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6Nov 2012

Time's Maia Szalavitz on radical change at a leading addiction treatment center.

Time's Maia Szalavitz on radical change at a leading addiction treatment center.

You might know that 12-step programs and abstinence are at the heart of many addiction and alcoholism treatment programs. But you might not know--I didn't--that one of the leading and most influential treatment centers has made a gospel of avoiding any medical treatments for addiction.

The treatment center is Hazelden, which began in a Minnesota farmhouse in 1949 and now has a treatment network stretching across five states. The problem with its allegiance to abstinence is that the science showing the value of addiction medications is harder to ignore, writes Maia Szalavitz on Time's website. (Disclosure: Szalavitz and I are members of a writing group in New York City. And we're friends.)

In an important scoop, Szalavitz now reveals that Hazelden will introduce the use of long-term substitute drugs, such as buprenorphine, for its patients. It's a tectonic shift in the world of addiction treatment, Szalavitz writes, affecting not only Hazelden, but the 90 percent of American addiction counselors who rely on what's known as Hazelden's "Minnesota Model."

It's a triumph of science over conviction, Szalavitz explains:

Studies show that people addicted to opioids more than halve their risk of dying due to their habit if they stay on maintenance medication.  They also dramatically lower their risk of contracting HIV, are far less likely to commit crime, and are more likely to stay away from their drug of choice if they continue maintenance than if they become completely abstinent.

“This is a huge shift for our culture and organization,” Dr. Marvin Seppala, Hazelden’s chief medical officer tells Szalavitz. It's a big deal outside of Hazelden, too. Hazelden's new trajectory is likely to transform the field of addiction treatment, moving it away from faith-based 12-step programs to treatments based on scientific evidence. Here's what Dr. Nora Volkow, director of the National Institute on Drug Abuse, told Szalavitz:

I was delighted. This was a change that I’ve been waiting for. I would predict that as data emerges as to how this change improves the outcome of their patients, then others may realize that this is beneficial for patients and not harming them in any way.

Szalavitz is the best writer I know of on addiction and related issues, as I and others have pointed out here before. She's not shy about revealing that some of her interest and expertise comes from her own experience with addiction. But she brings far more to the story than that. She's an excellent reporter, and her story on Hazelden's decision unfolds with breathtaking clarity, expertly making its way through the complex social and scientific issues involved.

Her stories at Time, which cover a broad range of medical subjects, are first rate. You can find her here.

-Paul Raeburn



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