Nine Suggestions designed to Help Hard Core Criminal Addicts

By David H. Kerr              

1. Continue to promote and encourage law enforcement to use the drug court for relapse prone addicts with a criminal background. The weight of the court and a pending prison sentence is enough pressure for many criminal addicts to enter and complete treatment.
2. Try new approaches such as have been suggested in Scranton, PA. See article below. Once an addict is apprehended, allow the option of treatment even before any criminal charges are filed. This would be a real incentive for many if not most chronic addict offenders since the charge would not be filed if treatment was completed.
3. I have noticed that regular visits with the addict in treatment by the criminal justice referring agent will have a positive impact on prolonged recovery. Addicts in treatment tend to forget that they're on Probation or Parole or Drug Court etc. The brief "legal" visits should be once every three to four weeks and must be face-to-face or virtual via Skype.
4. The recovery process begins upon entering treatment. Legal video referral visits between the referring agent and the recovering addict in treatment must begin {or continue} for a minimum of once every three weeks.
5. Random urine testing must be done and certified by the authorized same sex treatment staff member, occurring every two to five weeks based on the client's treatment plan.
6. *There must be continuing face-to-face or video coaching after treatment for a minimum of four years. This is the most critical point to understand considering the relapse nature of the disease. The fear of the {observed} positive urine test along with the encouragement of the coach are essential to ensure long-term recovery, legal compliance and success. {This new protocol is well worth State funding.}
7. The treatment coach and the legal referring agent should also maintain video contact while the client is in treatment and thereafter. 
8. All treatment programs know the relapse prone nature of the disease of addiction and should stick to the protocol of maintaining regular virtual contact with their client for many years thereafter. If the legal referring agent mandates regular observed urine testing for several years after treatment, I encourage the treatment programs to comply provided there is State financial support. A very minimal investment for considering the relapse nature of the disease.
9. It is my suggestion that the State Department of Human Services fund the coached recovery of each client during and continuing for several years after treatment, until recovery stabilizes as demonstrated by the client's new drug free lifestyle. More and more data shows that addiction is a lifetime disease similar to that of diabetes. Think of the need for an addiction treatment coach for a recovering person just as critical as the need for insulin for a diabetic. Based on my experience with thousands of recovering addicts over nearly 50 years, long-term coached recovery may be the missing piece in our present day protocols for treatment. This process is more likely to result in a durable long-term recovery. Credentials for a recovery coach should only require a signed approval letter by the treatment program director. Certification and degrees should not be a mandatory requirement for a recovery coach. Positive experience and the recommendation of the treatment director are more critical. If the recovery coach is in recovery as well, he/she must also submit to random urine testing by the State or by the treatment program.

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       The Proposed Scranton Project:

The department is preparing to apply for a federal grant of about $730,000 to fund a three-year program that would offer a treatment option to low-level offenders and others suffering from opioid addictions, before any criminal charges are filed police Chief Carl Graziano said.

If a person successfully completes the treatment program, no charges would be filed for what otherwise could have been a crime, such as simple possession of heroin, he said. That person won't have a criminal record and, hopefully, will have a better chance at full recovery, he said. If a person facing arrest does not complete the treatment program, charges would move forward.

http://thetimes-tribune.com/news/scranton-eyes-pilot-pre-arrest-drug-treatment-program-1.2149722

Scranton        eyes pilot pre-arrest drug treatment program

Jim Lockwood, Staff writer/published: February 2, 2017

The Scranton Police Department hopes to offer certain opioid addicts a chance for treatment that, if successfully completed, won't result in any charges filed for potential crimes, authorities said.

The department is preparing to apply for a federal grant of about $730,000 to fund a three-year program that would offer a treatment option to low-level offenders and others suffering from opioid addictions, before any criminal charges are filed police Chief Carl Graziano said.

If a person successfully completes the treatment program, no charges would be filed for what otherwise could have been a crime, such as simple possession of heroin, he said. That person won't have a criminal record and, hopefully, will have a better chance at full recovery, he said. If a person facing arrest does not complete the treatment program, charges would move forward.

