Prevention And Treatment: Basic Strategies In The Battle Against Addiction,Moshe Zwolinski, LMHC, CASAC, SAP, ADS, ICADC

"Tracht gut, vet zein gut" (Think good, it will be good) is the emblematic Jewish response to difficult situations. Spiritually and psychologically speaking, it is the healthiest way to deal with a troubling world. However, this response can mutate into states of denial-and denial is the primary obstacle to winning the battle against alcohol and drug abuse in our community.

An unknown percentage of our adolescents and adults are alcohol/drug abusers or addicts. In a recent survey, I personally found drug dealing - involving frum adolescents and young adults - going on openly, on the streets of every Jewish community in Brooklyn including: Boro Park, Crown Heights, Flatbush and Williamsburg. Not one community was free of this plague.

Having treated many members of our community (including Chassidishe, Yeshivish, Sephardic and Litvish) for a large variety of addictions, I am constantly informed by my patients how easy it is for seemingly normal members of the frum world to continue being addicted, and yet can remain undetected. And the problem appears to be growing.

Educators and parents must accept that there is no such thing as isolated addiction. If one adolescent in a school has an addiction, many more adolescents are abusing substances, but haven't reached the point of recognizable addiction yet. Since the monetary rewards of selling drugs are enormous, it is virtually impossible to put drug dealers out of business.

Therefore, openly educating potential victims and treating those who already are caught in the web of addiction are the two components of eradicating the scourge of addiction in our community.

Prevention

Preventing addiction by destroying attitudes in which addiction can flourish, is most important. Proven methods of prevention must be used. Well-trained addiction professionals who are able to create an environment where educators, parents, and adolescents can ask even the most shocking questions and receive honest, well-informed, answers, is imperative.

As much as we long to shelter children and teens from hearing about the negatives in life, this is not a successful way to prepare them to avoid substance abuse of any kind.

The New York State requirements for CPPs (Credentialed Prevention Professionals) and CPSs (Credentialed Prevention Specialists) are grueling. A total of 4,000 hours of supervised experience, course work, and testing are all required. Except for the CASAC (Credentialed Alcoholism and Substance Abuse Counselor) license, no other credentials are accepted by the state agency, OASAS (Office of Alcoholism and Substance Abuse Services) for prevention work since prevention methods are highly specialized and are the only prevention systems that have been proven clinically effective.

Treatment

Those who already use, abuse, or are addicted to alcohol or drugs must be sought out, screened, evaluated and professionally treated. Untrained observers, who may attribute symptomatic behaviors associated with addiction to other causes, like physical or mental illness or stress can easily miss (or misunderstand) addiction. This is a progressive, chronic and debilitative disease and this definition is supported by over 50 years of medical research.

Addiction is not a mental illness (though mental illness can be a factor in drug use and can co-exist alongside addiction). They are two separate and distinct diseases.

The biochemical changes that occur in the brain of addicts must be addressed during treatments. Addiction professionals work closely with psychiatrists (MDs) so that appropriate medication can be prescribed, if necessary, to alleviate the symptoms of withdrawal, including anxiety.

In order to treat patients effectively, clinicians must understand how treatment medications (as well as the addictive substances) affect the patient physiologically. Moral fortitude alone cannot prevent the patient from experiencing withdrawal or relapsing.

Effective clinicians must have knowledge of neurophysiology, psychology, sociology and modalities recommended by NYS-OASAS (Office of Alcoholism and Substance Abuse Services) and the federal agency, SAMHSA (Substance Abuse and Mental Health Services Administration). In its 2003 Best Practices Study, OASAS has identified the treatment by highly experienced clinicians as a strong indicator of success in treatment.

Additionally, clinicians should have long-term experience in the treatment of anxiety and related disorders. These are the most often manifested emotional components of pre-addiction substance use, addiction and withdrawal.

Cognitive Behavioral Therapy and group psychotherapy are invaluable tools. Government and private agencies do not consider treatment programs where individual psychotherapy is used alone, to be effective. Individual psychotherapy is used: 1. to prepare patients for group; 2.in conjunction with group; 3. for special-needs patients.

The addiction specialist community is comprised of CASACs, (as defined above, and is the most important addiction credential, accepted internationally, nationally and overseen by individual state agencies) federally licensed SAPs, (Substance Abuse Professionals) ICADCs (Internationally Certified Alcohol and Drug Counselor) ADS (Alcohol Detox Specialists) and specially trained MDs including psychiatrists.

These credentials require numerous years of training, experience and testing. These are the only treatment credentials that require periodic re-credentialing and ongoing education.

Though these concepts may seem radical and unsettling, we must combat addiction in our community by facing it head-on with proven, effective prevention and treatment. Because the problem of addiction is, thank G-d, not as severe in our communities as it is in the rest of the nation, this problem has not been openly addressed.

Unfortunately, the problem is now becoming more and more visible and we must use all our resources to stop it from escalating.

For more information about prevention and treatment contact OASAS, 1-800-482-9564 or at www.oasas.state.ny.us.

Moshe Zwolinski, LMHC, CASAC, SAP, ADS, ICADC, is a member of numerous professional mental health and addiction treatment associations. Moshe Zwolinski is a nationally and internationally licensed addiction specialist and psychotherapist with 25 years of experience and is a recognized expert in the fields of mental health and addictions. He has worked extensively with the Jewish community; the New York City and State governments; New York City hospitals; the federal government including Homeland Security; the Airlines and other transportation Industries; Wall Street Corporations; the NFL; and many other groups and individuals. He has a private practice in Brooklyn, New York. For more information please call 888-712-1988 or 917-470-5349 or email RMZwolinski@triaba.com.

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Prevention And Treatment: Basic Strategies In The Battle Against Addiction , Moshe Zwolinski, LMHC, CASAC, SAP, ADS, ICADC