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9/22/2014 12:00 AM

Yet another blogger has criticized and mischaracterized substance use disorder treatment providers based on faulty information. On September 15, a harm-reduction advocate named Kenneth Anderson published a blog post under the headline “The Training Manual for US Addiction Counselors is Full of Myths.” We read it and found it had plenty of “myths” — for want of another word — of its own.

It accused the International Certification and Reciprocity Consortium (IC&RC) of requiring training counselors “to memorize long-debunked myths originating in the 12-step-dominated treatment industry.” It quoted a National Epidemiologic Survey on Alcohol and Related Conditions study and said that 90 percent of people recovered from dependence without treatment (what it did not say was that 87 percent of people in the sample were dependent on nicotine).

Yet another blogger has criticized and mischaracterized substance use disorder treatment providers based on faulty information. On September 15, a harm-reduction advocate named Kenneth Anderson published a blog post under the headline “The Training Manual for US Addiction Counselors is Full of Myths.” We read it and found it had plenty of “myths” — for want of another word — of its own.

It accused the International Certification and Reciprocity Consortium (IC&RC) of requiring training counselors “to memorize long-debunked myths originating in the 12-step-dominated treatment industry.” It quoted a National Epidemiologic Survey on Alcohol and Related Conditions study and said that 90 percent of people recovered from dependence without treatment (what it did not say was that 87 percent of people in the sample were dependent on nicotine).

It relies on one study guide, Getting Ready To Test from the Distance Learning Center, to lambaste IC&RC, which does not produce study guides for its exams (that would be a conflict of interest). There are many training materials that are available. And the criticisms Anderson levies at IC&RC and the study guide are all based on his point of view — that AA is harmful, and that IC&RC is to blame for even allowing it to be mentioned in training manuals. He inaccurately portrays IC&RC and addiction counselors as being opposed to harm reduction. His post ends with this: “Who is to say how many of the people served by all these professionals have suffered additional harm—even death—from their addictions as a direct result of the inaccurate information contained in Getting Ready to Test? It’s high time to reform the credentialing process, teach accurate information and replace mythology with science.”

You can read his entire post at http://www.substance.com/the-training-manual-for-us-addiction-counselors-is-full-of-myths/12204/

Counselor Job Analysis

Had Anderson contacted IC&RC, he would have learned that they also are advocates of harm reduction. “Mr. Anderson did not contact IC&RC for verification of statements made in his article relative to our credentials and practices,” said IC&RC’s Mary Jo Mather in an email to ADAW. “Had he done so, much of the information could have been corrected.” For example, she said, IC&RC’s Alcohol and Drug Counselor 2013 Job Analysis (JA) does include harm reduction. The JA task statement for IC&RC alcohol and drug counselors calls for utilizing “multiple pathways of recovery in treatment planning and referral” and requires knowledge of:

  • Benefits and limitations of the 12 Steps and 12 Traditions.
  • Benefits and limitations of other recovery support approaches.
  • Benefits and limitations of harm-reduction-based models of recovery.
  • Ways in which medical consultation and treatment may enhance the recovery process.

As for the specific manual (which was very selectively quoted for the Anderson blog post), “There are many varied training tools available on the market, including flash cards, practice exams, online trainings, study guides, etc., all developed by independent organizations who market to addiction professionals,” said Mather. “No one has access to IC&RC examinations; not ReadyToTest.com which is referenced in Mr. Anderson’s article or any other organization.”

IC&RC does provide for free its JAs, which are developed by subject matter experts and the testing company, said Mather. “JAs identify domains, tasks, knowledge, skills and abilities for each IC&RC credential,” she said. “JAs are then used as a basis for developing curricula, trainings and study materials by organizations and colleges/universities.”

IC&RC does not have a formal process of reviewing and approving training and education materials, said Mather. “As such, content of training and education and content of study guides is not reviewed or vetted through IC&RC,” she said.