"Rather than get photographed and arrested, they would essentially sign what we're calling a 'Contract for Recovery,' " Chief Graziano told Scranton City Council during an informal caucus on Jan. 26.

He told council that the grant application would come before it soon for its consideration. City endorsement of the application is a required precursor of its ﮋling, he said.

The grant would come from a federal smart policing initiative seeking effective prevention and response approaches to prescription and/or illegal drug overdose and deaths, the tentative application says. The programs aim to help an addict get treatment before he or she has a criminal record, "to give them a real shot at turning their life around, of getting a job and having a future," the application says. It estimates the program over three years could help about 100 people, though the numbers could vary depending on lengths of treatments.

The Contract for Recovery initiative would complement Accelerated Rehabilitative Disposition and drug court programs already in existence, but differ from them in a key way. That's because people in ARD or drug court have been charged with crimes that, even if expunged, could remain on the internet and hinder them from getting or keeping jobs and staying clean, the chief said.

"The difference (with the proposed Contract for Recovery) is they never actually enter the criminal justice system, so they don't get a criminal record," the chief said. "It's going to be a pre-booking intervention program. It will target the heroin and opioid addiction problem in our area."

This effort would take two approaches:

Pre-offense diversions, in which police would spread the word on the streets about the Contract for Recovery to entice those who want to seek treatment immediately.
Pre-arrest diversions of people involved in "minor criminal acts," such as simple possession, and in which officers could offer the contract option.

The Gloucester, Massachusetts Police Department has a similar program that relies upon citizens going to police seeking help for addiction. The United Kingdom has a "test on arrest" program that results in mandatory treatment assessment for those testing positive for drugs. Scranton's proposed approach would fall between these other two methods.

Scranton's initiative would involve two treatment centers: A Better Today and Drug and Alcohol Treatment Service of Lackawanna County.

Results of the program also would be empirically tracked by the University of Scranton's Center for the Analysis and Prevention of Crime.

Lackawanna County District Attorney Shane Scanlon praised the city police department for "thinking out of the box" to try to stem the opioid epidemic. Early intervention hopefully would prevent what otherwise could become a downward spiral of addiction and recurring crime and jail time, Mr. Scanlon said.

"I think it's an outstanding idea," Mr. Scanlon said of the proposal. "If we can get a person on the right path — the sooner the better."

Parents Role in the Prevention or Spread of Opioid Abuse

Does our 2017 culture at home and work “acknowledge the realities and priority of parenthood?”  

By  David H. Kerr  

Founder, Integrity House             

  

Here are two problems today:

1)   Not enough parent to child time

2)   Negative role modeling by some parents even including parents who abuse of addictive substances

According to the New York Times editorial board, 1-16-17:

“Opioid overdoses have claimed more than 300,000 lives in the last 15 years, including some 33,000 in 2015 alone. But those numbers do not tell the full horror of this epidemic, which has devastated the lives of countless children whose parents have succumbed to addiction to prescription painkillers and other opiates. In one terrible case last month, a Pennsylvania couple died of apparent overdoses, and their baby perished from starvation a few days later.”

Parents should understand that when they have children, their actions as adults are heard and mimicked by those children, far more than their words.  Parenting by one’s own positive attitude and behavior often serves as the best predictor for children to grow up in a like manner – not what you say but what you do.  This article goes on to say that “the number of foster care children jumped 8% nationally between fiscal years 2012 and 2015. Experts say that opiate abuse accounts for a lot of that increase."[1]  {See complete article below.}  David Leonhardt, Op-Ed Columnist for the New York Times makes a key point about a balance between the workplace culture and parenting:  “I should make clear that I find The New York Times to have an excellent workplace culture.  Yet even here, there’s clearly a large demand for a new approach to designing career paths that acknowledge the realities of parenthood.”

Does our 2017 culture at home and work “acknowledge the realities and priority of parenthood?”  Linda and I live in a beautiful suburban community, not far from Newark where I worked for 47 years.  We’ve seen a change in values in suburban communities since March, 1970 when we moved into town.  Then, Moms’ stayed home with the children and Dads’ went to work.  Moms were always with the kids and they learned about their child’s needs and sensitivities, usually offering clear guidelines and rules for them.  Parents often exchanged experiences, good and bad, while watching kids play in a soccer game.  We worked together with other young folks in town to create a fun social group called “Friendship.”  There was a real sense of community in the 1970’s and parenting was a full time job for Moms and a number one priority for both parents. 

