Yours in the Natural State!
"The woods are lovely, dark and deep; but I have patches to keep, and jars to sterilize before I sleep...."
Edited by curenado (07/16/10 07:30 PM)
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5-HT2A
Registered: 01/30/10
Posts: 1,794
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Re: Does Teen Drug Rehab Cure Addiction or Create It? [Re: curenado]
#12911370 - 07/17/10 02:11 PM (2 years, 9 months ago) |
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I knew a kid who got high all the time and also did anything he could get his hands on, but he was just trying to fit in and have fun, he wasn't really anything but a pot head. He ran away before he went to rehab and came over to my house. The next morning he huffed some air and fell flat on his face, almost cut his head open on my metal computer case. I rolled him over and his mouth was bubbling foam and he started responding like 30 seconds later. Scary.
This kid was fucked up but that doesn't mean he's a drug addict. He's learning disabled and people wouldn't accept him so he'd get fucked up to fit in and functioned as a hookup etc. How the fuck can you cure the need for social acceptance?
Anyhow, he went to rehab, came out and started doing drugs not too long after. He would be like "ya 3 months sober" and I would think really? Is that the only point here? To not do drugs and assume things will be fine now?
So he brought this kid to my garage one night to smoke. They'd met in rehab. I asked him "what were you in for?" And as he coughed out a puff smoke he said "heroin."
I don't think we'd ever chilled with anyone who did heroin before. But here he was, probably still hooked up with dealers who might hook up with one of us some day. He also wound up ripping off $40 from me for acid that he never got. I'm pretty sure he was just going to buy more junk or whatnot.
And the kid who I knew? He had gotten arrested for pot 2-3x before, and after rehab had to at least have doubled that. He's stupid as hell, but he's not a real addict. I know this because he'd tell me that he's happy, despite everything. He's not an obsessive/depressive person, he gets over things that happen to him.
So I agree that when you send somebody in who hasn't lost all control, you're committing an act of sabotage. If you tell somebody in control that they're powerless and that the only way they'll get out of this building and back home is if you admit it, that is little more than a sophisticated form of child abuse.
Edited by 5-HT2A (07/17/10 02:24 PM)
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Mycjunky
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Re: Does Teen Drug Rehab Cure Addiction or Create It? [Re: veggie]
#12913082 - 07/17/10 09:57 PM (2 years, 9 months ago) |
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This article really related to a real life experience for me. My girlfriends brother went to rehab because his parents caught him smoking weed a bunch of times. They had him fill out sheets of paper saying what drugs he's done. We got to see them and he claimed he did a bunch of drugs he never actually did, we know cause he did them all with us or people we know. He even admitted he hadn't really done most of them.
His parents were convinced he was an LSD addict and was doing LSD every single day which is impossible unless your taking very high doses and this kid did not have the connections to do anything like that. The clinic basically convinced him he was an addict even though he wasn't and caused him to rat on us to his parents for a bunch of shit. This article really put to words how I felt about the rehab clinic at the time. He knew he wasn't an addict when he went in but they convinced him otherwise.
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