Addiction Management Blog

Archive for the ‘Video’ Category

A call for increased treatment and education for those behind bars

Sunday, October 20th, 2013

I have written before about the criminal justice system and addiction, but it has been awhile and my thoughts continue to evolve on this topic. So, time for an update!

First, as a society we should be embarrassed by how many of our citizens are in jail/prison due to problems associated with untreated addiction. We have the highest incarceration rate of any country in the world with approximately 2.3 million behind bars. If we add those on probation and parole the number jumps to almost 7 million under correctional supervision! And I have not even mentioned the 70K juveniles we are grooming for later prison life. What is so troubling about these statistics is that they are primarily the result of mandatory sentencing laws put in place in the 1980s to enforce the war on drugs (which I have also written about).

US in Prison

Most now realize the war on drugs has been a miserable failure. Putting people behind bars when the drivers behind their crimes are addiction-related is costly and fails to address the underlying problem(s). We know that many will get out and that recidivism rates are quite high. One recent study indicated that more than 1 in 4 offenders return to prison within three years. And we know that when addiction goes untreated it most often returns, leading many who get out of prison right back in.

While I believe we need to evolve our drug sentencing laws, and there is evidence that things are changing for the better, this post is not about that. It is also not about the proliferation of drug courts that offer an alternative to jail/prison. Instead, I want to comment on what we can do for those who are behind bars right now (and will be in the future). In short, I think we should make use of their time in jail to prepare them to succeed in life once they get out. What do I mean by succeed? Here are a few outcomes I think we as a society should support:

  • Stay clean and sober, manage co-occurring disorders, and maintain physical health by working a comprehensive addiction management program (5 Actions!)
  • Use personal talents to benefit society (Action 5) (Dave’s Killer Bread is a good example)
  • Develop a spiritual life
  • Keep learning and growing as a person
  • Obey society’s laws
  • Seek out (or increase) appropriate help when times become stressful (as they do for all of us at times)

I am sure you can add to this list, but it is a good start. How do we accomplish such lofty goals? In short, we develop a technology-based intervention system that individualizes behavioral health treatment and education for a fraction of what it would cost to utilize humans (nothing against humans). The treatment component would be based on the 5 Actions I have outlined on this site, and the educational part of the system would be built by those who have a track record of delivering online education. Why this has not already been done actually surprises me!

The details of how to construct and implement such a system are beyond this post, but I do want to provide you some thoughts on why I believe doing this is more than possible.

  • Studies show fairly consistently that timing is critical for helping people with many problems, including addiction, depression, and other life issues. Those in prison have nothing but time, and are in a place where we can take advantage of a motivational window of opportunity.
  • Computers memory is superior to humans and can track far more information about a person’s life, and leverage points for change.
  • New treatment interventions can be quickly programmed into the system, where there is a much longer learning curve for humans.
  • Delivery of interventions can be more consistent (i.e. therapists stray from intervention protocols fine-tuned by researchers, often thinking they are doing good, but in the end have less than optimal results).
  • Online systems can track outcomes in real-time and make adjustments accordingly. Most treatment today does not include any formal outcome or evaluation of process, let alone changing therapy based on adaptive outcomes.
  • Relationship with a relational online system can last indefinitely, whereas human counselors are less consistent and change jobs frequently (i.e., the turnover rate in addiction treatment programs is higher than in fast food restaurants).
  • Online treatment is significantly less costly than human treatment.
  • Studies show people are more apt to disclose sensitive issues to a computer than a human – issues like:  sexual abuse, domestic violence, child abuse, shaming behaviors (cutting, eating disorders, sexual disorders) – all can be addressed in a user-friendly, less threatening environment than with humans in many cases.
  • An online intervention system can link and communicate more consistently with other important stakeholders in a person’s life, including: primary care physicians, specialty providers, medication providers, legal system, pharmacies, insurance providers, complementary and alternative care providers, mental health and addiction programs (if necessary), and employers. Computer system can keep track of all these relationships, the flow of information between them, and manage information privacy and disclosures.
  • Online systems are flexible and can consult with humans when necessary – so human’s time can be used most efficiently (i.e., expert humans are not replaceable, they are just in limited supply).
  • And perhaps most important, the system can be utilized to manage ongoing treatment and educational goals both in and outside of prison seamlessly, and help manage parole and probation responsibilities.

Would it be easy to develop and implement? No. I think it would require a lot of work on behalf of many stakeholder groups. But I believe it is what we need to do as a society if we care about our future and the future of our children.

I also made a couple of brief videos on how I would utilize the 5 Actions framework in an online system for those behind bars. Excuse the coffee breaks, it is early Sunday morning.


