Among the millions of people who will be diagnosed with an addictive disorder in the new DSM are many whose lives will be derailed by their substance use, leading to car accidents, suicide, brain damage, sexual trauma...The new criteria will allow clinicians to intervene at an earlier stage in the addiction cycle, when relatively brief and inexpensive treatments can prevent more serious problems from escalating. Psycho-education, psychotherapy and group support should be available for people who seek treatment early on. Who would argue that it’s better to wait until the substance use escalates before treatment can be initiated?
Who would argue against early intervention? I would. There are costs to substance abuse treatment: big financial ones, the cost of limiting people's autonomy, and the risks of teaching someone who may never (yet) have experienced addiction that he probably will get addicted and will be powerless to stop it. Not to mention teaching that if a person continues to use drugs or alcohol, he's no longer responsible for his behavior.
I mean, imagine a bunch of typical 20-year-old drinkers sent into AA. They probably fit the diagnostic criteria (since the definitions of "binge drinking" and "heavy drinking" keep being revised downwards!), but does anyone think that such drinkers would benefit from a treatment program? In fact, we know that most young people who use drugs or alcohol heavily will age out of such heavy use naturally. In most cases, no intervention is necessary: and treatment programs have a terrible record of success. To call for early intervention drug and alcohol treatment is like calling for surgery to treat the common cold. We know it doesn't work for most people, it's expensive, and it does serious harm to the people subjected, in many cases involuntarily, to treatment.
Oh, and ignore the first sentence. As my astute readers will have noted, horror stories are totally irrelevant when talking about early intervention. For every person who will have serious problems with a substance, there are hundreds who fit the criteria for early intervention but will never have serious problems.
I mean, imagine a bunch of typical 20-year-old drinkers sent into AA. They probably fit the diagnostic criteria (since the definitions of "binge drinking" and "heavy drinking" keep being revised downwards!), but does anyone think that such drinkers would benefit from a treatment program? In fact, we know that most young people who use drugs or alcohol heavily will age out of such heavy use naturally. In most cases, no intervention is necessary: and treatment programs have a terrible record of success. To call for early intervention drug and alcohol treatment is like calling for surgery to treat the common cold. We know it doesn't work for most people, it's expensive, and it does serious harm to the people subjected, in many cases involuntarily, to treatment.
Oh, and ignore the first sentence. As my astute readers will have noted, horror stories are totally irrelevant when talking about early intervention. For every person who will have serious problems with a substance, there are hundreds who fit the criteria for early intervention but will never have serious problems.
