The Beginning of the End of Residential Drug and Alcohol Treatment?

[Katee]

OPINION
by STEFAN P. KRUSZEWSKI, M.D.
May 20, 2011

In my specialty as an addiction psychiatrist, I have often advocated for residential treatment when unremitting drug and alcohol problems persist because other, less intensive, services have failed. That may soon change.

Over the past two years, I've witnessed a worrisome trend: the medicalization of addictions. Some of this makes no sense to me. Let me explain.

There have always been drug treatments for acute detoxification of drug and alcohol problems. The drugs have changed over the years, but the concept of providing a brief period of drug stabilization to prevent seizures or delirium or to mitigate psychosis has gone one unabated.

Continue the report at:
ABC News
Citizens Commission on Human Rights International

[Reesacat]

I was appalled that a woman entering drug rehab for alcoholism left on 7 different meds, 2 of which are addictive! Dr. Kruszewski makes some excellent points in this thoughtful article. Thank you Katee!

[Islander]

I've seen comparable situations in residential mental health. Clients saw a psychiatrist weekly, whose main function was med management. I've sat in on these sessions when no other management person was on site and I was stunned at his interview methods and his willingness to dispense psychoactive meds like Pez. He asked leading questions in such a way that clients gave him the answer they thought he wanted. I was never trained as a CRMA because the 40-hour training is costly and there were others on my staff who were CRMA-certified (including, usually, an RN), but I knew how it was done (I sometimes had to step in because never mind) so saw the number of pills that clients got daily. I saw kids routinely cheeking meds (they usually got caught). I saw kids gain 50 pounds on some of these meds. And I'll go out on a limb and say that the majority were unnecessary. These teens were in a therapeutic environment 24/7. Yes, we did occasionally get kids so off the hook that we were unable to treat them — they were a danger to themselves or others — some kids were even given a choice: prison or our facility — and they were probably candidates for meds and for more secure control than we could deliver...but most did very well with talk therapy and the constant influence of staff. Yet they were discharged with a handful of scripts. It's an abuse and an outrage.

BTW: that psychiatrist was morbidly obese.

[jordanwhitman83]

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