A Healthier And Kinder Approach To The Challanges Of Subsrance Abuse Disorders

NY Times / Herald Tribune:  Alcoholism Center Rejects The AA Model


By The New York Times / Herald Tribune, Jul. 15, 2014

Their son’s psychiatrist, along with a few friends, suggested Alcoholics Anonymous. He had a disease, and to stay alive, he’d have to attend AA meetings and abstain from alcohol for the rest of his life, they said.

But instead, they turned to a group of psychologists who specialize in treating substance use and other compulsive behaviors at the Center for Motivation and Change.

The center is part of a growing wing of addiction treatment that rejects the AA model of strict abstinence as the sole form of recovery for alcohol and drug users.

It uses a suite of techniques that provide a hands-on approach to emotional and behavioral problems, rather than having abusers forever swear off the substance — a particularly difficult step for young people.

“The traditional language often sets parents up to feel they have to make extreme choices: Either force them into rehab or detach until they hit rock bottom,” said Dr. Carrie Wilkens, a psychologist who helped found the CMC 10 years ago. “Science tells us those formulas don’t work very well.”

When parents issue edicts, demanding an immediate end to all substance use, it often lodges the family in a harmful cycle, said Dr. Nicole Kosanke, a psychologist at the CMC. Tough love, she said, often backfires by further damaging connections to people to whom the child is closest.

The center’s approach includes motivational interviewing, a goal-oriented form of counseling; cognitive behavioral therapy, a short-term form of psychotherapy; and harm reduction, which seeks to limit the negative consequences of substance abuse. The psychologists also support the use of anti-craving medications like naltrexone, which block the high of using the substance.

A 2002 study in the journal Addiction showed that motivational interviewing, cognitive behavioral therapy and naltrexone, often used together, are far more effective in stopping or reducing drug and alcohol use than the faith-and-abstinence-based model of AA and other 12-step programs. Results of an updated study are not yet out.

Jack and Wendy’s son is in his early 20s. Friends suggested that if he did not attend AA, the only thing Jack and Wendy could do was attend Al-Anon.

“The implication was that there was no other solution,” Jack said.

On a warm evening last month, about a dozen parents gathered to hear Kosanke describe the center’s program for families, which goes by the acronym CRAFT, for Community Reinforcement and Family Training. It rejects, she said, the use of three words: “addict,” “alcoholic” and “enabling,” terms that help perpetuate unhealthy behaviors.

She prefers the terms favored by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, which says that patients suffer from “alcohol use disorder” or “substance abuse disorder,” terms that convey a spectrum of severity.

“There are real downsides to labeling a child with a lifetime identity, when that truly may or may not turn out to be the case,” Kosanke said.

CMC doctors say teenagers and young adults are neurologically, psychologically, socially and legally different from adults, and have different treatment needs.

In fact, a majority of college binge drinkers do not go on to become alcohol dependent, said Dr. Stanton Peele, a Brooklyn psychologist who is a critic of the AA model.

“Isn’t it more encouraging to know that most people are going to outgrow these habits than to think they’re going to have a disease for the rest their lives?” Peele asked. “The data show that the odds are in your favor.”

Source:  www.health.heraldtribune.com

Salon.com: Confessions of a Pot Addict: After 13 Years Of Daily Use, I Stopped Smoking Weed. But Quitting Only Made Me Feel Better About The Drug

Salon, by M. WELCH  

My relationship with pot started off badly. I lost all my high school friends after self-righteously refusing to smoke. I preached at everyone until our friendships evaporated. “I know if I try it, I will like it too much,” I remember saying — perhaps the only smart, true statement I would utter for many years to come.

The hardest friend to lose was a guy I’ll call Kevin. Kevin got me off Ratt and onto The Smiths. He got me playing guitar, which continues to provide me with happiness and social adventures at the age of 39. Without Kevin’s musical influence, I surely wouldn’t have moved from Florida to my beloved New Orleans after college. I worshipped Kevin until junior year, when he began smoking weed and abandoned me and my antidrug bitching. That same year, Kevin’s parents bought him a very nice car, which he crashed while skipping school and tripping on mushroom with his new drug buddies. At the time, I felt depressed but also extremely right.

