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Citizen's View: Toll of addiction keeps rising; here's what you can do to help

Despite all we know about addiction, the toll keeps rising.

Drug overdoses now kill more people than auto accidents in many states, and heroin use is significantly on the rise, according to a newly published report by the Centers for Disease Control. Kids now have unprecedented access to objects of addiction — pills, pot, porn, food, video games — that become substitutes for real relationships when fueled by trauma in all forms (e.g., emotional, sexual, physical).

Media potentiate trauma by streaming emotionally disturbing images and video that no child — or many adults — should ever see. We have become the fattest nation on the planet, in part due to addictive processes well-articulated in Dr. Nora Volkow’s recent Ted Talk (available online at www.youtube.com/watch?v=Mnd2-al4LCU.) In Oregon, shops that cater to gambling, pot and sex are now as common as convenience stores.

Sigmund Freud once said “Love and work ...work and love, that’s all there is.” When a Gallup poll shows that 70 percent of people are not happy with their jobs and Facebook friends replace real relationships, addiction makes an unbearable world bearable.

When addiction hits home, the knee-jerk reaction is treatment. But numerous reports have documented how our $30 billion-a-year addiction treatment system is badly broken. Less than 10 percent of those who are in need of help receive it, and of those who do successfully complete a program, about half will relapse within a few years.

While effective medications and behavioral interventions are available to treat addiction, they are significantly underutilized in practice. In 55 percent of counties in the U.S., no practicing psychiatrists, psychologists or social workers treat addiction. Even worse, treatment can be deadly when program administrators are more concerned with profit than care.

So if you struggle with addiction, what can you do?

As an expert who has been on the front lines treating addiction for almost two decades, I recognize there are no simple answers or quick fixes. Anyone who tells you otherwise is selling snake oil. While no one approach works better than all others, evidence-based practices optimize outcomes. If you are searching for a lasting solution, here are interventions you should know about:

Treat underlying trauma: Most who continue to struggle with addiction have unresolved trauma. Seek out clinicians in private practice who know how to treat trauma. Therapy requires going beyond talk therapy and engaging the body somatically in a safe, slow and relational environment. For more information, read “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma,” by Bessel van der Kolk.

Utiilize FDA-approved addiction medications: Naltrexone, methadone and buprenorphine products, when combined with psychosocial therapies, can be lifesaving. Not everyone needs medication, but if you have not tried a medication and continue to struggle, they are worth considering.

Outpatient over residential: Evidence suggests that there is no benefit of residential treatment over intensive outpatient care for most people, yet the cost between the two is significant. Instead of spending thousands of dollars on a few weeks of residential care, use your money wisely to fund outpatient treatment for years.

Developmental catch-up: Trauma and addiction stunt emotional growth, negatively impacting intimate, parental and work relationships. Most adults who enter treatment are emotional children. Seek out treatment that developmentally catches you up to your chronological age. For more information, read “The Growth of the Mind: And the Endangered Origins of Intelligence,” by Stanley I. Greenspan and Beryl Lieff Benderly.

CRAFT: If someone you care about struggles with addiction, learn all you can about the Community Reinforcement and Family Training Approach (addictionmanagement.org/help-loved-one-friend) and forgo watching reality TV intervention shows. For more information, read “Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening,” by Robert J. Meyers and Brenda L. Meyers.

Dr. John Fitzgerald is an addiction expert in private practice in Lake Oswego, an affiliate instructor in the Department of Psychiatry at OHSU and an adjunct assistant professor in the Systems Science Graduate Program at Portland State University. Learn more at www.drjohnfitzgerald.org.

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