 

Theater as a force of creativity, inspiration, and healing

Monday, July 15th, 2013

I am big believer in balancing our efforts to intervene on the pathological side of the equation of life issues, with efforts to enhance individual strengths, talents, and creative life energy. When we solely focus on problems, like addiction, depression, and trauma, we often – quite surprisingly and opposite to what you may think – get more of the same. The reason has to do with how systems operate in life, and the fact that there is a big difference between interventions aimed at reducing and stopping addictive behavior, and taking action to creatively bring something cool into the world that gives your life meaning and purpose.

One of my favorite books on this topic is The path of least resistance: Learning to become the creative force in your own life by Robert Fritz. He says: “There is a profound difference between problem solving and creating. Problem solving is taking action to have something go away – the problem.  Creating is taking action to have something come into being – the creation.” He goes on in the book to explain how the actions are very different, and why spending time creating cool things may in fact lead to better outcomes than focusing on getting addiction to go away. Now I say all of this because I believe one of the most creative, inspiring and healing forces in life can be found in theater. Yes, you heard me correctly, theater!

Whether you watch theater, decide to get into acting, or engage in set design, lighting or some other aspect of the production, being involved in theater is a way for the soul to nourish creative desires. While I am fortunate to have the opportunity to experience amazing theater multiple times a year in New York City, I can honestly say that theater in my home town of Portland, Oregon rivals the best of what I have seen on Broadway. Some of the most amazing productions come from Portland Center Stage that recently put together the following video in honor of theater and all that it can provide us. Enjoy!

Hitting Rock Bottom: New docu-drama about addiction needs your help!

Monday, June 3rd, 2013

I don’t think I have ever done this before on a post, but here goes. I need your help.

Not long ago I was contacted by some folks who have been working hard on a show called Hitting Rock Bottom. It tells the real stories of people who have struggled with addiction, hit rock bottom, and found a way out. Unlike reality television that often turns tragic stories about addiction into entertainment, this show has a far more noble and broader reaching aim. The creater and Director, Corey Snyder, who has been in recovery for the past five years and also happens to be a very talented film maker, wants to instill hope (and action) in those who still struggle. He portrays challenges with addiction through docu-drama storytelling that utilizes actors to dramatize real stories. He and his team have already completed the first four episodes of season one which you can watch right now for free on the Hitting Rock Bottom homepage. Each episode is a few minutes, so watching them all will not take you that long.

HRBThe first season tells the story of Daryl Brown, a very likable young man who sets out in life with no idea of what is ahead for him. The show is more than engaging, and realistically captures the underlying risk factors that contribute to going down a path of addiction. It is real, scary, and unfortunately a story that plays out far too often.

Fortunately, the story of Daryl has a positive ending, but that is where I need your help!

The show is need of funding to finish filming the first season and complete the story of how Daryl overcomes addiction. It’s the best part of the story and has the potential to motivate many struggling souls to seek help. To complete the season, the crew are presently running a fund-raising campaign on Indiegogo. The goal is $57,500 which will cover all costs to finalize filming the remaining episodes. Even with these funds, many involved in this project are giving their time and energy to see this project to its successful completion. By contributing whatever you can, be assured that your donation will go towards a project that has the potential to transform how we understand, treat, and address addiction in this country. Also, there are only 13 days left in the campaign, so please contribute now. And be sure to check out some of the cool perks at various donation levels.

Thank you.

Video, Video…and more Video!

Friday, April 15th, 2011

I learned recently that the number one online  activity is watching videos. My initial guess was email, but as I thought more about how we have grown-up watching television, and that the average American now spends more than five hours a day in front of a screen (TVs, computers and mobile devices, non-worked related), this outcome is hardly surprising. Email actually ranks third behind online banking. These statistics got me thinking about the most effective way to provide you science-based, easy-to-understand information about addiction and how to overcome it as a problem. Call me a little slow, but if watching videos is where all the action is online, then it seems to make sense that I go there as well. So I am excited to tell you that I have taken the leap and completely updated this site with lots of video! You will now find many short snippets, most just a few minutes long, on a wide range of addiction-related topics.

A few words about the clips. Last year I joined the Board of Shangri-La, a nonprofit organization dedicated to helping Oregon’s most vulnerable populations with housing, employment, and a multitude of other needed services. What an amazing group of people! I can’t say enough great things about how they are making a difference in the lives of so many people at a time when so many are struggling. One reason for my involvement has been the increasing prevalence of addiction among the populations they serve. To help out, I presented some material about addiction to about 80 of their managers and staff, and in return, they taped it so I could use it on this site. Thanks again guys!

The first set of clips I am posting are primarily aimed at helping you better understand addiction. Here is one of them focused on addiction being about relationships.