Now it’s 2017, and no surprise, things are different.  Now it’s likely that both parents leave home in the morning for work, not returning until 6pmor well-after.  The daytime surrogate parent is often a paid “baby-sitter.”  The high cost of taxes may be one reason for both parents working and when they return at night to their children, they are happy and caring but exhausted!  Then there are often activities at night that parents are part of and the children are sometimes again left with a babysitter.  Are our children getting the kind of strong foundational love, caring and discipline coming from their loving and caring birth parents?  Do we as parents understand the responsibility we have in our own lives, our actions and attitudes and feelings that are absorbed by our children when we least expect it? Here are three suggestions of mine:  1) Make an effort to eat together as a family, 2) Spend some time every night with your spouse and children – leave for your meetings after this, 3) Encourage listening.  These three suggested points, if practiced regularly may help to build a responsible and caring family.  There is no guarantee of course, but why not try it for a while and keep a record what happens?

Good parenting can be a trying experience at times but for the most part it can be fun and rewarding.  Bottom line, it’s an awesome responsibility.  Parents who use and abuse legal and illegal substances day in and day out are gambling with their children’s future.  If you are one of these parents, you might want to contact the Division of Mental Health and Addiction Services for help:

http://www.state.nj.us/humanservices/dmhas/home/

1-800-382-6717. Or you can mail to the following address:
Mailing Address:
DMHAS
Capital Place One
P.O. Box 700
Trenton, NJ 08625

Or send me an email at

 dkerr.recoveryadvisorygroup@gmail.com

Finally to restate, make a priority of what you do since your children will be far more likely to learn from that as opposed to what you say.

Misdirected Help?

We often offer Help To and For people in need, 

but what we should do is to offer help With those in need.

This approach works especially well with addicts and others whose goal is to build self-esteem and self-worth

By David H. Kerr               

Many people and agencies have been providing services to and for addicts, inmates and/or those with mental health issues, and this includes those with all of these issues combined.  In fact, when an issue is found, a label will be pronounced and this is in line with the psychoanalytic approach and a way to secure funding to help “a client.”  In my experience, this is exactly the wrong approach for many, but especially for addicts who must learn to take charge of their life, their families and their recovery.  They need to be encouraged to know their own strengths, even their greatness as well as the contribution that they can and will make not only to themselves but to others, i.e. their family and the community.  You might call this inspirational help and coaching.

In my experience, it is better to learn how to offer help with those in need than to those in need.  It is simple if you can truly care for the person whom we inappropriately call “client[1].”  This doesn’t mean babbling sympathy but some empathy, concern and understanding is critical.  Also, our present approach is often to fire many questions at a person coming for help, so that we can put together an appropriate (fundable) state &/or insurance approved "Initial Assessment," complete with an approved label - i.e. "emotionally disturbed" or "addicted with co-occurring issues," etc., etc.  Also, be very aware of the temptation to prescribe help via drugs.  I recommend working for six months with a person with addiction before offering a prescription even for drugs like suboxone.  In many cases, this dulls the interest by the person with addiction in making any substantive personal change, and with those addicted, a substantial personal change is usually essential.

We shouldn’t be throwing help at a client.  Rather we should be drawing strengths and direction from the person asking for help.  We should be creating an equal or one to one relationship with a person so that information is shared with, not dumped on the person in need of help, guidance and direction.  All of this information must come from the person with addiction.  We help a person by developing a relationship; by demonstrating caring; by coaching and by encouraging and promoting what he/she has that is positive.  Self-esteem and self-worth should be the goal.  The “what can you do and what have you done to help yourself” approach is most effective with addictsand also with the co-occurring recovering people with whom I have worked.  No inflicted labels but rather a caring, guided and sometimes necessarily confrontive[2] approach that puts you in the role of friend and coach rather than counselor.  More importantly, it allows them to better understand the role they must take in their own self-improvement.  Remember that addicts are not helpless or stupid.  In fact national tests show them to have above average intelligence[3].

