Monday, June 11, 2012
Adapting 12-Step Programs For Teenagers
By Celia Vimont | June 1, 2012 | 6 Comments | Filed in Addiction, Recovery,Young Adults & Youth
Twelve-step programs can be extremely helpful for teens who are struggling with addiction or who are on the road to becoming addicted, but they are more useful if they are adapted to the particular needs of adolescents, according to an expert on teenage addiction.
“These programs were developed for adults, and teenagers are not little adults—they are in a totally different developmental stage,” says Steven Jaffe, MD, Professor Emeritus of Psychiatry at Emory University, and Clinical Professor of Psychiatry at Morehouse School of Medicine, in Atlanta.
Dr. Jaffe, who has spent the past 25 years working to modify 12-step programs to make them developmentally meaningful for teenagers, spoke about his work at the recent American Society of Addiction Medicine conference. “These programs are free, they’re everywhere, they provide big brothers and sisters as sponsors, and they offer recovering friends,” he notes. “That’s really important, because if teens go back to their friends who use drugs or alcohol, they will start using again, too.”
Often, teens who are treated for substance use disorders are simply told to go to 12-step meetings. “You can’t just tell them to go, and leave it at that,” Dr. Jaffe says. “They have tremendous anxietyabout going, so you need to link them with a sponsor who will take them to a meeting, or else they won’t go.”
Just getting them to the meetings may not be enough, however. Some of the basic concepts of 12-step programs may be troublesome for teenagers, according to Dr. Jaffe. The first step talks about being powerless over drugs and alcohol, but the word “powerless” can be a big turn-off for teens, he observes. “The goal of a teen is to have power, and they think, ‘Who wants to be part of a group that’s powerless?’”
Instead, Dr. Jaffe encourages them to think about getting clean and sober in order to enhance their power. “It’s the same step, but it’s rephrased and reemphasized to make it developmentally appropriate,” he says. “I tell them, flunking out of school, being thrown out of the house and being arrested as a result of drugs or alcohol is not powerful.”
Another concept in 12-step programs that teens can have trouble with is surrender. “Many teens, especially girls, have found themselves in very vulnerable situations when they are drunk or high, and the last thing they want to do is surrender. I tell them if they get clean and sober, they’ll be strong, and never have to put themselves in a position where bad things like that can happen.”
Dr. Jaffe developed two workbooks he uses with teenagers to make 12-step programs more meaningful to them. “So often, teens will tell me the negative consequences of using drugs and alcohol one day, and the next day they’ll deny it. So I have them write down the consequences in the workbook, so they can’t deny it the next day.” It takes one hour to complete the Adolescent Substance Abuse Intervention Workbook, which is then presented to a counselor individually or at a group. The Step Workbook for Adolescent Chemical Dependency structures the working of the first five steps.
Dr. Jaffe can be contacted about his work with teens and 12-step programs at srjaffe@bellsouth.net.
Sunday, June 10, 2012
Commentary: Responding to America’s Medicine Cabinet Epidemic
By Congressman Hal Rogers | June 8, 2012 | Leave a comment | Filed in Drugs,Government & Prescription Drugs
A high school homecoming queen and a Hollywood bombshell. A rural sheriff and a college rugby-player. A small-town pharmacist and an expectant mother.
These individuals may not appear to have much in common – but tragically these are all among the thousands of lives fallen prey to the abuse of pain pills around our country. The Centers for Disease Control has described this as a national epidemic, and the statistics don’t lie.
While overdose deaths from prescription opioids have long exceeded deaths from heroin and cocaine combined, alarmingly in 2009, prescription overdoses also overtook motor vehicle crashes as a leading cause of accidental death. As a result of dangerous misconceptions about the recreational use of painkillers, ourmedicine cabinets have become more dangerous than our cars.
When this problem began to take root in southern and eastern Kentucky, we realized the unique nature of prescription drug abuse would require a multi-pronged solution. At the local level, our Kentucky communities coalesced around an organization called Operation UNITE (Unlawful Narcotics Investigations, Treatment and Education). UNITE has harnessed the energy of health, law enforcement and community leaders in a coordinated fight against pain pill abuse. At the same time, undercover UNITE detectives zero in on drug dealers, and school counselors help start up meaningful alternatives to youth drug use through UNITE clubs and extracurricular activities. Thousands of mothers, daughters, fathers and sons have been given a second lease on life through UNITE’s treatment programs or by participating in a drug court.
People in our region of Kentucky have taken a stand, and the nation is taking note. At the first of its kind National Rx Drug Abuse Summitin Orlando earlier this year, leaders from around the country joined with UNITE to think strategically about the path forward. Office of National Drug Control Policy Director Gil Kerlikowske, federal and local law enforcement, organizations like The Partnership at Drugfree.org, public health officials, prosecutors and medical researchers all rallied together to share ideas for reducing drug abuse in rural and urban communities alike and mending families ripped apart by this scourge.
