Prevention of adverse childhood experiences (ACE) seen accurately as key to preventing problem substance use; necessary resources diverted to systems causing and worsening harm

by Clark Miller

Published January 1, 2023

State’s Attorneys for DuPage, Winnebago, and Rock Island counties all took part in a virtual press conference to discuss why they believe a portion of the settlement money can help strengthen opioid prevention and remediation efforts through key early childhood programs, according to a press release. The speakers also went into detail on the impact the opioid epidemic has had on children, their families, and their communities in their respective counties.

The video recording of this virtual press conference is worth watching if only for the remarkable, anomalous consensus among three public officials that accurately identifies – against all probability and diversionary effort of corporate media narrative – the only way out of America’s intractable, increasingly lethal substance use epidemics. 

video image

That way is to focus on prevention to reduce incidence of ACE, adverse childhood experiences, that are established – by neurobiological, developmental, and epidemiological evidence, most saliently by reports of problem substance users in psychotherapy settings – as tied to and predicting development of multiple illness types including physical illness, mental health problems, and compulsive use of substances. 

ACE graphic

In a culture of untreated substance use epidemic fueled by harm-predicting sham treatment systems, ACE is transgenerational and self-intensifying. Children exposed to the psychologically and emotionally injurious experiences become vulnerable due to  underdeveloped capacity for emotional self-regulation tied to increased risk of  dependence on mood-altering substances that, as adults, sets them up to repeat exposure of their children to the neglect, abuse, and other ACEs that perpetuate and multiply effects. 

That is to say, problem substance use and associated social and public health problems including lethal epidemic will not be lessened until the cultural and psychosocial drivers of ACE are recognized and prioritized as high-risk and high-needs public health areas.

From a previous post – 

Turnbull’s programs engage in forms of “harm reduction” – including use of overdose death reversing Naloxone, safe injection sites, other measures to slow rate of deaths due to high-risk opioid use.

They are right, and they are describing what has been known,

established by research to be the evidence-based understanding of compulsive substance use (“addiction”) for decades. That established understanding explains, has predicted, why never-supported medical “treatments” for a non-medical problem has led to and worsened substance use epidemics. The longstanding evidence-based treatments for chronic effects of trauma, ACE, and other stressors – those complex, individualized states of inner distress driving compulsive use of a mood-altering substance – are all psychological, behavioral, psychosocial therapies and supports that address those individual experiences of pain, inner distress, and distorted beliefs, and more importantly help parents manage inner distress to better control their behaviors, prevent exposure of their children to ACE, and break the amplifying generational chain of emotional harm and substance use.

The lethal, empirically invalidated, and never-held-to-account folklore of addiction and its sham treatment is constructed and disseminated as true, as necessary to protect massive, lethal entitlement systems (including “addiction treatment”, “rehab”, “addiction medicine”) and their funding. It is fabricated, false knowledge, “doxa”, that goes without saying because it comes without saying, without competent, open examination of its grounding in evidence or of its or truthfulness or of health benefit, because public health benefit is not the purpose the “knowledge” serves. In that folklore, the compulsive use of substances – opioids, methamphetamine, alcohol, tobacco, food – is a disease of the brain, requiring medical treatments that have never provided relief and are established as invalidated, their use indicated against, while they fuel continuously worsening epidemics.

There seems no cure for the pathological drives that persistently defend, promote, and protect continued provision of invalidated, lethal medical “treatments” to vulnerable Americans, even as deaths mount the more medical fix is applied to diseased brains.

The evidence is clear.  

Yet the numbers climb. 

The virtual press conference in Illinois is remarkable and hopeful –

for the recognition of the true roots of America’s substance use epidemics and advocacy for effective efforts based on the longstanding evidence.

Speakers validated the understanding that resources and treatments “at the front end” are effective, in contrast to interventions after the harm has been done.

The State’s attorneys advocated for settlement and other opioid funds to be allocated to address the root causes of problem substance use and lethal epidemics. 

Unfortunately all of that will be extinguished,

doomed to be buried by Media accounts of the dominant narrative,  the sanctioned, falsified account of “addiciton” as a medical condition with medical treatments, against all evidence.

Doomed by the increasingly lethal, consistent, and predictable outcome record of medical model and approaches applied to entirely non-medical problems. 

Media medicalization of non-medical problems constitutes mass-messaged lethal disinformation by attributing competence and beneficial effects to services provided by America’s medical providers and systems, those providers entirely out of scope of practice and without capacity to provide any forms of treatments for the non-medical problem of compulsive use of substances or for the entirely psychosocial and psychological supports and therapies required to help parents and future parents gain insight, motivate, and change behaviors to avoid imposing ACE on their children.

