In rolling out a new design for the Wall Street Journal on January 2, publisher L. Gordon Crovitz said that he wanted readers "to experience the increased focus on interpretation, insight and ideas." But readers may have been puzzled by a recent front-page story on a dispute between judges over a New Mexico "alternative to prison" for drug offenders called Second Chance, which is based on Scientology's Narconon addiction treatment regime.
It was the kind of odd and compelling story that the Journal's front-page is renowned for; but it signally failed to deliver on interpretation and insight: Even though the Journal interviewed a leading addiction expert for the story, it failed to accurately represent what the research says about the odds of the alternative treatment's success.
The story describes the dispute over Second Chance Program (SCP) as primarily a personal one -- between a judge who himself attends AA and supports traditional treatment and a former judge who is now a consultant to SCP (which claims to have no official connection to Scientology). The program received a $350,000 federal grant and now wants $3.6 million from the state of New Mexico to continue its operations.
Like Scientology's Narconon, Second Chance uses saunas and vitamins to "detoxify" the body, claiming that drug cravings are caused by residue from drugs stored in tissue. There is no scientific evidence to support those claims.
Ironically, New Mexico is home to one of the world's leading experts on addiction treatment effectiveness: William Miller, a professor who recently retired from the University of New Mexico.
He was asked by the state for his opinion on the program and said, "The components of SCP do not correspond to what we know from science about the nature of addiction and its effective treatment."
But in response to a question from the Journal as to whether the program works, Miller is quoted as saying "We just don't know."
Miller was accurately quoted; it's certainly true that without an evaluation of any particular program, it's impossible to say for sure whether or not it works.
But the truth is far less favorable to Second Chance than that statement implies. There is an enormous body of literature on what works and what doesn't in addiction treatment, which Miller is famous for reviewing and analyzing. Second Chance explicitly rejects much of what is known to work.
For example, about 50% of addicts and alcoholics suffer a co-occurring mental illness, often depression, anxiety disorders or attention-deficit disorder. Second Chance does not allow the use of psychiatric medication, which is often essential in treating these conditions. Research finds that addicts with co-occurring disorders who do not receive effective treatment for them are far more likely to relapse than those who do.
Banning medication also precludes use of the most effective treatments for opioid addiction, methadone and buprenorphine, and denies access to drugs like naltrexone and acamprosate, which have been found to reduce relapse in alcoholics.
The program also appears to involve confrontational tactics that have been linked with increased relapse risk and does not utilize proven techniques like cognitive-behavioral therapy or motivational interviewing.
The history of addiction treatment is filled with quack cures that have received large amounts of government funding. But from studying their failures, we now know a lot about how to help addicts, and newspapers striving to make journalism relevant to readers need to provide this kind of context and analysis, which together add up to insight. We don't know whether jumping up and down ten times will cure addiction, but that doesn't mean we should put money into funding a study to find out, let alone sentence prisoners to such treatment just on the off-chance that it might help.