I work with at-risk teenagers and young adults in Vermont, serving as the executive director of Spectrum Youth & Family Services in Burlington. I’ve been at Spectrum since 2003 but have been in this field since 1981.
Vermont has suffered the ravages of heroin addiction, as has much of the country the last few years. One of the services we provide at Spectrum is out-patient substance abuse counseling, so we are no stranger to opiates and the destruction they have wrought. Our Governor, Peter Shumlin, made national headlines when he devoted his entire State of the State speech to this crisis in January 2014:
In every corner of our state, heroin and opiate drug addiction threatens us. It threatens the safety that has always blessed our state. It is a crisis bubbling just beneath the surface that may be invisible to many, but is already highly visible to law enforcement, medical personnel, social service and addiction treatment providers, and to many Vermont families. It requires all of us to take action before the quality of life that we cherish so much is compromised.
Those of us in my field saw this as a call to action, to increase in whatever ways we could the things we were already doing to address the opiate problem. Seven months later, in August of that year, scores of us gathered in a school auditorium to assess what we were doing, what was working and what was not. There were presentations by individuals from the medical field, law enforcement and addiction specialists.
After several hours, the person moderating the event stood up and stated that the next phase of the morning would be devoted to breaking up into groups to discuss specific topics. “Who has a topic they wish to discuss?” she asked.
I was the first one to raise my hand.
“We constantly hear, ‘The money should go to prevention.’ Everyone agrees with that,” I said, “but I would like to know exactly what that means. I’ve been doing this work for over three decades, and I still don’t know how you prevent someone from doing something that is harmful to him or herself, abusing opiates being a case in point.”
The moderator responded, “Okay, there’s a topic, who wants to go with him?”
More than half the room followed me. Apparently I was not the only one curious about this topic, and again, these were not lay people, these were people like myself who work in this field, many for years. And we all wanted to know, “What is prevention?”
We packed ourselves into a classroom. We met for over an hour. It was a good discussion. People talked about the need to strengthen families; to educate children about drugs as early as possible; to enact regulations that would limit the amount of opiate-based medications prescribed by physicians; to recruit more volunteer mentors for children and teenagers. All great ideas, but will they actually work to prevent people from becoming addicts? Two years later, I am still not sure.
I read everything I can get my hands on related to addiction. (Last week I spotted Beyond Addiction – How Science and Kindness Help People Change on the desk of one of our counselors and asked to borrow it; it is now on my nightstand.)
But still – how to prevent addiction? Most of these books deal with the aftermath of addiction, i.e. recovery, relapse, more recovery. But how to prevent it from occurring in the first place?
Maia Szalavitz, herself a recovering heroin addict and author of several books about the issue, wrote an important column in the New York Times a few weeks ago about a new prevention program tested in Europe, Australia and Canada that seems promising. Called Preventure, the program “recognizes how a child’s temperament drives his or her risk for drug use — and that different traits create different pathways to addiction. Early trials show that personality testing can identify 90 percent of the highest risk children, targeting risky traits before they cause problems.” Preventure uses a combination of intensive training for teachers; workshops offered to all students; therapy techniques used to combat psychological problems; and teaching students cognitive behavioral skills to address emotional and behavioral problems. According to Ms. Szalavitz, “Preventure has been tested in eight randomized trials in Britain, Australia, the Netherlands and Canada, which found reductions in binge drinking, frequent drug use and alcohol-related problems.”
I sent the column to the Deputy Health Commissioner for Alcohol and Drug Abuse Programs here in Vermont, as I believe Preventure sounds like an approach we should at least investigate and possibly implement. Treatment of addiction is vitally important; it is what we do at Spectrum, and I believe in it. I’ve seen treatment work, lives transformed. But we’ve also got to get ahead of the addiction epidemic, and the way to do that is by preventing it from occurring in the first place. So finding the answer to the question, “What is prevention?” is, to me, incredibly important.