Shifting the Addiction Paradigm

Shifting the Addiction Paradigm

Ross Ellenhorn, PhD, LICSW

Cracks in the medical model of addiction are forming. And that’s a good thing. It means the chance for greater creativity, treatment choice, and freedom in decisions on what to do about substances in one’s life. It potentially means a decrease in stigma, and a much more nuanced view of the use of substances. It fractures a cookie-cutter approach to the use of substances and the engagement in other habits, allowing for care, if one wants it, to be truly individualized. We are heading towards a paradigm shift. We can see the outlines of the next model, one based on psychotherapeutic values, a non-judgmental curiosity about why a person might engage in seemingly self-destructive behavior, a belief that a person is making the bests choices they can when they use, a total respect for the autonomy of the individual, and a firm belief that lasting change never happens through confrontation or coercion. This talk reviews both the ways in which the previous paradigm is shifting and how to locate the new forms of thinking.

​

Learning Objectives:

Following the presentation, participants will be able to:

1. Identify how the disease/medical model of addiction is being replaced by a model that can be more successful in engaging individuals who have rejected treatment for their problematic behaviors;

2. Paraphrase what works in treatment and that confrontation or coercion does not result in lasting change;

3. Explain changes practitioners can make in treatment for clients with problematic substance use.

​

The Scientific Revolution: From Addiction as Disease to Psychobiosocial Process, From Abstinence-only to Integrative Harm Reduction Psychotherapy

Andrew Tatarsky, PhD

Working as a clinician on the front lines of the “addictive behaviors” field for more than 40 years, I have wrestled with one particular question: Why have we done such a poor job of helping people who struggle with drugs? Over time, I have come to believe that it is our field’s dominant view of addiction as a “disease” that has been largely responsible for our failure to effectively support those who need and want our help. It is this disease model that has given rise to a treatment field dominated by an “abstinence-only” approach that is unappealing, ineffective and, in many cases, harmful to problematic drug users because it simply does not meet them where they are at in their lives. 

​

The good news is that there is an alternative psychobiosocial view of addiction as a multifaceted response to the conditions of our lives and the emotional and physical impact of such conditions. This alternative paradigm supports an evolving approach that I call Integrative Harm-Reduction Psychotherapy (IHRP), which I have developed to help those who struggle with problematic drug use and other risky behaviors. 

​

My conference presentation will include discussion of the psychobiosocial model of addiction as well as an overview of the seven therapeutic tasks of IHRP. I will also demonstrate some powerful techniques that participants can begin using immediately in their own practices.

​

Learning Objectives:

Following the presentation, participants will be able to:

1. Identify four core principles of the harm reduction framework;

2. Identify four of the seven therapeutic tasks of IntegrativeHarm Reduction Psychotherapy;

3. Recognize “urge-surfing”, a powerful technique for sitting with urges and interrupting action to facilitate healing, growth and positive behavior change.

​

Sustainable Concepts as Harm Reduction Organizations

Sam Rivera

During this session, participants will discuss, identify and analyze sustainability strategies that relate to their specific origination and or project/program. We will explore project relevance, acceptability, political expediency, viability and adaptability of the project. Other factors such as financial analysis, risk analysis, communication and network determination, operational plan, training, human resource development and capacity building, environmental and community analysis all help to determine sustainability. The philosophical and analytical framework of sustainability draws on and connects with many different disciplines and fields and has tended to be problem-driven (pathological/”what’s wrong”) we will create a shift in this way of thinking and overall approach by looking at sustainability through a lens of wellness (“what’s well”) and working from that place. 

​

Learning Objectives:

Following the presentation, participants will be able to:

1. Describe strategies for nonprofits that plan to stay open over the long-term;

2. Use leadership transitions and succession planning strategies;

3. Calculate a gaps Analysis: *Review Where You Are *Determine Where You Want to Be *Identify the Gaps.

​

The Use of Psychedelics in the Care of Problematic Habits

Julie Holland, MD

Cognitive rigidity is a feature of many psychological presentations, from compulsive behavior to delusional beliefs. What if, however, there was a way to loosen those strictures of cognitive structure so that clients could reformulate their beliefs and behaviors in order to align them with their true selves and needs? By working with people where they are, and not insisting on abstinence as a prerequisite for getting help, we can turn lives around, one existential transformation at a time.

​

Learning Objectives:

Following the presentation, participants will be able to:

1. Explain transformational medicines;

2. Describe how to enable neuroplasticity, aka learning;

3. Outline how harm reduction strategies fit into the psychedelic treatment paradigm.