When I finally broke down and tried pot in college at the age of 20, I realized I’d judged it totally wrong. Judgments regarding weed never prove factual, since the drug affects everyone differently. Some people plant themselves on the couch with snacks. Others grow manic and suffer panic attacks. I think of weed as a relaxant, a simple inverse of coffee — and not just because I smoked every morning for a long, long time.

Weed never made me unproductive. In fact, it helped me work. I’d leave fun parties because, within moments of smoking, I had to rush home and produce something: record a song, write a story. If asked, doctors might claim I suffer from ADD, although I’ve mostly lived by the advice “never ask a barber if you need a haircut.” I did visit a counselor once in hopes of replacing weed with a nonsmokeable drug that my daughter couldn’t see me take and that wouldn’t get me arrested. I told the counselor we could skip all the talking if he could refer me to a psychiatrist with a prescription pad. First though, I told him how much weed helped me. He nodded, confidentially agreed, then gave me a number I never called. I feared pills would kill my libido and my desire to record music and write, whereas weed made me more horny and creative. So, no thanks, doc.

Most important, though, weed made me calm and nice. I grew up in a tumultuous, mildly violent Irish household, which burdened me with lifelong anger issues. Before becoming a real and true pothead, I fought ferociously with my long-term college girlfriend — a fiery girl herself who was prone to throwing punches. Like my mother, I had trouble getting along with everyone. Unlike mom, though, I refused to ignore the common denominator: me.

So the discovery of pot was, for me, a mellowing godsend. Weed severely dampened my anger. My volatile girlfriend and I enjoyed more mindblowing sex while high. Also, once I officially gave in to a pot lifestyle, my brain slowed down by the perfect amount to let me, for the first time ever, sit and enjoy a book. I was even able to organize my thoughts enough to write a few books of my own.

Weed always provided outstanding musical companionship. Life never felt more perfect than when it was reduced to just me, pot and a four-track recorder. I remember wearing headphones and smoking a fat joint at the moment I received the phone call telling me I’d failed the drug test required to sell guitars at a Florida music store. That sounds ridiculous, but businesses whose employees pass drug tests get nice insurance breaks. “We all smoke here,” admitted the flustered guitar store manager. “How could you let this happen?”

Years later, I passed a drug test at New Orleans downtown public library with the aid of an orange drink called Vale, and then I began counting down six months of probationary days until the second test. Unfortunately, my library bosses loved me so much that, after five months, I arrived at work to news that they wanted to make my employment permanent immediately: “Just walk around the corner to the clinic and get the stupid drug test out of the way, and you’ll be ours forever!” announced my sweet old-lady boss. Despite first ducking into Walgreens and purchasing a tiny bottle of bleach to hide between my butt cheeks (I’d been told bleach confuses piss tests), I lost that job. It felt like being fired for drinking coffee.

Humiliated, sad and broke, I nonetheless refused to quit smoking, vowing to never again apply for a job that required drug testing. I’d also, by that point, realized I should never, ever try any “real” drugs (“I know if I try it, I will like it too much”). I have stood by both of those convictions ever since.

In 2005, my weed need was exacerbated by Hurricane Katrina. Lots of locals fared far worse than I, but watching everyone lose their homes and families poisoned even the unscathed with severe mental anguish. I began carrying a one-hitter pipe that I used every waking moment. As a busy freelance writer working from home, I took a pull off the metal cigarette roughly every half-hour until, by the end of the day, I had smoked the equivalent of a big joint (a bit more on band practice days).

New Orleans had previously boasted shitty and expensive weed. After Katrina, some entrepreneurial spirit realized this — someone from Houston, we suspected — and suddenly luscious, fragrant weed became available everywhere for $50 an eighth. For the next seven years, I spent roughly $200 a month — not a ridiculous amount for what I considered to be successful mental health medicine.

