In a move sure to send shockwaves through the recovery community, Hazelden has announced that it will offer buprenorphine (Suboxone) maintenance for patients addicted to heroin and prescription painkillers. That’s right: the pioneer of abstinence-based treatment, which put the "Minnesota" in the Minnesota Model of treatment used by most private programs nationwide, will now offer medication-assisted care—in some cases, indefinitely. The change, as reported today in Time, comes as a result of the epidemic in opiate-based prescription drug abuse, which over the past decade has flooded the renowned rehab with a new breed of patients with new needs (in 2001, only 19% of its adult patients, and 15% of adolescents and young adults, were addicted to heroin or prescription pain relievers; by 2011, the numbers had increased to 30% and 41%, respectively):
“This is a huge shift for our culture and organization,” said Dr. Marvin Seppala, Hazelden’s chief medical officer, who pushed for the new practice. As the program’s first adolescent patient, and someone who has been in recovery from multiple drug addictions for 37 years, Seppala is keenly aware of how dramatic this decision is for the organization, which once debated whether or not coffee was acceptable in recovery. “We believe it’s the responsible thing to do,” he says.
Driving the need for change is the sobering reality of how patients addicted to prescription pain relievers fare once they leave the Hazelden program.…Within days of leaving a residential treatment facility, most were relapsing—and at least half a dozen have died from overdoses in recent years. It was time, Seppala argued, for a radical change.
Although the World Health Organization, the Institute on Medicine, the National Institute on Drug Abuse, and the nation's "drug czar" have all determined that maintenance medications like methadone and Suboxone are the best hope for people addicted to opioids, Minnesota Model programs like Hazelden and Betty Ford have limited their use to short-term detox. Meanwhile, on the Minnesota model-based Celebrity Rehab, Dr. Drew has popularized an extremely negative—and completely unscientific—view of these treatments, claiming that methadone “takes your soul away”; one of his counselors called Suboxone “the root of all evil.” At least two of the patients that Celeb Rehab put through its harsh, nearly cold-turkey withdrawal have since died opioid-related deaths, including Alice in Chains bassist Mike Starr and actor Jeff Conaway. Research shows that such grim outcomes are often preventable: maintenance cuts mortality in people addicted to opioids by at least 50%. That’s why every scientific group that has examined the data has come down in favor of it.
Hazelden’s embrace of maintenance is likely to spur soul-searching in the recovery movement. Hard questions, which have mostly been ignored by the abstinence-only establishment, will now demand answers. Can maintenance really be integrated into a 12-step-based program? Will people on Suboxone or methadone—which, after all, can cause a high in people who aren't tolerant to the drugs—genuinely be seen as “recovering,” just like people who are drug-free? What will such people do in community-based 12-step groups that have traditionally viewed maintenance as being just “substituting one drug for another?” And will Hazelden “lose its soul” by making this change?
Robert Pattinson has seems to have moved on from the Twilight cheating scandal involving his on-off girlfriend Kristen Stewart last summer, and now he's focusing once again on his nicotine addiction. Pattinson previously attempted to kick cigarettes with the aid of toothpicks earlier this year, but started smoking again this past August when the stress from the scandal reportedly became too much for him. Now he apparently has Leonardo DiCaprio to thank for going cold turkey again, after his fellow actor introduced him to electronic cigarettes. He was seen puffing away on the fake smokes over the weekend at the LA premiere for Stewart's latest film, On The Road. And Stewart, a smoker herself, has also kicked the habit in an effort to stand by her man. "She has been trying to be as supportive as she can of Rob's decision to quit," says a friend of hers. "Kristen and Rob used to smoke cigarettes together all the time but they know how crappy it made them feel. Kristen doesn't like smoking that electronic cigarette, so she just altogether quit."
Marijuana fans may go on about how something so "natural" can't possibly be bad for your health, but what about Mother Nature's? In medical marijuana-puffing California, environmental health officials have had to clean up more than a ton of marijuana grow soil found dumped on the bank of the Eel River in Humboldt County. That might not sound serious, but the soil used in pot cultivation tends to be high in nitrogen, phosphorus and potassium fertilizers (NPK), which can wreak eco-havoc if they percolate into rivers. “It's bad for the rivers because it starves the river of oxygen, harms river organisms and can cause fish die-off,” says Melissa Martel, director of Humboldt County's Division of Environmental Health. “It can also stimulate blue-green algae blooms during certain times of the year in creeks or slower-moving bodies of water.” The 30 large bags of grow soil that were discovered have been taken to a landscaping materials company to be reused. “The best management method for spent soil is reuse. Growing vegetable crops in this high-nutrient soil, or mixing it with other soil, may result in high yields,” says Martel. ”When something is dumped inappropriately, it costs agencies and property owners time, resources and money." Pot plants need NPK fertilizers throughout their adult stages. With the battle over marijuana legalization very much in the balance, some growers may want to nurture their PR more carefully.