DLC responds

The other organization mentioned in the blog post but not contacted was the Distance Learning Center, which makes the guide. “Our Getting Ready To Test study guide is not a training manual,” said Kevin Scheel, CEO and director of education services for DLC, in an email to ADAW. “It is what we present it to be — a study guide designed to assist students who are seeking drug/alcohol credentialing.”

When students come to ReadyToTest.com, they already have their training hours and work experience in hand, said Scheel. “We work to provide them with materials to refresh many of the core elements they have already studied — after all, many of these students have worked for 2 years or more to gather the training hours they must have.” Scheel added that he is “quite proud of the fact that we have been doing this since 1992 and have tens of thousands of students that have been able to obtain their credential as a drug/alcohol professional with our help.”

Scheel said that Anderson did not contact him or anyone at the Distance Learning Center. “I am happy at any time to discuss this with anyone, sharing my thoughts and ideas while listening to yours,” he said. “I would have gladly entertained such a discussion with Mr. Anderson, but this did not happen. I do see from one of the comments posted with his blog that he claims to have reached out to me for feedback and comment. Yet a search of our email and phone logs do not indicate that we ever received an email, a fax, or a phone call. All of our contact information can be found at the bottom of our ReadyToTest.com website, including phone, fax, and email contact information. I’m really not that hard to find. To suggest that I ‘blew him off with no reply’ is both dishonest and far from the truth.”

Editor's Note: This article was updated to reflect the fact that the Distance Learning Center, LLC is the parent company. ReadyToTest.com is one division, which does test prep; the other division is DLCAS.com, which provides continuing education hours by distance learning.

9/15/2014 12:00 AM

A study published July 17 in Drug and Alcohol Dependence found that almost three-quarters of patients in treatment for substance use disorders (SUDs) report using synthetic cannabinoids to avoid having marijuana detected by drug tests. The study, by Erin E. Bonar and colleagues, found that 38 percent of the 396 patients surveyed reported using synthetic cannabinoids, with 71 percent saying the reason was to get high without having a positive drug test. The most common reasons were curiosity (91 percent), getting high (89 percent) and relaxation (71 percent). Patients who used synthetic cannabinoids had higher rates of other substance use and higher measures of depression and psychiatric distress than other patients in the program.

A study published July 17 in Drug and Alcohol Dependence found that almost three-quarters of patients in treatment for substance use disorders (SUDs) report using synthetic cannabinoids to avoid having marijuana detected by drug tests. The study, by Erin E. Bonar and colleagues, found that 38 percent of the 396 patients surveyed reported using synthetic cannabinoids, with 71 percent saying the reason was to get high without having a positive drug test. The most common reasons were curiosity (91 percent), getting high (89 percent) and relaxation (71 percent). Patients who used synthetic cannabinoids had higher rates of other substance use and higher measures of depression and psychiatric distress than other patients in the program.

“People do use these compounds primarily to evade drug tests,” said Kevin G. Shanks, a forensic toxicologist at AIT Laboratories in Indianapolis, who conducts many tests on biological samples — usually postmortem — for evidence of synthetic cannabinoids. “The typical urine drug test for cannabinoids does not pick up synthetic cannabinoids,” he told ADAW. This wasn’t known until about two years ago, he added. Now, however, people do know. So labs have to be updated to test for more than metabolites of tetrahydrocannabinol (THC), the active ingredient in marijuana, which doesn’t exist in synthetic cannabinoids.

Not marijuana

References to synthetic cannabinoids as “synthetic marijuana” or “synthetic weed” are misnomers, said Shanks. “These compounds are truly cannabinoids because they act on the cannabinoid receptors,” he said, “but they are nothing like THC in their effects on the body.” Also, if people think they are like marijuana, they could be dead wrong. There are many cases of death caused by use of synthetic cannabinoids, said Shanks.

Synthetic cannabinoids are full agonists, which means they produce more exaggerated effects than THC, said Shanks. “There’s much more agitation, much more tachycardia,” he said. THC is a partial agonist, with less severe effects.

