Never Fear, the New D.S.M. Won’t “Create More Addicts”

Last week’s New York Times article, “Addiction Diagnoses May Rise Under Guideline Changes,” offers a sadly pejorative take on the proposed changes to the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M.—the go-to manual for mental health (including substance use disorder) diagnoses. The reporter writes that the rewritten D.S.M. “could result in millions more people being diagnosed as addicts.”

There are a couple of problems with this speculation. First, people are not diagnosed “as addicts.” This is because there is no diagnosis of “addiction”—not in the current DSM or the revised version. To characterize the diagnosis of substance use disorders this way simply shows the extent to which stigma and depreciatory attitudes about this illness remain.

Second, the new D.S.M. would do one important and enormously beneficial thing: it would allow problematic and/or harmful drug use to be identified and diagnosed earlier. This is the first time Medicaid/Medicare have reimbursed effective services for people who misuse substances—not just for folks who qualify as chemically dependent. This is where programs like Phoenix House’s SBIRT (Screening, Brief Intervention, Referral to Treatment) come in. These programs, along with the new D.S.M., will help us catch and treat substance use problems before they become life-threatening—and before they require the expensive treatments that the Times article references. The fact that SBIRT is now available and funded is no small feat; to quote Dr. Keith Humphreys, former drug control policy adviser to the White House, this is in fact “the single biggest expansion in the quality and quantity of addiction treatment this country has seen in 40 years.”

Third, the article paints a ridiculous picture of the guys who wrote the new D.S.M. They aren’t money-grubbing evil scientists who take money from pharmaceutical companies to support an elaborate research ruse. I know many of these researchers—they’re passionate about the cause, and the D.S.M. is their labor of love. They put in a great deal of work with their efforts to better characterize the DSM categories, which will allow more people to get help. Why would The New York Times be so one-sided in criticizing these efforts? In reality, these researchers are the ones who want to help people the most.

So never fear, the new D.S.M. will not cause more people to be diagnosed with addiction. Instead, more people who may not yet be addicted (but whose drug use is nonetheless problematic and unhealthy) will be able to access very inexpensive but proven effective treatment earlier and easier. Treating these folks is no different from treating those in the early stages ofdiabetes—it requires minimal professional help, some education, and simple lifestyle changes. We wouldn’t wait until a pre-diabetic started experiencing the symptoms of full-blown diabetes before we offered him or her help. Instead, we would intervene early in hopes of preventing such a difficult future. The same should apply for those with early substance misuse.

Deni Carise, Ph.D.
Chief Clinical Officer
Phoenix House

Recovery Advocates to Be Recognized at National Event

By Join Together Staff | May 17, 2012 | Leave a comment | Filed in Addiction& Recovery

Four activists and a grassroots community organization will be recognized for their work as recovery advocates by Faces & Voices of Recovery. The addiction recovery advocacy organization will present the awards Wednesday, June 27 in Washington, D.C.

The awards honor the recipients’ contributions to advocating for the rights of people and their families in or seeking recovery from addiction to alcohol and other drugs.

Recipients of the award are Rev. Dr. Robert Gilmore, Sr., of Real Urban Ministry in Houston; Walter Ginter of the National Alliance for Medication-Assisted Recovery in New York; Rosemary Tisch of Celebrating Families in Saratoga, California, Jeff Blodget of St. Paul, Minnesota, and the Massachusetts Organization for Addiction Recovery in Boston.

To read more about the awardees and the event, visit the Faces & Voices of Recovery website.

Commentary: 6 Tips to Protect Your Child From Online Drug Threats

By David Festinger, PhD | April 17, 2012 | 1 Comment | Filed in Alcohol, Drugs,Parenting, Young Adults & Youth


Many people in Philadelphia were stunned by a recent report thatstudents in one community had been depicted on YouTube drinking and taking other drugs.

It’s not entirely clear what people were most shocked by – the realization that kids abuse drugs and alcohol, that videos glorifying the use of drugs and alcohol appear on the Internet or simply the fact that this was done by local students.