Nearly half of addiction counselors say they don’t always advise total abstinence for clients with substance problems, a new study shows. Researchers surveyed 913 members of the National Association of Alcoholism and Drug Addiction Counselors across the US, and found that around 50% of them believe it’s acceptable for certain patients with alcohol problems to have an occasional drink. This represents a dramatic rise since a similar study, released in 1994, showed just 25% of addiction therapists said they didn’t always push total abstinence. As for drug problems, about half the counselors in the new study also believe moderate drug use can be an acceptable intermediate goal, with one third able to accept it as a final goal—about the same as in a similar survey 10 years ago.
“Individuals with alcohol and drug problems who avoid treatment because they are ambivalent about abstinence should know that—depending on the severity of their condition, the finality of their outcome goal, and their drug of choice—their interest in moderating their consumption will be acceptable to many addiction professionals working in outpatient and independent practice settings,” write study co-authors Alan K. Davis, MA, and Harold Rosenberg, PhD, of the Department of Psychology at Bowling Green State University. “Our study did not examine whether those who want to moderate their drinking or drug use had better or worse outcomes than those who attempt to abstain immediately and completely, and research has found that episodes of lapse and relapse are common among clients no matter what outcome goal they pursue,” notes Rosenberg.“In light of this study, we suggest that clients ask about their counselor’s openness to limited or moderate consumption as an outcome goal, and that agencies acknowledge their policy regarding negotiation of outcome goals as part of informed consent.”
- Zetas Cartel Occupies Mexico State of Coahuila [LA Times]
- Weed Wars: If States Legalize Marijuana, Will Feds Still Crack Down? [NBC]
- The Nearer the Bar, the Greater the Chances of Risky Drinking [Chicago Tribune]
- "I'm Fighting Gambling Addiction for my Children" [BBC]
- Octomom's Father Checks Into Same Rehab as His Daughter [Daily Mail]
- What Shall We Do With the Drunken Sailors? Fire Them [The Guardian]
Of the three states voting on the legalization of recreational marijuana on November 6—Washington, Oregon and Colorado—Oregon's Measure 80 is faring the worst in the polls. The most recent figures show 49% opposed to the measure and 42% in favor, with the highest support coming from those under 35 (interestingly, only 32% of women back the initiative, with men more evenly divided).
There are various possible explanations for this. Of the three states' ballot measures, Measure 80 is the least well-funded, partly due to its late arrival to the ballot, in July. Whereas Washington's Initiative-502 received $5.5 million and Colorado's Amendment-64 received $3 million over six months, Measure 80 had just three months to raise about half a million dollars. Measure 80 is also the most "radical" of the three initiatives, calling for a total repeal of Oregon's marijuana laws, and allowing for privatized pot harvesting and distribution, to be regulated by a commission. It's unclear whether this all-or-nothing approach will harm or help the measure—interestingly, Washington's I-502 has lost the support of many pro-pot activists who see it as too restrictive. Like the other two initiatives, Measure 80 would allow non-medical marijuana to be sold in state-run stores only, to adults aged 21 and above.
Despite some bad omens for the yes camp, the chief petitioner and author of Measure 80, Paul Stanford, remains optimistic. About 50,000 newly registered student voters could swing the vote, he tells The Fix, citing the measure's popularity among young people. He adds that the poll numbers don't account for the "fear factor"—voters' possible reluctance to admit their support over the phone, for fear of endorsing "a taboo subject." Those who oppose the bill are "mainly concerned about health and safety," Sanford says. Some cite the "gateway theory" as a reason to vote no, claiming that marijuana use leads to other, more dangerous drugs. But Sanford argues that the measure would actually reduce drug abuse, by "taking [the drug] out of the hands of kids and substance abusers and putting it in state-regulated stores, where people are asked for ID in order to purchase." And 7% of the proceeds from marijuana sales—about $25 million a year, Sanford estimates—would go to Oregon's drug treatment centers.
Another concern for Oregonians is driving safety—although Sanford notes that a clause in Measure 80 promises to study marijuana impairment and establish new rules about impaired driving if necessary. "The one huge downside to pot being legal is that driving will most certainly get even worse in this city," says John Gordon, a 38-year-old Portland resident who claims the state already deals with "awful, slow and sloppy" drivers. Despite this, he tells The Fix that he's already cast an early vote in favor of Measure 80: "Pot being illegal makes no sense. For me, it's just a silly, arcane law and marijuana being illegal causes far more problems than it could ever hope to solve."