"He saw Jamal Anderson and Mark Hudson sniffing two lines of powdered cocaine off the back of the toilet.”

A police officer caught Anderson, formerly a running back for the Atlanta Falcons, and his "friend" doing lines of coke off a toilet in a bar. You have to wonder (1) how clean the toilet was at 3:00 AM on a Sunday and (2) how pathetic Anderson's life has become if he's doing lines of coke off the toilet in a bar at 3:00 AM on a Sunday.

does substance abuse treatment really work?

Ah, yes, the penultimate question of mental health clinics and substance abuse treatment centers everywhere: does what we are doing actually work?

Every year, state and federal governments spend more than $15 billion, and insurers at least $5 billion more, on substance-abuse treatment services for some four million people. That amount may soon increase sharply: last year, Congress passed the mental health parity law, which for the first time includes addiction treatment under a federal law requiring that insurers cover mental and physical ailments at equal levels.

Many clinics across the county have waiting lists, and researchers estimate that some 20 million Americans who could benefit from treatment do not get it.

Yet very few rehabilitation programs have the evidence to show that they are effective. The resort-and-spa private clinics generally do not allow outside researchers to verify their published success rates. The publicly supported programs spend their scarce resources on patient care, not costly studies.

And the field has no standard guidelines. Each program has its own philosophy; so, for that matter, do individual counselors. No one knows which approach is best for which patient, because these programs rarely if ever track clients closely after they graduate. Even Alcoholics Anonymous, the best known of all the substance-abuse programs, does not publish data on its participants’ success rate.

Treatment must be tailor-made to fit the individual. People come in all shapes and sizes, and so do their problems. Isn't it reasonable to expect that there would be various treatment methods? Some may not like to admit it, but treatment often involves trial-and-error: if one form doesn't work, then the therapist has to switch gears and try something else. Evidence-based therapies seek to eliminate trial-and-error.

When practiced faithfully, evidence-based therapies give users their best chance to break a habit. Among the therapies are prescription drugs like naltrexone, for alcohol dependence, and buprenorphine, for addiction to narcotics, which studies find can help people kick their habits.

Another is called the motivational interview, a method intended to harden clients’ commitment upon entering treatment. In M.I., as it is known, the counselor, through skilled questioning, has the addict explain why he or she has a problem, and why it is important to quit, and set goals. Studies find that when clients mark their path in this way — instead of hearing the lecture from a counselor, as in many traditional programs — they stay in treatment longer.

"Motivational interviewing" appears to currently be the method with the most buzz. When I went through grad school 13 years ago, everyone was talking about brief therapy.

oh meth, where are you?

Jack Shafer asks, where's the coverage on the decrease of meth use in America?

(HT: A. Sullivan)

Crystal meth on the rise in ER's

The survey of 200 hospitals run or funded by counties in 39 states and Washington, D.C., shows that 47% said methamphetamine is the top illicit drug involved in emergency room visits. Sixteen percent said marijuana, and 15% said cocaine.

"This is a national problem," association spokesman Tom Goodman says. "The costs of methamphetamine are placing a great strain on county governments."

Of the hospitals surveyed, 73% said emergency room cases involving meth have increased over the past five years, and 56% said hospital costs have risen because of the treatment of meth patients.

Methamphetamine is a highly addictive stimulant that can be injected, snorted, smoked or swallowed. Most methamphetamine is manufactured in Mexican labs and smuggled into the USA. The drug also can be cooked up in home labs using cold pills and other ingredients easily purchased. (USA Today)

If you haven't yet talked with your kids about drug use, do it now. I've already started with my six-year-old.