Dr. Martha Kane from Mass General Hospital and Dr. Scott Hadland from Boston Medical Center discuss addiction treatment and recovery for young adults in the Ideas Dome at HUBweek on Wednesday, Oct. 10, 2018, in Boston, Mass. Photo credit: Mariana Sánchez Gaona
BOSTON, October 13, 2018 – “We now understand that addiction is a chronic relapsing disease”, said Dr. Martha Kane at a HUBweek event about addiction treatment and recovery for young adults. Dr. Kane, the clinical director of the Addiction Services Unit at Massachusetts General Hospital, added, “everyone needs an individualized treatment plan.”
Dr. Scott Hadland, the second panelist, is a pediatrician and addiction specialist at Boston Medical Center. The two panelists discussed how they approached addiction in young adults with comprehensive treatments. Young adults are people between the ages of 18 to 25.
According to the 2014 national survey conducted by the Substance Abuse and Mental Health Services Administration, “more than 1 in 5 young adults aged 18 to 25 were current users of illicit drugs in 2014.” The Boston Medical doctor noted that at this age, the brain is still developing the parts of decision making, planning and impulse control. Heavy substance abuse can alter these development processes.
Dr. Hadland considered that this demographic might be more susceptible to have some type of drug disorder due to the transitioning periods they go through during this particular time in their lives.
Dr. Kane added that cognitive behavioral skill building is still very effective for a comprehensive addiction treatment. According to the National Institute on Drug Abuse, some of the skills taught are to “explore the positive and negative consequences of continued drug use, self-monitoring to recognize cravings early and identify situations that might put one at risk for use, and developing strategies for coping with cravings and avoiding those high-risk situations.”
Another innovative treatment applied at Mass General and Boston Medical Center is peer-based recovery. In this treatment, new patients talk with people who have been through a recovery process. In case of a relapse, the Mass General doctor said, “we need to tweak the plan. It is not that the person failed but that the plan failed.”
“Abstinence is a problem for everybody at every age,” said Dr. Kane. She suggested that people should be treated for addiction even if they are not willing to stop using substances. The Mass General doctor said that many people will have to be abstinent to meet the goals they set in treatment but the choice of abstinence should be a part of the treatment.
Both doctors persisted on first helping people with the problems caused by drug abuse. Then, figure out if the use of substances is manageable or not. Dr. Kane said that to put your life back together, you need to still be breathing. “Maybe you need to stay on medicine for the rest of your life to stay safe. Or in a number of years, you’ll be able to detox slowly once you put your life in order,” she added.
The National Institute on Drug Abuse also points out that “treatment for chronic diseases involves changing deeply rooted behaviors, and relapse doesn’t mean treatment has failed.” When a relapse happens, the institute recommends that the patient speaks to their doctor to resume, modify or try another treatment.
Karin Lee, attendee and clinical intern, works in an intensive outpatient program for substance abuse in southeast Boston. She agreed with the speakers’ approach to a comprehensive treatment. She said that it used to be black and white because doctors didn’t consider outside factors that contributed to someone’s addiction.
The existence of a mental health problem is another factor for a substance abuse disorder. Sometimes people auto medicate with substances to try to manage their mental illness’ symptoms. In a post-panel interview, Dr. Kane said that patients who are struggling with both disorders can have a more difficult time accessing health care to treat either.
According to the Mass General doctor, people have preconceptions of what a mental or substance disorder looks like and stigma is also born from the sense of hopelessness from relapsing. If people can see them as chronic diseases, where people are in a continuum, they might understand that relapses are when someone needs treatment the most.
“Young people are struggling with not only substance abuse but with everything else that leads to it. Like a history of depression, anxiety or trauma also needs to be addressed”, said Dr. Hadland. He concluded that the cutting-edge treatment for addiction in young adults is providing standard medical care and behavioral health services.