Catch them young
Health trends go in and out of fashion. Open your mouth and say "aahhh" - if you don't have tonsils, the chances are you're a pre-1970s child. Tonsillectomies were as routine then as tummy tucks are now. Similarly, there's been a radical shift in the thinking about addiction.
Drink-related hospital admissions in England have reached record levels, according to the latest NHS statistics. The numbers of cases of cirrhosis of the liver have risen 900 per cent in men and women under the age of 45 over the past 30 years in the UK. The amount adolescents are drinking, particularly young women, is toxic to their brains just at a time when they should be reaching a cognitive peak. A growing number of experts has become convinced that traditional addiction treatments are not working.
In the 1970s and 1980s the genetic link dominated thinking about addiction. However, the "booze gene" is no longer seen as inescapable destiny. Treatments in the past also focused on the addicted. Now experts are becoming increasingly convinced that addiction should be tackled before it starts by teaching children the skills to cope in life.
Patricia Conrod, a 36-year-old Canadian psychologist, is one of those behind the new approach. "It's the premise that there is nothing we can do to control abuse that I want to change," she says. Conrod is the first research fellow appointed by the charity Action On Addiction, which is funding the Preventure Project, aimed at reducing risky behaviour in young people.
"We teach adolescents how to challenge their thinking and control their 'hot thoughts'," she says during a visit to a school in South London. "Hot thoughts" are not about sex. They are about "how uncomfortable physical sensations and thoughts can control your mood and affect the action you take", Conrod says.
Nicola, one of a group of 15-year old girls, begins by describing her recent hot thought, which was about walking out of a GCSE mock exam to go drinking with her boyfriend because she was bored. "We help them to focus on how their short term behaviour could block their long term goals," Conrod explains. In other words, how their personalities might be making them unhappy.
Personality is the key word in addiction treatment today. The good news is that abuse of addictive substances can be prevented and controlled by encouraging people to take responsibility for self-damaging behaviour.
The Preventure Project is on trial over three years with 4,000 young people, from every socio-economic group, in schools across London. Conrod aims to prove that you can modify how personality influences addictive behaviour. "We're not talking about changing personalities but we know personalities can be managed."
The programme targets four factors - depression, anxiety, thrill-seeking and impulsivity - that are known to lead to increased risk of early-onset substance misuse. Preventure says surveys of the at-risk students it has helped showed the incidence of panic attacks had fallen 45 per cent. During six and 12-month follow-ups, it found that half of the adolescents who received the sensation-seeking intervention stopped binge-drinking altogether.
Leonie Frieda, author of a recent biography of Catherine de Medici, knows much about addiction. "I was tremendously unhappy aged 25," she says. "I also had a tremendous amount of money because I was going out with a billionaire and I happened to sit next to a coke dealer one night at dinner." Within six weeks Frieda had a coke and heroin habit. "I used to drive along the French coast to Monaco at 150 miles an hour and then take my hands off the wheel," she says.
Addiction experts describe her personality as "thrill-seeking" - something that began to manifest itself as severe anorexia when Frieda was a teenager. "Anorexia might as well been heroin because you get such a buzz from it," she says. Frieda had a family history of alcoholism (her mother and two grandparents abused either alcohol and drugs). Does she think being taught to control her negative coping strategies might have made a difference? "God yes. I didn't know the first thing about feelings," she says. "I'm now 50 and on a journey of self-discovery about things I should have learnt as a child."
Conrod catches kids at an age when binge drinking can begin to kick in. The Girasol Foundation, which has been operating in Spain for more than 20 years and is making its first foray into the UK, begins earlier, targeting children as young as seven. "In my view it's a little late by the time they are teenagers," says psychologist Pilar Lillo, one of Girasol's founders. "We like to start when they are building their personalities. We teach a broad life-skills educational programme." She uses a variety of techniques including group exercises, role-playing, relaxation and story telling to increase children's confidence, emotional skills and responsibility before they've had their first sip of alcohol.
"The younger you start the better," says fashion consultant and recovering addict Pandora Delevigne. As a child Delevigne was hyper-anxious and so unhappy that she couldn't sleep at night. "I couldn't cope and felt convinced I was a lunatic. Every time I said anything I was told not to be silly or to grow up."
Delevigne, who is helping to raise funds for Girasol's work in London and Herefordshire schools, says she is lucky to have survived years of drug abuse, which might have been avoided if someone had understood her "depressive" personality as a child. "If someone had spoken to me then about my personality it could have changed my life."
The problem with prevention is that there is little money in it whereas "picking up the pieces" is big business. The recommended primary stay in a private clinic to "dry out" is four to six weeks at a cost of up to ￡17,000.
"I have lost count of the number of clinics that I went to - maybe about 40," Frieda says. "But I'd come out of rehab and face the same situation." This illustrates why Conrod feels adolescence is the crucial time to learn coping skills. "You might go to a clinic in Arizona," she says, "but you have to come back and know how to cope with every day things."
