As part of its social work continuing education program, the Wurzweiler School of Social Work presented “Opioids, Addiction Treatment, and the Impact on Children and Families” on Friday, Nov. 22, 2019, at the Yeshiva University Museum.

Dr. Travis Rieder

The day began with an introduction by Dr. Gary Stein, chair of Wurzweiler's continuing education program. Dr. Stein noted the importance and timeliness of the conference in addressing the fallout of the opioid epidemic, including premature deaths, serious illness and addiction, lost productivity, family breakdown and increased stigma of those whose illness legitimately require pain management. He hoped that the day’s program would promote thoughtful understanding and effective strategies to address the crisis. Dr. Stein was followed by Dr. Travis N. Rieder on the topic of “The Opioid Dilemma: Responsible Prescribing During an Overdose Epidemic.” Dr. Rieder is a philosopher and bioethicist at the Johns Hopkins Berman Institute of Bioethics, where he directs the Master of Bioethics degree program. In his talk, a version of which he has also given at the TED conference, he noted that “America has a serious problem with prescription opioids, but the problem is bigger than the problem that immediately comes to mind. Opioids are both dangerous and also highly effective at treating some kinds of severe pain.” In the midst of a drug overdose epidemic, however, there is lack of clarity about how to use opioid analgesia, with the end result that “clinicians undertreat pain (out of fear of opioids) and overprescribe opioids (because they want to be able to treat pain),” a situation that Dr. Rieder called “The Opioid Dilemma.” Solutions to the dilemma are not easy to come by because “by being so bad at understanding pain, we’re not only screwing up in one direction, we’re screwing up in both directions.” However, there are solutions to be found if clinicians and institutions can have clear and honest discussions about how to close the gaps without worsening the problem. Some of those solutions came out through two panel discussions. The first, “The Impact of the Opioid Epidemic on Children and Families: What We Have Learned from Other Epidemics,” featured Carol Levine, a Senior Fellow at the United Hospital Fund (UHF) in New York City and former director of UHF’s Families and Health Care Project, and Ivy Gamble Cobb, LMSW, Executive Director of The Family Center.

Carol Levine

Levine presented the findings of the April 2019 UHF report, “The Ripple Effect: The Impact of the Opioid Epidemic on Children and Families,” the first comprehensive look at the successive waves of loss and trauma experienced by newborns, young children, adolescents and their families affected by opioid addiction. It also looks at the needs of kinship caregivers, typically grandparents, who often step in to care for these children. Levine also spoke about the potential remedies proposed in the report and the innovative programs around the nation that address these issues, “all of which,” she pointed out, “draw upon lessons learned from the HIV/AIDS and crack/cocaine epidemics, which, like the opioid crisis, were characterized by stigma and failures to provide needed services to children and families.”

Ivy Gamble Cobb

Cobb discussed her firsthand experience at The Family Center with families affected by illness, crisis and loss. The organization offers a variety of services to families across all five New York City boroughs, including individual and family counseling, legal assistance, mental health counseling and parenting groups and support specialized for grandparent caregivers. She explained that “the future is often uncertain for children affected by the opioid crisis, and these services help them have more secure and successful lives.” The second panel, “Diagnosing and Treating Opioid Use Disorder with Implications for the Family,” brought together Dr. Timothy B. Conley, LCSW, assistant clinical professor at Wurzweiler and a certified addiction specialist with the American Academy of Health Care Providers in the Addictive Disorders, and Dr. S. Lala Ashenberg Straussner, LCSW, professor and chair of the Human Behavior in Social Environment Area and director of the Post-Master's Certificate Program in The Clinical Approaches to Addictions at New York University’s Silver School of Social Work.

Dr. Tim Conley

Dr. Conley discussed the formal diagnosis and treatment of Opioid Use Disorder and how it should be treated as what it is: a mental illness, not just a bad choice. “Even clinicians sometimes stigmatize addiction whether they realize it or not,” he noted, “and this affects the course of treatment for individuals who are struggling.” As one of his presentation slides stated, “Effective work with opioid addicted populations, whether it is clinical, policy, or research, requires an objective knowledge of one’s own values, attitudes, and personal understanding of addiction.” Dr. Straussner focused on the effects on the family of an individual with this diagnosis, such as learning how to cope with a loved one’s opioid addiction, especially for parents of a child with Opioid Use Disorder or a child with a parent who has Opioid Use Disorder.

Dr. S. Lala Ashenberg Straussner

She highlighted Community Reinforcement and Family Training (CRAFT), which teaches the friends and family strategies to help their loved ones with Opioid Use Disorder change their behaviors and feel supported as they reduce their drug use. Participants learn, for example, the power of positive reinforcement for positive behavior (and of withdrawing it for unwanted behavior) and how to use positive communication skills to improve interactions with their loved one.