Work together with the person with addiction showing empathy, not sympathy.  Promote truth in your relationship, and encourage self-learning and self-worth.  Recovery is a long road, and treatment, engagement and coaching will help the person with addiction learn to climb and feel more secure, especially during the first five years of lifestyle change.

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[1] I do not like the names (labels) we call people with addiction.  Use their first names instead.  Talk to the person with addiction as a friend/colleague and reason with him/her in normal conversation.  You’re not there to do for him what he must do for himself.

[2] People with the disease of addiction have often had to learn to “stretch the truth” or to flat out lie to receive your money for their drugs.  Criminal addicts have perfected “the language of the lie,” often to the point of believing their lies as truth.

[3] {http://www.cnsproductions.com/drugeducationblog/dr-darryl-inaba/1198}

INTELLIGENCE AND ITS RELATION TO ADDICTION

Posted on November 28, 2011

“A new longitudinal study into the relationship between measured levels of intelligence, and addiction shows a marked tendency toward more addiction behavior among those with higher IQs -- twice as much for men, and a three times greater likelihood among women. Also a look at new research on brain physiology and its relation to pain.”

Call Us: (800) 888-0617  CNS Productions inc a leader in drug education since 1980.   Paul J. Steinbroner was born March 18, 1949 in Los Angeles. In 1983, he founded CNS Productions, a publishing and distribution company specializing in topics related to addiction, neuropharmacology, and brain chemistry. He is the publisher of Uppers, Downers, All Arounders, a textbook on theneurochemistry and neuropharmacology of psychoactive drugs. Paul Steinbroner has also produced over fifty films and videos on this subject.

Kerr to Speak at Lyons Vet. Administration Event in N.J.

Popular Chronicles contributor David Kerr, the founder of Integrity House, in Newark, New Jersey will be speaking at the Lyons VA Campus, Bldg. 143, Lyons, New Jersey on Tuesday, Dec. 6, 2016.

The purpose of the event, which is hosted by MTI, is to provide career information to veterans in recovery from drugs and/or alcohol. Veterans of all military services, and/or their family members are invited to this free event.

This program is specific to veterans and veterans' families from the North Jersey Area of the state.

Refreshments will be served. For more information, call Jim Purcell at (973) 224-6667.

A Law is in Place to Expand Help for Substance Abusers

{President Obama Visited Integrity House One Year Ago Today.

http://player.pbs.org/partnerplayer/MyhBxk1iLbPPDIFZ13Z_xw====/?autoplay=false}

By David H. Kerr                  

“Governor Chris Christie has signed legislation into law that will expand drug addiction treatment programs throughout the state.

The bill, A-3744/S-2330, provides for the establishment of law enforcement-assisted addiction and recovery programs in law enforcement departments throughout the state.”

http://patch.com/new-jersey/tomsriver/gov-christie-signs-drug-treatment-expansion-law

This legislation appears to have excellent potential and maybe long overdue.  There's no "middle man" required as I read this proposal.  Police can take direct action and help can be immediately available.  No extensive calling around for a bed or getting in line with a two month waiting list in order to get help.  Naturally I would expect that if police found a street addict needing help, any other connected legal jurisdiction such as probation, parole or drug court would be notified as to what would be done for the addict, beginning at that time.  Instead of waiting in jail for a treatment bed to become available, help can start immediately and when a bed does become available, the referral can be made.  While it is an expedient solution, it is far better than incarceration with no help.

Why for many, law enforcement should be the first step to help, followed by Sister Mary L., Father Pete and I.

I have met many savvy and understanding law enforcement officers in my 50+ years of work with addicts beginning in 1965 as a state parole officer in Newark.  For the most part, those with whom I have worked have had a positive influence on the law breaking addicts they had found on the streets.  In the 60’s we developed first name communication where help for an addict was just a phone call away.  Unfortunately, there were only a handful of residential treatment programs or referral sources in the mid to late 60’s but the Mt. Carmel Guild, Sister Mary L., Father Pete, and I were in daily contact with addicts coming to us for help.  We often sent them to a farm type facility in Garrison NY for detox and treatment.  The three of us did the critical follow up and support when they returned.  The police, prosecutor and probation departments were all part of our team as well.  Through our continued close communications we became an effective team, caring enough about our recovering addict referrals to know their names and even some of their family members.

