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Mon Sep 17, 2012, 05:22 PM

Question concerning policies in state-run drug rehab programs

A friend of mine who has struggled for years with meth addiction came to me recently and anniounced he wants to get clean. This is something he has needed to do for a long time, and I am pleased that he now seems ready and willing to try to tackle this particular demon. But he is coming up against a stumbling block in the last place one would expect: in the policies of drug treatment facilities. Let me explain...

My friend is unemployed and is on Medicaid, so his options are pretty much limited to using one of the state-run (NY) facilities. He is also a heavy smoker. Now, here's the thing: it turns out that New York has a statewide policy in its drug treatement facilities that requires complete abstinence from smoking in addition to the obvious requirement of abstaining from the addictive substance for which he is seeking treatment. (Note: many private-run facilities do not impose this requirement.) He confided in me that while he feels like he is finally ready to try to tackle his meth addiction, and while smoking is also something he eventually wants to kick, he fears he is nowhere near strong enough, emotionally or psychologically, to address both addictions at the same time.

I am not, and have never been a smoker. But I did observe my mother's decades-long struggle to quit smoking. By the time she was in her early 60s, she did finally manage to quit; alas, it was not soon enough to prevent her from developing the lung cancer that took her life at age 69. So I do have some understanding of how beastly difficult it can be to overcome nicotine addiction. I have to say I'm kind of surprised to hear about these policies. I mean, in a perfect world, nobody would ever be addicted to anything,so multiple addictions wouldn't be such a problem. But in the real world, people are often addicted to multiple substances. Both meth and nicotine addictions have serious health ramifications, but I think few would disagree that tackling the meth addiction is more imminently critical than kicking smoking. So, I guess my question is, why would the state impose such a policy, that seems, almost by design, to set people up for failure? Without in any way minimizing the importance of quitting smoking, when dealing with people with two addictions where both are harmful to one's health, but one of which presents a more immediate threat and is illegal to boot, why on earth would they institute a policy that simply puts yet one more hurdle in the already difficult challenge of treating the addiction to the illegal, and arguably more imminently harmful, substance? That simply makes no sense to me. Does anybody have any insight to offer on this?

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