I always made a point to speak honestly about my habit to medical doctors. At the end of any physical, after being told my lungs sounded pink, I derived perverse delight from admitting I smoked weed 20 times a day. My doctors never showed surprise and never gave me any real warnings, which I took to be further proof of pot’s innate harmlessness.

I never tried to quit, but whenever I ran out, it would only be a matter of hours before I’d end up in a loud argument with my girlfriend-now-wife or with an editor or with whoever else had previously pissed me off but had eluded my wrath when I’d been too stoned to care. “Jesus, go buy some weed!” my wife would shout back at me. And, unhappy with the angry intensity of my “real” personality, I did as instructed.

The birth of our daughter in 2009 did nothing to curb my use — not even when the baby would find and bring to me my dirty one-hitter, announcing, “This is yours!” Once, she got hold of a paperclip gooey with resin (which I’d used to unclog a pipe) and ruined her very cute pink onesie. But I just couldn’t bear the possibility she might ever hear me shout like an angry maniac. Stoned, funny daddy did nothing but right by the little girl.

Finally, this holiday season, my wife planned a 10-day trip for us to visit her family in DC, which meant 10 days without medicine. The idea intimidated me, but for the first time, I looked forward to a break — my longest in maybe seven years.

Real weed withdrawal occurs only in serious potheads, who are so used to feeling mellow and content that neutrality prickles. Vacation preparation consisted of reading up on what to expect: irritability, loss of appetite, insomnia. That first week up north did indeed feel like the “Basketball Diaries.” Not really. But my brain burned for five sleepless nights and days and, had we not been in her parents’ house, my wife and I would have argued constantly — that need to fake sanity proved a blessing.

Then, on the fifth day, I began to calm. By the eighth day, the monkey vanished, and I haven’t seen him since.

During the following month of sobriety, I’ve turned down weed a dozen times, sans temptation. Which says a lot for pot. To put it in perspective: I also love milk, and upon the birth of my daughter, I ceased buying cow’s milk, wary of its corporate hormones. But soy never satisfied my intense lactose craving, and I caved within six months. Even though I’m not a big boozer, after Mardi Gras every year I abstain from alcohol for only 30 days (a sort of agnostic Lent) because the prescribed 40 is just too long. And two weeks after Fat Tuesday, I simply must gulp down one big glass of red wine to get me through the final two weeks.

But after 13 years of heavy daily marijuana usage I, miraculously, do not crave it at all. Which leads me to believe even more strongly that pot is as harmless as coffee. I simply abused it. It was me. Had I eaten as much peanut butter as I smoked weed all those years, I might have died of peanut butter overdose.

I can’t deny feeling smarter and more productive now. I wrote and published four books while high, but I might’ve written eight sober. By now, my brain feels permanently baked to perform at a slower, more comfortable speed, and I feel nowhere near as insane as I expected. I feel in better control of my emotions than at any other time in my life.

Or maybe I just feel temporarily good right now, having grown tired of a wonderful thing. I similarly love snorkeling, exploring the psychedelic depths and strange, colorful creatures therein. But if I could somehow stay under the beautiful water for 13 years, I imagine my eventual time back on land would feel fresh and interesting and that I could gladly avoid the ocean for a long, long time.

M. Welch is a New Orleans author and journalist. His work has appeared at Newsweek, Oxford American, McSweeney's, Vice and many other publications.

Source:  www.Salon.com

TBAC - Roger Morgan: Obama/Holder Serving Soros, Republic Enemy Number One

By Roger Morgan, Take Back America Campaign

Obama, faced with his “redline” declaration, is about to bomb Syria to avenge the 1500 people who were heinously gassed to death in Syria. 

How about, Mr. President, we Americans “redline” you for turning your back on America’s drug problem, even perpetuating the problem by ignoring your obligation to enforce federal CSA laws.  Almost all of the 1500 Americans who die every two weeks started their drug journey with marijuana.  While you punish Assad, maybe America should punish you.