With this new law, police will be allowed and encouraged to take addicts right from the "streets," offer them help and advice and see that they enter treatment.  Police officers now have little option but to place an addict in jail for crimes related to the disease of addiction while awaiting an open treatment bed.  Adding police to the network of addiction help is not a new concept and in fact, it has been practiced informally for decades.  With this new law however, the essential but informal liaison between police and the treatment networks can be formalized offering more opportunity for help for those on long waiting lists.  Linking law enforcement with treatment programs is also not new, but giving front line police officers a more direct connection with treatment is an idea that can now become a reality.

The consequences of this law working effectively could ultimately place an even greater demand on drug treatment and our Governor and legislators must prepare for this reality now.  Here is a summary of the proposed legislation:

“This new law allows police officers —often the first people to discover nonviolent drug offenders in their worst state — to become a point of access for help and recovery," Christie said. "This law improves upon access and assistance for those suffering from addiction, helping them to obtain treatment and re-enter society as productive members.”

The law also provides for:

·    Supporting and facilitating the linkage of law enforcement-assisted addiction and recovery programs to facilities and programs that provide appropriate substance abuse recovery services and health care services

·    Coordinating with law enforcement officials and program volunteers to ensure that individuals seeking to participate in the program are treated with respect, care and compassion, and are reassured that assistance will be provided

·    Establishing requirements for an individual to be eligible for participation in the program, and develop and implement procedures for determining eligibility requirements for the program.

The legislation is sponsored by Sen. Richard J. Codey and Senate Health, Human Services and Senior Citizens Committee chairman Joseph F. Vitale.

Law enforcement will also help a treatment completer to maintain contacts with his/her treatment coach and mentor for the essential five years after treatment completion.

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Governor Christie Signs Legislation Strengthening State’s Fight Against Addiction

For Immediate Release                        Contact:  Brian Murray

Wednesday, October 26, 2016                        609-777-2600

Trenton, NJ – Governor Chris Christie today signed legislation to enhance and expand addiction treatment opportunities and improve relationships between law enforcement officers and those suffering from addiction.

“All too often people afflicted with the disease of addiction have negative, counterproductive and repeated interactions with the criminal justice system,” Governor Christie said. “This new law allows police officers —often the first people to discover nonviolent drug offenders in their worst state — to become a point of access for help and recovery. This law improves upon access and assistance for those suffering from addiction, helping them to obtain treatment and re-enter society as productive members.”

Drug overdose death rates in New Jersey have been reported this year as multiple times higher than increasing national rates.

A-3744/S-2330 (McKeon, Vainieri Huttle, Caputo, Jasey, Downey/Codey, Vitale), with the governor’s recommendations from an August conditional veto, provides for the establishment of these law enforcement-assisted addiction and recovery programs in law enforcement departments throughout the State. Under this new law, the Director of Mental Health and Addiction Services, in consultation with the Attorney General, will prescribe by regulation requirements for county and municipal law enforcement departments to establish a program within their departments; develop and implement guidelines for the recruitment and training of law enforcement officers, volunteers, and treatment providers to participate in the program; support and facilitate the linkage of law enforcement assisted addiction and recovery programs to facilities and programs that provide appropriate substance abuse recovery services and health care services; coordinate with law enforcement officials and program volunteers to ensure that individuals seeking to participate in the program are treated with respect, care, and compassion, and are reassured that assistance will be provided; establish requirements for an individual to be eligible for participation in the program; and develop and implement procedures for determining eligibility requirements for the program.

This reform is the latest lifesaving action taken by Governor Christie’s administration, to go along with drug court expansion; statewide Narcan and recovery coach program implementation; new legal protections for those helping drug overdose victims; criminal justice reform to put nonviolent offenders on a path to recovery and productivity; the conversion of a correctional facility into a drug treatment center for inmates with addictions; and increased participation in the multistate Prescription Monitoring Program to prevent doctor shopping.

