Thinking About Addiction

Doesn’t seem to matter much whether fame is rooted in music, film, TV, sports, politics — there’s this sense of unreality to all of it.

What we’re seeing now is an unintended consequence of a change in prescribing. Which doesn’t mean that the medical professions weren’t warned about the possibility, however — they were.

If estimates are correct that a typical offender has driven under the influence between 60 and 100 times prior to first arrest, it’s clear the actual problem is far, far greater than arrests alone can document.

It seems to me that a successful approach to DWI must be based on the assumption that drunk drivers are a diverse population.

One state estimates around a fifth of offenders are rearrested within three years of the prior conviction. Expand that window to five or ten years and the rate is likely substantially higher.

One or two (risk factors) is not as suggestive of repeat offending as four or five. But it does allow a clinician to apply a rough risk profile to a particular offender.

It’s difficult to squeeze a lot of motivational work into the course of outpatient counseling. Clinicians are anxious to get to the behavior change part.

Public perceptions of how we should and shouldn’t treat offenders often result in less than optimal solutions both for the addict/alcoholic and for the victims and the larger society that must pay.