The reality is America has been hijacked by Republic enemy number one, master of subversion, billionaire, sociopath Drug Lord George Soros.  Soros hates America, and is the principle financier behind the pro-legalization movement, and Obama’s campaign.  Soros’ purpose is designed to destroy a significant percentage of our population to help fulfill his messianic vision of a new world order. Unfortunately, due to the corruptive powers of his money, he controls the President, the press and the Democratic Party. 

Obama’s first act was to downgrade the Drug Czar position from cabinet level to reporting to the Vice President, a nice buffer so he wouldn’t have to face America’s biggest problem directly.  The result was we ended up with two national drug policies: 1) Drug Czar Kerlikowske’s official national drug policy, for political cover, and 2) Holder’s “do nothing” policy in terms of enforcing federal law. The result is a 15 to 20% increase in marijuana use, and an unenlightened nation being led down the path of destruction by legalization efforts for a drug that causes permanent damage to adolescent brains, and myriad other adverse outcomes.

Marijuana doesn’t kill by overdose, but overdose isn’t the only cause of death.  Marijuana is a causal factor in psychosis, including schizophrenia, paranoia and suicidal depression.  It is a major factor in armed robberies, violent crime, traffic deaths, testicular cancer, respiratory problems including cancer of the head, neck, throat and lungs, just to mention a few.

The mass shootings of late, like Tucson, Aurora, the Pentagon and more are a result of marijuana induced psychosis.  Even the Boston Bombers were both pot heads.  Marijuana isn’t the only cause of psychosis, but it is a major cause.  And rather than find resources to treat it and shovel up the damage, we should be preventing it to begin with.

Nationally 53% to 87% of arrestees test positive for drugs.  The average addict commits 100 crimes a year.  America has declined to 26^th in the world academically, with a one-third drop out rate.  Each drop out carries a life time cost of $392,000 … which equates to $470 billion per annum considering we have 1.2 million dropouts. 

In August 2012 research at U of Texas San Antonio revealed that today’s high potency pot can kill a baby in the womb within two weeks of conception, before the mother even knows she is pregnant.  Research from 40 or 50 years ago showed marijuana caused still births to ruse from 12% normal to 44%.  Babies that survived child birth often had physical deformities and brain damage.  What’s worse, because of mutations to sperm the problem could result from the male partner, and because it led to chromosomal abnormalities, it was mutagenic, which meant the problem could leap one generation and effect the next. 

Obama’s administration REFUSED to issue a health alert.  Of course that was pre election. How many babies have died, and/or will die, because Obama is serving Soros instead of the American people? 

By doing nothing, Obama has intentionally allowed the proliferation of “medical hoax marijuana,” to spread to 21 states, and marijuana use to grow by 15 to 20%.   Now he and Holder have arrogantly condoned recreational use of marijuana in Colorado and Washington, in direct contradiction to the federal laws they are expected to uphold

Drugs, starting with marijuana, kill, destroy and inflict more economic harm on America than all events in modern history.  If the Commander-In-Chief is unwilling or incapable of fulfilling his oath of office to protect the American people, then it is time to replace him with someone who will.

More at:  www.tbac.us

The Advocate: LSU Professor Finds Link between Anxiety, Marijuana Addiction

BY ELLYN COUVILLION

ecouvillion@theadvocate.com

August 12, 2013

More than 4.5 million people in the U.S. are addicted to marijuana, and LSU professor Julia Buckner says her research shows that if you have social anxiety, you are seven times more likely to join those ranks.

According to a 2010 survey by the U.S. Department of Health and Hospitals, the number of people addicted to marijuana is almost as large as the number of people who struggle with addiction to all other illicit substances combined. A subset of those pot smokers also struggle with anxiety disorders like social anxiety.

“People with anxiety disorders have much, much higher rates (of addiction) than you would expect,” said Buckner who is also director of the university’s Anxiety and Addictive Behaviors Clinic.

Through new research she launched this summer, Buckner hopes to develop treatment that both addresses marijuana addiction and helps people manage anxiety of all types.

“We’re not judging the fact that they use (but looking at) what about their (marijuana) use is causing them problems and how can we help them avoid that,” Buckner said.

