An Important Conversation about Addiction

July 8, 2014

DialogThe New York Times article (A Different Path to Fighting Addiction, published July 3, 2014) discussing CMC and our book Beyond Addiction: How Science and Kindness Help People Change has generated so much important commentary. We are grateful to have the opportunity to start a conversation about all the options available to people who struggle with substance use disorders and their families. On one hand, we are thrilled with the responses as so many people have reached out saying how desperate (and excited!) they are for options. Coupled with this response however is the painful awareness that the conversation in this country about the many different ways to approach substance use disorders is still lacking. And even more painful is the number of people who respond with the assumption (and accusation) that if you offer non-12-step based treatment that you are somehow against AA. The clinicians at CMC (and most clinicians who use evidence-based strategies) encourage and support our clients going to self-help meetings (of all kinds) as there is a significant amount of research that suggests that clients who engage in 12-step based recovery groups sustain significant changes. We know it is an amazing place to build a sober support system and find good models of sobriety. And many find a deeply spiritual connection that is life changing.

Our goal however, is to use the best that science has taught us in the last 40 years. We know AA and the 12-step community does not reach everyone. For whatever reason. And we also know that substance use disorders are very clearly on a spectrum of severity and different strategies work for different people, at different times. The evidence based treatments (EBT’s) that we use at CMC have been well researched and are consistently found to be effective in reducing the consequences associated with substance use disorders and are helping people reach sustained remission from the problem. Instead of feeling threatened or assuming that these strategies are somehow “against AA” or somehow condoning substance use, it would be great if people would slow down and really educate themselves about these options. As a field we should be reaching more people. And we have effective ways of doing it. And consumers should be empowered to ask for options.

Our goal of writing Beyond Addiction: How Science and Kindness Help People Change was to start this conversation. To help consumers (families,parents, kids, couples) and treatment providers truly understand their options. We hope that people will start asking that their local treatment programs get trained in evidence-based techniques like Motivational Interviewing and Community Reinforcement Approach and CRAFT. We hope that people will seek treatment from well-trained clinicians who can help with all of it’s complexity and present clients with all of their options (different EBT’s, family therapy, self-help, medication). We also know we are spoiled in NYC and have access to resources that much of the country (and even within NYC!) do not have and we are developing free content to provide support from afar. There are educational videos on our website and we developed another website The 20 Minute Guide ( which provides free content, in an attempt to give clients, families and clinicians tools to support change, no matter at what stage!

We truly hope that people who responded positively to the article will find the supports in their community that they need, once you are armed with the permission to ask for it! We also hope that those who had a more concerned response will read more and come to see the value in working at all stages of this problem, with the most sophisticated strategies that we have. We are all fighting the same fight. We all have things to offer. The black and white discussion that inevitably come out of talking about substance use disorders is pretty striking and speaks to the stigma and shame that substance users, their families and treatment providers all struggle with…and it is tragic. We thank the New York Times and Gabrielle Glaser for spotlighting this topic and we hope we can do a good job of helping move the conversation along.

Carrie Wilkens, Ph.D.
Co-Founder & Clinical Director

Jeff Foote, PhD
Co-Founder & Director

Nicole Kosanke, PhD
Director of Family Services

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