An Interview with John C. Fleming MD on Preventing Addictions
Addictions are easy to establish, but almost impossible to undo. The core feature of addiction, once it is established, is the craving for intense, drug-mediated experience. Though physical dependency on particular substances can be undone, cravings for more and stronger intoxicated states tend to linger. It is therefore imperative to avoid becoming addicted in the first place when this is possible.
Children are particularly vulnerable to becoming addicted. Those who start using drugs and alcohol prior to age 15 are five times more likly to become addicted than peers who do not encounter substances until after age 15. Alcohol, prescription medications and other substances are surprisingly easy for children to get. Average American children have used drugs by the time they are in their early teens.
Dr. Fleming is a strong advocate for parents taking strict but loving steps to restrict and limit childrens' opportunities for becoming addicted. He suggests that parents do not model drinking in front of children, indoctrinate children against substance abuse in the same way that they would teach children to not run into the street, to not allow children to have long periods of unsupervised time, to lock medications and alcohol away from children, and to use breathalizer and other drug tests on at-risk children to disincentivize them from using or experimenting. So as not to shock children with a sudden change of the rules, these measures should be implemented from birth and be applied consistantly.
Links Relevant To This Podcast:
About John C. Fleming
Dr. John C. Fleming is author of the 2007 book, Preventing Addiction: What Parents Must Know to Immunize Their Kids Against Drug and Alcohol Addiction. A native of Mississippi and a graduate of the University of Mississippi Medical School, John Fleming, M.D. currently lives and practices family medicine in Minden, Louisiana. During his medical residency he trained at the drug and alcohol treatment unit at Navy Regional Medical Center, Long Beach, California, which was then a pioneer in chemical dependency treatment. That program influenced his medical practice, and also helped shape the way he and his wife, Cindy, raised their four addiction-free children.
What about intrinsic motivation and self esteem - - Mar 5th 2009
I expect Dr Fleming's children grew up to have good intrinsic motivation and good self esteem. If they are addiction free and enjoy sound and wholesome values it sugests they were loved and nurtured in a relatively stable home environment with good parental role modelling. Some of us believe these attributes are very significant "addiction proofers" for our children. No doubt the myriad of other issues have their own relevance but the common attributes of abuse, deprivation, emotional trauma, attachment disorders and the trans generational threads of challenged parental circumstances we see linking addicts seem to have a lot to do with addiction risk profiles.
Sadly we cannot choose our parents.
Dr Symon Armstrong
Generalisations ? - John Rutledge - Sep 22nd 2008
I have visited Dr Fleming's websites (medical and political), and found the experience ... interesting. Clearly, he is a politician as well as a doctor - so it should not surprise that in his comment below, he resorts to the dodgy debating technique of "generalisation".
"My wife and I used these techniques and concepts with all 4 of our, now, grown kids and each is happy, well-adjusted, non-addicted and we enjoy a close relationship with each. Therefore the score is now:
"heavy-handedness" 4 passivity 0"
Well, good for the doctor, and congratulations! However, it proves - or even shows - nothing of any necessary application beyond the doctor's own family. It is about as convincing as saying, "I like to drink grappa. My wife likes to drink grappa. My brother likes to drink grappa. Therefore, everybody likes to drink grappa." Generalisations of this sort are of no use whatsoever in making out the applicability, for example, of a particular approach to child-rearing to the population in general. Certainly, one should not be surprised to find a politician/doctor using such a debating technique. One might be surprised by the crude way in which it is employed here.
