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Where a few might benefit many

November 1, 2007
by Thomas G. Durham, PhD, LADC
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Individuals in recovery work to develop a treatment ethic in China

In Chinese society, addicts are treated with moral disdain; punishment is a component of addiction treatment; rural jurisdictions ignore the central government's policy on treatment; and treatment generally is limited to acute care/detoxification while being provided by those not necessarily trained in addiction treatment. While addiction professionals in the United States could argue that they face some of the same challenges, brought on by stigma toward the addict here, one can only imagine the barriers faced by those promoting effective care in China.

Among those in China who advocate effective care and the eradication of discrimination against the addict are those in the recovery community who are active in a relatively young but growing Chinese 12-Step movement. Among them is Mr. H., an active member of the AA community in Beijing and a leader in the development of AA in his native country. When I met Mr. H., he was introduced to me as the “Bill W. of China.” His own recovery, subsequent 12-Step work, and respect as a caring helper have given him the desire to become a professional counselor. However, until recently, only those professionally trained in a helping profession have been allowed to have direct contact with patients.

I met Mr. H. and a group of other recovering alcoholics during a training program at Beijing Medical University in March. Although the main purpose of the conference was to address training needs for addiction treatment professionals in China, there was a group of about 12 recovering alcoholics who were invited to attend the training.



Tom durham at the sino-american workshop of psychotherapy on substance abuse, and pictured with chinese psychiatrist zheng xiao hua.

Tom Durham at the Sino-American Workshop of Psychotherapy on Substance Abuse, and pictured with Chinese psychiatrist Zheng Xiao Hua.

There have been many changes in China over the last several decades and, not surprisingly, this has included an increase in alcohol consumption. As reported by David J. Powell, PhD, president of the International Center for Health Concerns (see March/April 2007 issue), this current trend is moving China toward a statistic that will overwhelm its burgeoning treatment community. China is on the verge of having one of the highest per-capita rates of addiction among major world economies.

The conference I attended, organized by David and Barbara Powell, was the 4th Sino-American Workshop of Psychotherapy on Substance Abuse. Most participants were Chinese professionals, including psychiatrists, psychologists, nurses, and medical students. Along with the involvement of David Powell, I shared week two of the three-week conference with two other faculty members: William Mock, PhD, LISW, of the Center for Interpersonal Development in Ohio and Mark Schorr, MA, LPC, of Cascadia Behavioral Healthcare in Oregon. One of my tasks, while my two colleagues conducted demonstrations with live patients, was to lead the group consisting of Mr. H. and the other people in recovery who were interested in becoming counselors. Since those in recovery were not permitted by the hospital to witness the demonstrations with actual patients, I spent three hours each afternoon for five days with this group.

I am sure that my experience working with these energetic and eager individuals will continue to be one of the most memorable of my professional career. The participants seemed to be doing quite well in their own recovery and were very active in local AA groups. They very much wanted to take what they were getting out of AA and their own successful recovery to others—and to help eradicate the rampant discrimination toward the addict that exists throughout Chinese society. The Chinese treatment community indeed could benefit from these enthusiastic individuals' experience and passion.

Limited help

Drug addiction is not new to China. At one time it was estimated that 27% of the male population was addicted to opium. However, this figure dropped significantly from its peak in 1906 to the establishment of the People's Republic in 1949. Changes in Chinese society in recent years have meant new freedoms and new choices. As a result, drug addiction is again on the rise and, although seemingly insignificant when compared to the epidemic of the early 1900s, reports indicate there were 1.16 million Chinese addicted to heroin in 2005.1

Currently the number of beds available for those dependent on alcohol or drugs is quite small, especially when considering the vast number of those who could benefit from treatment. In Beijing alone, a city of more than 10 million, only a few hospitals with a handful of beds currently treat patients addicted to alcohol or drugs. While effective treatment for addiction is being recognized in China, the nation is merely scratching the surface when it comes to treatment availability.

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