Welcome to the penultimate issue of 2018 San Diego Psychologist. This is the first of two issues highlighting this year’s SDPA Fall Conference entitled, “Encountering Substance Use in Clinical Practice: Emerging Issues and Divergent Perspectives.” Both issues will feature articles on topics related to the theme of the Conference, authored by experts in their field. I would like to express my deep gratitude to Dr. Mary Mulvihill, the Co-Chair of the Fall Conference. She was instrumental in shaping the content of this issue; she not only reached out to the authors of the articles for this issue, but gathered their initial drafts, did the initial edits, and arranged and conducted the interview with Dr. Silverman that is featured in this issue. 

Most mental health providers have encountered patients whose problematic substance use has led to a breakdown of psychological processes and social networks. The number of people seeking substance use treatment has been dramatically rising. Substance abuse wreaks havoc on the users, their families, and their communities, costing the country approximately $740 billion as a result of crimes committed, loss of productivity, and medical expenses (National Institute on Drug Abuse). Substances of abuse range from widely prescribed medications (such as opioids and benzodiazepines) and legal (in some states, including California), recreational drugs such as alcohol and marijuana, to new illicit drugs, whose potential for harm may be yet unknown.

“Simply Addiction” (Painting by Anyes Galleani)

The first article in this issue of The San Diego Psychologist is an interview with Scott Silverman conducted by Dr. Mulvihill. Mr. Silverman is a community advocate for substance use recovery in San Diego, and has developed highly successful programs that are aimed at supporting prior substance users so that they can be contributing members of their community. The next two articles highlight two common substances with the potential for abuse, both legal in California; Dr. Writer’s myth-busting report on marijuana and its implications is in-depth and eye-opening, and Dr. Barnes addresses the alarming trend of long-term benzodiazepine prescription and use and what we as providers of therapy can do to check this dangerous practice. The last three articles focus on intervention; Dr. House makes a compelling case for psychologists (and allied mental health professionals) as the first-line providers of substance use treatment, regardless of whether they have specialized training in substance use treatment. Dr. Mackeogh discusses strategies that parents of teenagers who abuse substances can use to get them more involved in their own treatment. Finally, we are fortunate to hear from Dr. Horvath, an international leader in addiction recovery, whose SMART Recovery program that began in San Diego, is widely hailed as a successful and effective mutual support group for people trying to limit or stop substance use. 

The world of substance use research and clinical practice is rife with divergent perspectives and approaches to treatment, and you may find that the articles in this issue often posit opposing views and opinions. However, the goal of each of the authors, the approaches they espouse, and the work they do is the same—to guide people back from the narrow, tragic path of substance abuse to fuller and healthier lives.

If you have comments or questions, you may directly contact the authors or email us at TheSanDiegoPsychologist@gmail.com.

Thank you for reading.

-Gauri

Dr. Savla’s private practice in Encinitas, CA is focused on seniors with aging-related challenges and/or mental illness. Before devoting her professional life to clinical service, she studied primary psychotic disorders among older adults at the University of California, San Diego and the VA San Diego Healthcare System. She has co-authored 30 peer-reviewed papers and book chapters to date. She has been the Editor of the San Diego Psychologist since 2016.