Something’s Missing in the Current Drug Prevention Rhetoric

I have been an addiction therapist for approximately thirteen years.  While for some professions that may not seem like a long time, for a substance abuse professional, thirteen years in the trenches is a very long time. It is thirteen years of being underpaid, overworked, and underfunded.  It is also thirteen years of working with lost and often traumatized souls who may never ever get better.  Thirteen years as a substance abuse professional can make you weary.  However, you don’t end up in this profession and last for any length of time unless it is a calling.

Unless you are completely cut off from the outside world, you have seen many a news article lately about what is being called the heroin or opiate epidemic.  The apparent meteoric rise of addiction problems due to a prescription pill problem that for many turns into a heroin problem.  In March of 2016, the Centers for Disease Control issued new guidelines for doctors who prescribe opioids for chronic pain.  In 2015, hydrocodone combination products were moved to a Schedule II drug classification, indicating their highly addictive potential.  These changes were made in the hope of curbing the opiate addiction problem in our country, but with little effect.

This blog is not meant to be a discussion of anything related to why the situation continues to decline or what to do about it now.  What I want to talk about is prevention.  Most resources, even good resources like www.PASTOP.org, spend most of their page space talking about prescribing, what to do with unused medication, overdose and treatment information.  While all of this is very useful information, it is what I would call secondary prevention.  This is prevention of use by teens or adults, frequently who are prescribed medication initially by a doctor for a legitimate medical issue.  What is missing from the big picture of this prevention discussion is childhood.

Earlier this year, I finished reading both Dr. Gabor Mate’s, In the Realm of Hungry Ghosts and Dr. Bessel van der Kolk’s, The Body Keeps the Score.  Both are must reads for anyone who works in the addiction field.  I would like to share with you the line from In the Realm of Hungry Ghosts that inspired me to write the post.

“The prevention of substance abuse needs to begin in the crib – and even before then, in the social recognition that nothing is more important for the future of our culture than the way children develop.” P. 443

What is missing in almost all current talk about prevention is that, unfortunately, for all the people already addicted or prone to addiction, it is potentially too late.  Why do people become addicts?  Trust me in that no one wants to be an addict when they grow up or enjoys addiction.  Maybe, in the beginning, they liked the effect of the drug, but that quickly wears off.  What many addicts like is the escape.  The ability to take a substance that makes them not feel feelings they don’t like or can’t handle.  They like the fact that when they are taking the substance, they don’t have to sit in reality.  They like that the drug makes their flashbacks go away.  They like the fact that many drugs make them forget for a period of time.

In 13 years, I have yet to meet a drug addict who, at some point in their life, and most likely in childhood, did not suffer from at least one form of abuse or neglect.  Many drug addicts and alcoholics (gamblers and sex addicts too) endured verbal, physical and/or sexual abuse by their parents or family members growing up.  Many endured neglect in childhood as well, whether that was physical or emotional.  Many addicts were bullied in school and had no one safe at home to talk to about their experiences.  These childhood experiences mean that often, they looked for ways to self soothe, ways to cope or ways to feel better even if it was for a short period of time.

The ACE studies (Adverse Childhood Experiences) have shown scientific proof of what addiction counselors have known for years.  The more ACE events in a person’s life, the more likely they are to not only have physical issues but also mental health issues.  People with higher ACE scores are 2 to 4 times more likely to use alcohol or other drugs and to do so at an earlier age.  If a person’s ACE score is 5 or higher, they are 7 to 10 times more likely to use illegal drugs, report addiction or to inject illegal drugs.

So what do we do?  Addiction prevention starts before a child is born.  The in-utero environment of a child affects their neurobiological reaction to stress as an adult.  To stop drug addiction, we need to stop child abuse.  How do we do this?  Obviously, this is a tall order.  Make parenting classes more accessible to all expecting men and women.  Teach not only about physical care of a child but their mental health care as well.  Talk about attunement to a child and how that affects his or her ability to regulate emotion later in life.  Work to create safe spaces in a home and healthy attachment.  Teach communication skills from the start.  Teach healthy coping skills to even very young children.  Teach healthy coping skills to the adults so that they can model these for their children.  Work as hard as we can to prevent physical, sexual and emotional abuse of everyone.

I realize that my goals are idealistic.  I have always said that if the world gets healthy, I would happily change professions.

We need to start addiction prevention from the beginning by having discussions about childhood abuse, neglect and trauma.  We need to work to take away the stigma of therapy and getting help for emotional problems.  We need to teach everyone how to effectively communicate and cope.

I know that this is a tall order and that many do not have the resources to learn all these skills.  We need to work to provide these resources to everyone.  As a society, we need to do more……….

For more information on Dr. Weeks please go to our company website www.sexualaddictiontreatmentservices.com.

Photo credit.  The Watsons, NYC, NY.