No quality control

Many synthetic cannabinoid compounds were developed in legitimate research, with the process published and eventually forgotten about, said Shanks. These are in a gray area that he calls “trolling the patent” — clandestine chemists see that these compounds exist but are not scheduled (controlled by the Drug Enforcement Administration), or if scheduled, they can be modified in ways that aren’t scheduled. They then sell them as synthetic cannabinoids, which can have many “analogues” or chemically similar substances. These substances first appeared as “K2” and “Spice,” but there are constantly and apparently infinitely expanding types now out there, and there is no quality control regardless of what the compound is sold as.

“We have a long history with marijuana and THC,” said Shanks. “We know more about them every day from research.” By contrast, very little is known about synthetic cannabinoids, because there are so many different versions. “For 99.9 percent of the compounds showing up, we don’t have any toxicology or pharmacology information,” said Shanks. “They have not been through through controlled dosing studies, or clinical trials,” he said. “They may have been invented by someone in a lab, and we don’t even know if they truly act on the cb1 and cb2 receptors,” he said, referring to the cannabinoid receptors in the brain. “Even though people talk about K2 and Spice, we don’t know what they are — if someone buys them in a smoke shop or a head shop, you’re not guaranteed to have anything specific.”

Some products have as many as 11 different synthetic cannabinoids in them, said Shanks. “And we’ve seen some that sold as synthetic cannabinoids that didn’t have any,” he said.

Underground chemists

Most recently, Shanks and colleagues published a paper in the Journal of Analytical Toxicology that documented four deaths in Iowa and Nebraska, all centered around one specific compound: 5F-PB-22.

Shanks isn’t sure that controlling each individual substance is going to be effective, because then the clandestine chemists just move on to a different substance. The analogue law — and state analogue laws — can be useful, however. That way authorities can shut down head shops found selling such substances.

“I do think legislation is good, but it’s a double-edged sword,” said Shanks. “Legislating is almost a knee-jerk reaction, because it allows a lot of the underground chemists to use even more unproven and unknown compounds,” he said. “It’s a diverse chemical grab bag, with many of the compounds now out there having never been under patent, never studied,” he said. “There are outbreaks and illnesses that have been caused by synthetic compounds. Now it’s must mix and match, and we’ve gone from the ones we knew most about causing the problems to substances we know nothing about.”

“Clearly, further investigation is required with respect to the pharmacokinetics of 5F-PB-22 and other synthetic cannabinoids, their role in human toxidromes and their relevance to detection in postmortem casework,” Shanks and colleagues concluded in the Journal of Analytical Toxicology paper, which will be published next month. “Important point sources for this information will continue to include the US National Network of Poison Information Centers, reporting emergency departments and urgent care centers and medical examiner/coroner systems with their attendant toxicology laboratories.”

Bottom Line…

Sold under various names in head shops and smoke shops, synthetic cannabinoids are not marijuana and are killing people — including those who take them to evade drug tests.

8/25/2014 12:00 AM

One year ago, Attorney General Eric Holder announced the “Smart on Crime” initiative of the federal Department of Justice, which is aimed at releasing low-level drug offenders from federal prisons (see ADAW, August 19, 2013). However, many drug offenders are headed for state, not federal, prisons, and their prosecutions are by district attorneys, not federal prosecutors. 

One year ago, Attorney General Eric Holder announced the “Smart on Crime” initiative of the federal Department of Justice, which is aimed at releasing low-level drug offenders from federal prisons (see ADAW, August 19, 2013).

Holder directed federal prosecutors not to seek mandatory minimum sentences for nonviolent drug offenses, and also asked Congress to pass the Smarter Sentencing Act, which would reduce the length of sentences and give federal judges more discretion.

However, many drug offenders are headed for state, not federal, prisons, and their prosecutions are by district attorneys, not federal prosecutors. The National District Attorneys Association (NDAA) has not formally endorsed or proposed either bill, but the “NDAA has testified during both hearings that reducing mandatory minimum sentences and/or giving federal judges discretion on applying mandatory minimum sentences solely as a cost-saving measure was a dangerous precedent and could have grave consequences, including a potential uptick in crime rates,” according to the NDAA’s website, which adds that the NDAA is drafting a policy paper on sentencing reform.