The fact that kids abuse dangerous substances is definitely not new. Findings from the Monitoring the Future Study (2010) indicated that in the prior year alone, 1.8 million kids under the age of 18 reported using drugs for the first time – that’s almost 5,000 kids each day. In addition, 48 percent used illicit drugs. What’s more staggering is that these estimates do not include alcohol.

The existence of online media that promote drug and alcohol use is also not a recent phenomenon. Research conducted by our team at the Treatment Research Institute has catalogued hundreds of YouTube videos, chat rooms, social networking venues and other online sites that extol the virtues of drugs, provide information about how to use drugs “safely” and even teach kids how to manufacture and sell drugs.

Although most of us are aware of the influence that friends, peers, television and movies may have on our children’s perceptions of drug and alcohol use, many people are not aware of the incredible prevalence of pro-drug use propaganda and misinformation available on the Internet.

The fact that this happened in someone’s backyard may have been the thing that caught local attention, but the prevalence of these online drug threats are the issues – at the local level and nationally – that we should be most concerned about. Similar to strategies taken to safeguard our children against online predation, there are many ways to protect them from these pro-drug and alcohol use influences.

The Treatment Research Institute has developed a training program for parents that provides practical recommendations to help them defend their children from these online drug threats. Some of the most basic recommendations include:

• Setting limits on Internet use and availability depending on the age and maturity of the child. (These limits need to be discussed with the child – see below.)
• Monitoring your child’s Internet use and making use of commercially available parent controls. Placing the computer in a central area of your home can make this easier.
• Having a formal or informal contract with children about the proper use of the Internet and making clear the consequences for misuse. (Be sure to follow through with those consequences when misuse occurs.)
• Having children walk parents through the places they go online, and who they communicate with (their contacts).
• Discussing your house rules related to Internet use with the parents of the friends your child visits. Make sure that your child is not able to engage in unmonitored or inappropriate Internet use while at their friends’ homes.
• Remaining calm and having a plan as to what to do if you discover inappropriate use. (Keep in mind that children are naturally curious and there can be many reasons why they happen upon a particular website. Don’t overreact!)

Technology has made many things possible. While the Internet serves as an amazing tool that can greatly benefit our children, we must also be conscious of its potential dangers.

The writer is a Senior Scientist at the Treatment Research Institute, an independent, nonprofit research and development organization dedicated to science-driven transformation of treatment, other practice and policy in substance use and abuse.

New Steps Pediatricians Can Take to Reduce Teen Substance Use

By Celia Vimont | May 18, 2012 | 2 Comments | Filed in Alcohol, Drugs,Healthcare, Prevention, Young Adults & Youth


Teens who complete a five-minute computer screening program that includes six questions about alcohol and drug use, and who talk with their pediatrician briefly about the results, reduce their risk of drinking up to one year later, according to a new study.

Researchers at Boston Children’s Hospital studied more than 2,000 teens from New England and the Czech Republic. The teens completed the screening program, which asks six questions about alcohol and drug use, and then presents a score and risk level. The teens read through 10 pages with facts and stories that illustrate the serious health effects of substance use.

The teens’ doctors receive a report with the results, and a list of talking points for a two- to three- minute conversation about the risks involved in alcohol and drug use. They tell the teens it would be best for their health not to use alcohol or drugs at all.

The study found that after using the program, teens’ risk of drinking dropped almost in half for three months, and by about one-quarter one year after the doctor’s visit, the researchers report in the journal Pediatrics.

Screening and brief intervention has been shown to be effective in emergency departments and college campuses, but this is the first study published in an English language journal to demonstrate it is effective in adolescent primary care settings, according to senior author Dr. John R. Knight, Director of the Center for AdolescentSubstance Abuse Research at Boston Children’s Hospital. “It’s important to get pediatricians involved, because we know 70 percent of high school seniors have started to drink, and almost 60 percent have started to use drugs, but there are few specialists available to deal with early intervention with teens,” he said.
Dr. Knight noted that teens generally see their primary care physician for a yearly physical. “Kids know they can tell the truth to their doctor, and it won’t get back to their parents. They really listen to their doctors’ advice,” he said. “Since substance abuse kills more teenagers than infectious disease, parents should view this screening as another important vaccination.”