She’s looking for participants for the study who are between the ages of 18 and 65, experience daily anxiety and want to quit smoking pot. All participation in the study is confidential and protected by the Health Insurance Portability and Accountability Act.

Funded by the National Institute of Drug Abuse, the study incorporates cognitive behavior to find new, better ways to deal with anxiety-causing situations.

The participants meet in small groups of four to five people several times a week for up to 12 weeks. The meetings are led by two graduate students under Buckner’s supervision.

“It’s been very positive so far,” Buckner said.

Among the things the groups look at are what are called “false safety aids” — activities people do to feel “safe,” but that actually maintain their anxiety.

“We look at marijuana use as a false safety aid,” said Buckner, whose colleague in the research is Michael Zvolensky, of the University of Houston, an expert on the relationship between anxiety and substance abuse.

The researchers are also consulting with Kathleen Carroll, a professor of psychiatry at Yale School of Medicine.

Addiction to marijuana can disrupt a person’s life in many ways.

“It interferes with people going to work,” said Buckner. “They don’t have the motivation to go to work or to go to class.”

The addiction can cause problems with partners, family members and friends.

People addicted to pot are “smoking instead of doing other activities they used to enjoy,” Buckner said.

Buckner and her colleagues are writing a treatment manual, with the goal of publishing it.

To learn more about the study at LSU, contact the LSU Anxiety and Addictive Behaviors Clinic at (225) 578-5778 or email aabc@lsu.edu.

Source:  www.theadvocate.com

Jane Velez-Mitchell, Woman in Recovery Shares An Excerpt from 'Addict Nation: An Intervention for America'

Get Jane's book here:  www.amazon.com

Treatment and Recovery Reform would Explain a Lot

Fox News Link:  Calls for Mental Health Reform Grow after Newtown Massacre

Lindsay Lohan is Not in a Position to Make Anymore Excuses

Anyone who has experienced the humiliating aspects of hardcore drug addiction and alcoholism knows what might eventually happen to Lindsay Lohan.  No matter what the public thinks and how much we may want to see her get better (or not), when the law steps in, the consequences are serious and the lessons are harder than we can ever imagine. 

This morning, TMZ reported that the IRS has ceased all of Lindsay’s bank accounts to settle massive tax debt.  Assuming Lindsay can pay the debt, she still has to face a judge on the east coast for assault, and one on the west coast for violating the conditions of her probation by lying to police officers.  Troubles are mounting with rumors in the press saying Lifetime Network wants to sue Lindsay for breech of contract because she drove during production of “Liz & Dick” and got in an accident, which violated her contract.  This is a lot of conflict for someone who should be in a setting that would allow her to find the will to get and stay sober.  Conflict often drives addiction and gives addicts an excuse to drink and use, in order to foolishly find fault in others.

Lindsay is going to be hard to insure for future productions and she also may end up in jail for violating her probation.  If Lindsay is held responsible and the courts show they have had enough, this could very well happen.  So what’s left?  If you read any comment section about Lindsay, there is little sympathy for her.  But if no one can save her, will Lindsay Lohan be able to find the will to save herself? 

Let’s examine this question because we have several factors here.  Saving herself according to public opinion is one thing.  Chances are the public is willing to forgive her one more time, if she goes to rehab and stays there for at least six months to a year.  But then we also have to factor in the law and in the eyes of the law, Lindsay is an evermore increasing danger to herself.  This is difficult to repair because the law and how it applies to Lindsay is, in my view, no longer negotiable. 

In the eyes of the psychiatric community, Lindsay is seen as someone who may need all kinds of voluntary and even involuntary treatments for years to come.  This solution is as difficult, if not more difficult than jail by itself.   In treatment, Lindsay would have to be in a controlled environment so she will no longer be a danger to herself and others.  Treatment methods of today will break her down, tear down every part of herself she has ever known and then she would be rebuilt by her therapists, according to what they think is right for her.  That most likely means, no more Hollywood, no more parties, no more bad people to hang out with, no more enablers.  That is the reality of treatment if you’re going to get better.  Is there a way back?  Sure there is!  But that takes many years of hard work.   Is this good for a person?  It won't feel like it at first and by "at first" I mean probably the first two years.  But it is, in some cases, the only way recovery experts can successfully treat someone in Lindsay’s condition. 