Carol Woolton is an editor at Vogue magazine
欧美的“戒瘾”新发现
健
康趋势在不断轮回。张开嘴，说“啊……”――如果你没有扁桃体，那么你可能是上世纪70年代以前出生的。当时，扁桃体切除术与如今的腹部除皱一样普遍。与此类似，人们对于成瘾的看法也发生了巨大变化。
英国国民卫生保健体系(NHS)的最新数据显示，在英格兰，饮酒造成的住院率达到创纪录水平。过去30年间，英国45岁以下的男女中，肝硬化患者增加了9倍。青少年正处在认知高峰时期，但他们中很多人饮酒，尤其是年轻女性的饮酒量更大，而饮酒有害于他们的大脑。越来越多的专家已经相信，传统的戒瘾疗法并不奏效。
防“瘾”于未然
上世纪70年代和80年代，遗传因素主宰了人们对成瘾的看法。然而，“酒精基因”不再被视为不可逃脱的宿命。过去的治疗方法也关注成瘾人群。如今，专家们越来越相信，应该通过在生活中教授孩子应对成瘾问题的技巧，防患于未然。
36岁的加拿大心理学家帕特里夏?康罗德(Patricia Conrod)是提出这种新方法的人之一。她表示：“我想改变的正是‘我们无法控制成瘾问题’的假设。”康罗德是慈善组织“对成瘾采取行动”(Action On Addiction)任命的第一位研究人员。该组织为旨在减少年轻人危险行为的Preventure Project提供资金。
她在走访伦敦南部一所学校期间表示：“我们教育年轻人如何挑战自己的思想，控制自己的‘冲动想法’。” 她表示，“冲动想法”指的不是性，而是“令人不安的身体感觉和想法如何控制你的情绪，影响你的行为。”
15岁女孩年龄组中的妮古拉(Nicola)首先描述了她最近的冲动想法，当时，她想退出普通中等教育证书(GCSE)模拟考试，与男友一起出去喝酒，因为她感到无聊。康罗德解释道：“我们帮助他们关注自己的短期行为如何会阻碍他们实现长期目标。”换言之，就是他们的个性如何会让自己变得不快乐。
性格是当今戒瘾治疗的关键词。好消息是，通过鼓励人们对自毁行为承担责任，可以防控滥用成瘾物质。
控瘾，从年轻人开始
Preventure Project对4000名年轻人进行了历时3年的试验。这些人来自伦敦各个学校，来自不同的社会经济阶层。康罗德试图证明，个性影响成瘾行为的方式可以改变。“我们说的不是改变性格，但我们知道，性格可以被控制。”
该计划将目标对准了4个因素――沮丧、焦虑、寻找刺激和冲动。据说，这些因素会增加早期成瘾物质滥用的风险。该计划称，对接受过其帮助的有风险学生的调查显示，恐慌发作的频率下降了45%。之后6个月和12个月的追踪调查发现，在接受“寻找感觉”干预治疗的年轻人中，有半数完全停止了无节制地饮酒。
莱奥妮?弗里达(Leonie Frieda)很了解成瘾问题。她最近写了一本关于凯瑟琳?德梅迪奇(Catherine de Medici)的人物传记。“我25岁的时候非常不快乐，”她说，“我当时还很有钱，因为我正在和一位亿万富翁约会。一天晚上吃饭的时候，我碰巧坐在一个毒贩子旁边。”不到6周，弗里达就染上了吸食可卡因和海洛因的习惯。她说：“我过去常常以每小时150英里的速度，沿着法国海岸开车去摩纳哥，然后手才离开方向盘。”
戒瘾专家说她的性格是“喜欢找刺激”。在弗里达青少年时期，这种性格开始表现为严重的厌食。她表示：“厌食就和海洛因一样，因为你能从中获得那样一种沉醉。”弗里达有家庭酗酒史（她母亲和外祖父母不是酗酒就是吸毒）。她是否认为，如果有人教她控制负面性格的应对策略的话，她的情况也许会有所不同呢？“上帝啊，当然了。我一点也不知道感觉方面的事，”她说，“我现在50岁了，还在进行自我发现之旅，去发现那些原本在孩提时代就应知道的东西。”
用责任感控制情感
康罗德在孩子们可能开始酗酒的年龄，就着手对他们进行教育。Girasol Foundation开始得更早，作为其对象的孩子，年龄最小的只有7岁。这家基金会在西班牙已运作了20多年，目前正首次尝试进军英国。“依我看，到他们10多岁的时候就有点晚了，”Girasol创始人之一、心理学家皮拉尔?利略(Pilar Lillo)表示。“我们喜欢在他们开始形成自己的性格时就开始。我们讲授各种生活技能教育课程。”她运用大量技巧――包括团队练习、角色扮演、放松和讲故事等，在孩子们第一次沾酒精之前，就增强他们的自信、控制情感的技能和责任感。
时尚顾问、正在康复的成瘾者潘多拉?德莱维涅(Pandora Delevigne)表示：“开始得越早越好。”德莱维涅小时候高度焦虑，非常不快乐，以至于晚上无法入睡。“我无法应对，深信自己是个疯子。每次我说点什么，别人都告诉我说别傻了，要么就是让我成熟点。”
德莱维涅表示，她很幸运，度过了吸毒的那些年，如果有人能理解她的“忧郁”性格，吸毒本来是可以避免的。德莱维涅目前帮助Girasol为在伦敦和赫里福郡学校的工作筹集资金。“如果当时有人能和我谈谈我的性格，那可能会改变我的一生。”
预防的问题在于没有钱，而“重新站起来”却是个大买卖。在私人诊所接受推荐的“戒酒”初步住院治疗，需时4至6周，花费多达1.7万英镑。
“我已经数不清去过多少诊所了，可能有40家左右，”弗里达表示。“但我康复以后，面临的还是同样的情况。”这正好说明了为什么康罗德会认为青春期是学习应对技能的关键时期。“你可以会去亚利桑那州的诊所，”她说，“但你还得回来，了解如何应对日常事务。”