State courts different

Still the NDAA has yet to take a position on Holder’s initiatives — and it may never take a position. “All of our members are associated with state courts,” said Kay Chopard Cohen, executive director of the NDAA, explaining that “it’s not our position to comment on what the feds want to do.”

She told ADAW that district attorneys have more options than federal prosecutors in terms of sentencing — there are local jails, for example. “At the state level, lower-level offenders would probably go to the local jail,” she said. “In some states, drunk driving or drug-impaired driving has mandatory minimums that are only two days to a week,” she said. “The federal system is different.”

(Homicide, unless a federal agent is killed, is a state, not a federal crime, so it’s not correct to say that state offenses are by definition less serious than federal offenses. However, even low-level drug offenses, if they involve crossing state lines, can involve federal prosecution and prison sentences.)

Presentence investigations

Cohen also noted that, recently, the rising costs of incarceration have led many jurisdictions to look more closely at who is appropriate for incarceration. “It’s not unusual, especially when drugs or alcohol are involved, for a judge to request a presentence investigation into the most appropriate consequence, which may not be incarceration,” she said. “With the proliferation of drug courts and impaired driving courts, you see offenders being ordered to treatment, with incarceration as the backup.” In these arrangements, which don’t always end well for offenders, participants are told that ‘If you can’t follow through with your treatment, if you’re not willing to cooperate or not following through all parts of the program, then incarceration is the other option,’” said Cohen. “But you can only do that in state courts.”

More treatment options

In fact, district attorneys would like there to be more treatment options, because they recognize that so many of the crimes they prosecute, even if not directly related to alcohol or drugs, are caused by them — a person addicted to drugs committing a burglary or forgery to pay for his habit, for example. “I hear more frustration from local prosecutors about there not being enough services, there aren’t enough treatment beds,” she said. Instead, they end up with programs that may consist of attending AA meetings, while many people might benefit more from an inpatient program, she said. And while the NDAA hasn’t taken an official position on medication-assisted treatment, many prosecutors are looking for more treatment options. “There’s been such an increase in heroin usage that prosecutors are asking how to address this,” she said. “They are more open to getting more information” about medication-assisted treatment with methadone, buprenorphine and Vivitrol, she said.

Pardons and clemency

The Justice Department is also expediting pardons for federal inmates who would have received a lower sentence if convicted today of the same offenses, who are nonviolent low-level offenders, who have served at least 10 years of their sentence, who do not have a significant criminal history, who have shown good conduct in prison, and who have no history of violence. Last December, President Obama commuted the sentences of eight individuals under this initiative.

The American Civil Liberties Union (ACLU) approves of the Smart on Crime and other initiatives designed to keep people who commit low-level drug crimes out of prison. “Our country’s top prosecutor continues to show his dedication to ending the failed, racially biased war on drugs,” said Laura W. Murphy, director of the ACLU’s Washington Legislative Office, in a statement. “With each proposed reform, we move closer to a criminal justice system that is smarter, fairer and more humane,” she said. “Attorney General Holder seems committed to making criminal law reform his legacy, and we’re eager to see what he does next.”

The Justice Department has a Pardon Attorney’s Office that is reviewing such claims, and will help coordinate pro bono lawyers from the Clemency Project 2014, which is made up of federal public defenders and independent, outside groups. All 93 U.S. attorneys have been asked to help identify candidates for clemency. Last month, the attorney general took a step further, specifically proposing reducing prison sentences for nonviolent drug traffickers by 11 months.

Meanwhile, treatment providers do not report seeing increased numbers of patients as a result of federal sentencing reform. This makes sense, said Cohen. “It’s not possible to open up the floodgates in the federal prisons, because you don’t get sent to the federal penitentiary for using,” she said. “You can see that our federal penitentiaries are not filled with just drug users, whereas at the state and local level, you see a lot more drug programs, treatment programs, drug courts.”