There’s not much left for Lindsay to destroy.  Her behavior has bulldozed over just about everything precious that we have ever seen in her.  We know she's trying, but for every step forward she takes three steps back.  The change must come.  It must come now, or Lindsay will destroy the only thing she has left.  Herself.

U.S. Drug Czar: Treatments for Addicts Starting to Change

I have long said that the 12 Step program needs to be brought into the 21st Century, as it's basic text has not been revised since 1957 and was published in 1934, which means it was written during alcohol prohibition.  While it has worked for some, most people seeking recovery are not able to stick with cold-turkey sobriety, while dealing with life on life's terms.  U.S. Drug Czar R. Gil Kerlikowske makes some very good points in this L.A. Times article on what he believes recovery from addiction should be. 

Only a few months ago, Director Kerlikowske added recovery to the National Drug Control Strategy, alongside criminalization, treatment and prevention.  It's been a long time coming, as the 12 Step program's success rate at the community based level is only between 3-7%.  As someone who is now almost 14 years in recovery, I am glad we are changing the way we see recovery.

More in this L.A. Times Article

CNN's Dr. Sanjay Gupta: Smoking Pot Can Permanently Lower IQ

Recovering Alcoholic/Addict to Randy Travis: YOU'RE AN ALCOHOLIC!!!!!!!!!!!!!!!!

How do you get from a minus one to a plus one? You have to go through zero. Seems pretty easy right? Well, when you’re an alcoholic or an addict it’s anything but that. Randy Travis is falling from grace and he’s falling hard. And while he’s falling he’s hitting every branch on the way down. Maybe he should listen to the title track from the movie Crazy Heart. “Fallin and Flyin” describes the terrible example of alcoholic black out drunk behavior Randy Travis has been exhibiting. But don’t take my word for it, have a listen for yourself.


But seriously, is someone going to put Randy into protective custody or what? Where is the psych unit in this? How can it be that Randy even still has a license to drive a motor vehicle??? HELLO??? There are innocent people on our highways and Randy is on the lose, clearly being a danger to himself. Someone better yank his license, take away his car keys and get him into detox NOW. HE IS GOING TO DIE if he does not get the help he needs!

Hey Randy?  Not sure if you're an alcoholic?  Try answering the 20 official questions of Alcoholics Anonymous.  That might help.  Oh and if you answer YES to more than three of these questions, you are definitely an Alcoholic.


1. Do you lose time from work due to your drinking?
2. Is drinking making your home life unhappy?
3. Do you drink because you are shy with other people?
4. Is drinking affecting your reputation?  (I'm thinking yes on this one)
5. Have you ever felt remorse after drinking?
6. Have you gotten into financial difficulties as a result of your drinking?
7. Do you turn to lower companions and an inferior environment when drinking?
8. Does your drinking make you careless of your family's welfare? (I'm thinking yes on this one)
9. Has your ambition decreased since drinking?
10. Do you crave a drink at a definite time daily?
11. Do you want a drink the next morning?
12. Does drinking cause you to have difficulty in sleeping?
13. Has your efficiency decreased since drinking?
14. Is drinking jeopardizing your job or business?  (I'm thinking yes on this one)
15. Do you drink to escape from worries or troubles?
16. Do you drink alone?
17. Have you ever had a complete loss of memory as a result of your drinking?  (I'm thinking yes on this one)
18. Has your physician ever treated you for drinking?
19. Do you drink to build up your self-confidence?
20. Have you ever been in a hospital or institution on account of drinking?

Time.com: Addiction Treatment, Not Based on Science, Science or Medicine

By Maia Szalavitz, health writer at TIME.com


Addiction is typically characterized as a disease by experts and government officials. Yet, unlike most known diseases, the treatment of addiction is not based on scientific evidence nor is it required to be provided by people with any medical education — let alone by actual physicians — according to a new report.