As to the point made by a previous poster about the doctor's views on immigration - I was highly amused by the comment on his political website that "By definition it (illegal migration) is not immigration, because immigration is an orderly, legal process." Well, not in the long view of history it isn't. Take a family like, oh, the Flemings, for example. This name originally referred to people who migrated from Flanders in the 11th/12th centuries to France and England, where (being foreigners from Flanders) they tended to be described as "le Fleming'", or some variant thereon - I have come across this name myself in 13th century English legal records. It would appear that the Flemings currently in the US are descended in great part (generalisation) from people carrying this name who immigrated into Wales as part of the Norman invasion of the late-11th century, and subsequently into Ireland by means of the South Wales-based Norman/Plantagenet invasion of that country in the 12th century. I suppose one might conclude that the decision of the Norman king of England, William Rufus, to steal the lands of the people of South Wales by fire and sword was part of "an orderly and legal process", and that the same could be said of a similar decision on the part of the Angevin king of England, Henry II, to steal the lands of the Irish by similar means. The Welsh and Irish of the time certainly did not think so. Mind you, the latter invasion was supported by the Pope. Perhaps that made it "orderly and legal"? Or is this another rather over-stretched generalisation?
Of course, my own family name also travelled to the United States through Ireland, where it appears to have arrived from England by a similarly "orderly and legal process", probably in the 17th century. We should all be a bit careful with generalisations!
Fleming Is Loony Tunes - - Sep 21st 2008
Dr. Fleming is now a candidate for Congress representing the Fourth District of Louisiana. Not only are his child rearing methods scary (thank God I was not raised in such a house), you ought to hear his answer to solving illegal immigration. See: http://www.youtube.com/watch?v=wnKhj6L7J3o
parents should take care - George Mathew - Jul 16th 2008
Preventing drug addiction of children is great challenge for community.The main reason for drug addiction for children are their parents itself.They are drinking before their children.It should be changed.
Preventing Addiction - John Fleming, MD - May 5th 2008
Your responses of my techniques and advice being "too heavy-handed" is common, but that is often how we end up with "conventional wisdom." I will challenge you as others----give me a single real life example of how such techniques and concepts have harmed anybody. And while you are at it, tell me what you think we should do to stop 10% or more of our youth falling prey to addiction. What, no answers? My wife and I used these techniques and concepts with all 4 of our, now, grown kids and each is happy, well-adjusted, non-addicted and we enjoy a close relationship with each. Therefore the score is now:
"heavy-handedness" 4 passivity 0
John Fleming, MD
Bad advice - Anne Frid de Vries - Jul 23rd 2007
There are two things I agree on with Dr. Fleming: addiction is a trap that is extremely hard, if not near impossible to get out of. Therefore the best way to handle addiction is to prevent it. Second, in the light of that, parents cannot afford to be naive in any way about their children's exposure to addictive substances and consequent chances of turning addictive.
Other than that I am rather skeptic on his analysis of addiction in its entirity and I disapprove of the methods for prevention. I think they are too heavy handed and thus are not justified as being disproportionate. I doubt the efficacy and on the example of using a breathalyzer for your child in his puberty, I think this is even harmful and counterproductive.
Insisting on letting your child do a drug test (either breathalyzer or urine sampling) gives off the wrong signal ("I do not trust you anyway. You are considered a liar a priori") pushes for more dangerous evasive behavior, flight to worse substances or addiction to non-substance stuff like gambling, gaming, pornography etc, and to an atmosphere of distrust while the parents lure themselves into a false sense of safety on account of the tests.
All in all bad advice and it should be posted here with a huge disclaimer lest the approach receive the odium of legitimacy by virtue of being exposed on the mental help website.
Editor's Note: Neither Dr. Van Nuys or myself (Dr. Dombeck) particularly agrees with Dr. Fleming's recommendations, ourselves finding them heavy-handed and potentially counterproductive. At least I believe that (not having consulted Dr. Van Nuys directly before posting my comment here). I think I can speak for Dr. Van Nuys on the basis of having listened to his scepticism during the interview. We both felt that he has delivered them in a reasonable enough way and that his biases are on the table for examination to listeners of the podcast who are intelligent enough to draw their own conclusions. There is room for a variety of approaches within the field, and there may very well be some instances where this advice may prove profitable, however few instances that may be.