Interviews BLOG

There are a lot of health care providers doing some great work in the field of substance abuse and promoting recovery. One of those centers is KLEAN Treatment Center, a residential facility with a primary treatment focus on drug and alcohol addiction and an additional focus on dual diagnosis. The program offers supervision and support twenty-four hours a day, prioritizing client-care above all.

We were able to meet up with Andrew Spanswick, MSW, one of the co-founders and CEO of KLEAN. He has 20 years of experience working with mentally ill and addicted patients, specializing in a dual diagnostic treatment modality. This means he works with those who have a mental health disorder and are substance abusers. We discussed some important issues regarding treating addiction, the use of synthetic drugs in particular, and also about what it means to have a dual diagnosis.

TestCountry: How serious is the problem of synthetic drug abuse?

Andrew Spanswick The Comprehensive Crime Control Act of 1984 gave the Attorney General the authority to temporarily control a substance if it posed a significant threat to the public safety. The problem of synthetic drug abuse is so serious that on October 21, 2011, the DEA invoked this authority and temporarily banned some of the synthetic substances that comprise bath salts because synthetic drugs are comprised multiple substances. The Association of Poison Control Centers reports that in 2010 there were 2,906 calls relating to human exposure to synthetic marijuana, and the number doubled in 2011 totaling 6,959 calls (Office of National Drug Control Policy).

TestCountry: Are synthetic drugs just a fad, or are they here to stay? What makes them desirable to people, and are they currently what you have been seeing as the number one drug of choice?

Andrew Spanswick The chemists who create the synthetics are able to do so more quickly than legislation can be passed to outlaw the drugs. The allure of synthetic drugs is their legality, even if only for a temporary period of time. Legality, in this case, equates with readily available. In my experience with drug-addicted patients, I have not found an overwhelmingly vast majority of the addictions being to synthetic drugs. However, in a residential environment, synthetic drugs are more common; nowadays, synthetic drug testing can regulate these substances.

TestCountry: Are addicts of synthetic drugs any different from those who choose other drugs? For example, are there any trends you have discovered as a result of working in this field?

Andrew Spanswick I have noticed that compared to other drugs, synthetic drugs appear to appeal to a younger demographic. More specifically, the synthetic drugs seem to be especially popular among young adults who are still living with their parents. Again, the reason for this may be that the synthetic drugs are less conspicuous.

TestCountry: You specialize in people who have a dual diagnosis. Can you talk to us a little about this term, and maybe the prevalence of comorbidity in the field of drug abuse? Is this an underserved population?

Andrew Spanswick The term "dual diagnosis" speaks to the presence of more than one diagnosis. For example, a person who comes into treatment presenting with an addiction to synthetic drugs may also experience a constellation of symptoms indicative of another diagnosis. Mood disorders such as bipolar I and II and personality disorders such as borderline personality disorder often co-exist with a drug dependency. An addiction often develops as a means of managing symptoms of another diagnosis. For example, a person presenting with Generalized Anxiety may have begun to smoke marijuana as a means of treating the anxiety. If the aforementioned person ultimately becomes addicted to marijuana, he or she must not only be treated for the addiction, but also for the generalized anxiety. It is important to note that symptoms of both using drugs/alcohol and detoxification from drugs/alcohol can often look like symptoms of an alternative diagnosis, and for this reason, the primary issue becomes the substance dependence. Only when the person has been cleared of the drugs and alcohol can an official determination be made as to additional diagnoses.

TestCountry: What is the biggest factor in drug use? Is it socioeconomic, environmental (for example, prevalence in the media), related to self-esteem, lack of knowledge, etc.

Andrew Spanswick There is not one overarching factor in the case of drug use. Genetic predisposition, life-experiences, and one's level of distress tolerance are certainly main contributors. Rather than taking a nature vs. nurture approach, perhaps it is more accurate to take a nature and nurture approach. It is not enough, for example, to look to low self-esteem as a contributing factor of drug use; it is equally as important to look at the factors that contribute to the low self-esteem.

TestCountry: How would you recommend an addict go about finding treatment, what is the first step? What about for a concerned family member, teacher, or employer?

Andrew Spanswick Be resourceful: use the internet, reach out to a therapist or social worker, contact clergy, school counselors, employee assistance programs, support groups.

TestCountry: Do you think current legislation is keeping up with drug abuse in this country? In your opinion as health care providers, what changes should be made?

Andrew Spanswick The concern is less about legislation's ability to keep up with drug abuse, and more about its ability to comprehend drug addiction. The movement needs to be toward rehabilitation as opposed to incarceration. A person struggling with an addiction needs to be treated as a person in need of emotional and medical support as opposed to being punished for needing help. Incarceration is counter-intuitive in that it sets the person up for failure as opposed to success, and the message becomes that addiction is a crime rather than a maladaptive coping mechanism.

TestCountry: I see that you work with family therapy as well as provide a wealth of opportunities for your clients to begin developing healthy living habits. Have you found that these initiatives make a big difference in your success rates?

Andrew Spanswick Absolutely. Treating addiction without addressing both its impact on the family and the family system's impact on the addiction. When a person who has completed treatment returns to a family system that has not received treatment, the likelihood of relapse increases. Developing life skills while in treatment is extremely important to one's long-term success. If in treatment one does not learn how to live outside of treatment, the treatment has done a disservice.

TestCountry: What do you think is the most important thing for the general public to take away in regards to substance abuse?

Andrew Spanswick Recovery is a process, not a remedy.

KLEAN's top-level clinical team has created individual and group programming with careful consideration and attention to detail. On a weekly basis, residents partake in three individual therapy sessions and a plethora of therapeutic groups. Recognizing the importance of family involvement in treatment, KLEAN also provides a three-day, intensive family program every six weeks. KLEAN subscribes to a holistic approach in which health and wellness are an integral part of recovery; all residents are provided a gym pass upon arrival and an opportunity to participate in on-sight yoga at least two times a week. KLEAN is more than just a treatment center, it is a community. KLEAN's alumni program offers an opportunity for residents to stay connected to the community they have become a part of. On Sundays and holidays, Klean alumni have an opportunity to come together with current residents for a barbecue followed by a peer-led support group.

For more information on KLEAN Treatment Centers, check out