The 586-page tome, which was published by Columbia’s National Center on Addiction and Substance Abuse (CASA), is based on large surveys of treatment providers, people who suffer from addiction and those in the general public, as well as a review of more than 7,000 publications on addiction.

It finds that most addiction care is administered by “addiction counselors” for whom there are no national standards of practice. It finds also that 14 states don’t require any education or licensing at all for addiction counselors. The risks to those seeking treatment can be dire: California is one of the states that allows uncredentialed providers, for example. In a recent case in that state, a sexual predator was found to be offering “intimacy therapy” to addicted teenage girls; treatment consisted of sex with him. Without oversight, there’s no way to stop people from preying on vulnerable people under the guise of addiction care.

Only six states require addiction counselors to have a minimum of a bachelor’s degree; just one requires a master’s degree, according to the CASA report. The main qualification for treating addiction in this country is having suffered from the disorder oneself — a standard of care that would be considered absurd if any other medical condition were involved.

Moreover, addiction treatment providers are typically not held accountable for their patients’ outcomes: the report found that nearly half of all patients with illegal drug problems are referred to treatment by the criminal justice system and, of course, it is the patients, not the counselors or program directors, who go to prison if they fail.

(MORE: DSM 5 Could Mean 40% of College Students Are Alcoholics)

The new publication is not free of CASA’s tendency toward hyperbole, however. It overstates the breadth of the addiction-treatment problem in the U.S. by arguing that anyone who takes any illegal drug needs help. The report makes the exaggerated claim that 16% of the U.S. population suffers from addiction (this includes cigarette smokers) and that an additional 32% are engaged in “risky” substance use.

The report’s estimates do highlight some inherent problems in the definition of addiction, particularly in the proposed definition slated for the upcoming revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the standard manual used to diagnose all mental disorders. The new DSM-5 definition, which collapses addiction under one diagnosis, instead of the current two, may well result in widespread overdiagnosis, opponents of the new definition say.

In the current DSM, addiction is described under two diagnoses: the short-term and less severe “substance abuse” (a classic case would be a college binge drinker who outgrows the behavior), and the chronic and more dangerous “substance dependence” (classic case: a full blown alcoholic). DSM-5 would define all alcohol and other drug problems as substance-use disorders, which would be further characterized as “mild” “moderate” or “severe.”

The DSM-5‘s definition of “severe” substance use disorder will replace what was formerly known as addiction or dependence. That means that anyone who uses a drug but will never have a chronic problem would be diagnosed as “mildly” addicted — a condition that most people would see as akin to being “mildly” pregnant.

(MORE: Do Family Dinners Really Reduce Teen Drug Use?)

The CASA report points out that even under the current diagnostic rules, the lack of professional training of most treatment providers means that severity is rarely assessed adequately. Most people are therefore slotted into one-size-fits-all programs, typically based on the 12 steps of Alcoholics Anonymous. Such programs advocate total abstinence, a tack that offers little help to the majority of people whose problems aren’t severe, since they need guidance on moderation.

The dominance of the 12-step approach also leads to a widespread opposition to change based on medical evidence, particularly the use of medications like methadone or buprenorphine to treat opioid addictions — maintenance treatments that data have shown to be most effective. Other medications that are known to treat alcohol and drug addiction, such as naltrexone (reVia, Vivitrol), are also underutilized, while philosophical opposition to the medicalization of care slows uptake.

To fix these problems, CASA recommends a more careful definition of addiction and substance-use problems (note to the center: start with your own), as well as the requirement that all treatment providers be licensed as health-care organizations. CASA calls for national standards for accreditation of such care and for all physicians to receive required education about substance-use disorders in medical school.

The report notes that only 10% of people with substance-use problems seek help for them: given its findings about the shortcomings of the treatment system, that’s hardly surprising.

Maia Szalavitz is a health writer at TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.

Read more: http://healthland.time.com/2012/06/26/addiction-treatment-in-america-not-based-on-science-not-truly-medical/#ixzz1z9Tfksgq