The Challenge of Addiction Treatment Today

 What help really works for hard core drug abusers? 

By DAVID KERR

Maia Szalavitz[1] is a thoughtful, respected and long-time writer in the field of addiction and I support most of her 8 points as listed below and seen in her article in the Huffington Post; “The Rehab Industry Needs to Clean Up Its Act. Here's How.” Here’s the link:
CLICK HERE. 

Though I disagree (in blue below) with some of her points, she presents a concise summary of what she sees needing to change in our field and she knows from her own personal history using heroin and cocaine.  Here is part of what she has to say:

“I have covered addiction as a journalist for nearly three decades, and also have my own history of heroin and cocaine addiction, and of receiving treatment. With the input of longtime leaders in and critics of the field, here are my views on what needs to change.

1. Remove 12-step-related content from treatment — or at least, stop charging for it

2. Ensure access to maintenance treatment for opioid addiction

3. Fight corruption and unethical practices

4. End the reliance on criminal justice system referrals

5. End humiliation and confrontation

6. De-emphasize residential treatment

7. Create truly independent accrediting bodies that are consumer-friendly—and national standards of care

8. Expand harm reduction”

I have a problem with three of her eight points but she missed a major point as described below.  Also I would add to her eighth point: “Expand all treatment.”

I disagree with her points #1, #4 and #6.

 #1.  The AA 12 step approach is a marvelous group process where recovering substance abusers are accepted by their peers, finding a mentor and/or coach who guides the new candidate for years through the process of recovery.  Why would we want to end a process that has clearly helped many addicts for years and years?

#4.  I don’t think that treatment programs in New Jersey, for example, rely on criminal justice referrals.  Rather they see the desperate need of those addicts caught in the criminal justice system who need treatment rather than incarceration.  According to the Human Rights Watchreport, 10-17-16, “ every 25 seconds someone in America is arrested for possessing drugs for personal use.”

To make matters worse, many of those failing to meet bail requirements are incarcerated since treatment beds are usually full with a waiting list.

What’s the alternative?  Recovery help and treatment must be available to all people in all cultures.  Should we just bypass the treatment of addicts whose disease causes illegal drug use and associated crime?  In New Jersey, residential treatment programs have contracts with Corrections and Parole and they are showing positive results over years with the legally supervised treatment and follow up support of hard core criminal addicts.  Many studies have shown that this treatment enhances the likelihood of continued recovery with fewer relapses over time.  It makes no sense to arrest and incarcerate but provide no treatment to some addicts just because of their background and previous record while offering treatment for the same crime to others with little or no criminal record.  Many of these “others” are those who are part of the growing heroin epidemic in the suburbs.  Punish some and help others based on their skin color, criminal background and/or lack of bail money?  Not the right direction.

#6. Residential treatment is part of the continuum of help for many if not most hard core addicts.  Very, few of the thousands of addicts I’ve known could ever begin to put their life back together without removing themselves from the temptations of “the streets” and their neighborhood i.e. “the hood”. 

Here is an alternative model for Treatment and Recovery, call it the

Long Term Continuing Care Recovery Model

Help and caring for hardcore long-term addicts must be long-term (years.)  Also, the life supporting connections between treatment and the community neighborhoods to which recovering addicts re-enter after treatment, must be strengthened. 

The full recovery model of help for hard core criminal addicts often looks like this:  The detoxification phase followed by the residential phase followed by the reentry phase {followed sometimes by the out-patient phase} and then the most critical, the follow up coaching phase.  These are all part of the essential many year recovery continuum of care for hard core addicts.  I emphasize the word “caring” in this continuum. 