From the Field
6/30/2014 12:00 AM

Marijuana is a potent drug. My personal experiences with marijuana — occasional recreational use during graduate school — were relatively benign. A few times I had experiences I found distinctly unpleasant. Usually I found that marijuana made me feel slow, heavy, dull and sedate. And because I am a person who is predisposed to the seduction of altered states, I generally enjoyed those feelings. But I found that mixing alcohol and marijuana tended to make those unpleasant experiences more likely. And because I greatly preferred the effects produced by alcohol to those produced by marijuana — and because I was uncomfortable with the illegality of marijuana — I almost always forsook smoking for drinking.

In sobriety, I have had the opportunity to see a very different side of marijuana from the privileged, private-university world I inhabited when I indulged. In the rooms of Alcoholics Anonymous, it is very common that the stories I hear involve both drugs and alcohol. While I consider myself to be fairly exclusively an alcoholic and not a drug addict, I have no illusions about the nature of my disease: I enjoy treating discomfort with mind-altering substances. Though alcohol is my preference, I have also used marijuana and benzodiazepines. That’s not uncommon at all, nor is using cocaine, heroin, methamphetamine, or any number of prescription drugs.

The effects of chronic marijuana use that I have seen are not particularly dissimilar in their manifestations from the effects of chronic alcohol use. Not in terms of how they affect a person’s body, perhaps, but in terms of how they affect a person’s life — increasing isolation from mainstream society, ruptures in relationships and families, unemployment, legal consequences, despair, suffering and misery — problems that are routinely relieved when the abuser commits to abstinence and a program of recovery.

I also see what we in AA call “The Marijuana Maintenance Program.” Many of us come to realize that we have a problem with alcohol and need to stop imbibing. But we are unwilling or unable to face the things in ourselves that are necessary to face in order to recover. And so we turn to a drug that we believe is less harmful, or more manageable. This is no different from deciding that liquor is too dangerous so we try to switch to beer. There is occasionally a brief period of respite, but our addiction will not remit until we abandon all of our artificial anesthesias and examine the underlying causes of our affliction.

As a member of Alcoholics Anonymous — I do not, of course, speak for that organization — I take no position on the legalization of marijuana for recreational use. As a scientist, I do believe that the medical value of the cannabis plant should be studied as we study any other plant and given appropriate opportunities to relieve human morbidity and suffering as is possible. Simply because some people abuse it, we should not discard it as a source of medicines. And there is significant evidence that medicines derived from marijuana, or marijuana itself, may be beneficial for a variety of conditions. A recent article in the British Medical Journal (Farrell M et al., Should doctors prescribe cannabinoids? BMJ 2014;348:g2737) neatly capsulizes the evidence and counter-evidence for marijuana as a medical intervention for a variety of conditions.

Medical marijuana is, of course, also obviously a capillary-action attempt to open the door to recreational marijuana, and it has been successful in Washington and Colorado. The joke I’ve heard over and over again from such advocates is “I need medical marijuana because I get depressed when I run out of pot.” From the pragmatic perspective of someone who is primarily interested in addicts and alcoholics having a path to recovery, and the opportunity to reclaim lost lives, I am not certain that whether marijuana, or even alcohol, is legal or not matters much to me. Humans will use and abuse mind-altering substances. Some will become dependent. Of those, a few will seek recovery.

There are enormous societal investments and consequences associated with the control and enforcement of marijuana as a banned substance, and it may be worth investigating whether legalization would have a net positive or net negative impact on things like crime, poverty and social disparities. I don’t pretend to know the answer. What I know is that marijuana abuse and dependence are real and troublesome problems, but recovery from them is entirely feasible. I have seen it countless times.

From the field
12/20/2012 12:00 AM
Advocates call for mental health treatment, gun control in wake of tragedy in Newtown.

(Editor’s note: On December 14, 20 elementary school students and six school teachers and administrators were shot and killed by a troubled young man, Adam Lanza, who also killed his mother and himself.)

