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Why 'Tough' Treatment Doesn't Help Drug Addicts

A new book by journalist Maia Szalavitz exploring treatment for drug addiction explains how some of the most common methods for treatment can often be counterproductive for helping addicts.

Szalavitz, who has been covering addiction and other drug related stories for almost 30 years, told NPR that tough love and 12-step programs commonly deployed to help fight addiction are actually less useful than simply treating people with addiction "like human beings."

Szalavitz's book, "Unbroken Brain: A Revolutionary New Way of Understanding Addiction," advocates for "harm reduction" programs which don't punish addicts, but instead provide them with support and empathy.

"When you go into a needle exchange, one of the most amazing things is people are just treated with dignity and respect," said Szalavitz, a former addict of heroin and cocaine. "And when you're an active drug user, when you are injecting, everybody crosses the street to avoid you. And here you're just seen as a person who deserves to live, and you deserve a chance. And it's that [which] gives people hope. And it's that [which] shortens the period of addiction."

Szalavitz speaks from her own experience -- when she was 20, she was caught with about 5.5 pounds of cocaine. She didn't serve jail time (which she says was in part due to a racist judicial system that favored her as a young white female at an Ivy League school) but she said that in the end, getting "some kind of hope that I could change" was what led to her getting help for her addiction.

Szalavitz also advocates destigmatizing the use of methadone and buprenorphine for the treatment of addiction to opioids like heroin. Methadone, which was found to be more effective at reducing heroin use among addicts than a treatment program of total abstinence by a study conducted by UC San Francisco, is a controversial treatment for opioid addiction because of its status as an opioid itself.

Thousands die each year because of the view that using drugs to fight drugs is not good, said Szalavitz in a Vice column. 

"The way they are able to do that is because if you take an opioid in a regular steady dose every day at the same time and the dose is adjusted right for you, you will not experience any intoxication," said Szalavitz, who added that because the opioid medications help build up a tolerance to opioids, addicts who regularly use methadone or buprenorphine as part of their treatment have a 50 to 70 percent lower chance of dying in the event that they relapse. "Unfortunately," she said, "We have this idea that if you take methadone or buprenorphine, you are just substituting one addiction for another."

Sources: NPR, Vice, UC San Francisco / Photo credit: e-Magine Art/Flickr

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