What If My Child Isn’t Motivated to Get Treatment for Addiction?
Suggesting Treatment to a Loved One
Intervention – a Starting Point
Drug Use, Stigma, and the Proactive Contagions to Reduce Both
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To protect my sobriety, I had to stop doing these three things.
- Being Around Alcohol
- Debating Myself
- Not Asking for Help.
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In opioid use disorder treatment, there’s been a persistent (though not always acknowledged) tension between what’s good for public health and what individuals and their families want from treatment. I’ve written about it before. For public health, there’s plenty of evidence that MAT (medication assisted treatment) reduces illicit drug use, improves health and reduces crude mortality rates.
Meeting people with opiate use disorder who were in long term abstinent recovery from illicit and prescribed drugs changed my mind about what was possible. I suppose I have met hundreds of such people over the years. That’s a game changer. I worry that some prescribers don’t spend enough time with people in recovery.
Although there are substantial benefits to MAT, there are also problems: non-engagement with those who would benefit and timely access for instance. Then there are other issues too: stigmatisation of those on methadone, poor retention in treatment and how MAT fits in with the management of problem polysubstance use, including alcohol.
So, does MAT help patients achieve their wider goals – those person-important outcomes?
We don’t really know is the short answer. A systematic review published in 2017[1], found that health related quality of life measures are rarely used as outcomes in MAT research. When looked at from a recovery perspective, we have more evidence on the negatives that go than on the positives that arrive. There are studies showing improved quality of life, but we need more on whether people reach their goals and get improvements in the things that matter to them.
A small in-depth Norwegian study[2] involving 7 women and 18 men on MAT found evidence of them being ‘stuck in limbo’ in terms of not moving on despite national guidance that the patient’s own goals ‘should be the basis of treatment’. These drug users were still engaged in illicit drug scenes. The researchers found four themes:
- Loss of hope
- Trapped in MAT
- Substitution treatment is not enough
- Stigmatisation of identity
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“It’s not that difficult to overcome these seemingly ghastly problems [drug addiction]… what’s hard is to decide to do it.”
This is where assisted decision-making is imperative. The drug addled brain has corrupted processes due to the presence and interference of psychotropic toxins. The Judicial Educator effectively used, is best placed to be actively engaged through problem-solving courts as a key circuit breaker needed to help facilitate the exit from this capacity and agency diminishing haze. Punitive action is not necessary, if coercive mechanisms are able to recalibrate the dysfunction posture, through drug use exiting recovery processes. This is just one reason why 'legalizing' drugs is a very bad idea, as it eliminates this vital, individual and community benefiting intervention and it is also a care-less action for a society with increasing drug use induced harms.
Why Calls for Decriminalizing Drug Use, is Really Not a Care-full Agenda! Anti-drug laws were always meant to be a vehicle to protect Community, family and our most important asset – our children – from the harms caused by permission models that ‘grown ups’ believe they have the right to exercise around the use of psychotropic toxins.
These proactive and protective laws have not been used in any real punitive context for decades now and our families and communities are paying the price for this so called ‘progressive’ agenda.
It’s time we tasked these protective laws again in their most proactive framework – As the ‘Judicial Educator’.
The law used (not in a punitive context) but as with Problem Solving Courts, to facilitate not only exit from drug use, but entrance into productive, safe, health and community benefiting narratives, that are drug free.
You don’t have to change or remove laws, but you can task that legislation to facilitate rehabilitation and recovery, as is being done more and more to great success.
The existing criminal codes don’t need to be weakened, or worse erased, through legalization or even depenalization. They can be used, as mentioned for diversion, but still have the coercive potential of criminal sanctions if the drug user choices to carelessly re-offend, often with harms to those around them.
No criminal records need to be recorded if the diversion path is embarrassed to its effective end.
The pro-drug lobbies completely fallacious meme of ‘war on drugs has failed’ only has traction for the uniformed. There has been no ‘war on drugs’ in this nation since 1985. However, the ever growing ‘war FOR drugs’ continues to look to remove genuine tools that can bring best-practice drug use exiting outcomes, by mislabelling and propagandizing.
The Judicial educator is the perfect bookend for the other bookend of health and education. Together these will see, not further ‘permission’ for drug use and the ensuing uptake that always precipitates, but rather, as with Tobacco, a community with One Voice, Once Message and One Focus – the cessation of humanity, dignity, agency and family devastating drug use. That should be the agenda of all drug use reduction vehicles.
The excising of any vehicle that can assist with that proactive and productive end, is not only non-sense, but also only adds to the harms that drug use does to our communities and their families.
Once psychotropic toxins are an intrenched part of the behavioural mechanisms of an individual, whether it be short-term intoxication, or long-term dependency, the risk to health, safety and well-being of that individual and more concerningly, those around them requires more than a ‘doctor’ for change. Secure welfare engaged for rehabilitation continues to prove the safest and healthiest vehicle to assist that change.
We seem to care more for Tobacco users, than illicit drug users – Don’t the latter deserve the same passionate enabling to exit drug use, with no voice of permission or approval in the marketplace?
There must be a thorough enabling, equipping and empowering of drug users to exit drug use, even more importantly before the inevitable dependency takes hold.
Any permission model – decriminalisation, legalisation or depenalization – does not add to that capacity of drug users to move out of drug use. However, it has and will continue to do so, if the only proactively coercive vehicle – The Law – is removed, further normalizing drug use and the inevitable entrenched harms this will bring.
The Judicial Educator At Its Best – Law for Recovery + Drug Courts + Secure Welfare = Rehabilitation!
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This is where assisted decision-making is imperative. The drug addled brain has corrupted processes due to the presence and interference of psychotropic toxins. The Judicial Educator actively engaged through problem-solving courts is the key circuit breaker needed to help facilitate the exit from this will diminishing haze. Punitive action is not necessary, if coercive mechanisms are able to recalibrate the dysfunction processes, through drug free recovery processes. This is why 'legalizing' drugs eliminates this vital, individual and community benefiting intervention and a care-less action for a society with increasing drug use induced harms.
https://clearskyibogaine.com/robert-downey-jr-and-drug-addiction/
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Results: Net of controls, offenders in the treatment group took 22 per cent longer to re-offend for a person offence than offenders in the control group. Offenders in the treatment group also had a 17 per cent lower re-offending rate than offenders in the control group.
CONCLUSION: The Drug Court appears to have long term beneficial effects on the total number of reconvictions and the risk of another person offence.
NSW Bureau of Crime Statistics & Research – Crime & Justice Bulletin No 232 (September 2020)