For my part, through the Congressional Caucus on Prescription Drug Abuse, I have worked to alert Washington decision-makers to the serious dangers posed by our nation’s fastest growing drug threat. Members of the Caucus collaborate across the political spectrum toward immediate and long-term policy solutions in our battle against prescription drug abuse.
This week, I was particularly proud to speak at the Annual Meeting for the Alliance of States with Prescription Monitoring Programs (ASPMP). Prescription drug monitoring programs (PDMPs) are among the most efficient and cost-effective tools in our arsenal, bridging the gap between legitimate medical need and potential misuse. Since Congress established a grant program at the U.S. Department of Justice in 2002, the number of states with authorized PDMPs has tripled from 15 to 48; however, a secure interstate exchange system to combat so-called “doctor shopping” has lagged.
I was pleased to stand with these trailblazing members of ASPMP as they voted to adopt the PMIX Architecture – a landmark, consensus-based set of technical standards to facilitate interoperability among state-run PDMPs. Soon data exchanges will allow doctors, pharmacists and investigators to sniff out the interstate doctor shopping that has fueled the pill pipeline in our country.
While this marks a huge victory for those of us who have been engaged in this fight for years, our work is far from done. This is an epidemic which crosses socioeconomic and gender lines and which threatens the very fiber of our society. I would encourage you to reach out to your Member of Congress and request that he or she join the Congressional Caucus on Prescription Drug Abuse or cosponsor one of the several measures that seek an end to the abuse of painkillers; only together can we curb this rising tide.
Rogers has served Kentucky’s 5th Congressional District since 1981 and is currently serving as Chairman of the House Appropriations Committee. As part of his efforts to fight this growing epidemic, Rogers joined with Representatives Mary Bono Mack (CA-45) and Stephen Lynch in forming the bi-partisan Congressional Caucus on Prescription Drug Abuse, which aims to raise awareness of abuse and to work toward innovative and effective policy solutions, incorporating treatment, prevention, law enforcement and researc
Thursday, June 7, 2012
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Wednesday, June 6, 2012
Commentary: Peer Recovery Coaches: Expanding the Career Ladder
By Mary Jo Mather | June 5, 2012 | 1 Comment | Filed in Research
In a coffee shop. In a treatment center. At the library. At a sober living home. These are all settings where peer recovery services take place. Whether volunteers or staff, the role of a Peer Recovery Coach (PRC) is a legitimate and important one within the continuum of care, and IC&RC is proud to be developing the first, international credential for PRCs.
In recent years, a rapidly growing segment of the addiction recovery workforce has been made up of PRCs, who use their personal experiences of recovery to facilitate it and build resilience of persons with addiction, mental illness, or co-occurring substance and mental disorders. Many PRCs provide these valuable services as volunteers and in community settings, but seek the objective verification that certification provides.
A 2008 report from the U.S. Department of Health & Human Services, the Substance Abuse and Mental Health Services Administration and the Center for Substance Abuse Treatment wrote:
“Recovery support services are non-clinical services. Many recovery community organizations have established recovery community centers where educational, advocacy and sober social activities are organized. Peer recovery support services are also offered in churches and other faith-based institutions, recovery homes/sober housing.”
Wherever they are, PRCs form the connecting tissue between professional systems of care and indigenous communities of recovery. They are specifically trained to assist people in accessing a broad range of support services including education, employment, health care, housing, day care, transportation and counseling for co-occurring problems.
Unlike a sponsor, the PRC usually works – as a volunteer or staff member – within a formal organization that is bound by accreditation, licensing and funding guidelines. Another distinction is that PRCs start coaching clients before they have formally entered recovery, continue the relationship even in the face of relapse and check-in with clients after they have disengaged from active participation in mutual aid groups.
Responding to demand in their jurisdictions, several IC&RC Member Boards – Florida, Georgia, Illinois and Pennsylvania – developed Peer Recovery credentials, and it soon became clear that there is a growing need for a credentialing process at the reciprocal level.
An IC&RC Task Force, headed by Kristie Schmiege of Michigan, explored and recommended standards for two levels of PRC, which were adopted by board vote in October, 2011. The organization is in the process of developing the formal job task analysis and written examination for the credential.
The 2008 report emphasized that “maintaining the peer-ness of peer recovery support services and resisting the pressure to professionalize these services is a key challenge.” As we developed the standards for the first-ever international PRC credential, IC&RC believes we have met this challenge.
Mary Jo Mather is the Executive Director of IC&RC, the largest addiction and prevention credentialing organization in the world. Today, IC&RC represents 78 member boards and 45,000 professionals from 25 countries and 47 U.S. states and territories. IC&RC’s seven credentials include counselors, clinical supervisors, prevention specialists, criminal justice and co-occurring disorders professionals.
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