One of the most effective ways to measure quality in a program is to notice the level of concern and caring shown by all staff, not just counselors.  Assuring a caring staff must be the first step to assuring a quality staff and a quality program.  The best measure of a caring staff often comes from comments by the residents.[2]

The reentry phase of this continuum can be very challenging and it is not always the recovering person’s fault.  If we think of the cause of addiction as much from an addiction seeking culture as from a disease, we can begin to understand how difficult it can be to help people who must return after treatment to their home environment that is loaded with temptation.  Yes I know and believe the studies supported by Nora Volkow, NIDA, demonstrating that addiction is a brain disease.[3]  However, I attribute the present day growing problem of heroin addiction in the suburbs more from copy-cat and cultural behavior rather than so many people suddenly developing a “disease.”  AA talks about changing “people, places and things,” to stay clean and sober but this is often not possible in a drug seeking culture and as a result, addiction spreads.  Today, if you want to help and coach an addict towards recovery sometimes your most formidable enemy is our present day growing feeling that “heroin is ok.”  Some are saying under their breath; “yeah right, now that white people are using heroin, it’s ok;” and this has a ring of truth to it.

Peer support is often critical for hardcore criminal addict recovery

I founded a TC in Newark in 1968 called Integrity House. I retired from this work in March, 2012.  The TC concept has come a long way since the early 1960's.  We recognize the impact of the recovering peer, clean and sober for years, as a role model for change in our residential and out-patient programs.  We recognize the need for changing our system of care from long-term residential help to long-term support and coaching so that self-realization and the new drug free lifestyle has a chance to become internalized and practiced over years.  I have not found much long-term recovery success for hard core criminal "lifestyle addicts" without years of interaction with positive peers, and without support and coaching[4].

That said, most hardcore criminal addicts that I have worked with need to start and become part of a culture of safe, clean and sober living in a residential setting.  Each participant has a role in helping him/herself and others while learning, practicing and finally internalizing a new positive and ethical lifestyle. In my experience, the Therapeutic Community is the most effective tool, demonstrating a positive culture of right living for many months in treatment and for years thereafter following the long-term recovery continuum model.  

I have found that they must give help to others to get the full measure of help for themselves. 

A properly functioning TC must be sensitive to others needs and wants and what will help and what will hurt.  I've found that those addicts I have worked with over the years need a combination of understanding, love and straight honest talk and finally the role modeling of others like them, clean and sober for many years.  What I didn't expect to find, as I began to know them in the mid-1960’s, was a deep understanding of their own motives and behavior to help themselves as well as their strong need for help and guidance from others in long-term recovery. Finally I have found that they must give help to others to get the full measure of help for themselves.  Addicts in recovery for years make some of the best counselors I’ve ever met and this is with or without a degree! 

Let’s not mandate a degree since the bi-product may be to eliminate the recovering peer from our system of treatment.[5]

My experience supports the idea that a durable recovery is best insured by a counselor and/or peer who can feel a deep understanding and sincere sense of love and caring for others.  I have seen that recovering addicts who attain a degree are seen as role models to others in recovery!  On the other hand, I have found that the most effective people to inspire change are often former addict role models with a strong history of recovery, with or without a degree.

Growing addiction in the mainstream society is setting a bad example for our children

It is difficult today to help someone in a residential or outpatient treatment program to pursue a lasting recovery, when they leave treatment to return to our present drug consuming culture.  Addiction today is part of our culture whether it be from middle class in more affluent suburbs or ghetto pockets in the inner-city. If we want to make a serious impact on this personal and cultural malaise, we have to look at our own addictive behaviors and negative role modeling!  It's what we as parents do that is having a noticeable impact on the behavior of our children.  Growing addiction in mainstream society is setting a bad example for our children.  As a result, many have fallen into the deep hole that takes “adolescent recreational use and abuse” down the path of lifetime addiction.

Let's work together and with the media to develop more effective prevention plans that will be part of our culture and that will help our children grow up healthy.  These plans must start with changing our own habits and negative role modeling and personal substance abuse that will be mimicked by our children!

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 [1] Maia Szalavitz is a columnist for The Influence. She has written for Time, The New York Times, Scientific American Mind, the Washington Post and many other publications.

[2] Be careful though not to base staff evaluations on resident comments!

[3]  http://www.memoirsofanaddictedbrain.com/connect/nora-volkow-the-disease-model-and-moi/

 [4] While I never used drugs, I lived with active addicts in Newark while starting Integrity House and learned much from what they said and how they lived.

[5] Most addicts in recovery owe fines and are just beginning a stable life in the workforce.  They will not be able to afford to pay for a degree for years if not decades!