Those are behavioral health issues requiring psychological, not medical, treatments.  

We would not expect medical attention or visits to be any more helpful for those needs – would instead predict harm  by diversion of vulnerable patients away from real, evidence-based treatments – than for other non-medical conditions. 

Like chronic pain – its inappropriate medical treatment, supported by the lies of America’s medical-media collusion, generating a decades-long, increasingly lethal opioid crisis that American Medicine continues to fuel and worsen.

Like all problem substance use, established as a compulsive behavior driven by, a symptom of, underlying unmet emotional/psychological needs, injuries, pain, mental distress and distortions – requiring psychological and psychosocial treatments, the lie of a pill or other medical intervention an increasingly lethal absurdity and crime. 

Like smoking, never supported by research evidence as benefitting from medical model approaches, instead nicotine use and dependence surging under the FDA’s “innovative plan” to address cigarette smoking by promotion of vaping, as endorsed in America’s top medical journal. 

Like depression, never supported as a medical condition or with medical treatments, that inconvenient truth never a barrier to America’s medical-media collusion achieving the population-level poisoning with, now withdrawal from, “antidepressant” medications diverting Americans away from the evidence-based, durable treatment – psychotherapy. 

Like America’s latent, looming juvenile and adult diabetes epidemics, driven by lifestyle risk factors including nicotine use, compulsive use of food, and inactivity. No pill for those conditions, instead behavioral health treatments displaced and deprived of resources by medical systems that demand more $billions for the next best pill. That promised, lucrative passive fix of a pill robbing increasingly obese and nicotine dependent Americans of motivation to make the behavioral and psychological changes that would provide prevention, enhanced mental health, and multiple physical health protective factors. 


The road to uncontrolled, lethal epidemic 

may be paved with good intentions, as seems the case for at least three State’s attorneys in Illinois. 

But the controlling, funded model – medical – to address the adverse childhood experiences that predictably will perpetuate psychological and emotional harm and more ACE down through generations predicts more illness and death. There’s no pill or medical intervention of any type for parents screaming at each other, exposing young children to violence, abusing them, neglecting them. And home visits provided by medical systems that identify those problems are too late, the harm has been done. 

Proactive, protective psychological, psychotherapy interventions for young people before they become parents are required. That is, behavioral health interventions. 

Addressing ACE, the driver of problem substance use, under the medical model is like preventing war by deploying battlefield medics, like preventing domestic violence after after the victim gets to the ER. It’s too late, and the practitioners are entirely out of scope of practice. 

It’s like treating substance use, or depression, or chronic pain in medical systems and settings, by medical providers. 

How’s that going? Right. 

But what about referrals? Medical providers will, as standard practice, refer kids they evaluate as at risk along with adult family members exposing them to ACE to the social, behavioral health, and psychotherapy services they need to treat and mitigate effects of ACE, right? 

Here’s an example of a healthcare system funded and empowered to address ACE – 

New Mexico has the highest rate of adverse childhood experiences—child abuse, poverty, substance use and more—in the United States. These events increase the chances that a child will develop a substance use disorder, mental health disorder or chronic pain.

Using the ECHO Model, this program will increase health care providers’ understanding of the many complex factors at the root of opioid epidemic, equipping them with the skills they need. With this increased knowledge and skill, health care providers will be better equipped to identify children at-risk, provide immediate intervention, and refer children and their families to long-term interventions designed to end the opioid crisis in New Mexico.

That sounds great. 

Doesn’t it?

To “refer children and their families to long-term interventions designed to end the opioid crisis . . .”? And to provide “immediate intervention” for those kids and families? 

It is absolutely true and vital that before they inflict or continue to inflict substance-use-related ACE on children, the responsible adults  need effective treatment to address those behaviors

But there’s a problem – that the needed, evidence-based treatment for all practical purposes does not exist, the treatment programs, “addiction treatment” that medical providers and programs would refer to are, in fact, sham, failed systems that predict harm

As related more specifically to America’s opioid crisis exacerbating harm to children by substance use related ACE and described in more detail in this recent post – 

It is established that 

Precisely as in the collusion of fabrications generating American Medicine’s opioid crisis, there has never been evidence to support MAT or other medications as effective or supportive in the treatment of the behavioral symptom of compulsive substance use. 

Instead, evidence consistently and congruently establishes harm, perpetuation and worsening of lethal epidemics by promotion of medication use and their provision. 

