Dawn Farm is passionate about helping addicts find recovery and we have been doing it for a long time. Over the years we’ve learned a thing or two. We’ve also watched addiction treatment change–some of it good, a lot of it terrible.
Here are some of the positions we’ve taken over the years.
Dawn Farm’s Position on Buprenorphine Maintenance
Dawn Farm has had a longstanding commitment to helping opiate addicts, especially IV heroin addicts. But withdrawal from opiates produces symptoms that clearly make it more difficult for opiate addicts to join the recovering community. So even though our treatment approach had a history of proven success, we were excited about the FDA approval of buprenorphine (Suboxone, Subutex) in 2002. Any drug that reduced the suffering associated with opiate withdrawal without significant mood altering effects was cause for celebration.
Today, Dawn Farm still believes that buprenorphine can be a very helpful detoxification tool. But over the last several years we’ve watched long-term buprenorphine maintenance become a treatment norm around us, apparently following a tradition that began with methadone maintenance. We are profoundly troubled by this trend. (Read the rest here.)
Dawn Farm’s Position on Addiction and Mood Disorders
Dawn Farm recognizes that the chemical dependency field once had a poor track record of identifying and treating psychiatric disorders. For many years the field reflexively viewed too many other problems as secondary to addiction and ignored them with blind faith that they would dissipate with ongoing abstinence. However, we now believe that mood disorders are grossly over-diagnosed in the addicts and alcoholics that we see. We routinely see people who have been diagnosed with a psychiatric disorder while they are still under the influence or very shortly after their last use. When they receive this diagnosis they are generally experiencing an intense crisis (more accurately, several crises) and are often baffled by their life circumstances and their inability to control their use in spite of the countless reasons to stop. Often receiving a psychiatric diagnosis is a relief; it provides an answer to many of the questions that have been baffling them. Addicts and alcoholics often say they would rather be crazy than an addict. When a prescription is coupled with this diagnosis it offers both a simple answer and a simple solution. Additionally, many addicts cling to hopes that this may mean that their substance use problems are secondary to a psychiatric disorder, and therefore they may be able to use safely again after their other problems are addressed. Physicians, social workers and psychologists should recognize how seductive these diagnoses can be to baffled addicts who can’t imagine life with or without alcohol and drugs. (Read the rest here.)
Dawn Farm’s Approach to Psychotropic Medications
Many Dawn Farm clients report symptoms of depression, anxiety or sleep disorders. Dawn Farm takes a conservative approach with diagnosing psychiatric disorders and the use of psychotropic medications for the following reasons. . . (Read the rest here.)
Dawn Farm’s Position on Harm Reduction
The International Harm Reduction Development program defines harm reduction as “a pragmatic and humanistic approach to diminishing the individual and social harms associated with drug use, especially the risk of HIV infection.” Harm reduction emphasizes reducing harm from drug use rather than focusing on reducing drug use or on abstinence. Harm reduction initiatives cover a broad range of interventions including educational programs on the risks associated with specific substances and/or behaviors, needle exchange programs, drug purity testing, designating spaces for drug use free of criminal justice interference, drug maintenance programs, decriminalization and legalization of drugs.
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Values do matter. We routinely see exciting new programs with innovative and unconventional ways to help addicts. We also routinely see new programs that are troubling to us. What separates these programs are the values with which they approach the addict. (Read the rest here.)