Now is the time for the substance use and mental health community to act together to help end the violence and self-mutilation we as a nation encourage. The victims, their families and all of our children and communities must be comforted. Substance use and mental health clinicians are often at the forefront helping in the aftermath of these too frequent massacres.

We can resolve to change this social environment of destruction. Below is a letter from the behavioral health community to President Obama, congressional leadership, members of Congress and state government officials. Will you sign on? Will you send this or your own letter to your member of Congress, governor or state legislator? Will you help recruit others — people in recovery, families caring for a loved one struggling with substance use or mental illness, counselors and leaders of behavioral health programs — to send letters and call their congressional delegations, governors and state legislators?

As people touched by the tragedies in Connecticut, Arizona, Colorado and too many other communities, as people who are touched by the destruction of untreated alcohol, drug and mental health problems, we must act together to end these killings.

We must all be part of the solution — by showing the faces, voices and resolve of people affected by mental illness and addiction to end this violence and repair our communities. Mental health and substance use are not the causes of the violence, but we can help with solutions.

Dear Mr. President, Mr. Speaker and Members of Congress:

As people who have direct, lived experience with mental illness and addiction, as family members caring for our loved ones with these illnesses, as counselors and healthcare workers and as leaders of behavioral health programs, we all call on you, the leaders of our nation, to begin with us a road to recovery from these tragedies. We grieve for the innocents murdered in Newtown. These are our children, our neighbors, our families, our friends. There can be no greater tragedy in a society than losing its young, its own future, so needlessly and so senselessly. Such actions strike at the very heart of who we are and who we hope to become.

So we must grieve. We grieve for the families who lost their children, for the families of their teachers who were killed, for the entire Newtown community and for America itself. Yet, we owe them all much, much more than just our tears. They also deserve our action to identify and implement solutions.

To begin our recovery, we recommend that you provide federal assistance to:

  • Immediately double the capacity of public mental health and substance abuse programs. Funding for community mental health and substance use treatment services has been cut dramatically. As a result, only a third of those with moderate mental illness and two-thirds of those with severe illness ever receive any care. Families simply cannot get badly needed care. The Affordable Care Act must be implemented fully, and mental health and substance use care must be fully integrated into good medical care.
  • Immediately implement school- and community-based programs to promote mental health, to prevent mental illness and substance abuse and to provide early interventions for those exhibiting these conditions. Prevention and early intervention strategies can strengthen children’s mental health and resiliency, prevent or lessen the burden of illness and help them and their families to recover from trauma. Further, teachers must be taught how to identify troubled children and to guide them into effective supports before these children get into trouble.
  • Immediately begin teaching students at all levels to recognize the signs of mental illness and addiction, and to seek help when needed. Few young people get even a single hour of education about mental illness or addiction, its signs or its treatment. We can’t expect people to step forward or to seek help for a family member when we don’t even provide them the rudimentary tools to do so. We must begin to do so.
  • Immediately ban assault rifles and large-capacity clips. Possession of these weapons is a fundamental public health problem. They are designed for the battlefield, not our closets. They are used to kill people senselessly and needlessly. In Newtown, an assault weapon was used to kill 20 young children just starting their lives and six of their heroic teachers. Enough!

Yes, we must grieve for the innocents, just as we grieved recently for those lost in Tucson, Aurora and Portland. But this time, our grieving must have a direction and purpose to galvanize action. As people who know firsthand the tragedies of mental illness and addiction, and the triumphs that are possible, we all call on you to take immediate action.

Our nation expects nothing less of all of us.

From the Field
10/1/2012 12:00 AM

We have seen a recent uptick in one-sided reporting by media outlets that are either misinformed about the successes and difficult challenges of the treatment field, have no interest in balanced reporting on these important issues or are using old and outdated information. CRC Health Group, in particular, the nation’s largest provider of behavioral health and addiction treatment services, has been the subject of a disproportionate number of these reports. And while this increased attention on addiction and treatment would be welcome if it were to raise awareness about this devastating disease, the unfortunate reality is that these media inquiries are spurred by our nation’s upcoming presidential election, CRC’s exaggerated connection with one of the candidates and the continued stigmatization of addicts and treatment.

