By Dennis D. Embry, Ph.D.
Addicted adults don’t make great parents at inception, pregnancy, or after birth: something that both science and common sense agree. I experienced that pain both as a child and as an adult child caring for an alcohol-addicted parent. As I write this, hundreds of thousands of babies, children and adult children are the walking wounded, victims of the opiate epidemic. Such pediatric exposure is not good[1-3], and much, much worse than what I was exposed to from alcohol. Addictions are awful for children, no matter what the drug of choice is by their parents. Opiates tend to have a faster negative effect on families, however. Both prenatal and postnatal exposure to opiates, alcohol or other drugs can have a horrific impact on children’s development. For example, half of the Ohio children taken into protective custody in 2015 were removed from their homes because of a parental drug addiction, according to the Public Children Services Association of Ohio.
Ohio—like most places—doesn’t have a superabundance of scientifically proven treatment strategies in every county, let alone every community. Narcan® can bring people back from near death, but it doesn’t necessarily lead to a clean and sober lifestyle. Most communities in America don’t’ have standard resources to treat opiate addicted parents. That is the bad news. The good news is that most communities have no idea of low-cost, evidence-based practices that can be implemented almost anywhere. And what is the miracle treatment?
Something called the Prize Bowl. You can order a book from Amazon to implement it, called Contingency Management by Dr. Nancy Petry. It’s something that can be done anywhere, and it doesn’t require a Ph.D., M.D. or clinical degrees to do. We’ve taught church-groups to use Dr. Petry’s “prize bowl” strategy. You can read more about this powerful science at the National Library of Medicine and other resources here:
- Annotated bibliography http://bit.ly/ContingencyManagement.
- Copies of selected studies: http://bit.ly/Prize-Bowl-for-Opiates
- A brief summary by NIDA (the National Institute on Drug Abuse) http://bit.ly/NIDA-prize-bowl
- A free manual on how to do the Prize Bowl: http://bit.ly/PrizeBowlManual
So how does the Prize Bowl or Contingency Management work?
First, it’s important to remember that addictions are all about dopamine—the reward molecule. Dopamine is essential for human, and all critters for that matter. That includes the readers of this essay. Without dopamine, we’d never learn novel behaviors. The problem is that Mother Natures’ gift can be hijacked. All manner of human enterprises can hijack dopamine to turn a handsome profit: tobacco, gambling, cellphones, computer-games, legal, and illegal drugs.
Second, humans would still be slugs if they were never reinforced for trying new things, building new things, wondering about the other side of the hill, etc. Dopamine receptors are key to our increased intelligence and problem-solving abilities, as well as willingness to take a risk. Otherwise, none of us would be here.
One does not effectively get people off drugs by punishing them. We get people off drugs by reinforcing all manner of behaviors that lead to a better life: 1) being clean and sober using a variety of methods, 2) hanging out with people who are not using, 3) learning to do tasks and activities that enrich and improve our lives, 4) participating in counseling or recovery groups, and 5) engaging in healthy fun, and more.
The beauty of the Prize Bowl is that it can be done anywhere, by volunteers and funded by local resources. We’ve done it using faith-based groups or community groups. Local businesses and groups donated the rewards and prizes. For the faithful Network readers, the Prize Bowl is particularly effective for adolescents. To get the community moving on this powerful, proven strategy: read up on the materials, shout about it to law-enforcement and the medical people. Go see your elected officials, and tell them to call their governor’s office about using the Cure’s money for the Prize Bowl.
PS. The Prize Bowl procedures are in the public domain, and there are entities that can provide training and support on using it. Most communities can get prizes donated by local businesses and employers, which is what I’ve done in multiple jurisdictions.
- Comiskey CM, Hyland J, Hyland P: Parenthood, Child Care, and Heroin Use: Outcomes After Three Years. Substance use & misuse 2016, 51(12):1600-1609.
- Skinner ML, Haggerty KP, Fleming CB, Catalano RF, Gainey RR: Opiate-addicted Parents in Methadone Treatment: Long-term Recovery, Health and Family Relationships. Journal of addictive diseases 2011, 30(1):17-26.
- Stover MW, Davis JM: Opioids in pregnancy and neonatal abstinence syndrome. Seminars in perinatology 2015, 39(7):561-565.
Dennis Embry, President/Senior Scientist at PAXIS Institute – Dennis D. Embry is a prominent prevention scientist in the United States and Canada, trained as clinician and developmental and child psychologist. He is president/senior scientist at PAXIS Institute in Tucson, Arizona. Dennis Embry serves on the scientific advisory board for the Children’s Mental Health Network, the board of the Federation of Families for Children’s Mental Health, and the National Advisory Council of the U.S. Center for Mental Health Advisory Council.