Those “long-term interventions designed to end the opioid crisis” have been provided, increasingly, for decades now, while overdose and death rates have persistently mounted, the more medical and “addiction treatment” is provided. Persistently mount now almost a year after dissipation of COVID presumed stressors that served as fictional rationalizations of worsening overdose and deaths as medical treatments were increasingly available. 

That is, demonstrably by decades of consistent and congruent evidence, it’s American treatment systems vulnerable adults and kids are being referred to by their doctors that are the problem, that are failed sham, lethal systems. 

I witnessed it directly from within a primary care clinic in Tillamook County, Oregon, working there with medical providers and administration. And witnessed the inappropriate, incompetent care by medical providers outside of scope of practice that routinely, predictably, led to inadequate care for kids at risk. 


Real world medical model implementation of ACE interventions

The clinic systematically, characterologically failed the high-needs children and families in its primarily Medicaid population served, under the clinical guidance of one of Oregon’s managed care organizations – Columbia Pacific CCO. It was during a time of heightened focus on opioid over-prescribing and unmet need for pediatric care by identification and effective provision of services for kids at risk. 

For example – 

In attempt to reinforce clinical and ethical standards of care, providers were repeatedly reminded of the necessity of providing opportunity to identify children at risk of ACE effects by asking any other family members to leave the exam room to interview in confidence a child, or parent alone, about any concerns about violence or other serious stressors in the family. Left to the medical providers, this almost never happened. They seemed uncomfortable doing it. 

For example – 

Under guidance of the Oregon Pediatric Improvement Project (OPIP), medical model protocols were established for identification and referral for additional evaluation of children with signs of ACE or mental health/behavioral needs. Clinic medical providers were expected to refer kids for specialized psychological and/or developmental evaluation at a medical center, often returning with a diagnosis of ADHD, autism spectrum, disruptive behavior, often with recommendation to medicate. A critical clinical service was missing, should have been the initial and primary referral – for a comprehensive child and family psychosocial assessment that would have, for example, often accurately identified anxiety or PTSD related to family dysfunction and ACE as the accurate diagnosis, of course pointing to effective treatments instead of mis-medication based on misdiagnosis.This was a not-uncommon scenario, with real children and families in the clinic. 

As child and adult therapists will explain, the accurate clinical picture for children emerges over multiple sessions and time as family members gain trust and sense of safety toward disclosing the material needed to construct an accurate diagnostic and treatment picture, never obtained  from a single, stand-alone psychological evaluation. 

But that’s not how things are done under the medical model, kids at risk and  in need  becoming the victims. 

For example – The much broader problem, for adults as well as kids, is that medical professionals have no competence in diagnosing or treating behavioral health (mental health, emotional, psychological) issues. None, leading to misdiagnosis as the default, the predictable outcome. Generally, mis-medication follows from misdiagnosis and from generalized, profound ignorance regarding mental health conditions and their treatment. Kids are especially vulnerable because choices are made for them.  

SSRI anyone? 

For example – 

Clinic administration had priorities higher than the identification and appropriate protections for children at risk due to family dysfunction and violence, one of those priorities was protecting strong (i.e. conflict-free and go-along-to-get-along) relationships with the “community partners”. One of those partners was the women’s domestic violence program in Tillamook, where clinic medical providers were expected and did refer women with children to the DV program when the woman reported domestic violence in the home. 

The DV program and clinic had it worked out so that women who were exposed, often along with their children, to domestic violence would be connected directly to the DV center “advocates” – women with no training, background, or competence in behavioral health or social services provision – diverting them away from behavioral health services in the clinic.

That was important, because those advocates immediately established an understanding with mothers reporting DV in the home – that they would not under any circumstances make reports to child protective services, regardless of what the children were being exposed to and regardless of whether the mother chose to maintain the relationship with the DV perpetrator. That’s how that worked. The mother could stay in the relationship and not have the inconvenience of a visit by CPS (child protective services). 

Clearly, the safety and long-term well-being of the children were not the priorities. In effect, the medical providers and clinic were abdicating their statutory and ethical duties as mandatory reporters to instead support their community partner. The most vulnerable had no voice. 

child sitting alone head bowed

By lack of courage and will for defiance and demand for change we have remained a culture perpetuating harm to our most vulnerable, lethal epidemic, and our decay. 

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.”

– Pierre Bourdieu  Outline of a Theory of Practice (1972)

In Bourdieu’s Theory of Practice, heterodoxy is dissent, challenge to what “goes without saying” – the accepted, constructed doxa, “knowledge”, reality, that goes without saying precisely because it “comes without saying”, without real scrutiny, untested, unquestioned. The function of doxa is not knowledge or truth or promotion of the collective good, but to protect and serve the interests of those with the power, the cultural capital, to create it.

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

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