We have seen a recent uptick in one-sided reporting by media outlets that are either misinformed about the successes and difficult challenges of the treatment field, have no interest in balanced reporting on these important issues or are using old and outdated information. CRC Health Group, in particular, the nation’s largest provider of behavioral health and addiction treatment services, has been the subject of a disproportionate number of these reports. And while this increased focus on addiction and treatment would be welcome if it were to raise awareness about this devastating disease, the unfortunate reality is that these media inquiries are spurred by our nation’s upcoming presidential election, an exaggeration of CRC’s connection with one of the candidates and the continued stigmatization of addicts and treatment.

Some recent media articles have attempted to politicize what CRC does and have accused CRC of “putting profits ahead of patients.” This is just not true. The truth is, having for-profit, investor-owned treatment centers is a positive thing for our country. Unlike many nonprofits or single-owned facilities, we have the geographic breadth and financial stability that enable us to continue to provide these necessary services, even in challenging economic times. As a result of our structure and access to capital, our programs are more insulated from state and local budget cuts or economic downturns. Our structure also allows us to invest significant dollars on patient quality, even when the general economic environment is stagnant.

Some journalists have chosen to focus on anecdotal — and dated — reports of incidents in our facilities and falsely extrapolate to a conclusion of declining quality. But the reality is that the addiction treatment field is increasingly dealing with more medically complex and highly compromised patients. While very unfortunate, incidents do happen within this field of healthcare, one that treats a population of people who are at the ends of their ropes, in the depths of their despair: troubled teens, patients with alcohol and drug abuse addiction, co-occurring mental health and drug and alcohol issues, sometimes suicidal, most in denial, and many untruthful to themselves, their families and us about preexisting medical and mental health conditions.

Some media have chosen to focus their criticism on incidents that occur outside of our facilities, when patients, under the supervision of doctors, take their methadone or buprenorphine home for administration of doses, despite the safeguards that we put in place such as lockboxes and patient accountability checks and contracts. Our mission is to help these individuals, but sadly, we cannot report 100 percent success. No treatment provider can.

The media often fails to mention that the overwhelming number of patients do experience significant success. Journalists rarely interview any of the number of referrals provided by CRC who have positive experiences. Instead, the articles rely extensively on “survivor” organizations that criticize youth treatment or drug and alcohol programs across the board, critics with no firsthand knowledge of the events they purport to describe, and the selective republication of erroneous information from earlier media articles.

It is a fact that treatment organizations are prohibited by law from discussing specific cases or patient care, while other sources and family members making allegations have no such restraints. The occasional article that does mention such privacy regulations does so in a way that implies that treatment providers hide behind this language so as not to have to publicly discuss patient incidents. In actuality, these regulations are to protect our clients, every individual who enters our doors to get the treatment they so desperately need, who can take some comfort in this time of great distress knowing that their confidentiality is assured and trusting that it will never be revoked.

Several journalists who have written about CRC and treatment began their reporting with biased perspectives, specifically soliciting only critics of treatment programs to be sources.

CRC treats 30,000 people every day, yet this is just the tip of the iceberg when considering this nation’s treatment gap of people who need but do not receive treatment is over 20 million. We need more, not fewer, treatment options. When the media criticizes one provider because that sells newspapers or increases web hits, ignoring all of the positive aspects of treatment and lambasting our outcomes research, they are perpetuating the stigmatization, condemnation and discrimination of the entire treatment industry, with likely ramifications on millions of lives.

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  • Meet the Editor

    Alison Knopf
    Editor

    Alison Knopf is a professional journalist who began covering the addiction field in 1984 as founding editor of Substance Abuse Report. She has been the editor of Alcoholism & Drug Abuse Weekly since 2005.
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