Question: Will you tell me what you know about somatization disorder and addiction?

Judge Karen Freeman Wilson: Somatization is pain associated with psychological factors. The symptoms are not intentionally fabricated; in fact, patients feel pain. The patient seeks medical attention for the pain they have identified in one or more areas of their body. The pain also causes significant distress or impairment with social or occupational functions.

Because physicians readily treat symptoms first, pain medicine is often prescribed for this disorder. This provides an opportunity for the abuse of prescription pain medicine while the medical issue is being determined. By the time somatization is diagnosed, there may be a co-occurring addiction. Additionally, individuals may have self-medicated with prescription pain medicines before seeking medical for their pain. This makes it necessary to provide psychiatric counseling in addition to treatment for opioid addiction.

Question: My son is a meth addict, I have tried to put him in rehab, but, as always, he is over 18 and must go voluntarily. My question is: He has been to court about 10 times and they keep letting him out on the condition he goes to rehab. Well he is not going. He was in jail again last week and they let him out again. Why can't they send him to court-ordered rehab?

Judge Karen Freeman Wilson: Most courts have the ability to order treatment as a condition of probation. In addition, many places offer the opportunity to participate in drug court. A drug court is a court that combines case management, treatment, and accountability while at the same time ensuring public safety. Individuals are required to participate in court-ordered treatment that is determined after an assessment. Additionally, they are assisted in employment, education, housing, and other needs that will reduce the chance of relapse or further criminal activity. If your son is still under the court's supervision, contact his attorney about the availability of the drug court option or suggest to his attorney that, while he may be trying to minimize your son's contact with the system, he is really in need of court-ordered treatment. You should also encourage your son to request the same. If they hear the same message from different places, it helps a lot.

Question: Does a person get delium tremens (DTs) from withdrawal of antidepressant/antianxiety pills around the fourth day, or do DTs only come from alcohol?

Judge Karen Freeman Wilson: Benzodiazepines such as valium are sometimes used to treat individuals who suffer from alcohol dependence. If a person abruptly stops taking this medicine, then DTs may occur. It is unlikely that withdrawal from an antidepressant that is not a benzodiazepine would result in DTs. It is important to consult a physician whenever changing the use or frequency of prescription medicine.

Question: Honorable Judge Karen Freeman Wilson:
Thank you for this opportunity for me to ask your advice on a serious issue. I was born and raised in New Orleans, LA. I'm sure you've heard of the degrading political reputation in Louisiana.

Prior to Hurricane Katrina, I owned a small business in Metairie, LA. I worked daily with Orleans Parish traffic court judges providing substance abuse assessments, treatment referrals, and education classes for first-time DWI offenders (Program I) and another for multiple DWI offenders (Program II). The recidivism rate dropped by 92 percent for those individuals that I assessed who followed through with the recommendations I made.

The problem is that the traffic court has relocated due to the storm and they have not responded to my efforts to let them know I am still in business. The judges were giving the DWI defendants a choice to seek their assessments from my company or a government or nonprofit agency called the Council on Alcohol & Drug Abuse.

My agency is called: Lasting Effect-Alcohol & Drug Education & Reparation Services d/b/a/ LEADERS. My qualifications are as follows: Licensed clinical social worker; certified criminal justice addiction specialist; licensed addiction counselor; certified in gerontology by Tulane University, with my research thesis on "Is There a Need for Age-Appropriate Substance Treatment for the Elderly?" In addition, I completed the Duluth Non-Violent Intervention Project Training to work with perpetrators of domestic violence.

I have tried writing the judges more than once with no response. I've tried to be visible at court and I told everyone who works for traffic court that I'm back in business. But nothing.

Traffic is an untouched awesome vehicle for detecting early, middle, and late-stage alcoholism. This work must continue. Our country has an epidemic of alcoholism and drug addiction. Such a vehicle as traffic court is perfect for detecting and clinically addressing this disease, especially since the court system provides the clients with the motivation to get an assessment and follow the clinical recommendations. Please advise.

Currently, I have taken a position with Synergy Behavioral Health to have an income. But this is not where my heart is.

Judge Karen Freeman Wilson: You have chosen a noble calling. Your resilience is an inspiration. I have forwarded your inquiry to the State Drug Court Coordinator in Louisiana and I will have the person on my staff responsible for Louisiana to contact you. You can also reach me at 703-575-9400, Ext. 12.

Question: Given the influence of parole and probation officers, I am appalled to learn about the training most receive. Perhaps what I have learned is unique to my State. Nevertheless, I am curious to know what you think of the evidence-based practice "motivational interviewing" (MI) and why it is not used more in working with parolees and probationers? Or is the role of these officers mainly law enforcement, which would not include MI?

Judge Karen Freeman Wilson: The American Association of Probation and Parole Officers is a premier organization dedicated to advocacy and education on behalf of probation and parole officers. From my experience with this organization and attendance at their conferences, I know that training and education for all probation and parole officers is a priority. Many State organizations mirror this emphasis on training and education. Motivational interviewing is often part of training curriculum sponsored by these groups.

We are pleased to count a number of probation and parole officers among the ranks of the National Association of Drug Court Professionals. Because of this fact, we have included motivational interviewing in our conference curriculum as well.

Unfortunately, sometimes the availability of resources or the disinterest of a scattered few may cause you to think that the interest does not exist. But from my personal and professional experience, I know that probation and parole officers are fully vested in their role in the rehabilitative process and believe that to be an important part of their role as law enforcement officers.