Two key factors may prevent a teen’s doctor from asking about drug and alcohol use, and this program addresses both, Dr. Knight says. One is time constraints. “Doctors are pressed for time, and they have a lot of things they need to screen patients for,” he says. By having patients complete the screening before the visit, doctors have more time to interpret the results and discuss them.

The second factor is that doctors who do screen teens for substance use don’t always know what to say to those who admit to using drugs or alcohol.

The screening program is based on the CRAFFT test, a behavioral health screening tool for use with children under the age of 21 that is recommended by the American Academy of Pediatrics (AAP) Committee on Substance Abuse for use with adolescents.

Last fall, the AAP and the National Institute on Alcohol Abuse and Alcoholism unveiled a new tool designed to help pediatricians talk to teenagers about alcohol use. The “Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide” provides doctors with basic questions about whether and how much a patient drinks, and how much their friends drink.

“Our program takes a similar approach, but by using a computer, we are saving the doctor time,” observes Dr. Knight.

As Summer Approaches, Experts Warn Alcohol is a Key Factor in Boating Accidents

By Join Together Staff | May 18, 2012 | 1 Comment | Filed in Alcohol &Community Related

Intoxication is a key factor in many boating accidents, experts say, as boating season gets underway. In Texas, almost 100 people died in boating accidents over the last three years, and alcohol use was the leading contributor, the Houston Chronicle reports.

Not wearing a life jacket also plays a role in many boating-related deaths, the article notes.

“It’s unfortunate that there’s probably a boating culture out there … a little bit different from driving your car. When you get into the boat, you’re going to have fun,” Game Warden Capt. Ron VanderRoest told the newspaper. “Not being able to drink or having to wear life jackets are not the most fun thing to do, but it’s a whole lot better than someone losing their lives.” The article notes 820 Texans were citing for boating while intoxicated from 2009 to 2011.

The Coast Guard announced the start of National Safe Boating Week, May 19 to 25, reminding the public that boating under the influence (BUI) or boating while intoxicated (BWI) is just as deadly as drinking and driving.

In a news release, the Coast Guard states, “It is illegal to operate a boat while under the influence of alcohol or drugs in every state. Penalties for violating BUI and BWI laws can include large fines, suspension or revocation of boat operator privileges and jail terms.”

STAND DOWN PROGRAM FOR VETERANS!

The original Stand Down for homeless veterans was modeled after the Stand Down concept used during the Vietnam War to provide a safe retreat for units returning from combat operations. At secure base camp areas, troops were able to take care of personal hygiene, get clean uniforms, enjoy warm meals, receive medical and dental care, mail and receive letters, and enjoy the camaraderie of friends in a safe environment. Stand Down afforded battle-weary soldiers the opportunity to renew their spirit, health and overall sense of well-being.

That is the purpose of the Stand Down for homeless veterans, and achieving those objectives requires a wide range of support services and time. The program is successful because it brings these services to one location, making them more accessible to homeless veterans.

In July 2002, the founders of Stand Down – Robert Van Keuren, Dr. Jon Nachison and Vietnam Veterans of San Diego – asked the National Coalition for Homeless Veterans (NCHV) to become the “keeper of the flame” and provide national leadership for the movement. Since the first Stand Down in San Diego in 1988, the program has become recognized as the most valuable outreach tool to help homeless veterans in the nation today.

Stand Down Guide
Information about the history of Stand Down, essential program components, event classifications, and how to organize and develop a Stand Down program for your community.

2012 Stand Downs
The National Registry of scheduled Stand Down programs and contact information for event coordinators.

Stand Down Information FormTo include your Stand Down event in the national registry and NCHV’s newsletter and website, please complete the Stand Down Information form and return it via fax or mail to NCHV, attn: Samira Denardo.

2012 After Action ReportOnce your event has concluded please fill out the after action report.The information on this form is used by NCHV and the U.S. Department of Veterans Affairs to compile an annual report on Stand Down programs that provide outreach and supportive services to homeless veterans. If you have questions or need assistance with this report, contact Samira Denardo at 202-546-1969 or by email at sdenardo@nchv.org.