4 actions each day I posted some time ago about 4 actions to take each day for those just starting in treatment. In the long-term residential therapeutic community (TC) program where I worked, we would teach this to newer patients. What were the four actions? Reading the literature. Talking with someone who has what we … Continue reading Self and Others: Recovery Trajectory and Its Shifting Emphases
Science, policy, and the public trust
Keith Humphreys recently published a reflection on the social roles of public health professionals. in response to a recently published memoir by Griffith Edwards, the former editor of the journal Addiction for 25 years. The contract to which I refer, roughly speaking, ran as follows. Researchers’ fundamental duty was to systematically and accurately describe the … Continue reading Science, policy, and the public trust
The 12 Traditions, character development, and personality
It seems to me that the 12 Traditions can serve as a bolt-on character structure. And that living within that bolt-on character structure (our own life on its own, our life in the fellowship, or both), can directly or indirectly result in character development that is helpful for recovery. A few points about personality As … Continue reading The 12 Traditions, character development, and personality
Listing tobacco use in “Social History”?
At this point in our field, tobacco use is on the checklist of topics barely addressed beyond the most mechanistic and minimal of ways – if at all. One evidence of this is a very large proportion of in-bound medical records I see from providers of all disciplines and settings where “Social History” is the … Continue reading Listing tobacco use in “Social History”?
The Deadly Mirror of Validation in the Age of Artificial Community
Just over 2,000 years ago, the Roman poet Publius Ovidius Naso, penned the parable of Narcissus. To punish Narcissus for his vanity and rejecting all those who loved him, the goddess Nemesis cursed him to fall in love with someone he could never have. While hunting, Narcissus bent over to drink from a clear pool … Continue reading The Deadly Mirror of Validation in the Age of Artificial Community
What I Wrote to Medical Students About Recovery
Credit: Parentingupstream at Pixabay My friend, a doctor, reached out to me recently and asked if I would write a few words for her annual address to medical students at a fairly prestigious school. The topic was "opioids", but she wondered what a recovering person would say if they had a few moments with a … Continue reading What I Wrote to Medical Students About Recovery
Cochrane Review of cannabis-based medicines for chronic neuropathic pain in adults
Before we get to the results of this Cochrane Review, let's ask and answer one basic question. What's a Cochrane Review? A Cochrane Review is a specific kind of meta-analysis: a study of available studies. It's one of the most rigorous methods in the research arena. The Cochrane Review website provides an easy to understand … Continue reading Cochrane Review of cannabis-based medicines for chronic neuropathic pain in adults
N-Propionitrile Brorphine is here
On December 13, 2025 I posted about the emergence of Cychlorphine (N-Propionitrile chlorphine). Now we're hearing about another synthetic opioid in the group being called "orphines". This one is N-Propionitrile brorphine. It's been found as a contaminant in upstate New York. For a brief overview, check out this resource from the New York State Office … Continue reading N-Propionitrile Brorphine is here
When Systems Become Isolated: The Erosion of Authentic Dialogue Across Our Addiction Care Institutions
There is a lot wrong with our SUD service system across our country currently when you scratch the surface to get underneath the press releases about how swell things are going. I was reminded of this recently when I read Rob Kent’s essay in Alcoholism & Drug Abuse Weekly Unstable Foundations. In it he referenced … Continue reading When Systems Become Isolated: The Erosion of Authentic Dialogue Across Our Addiction Care Institutions
Transformation grounded in the reconciliation of identity, values, and belonging
Yesterday’s post about confrontation as a goal versus confrontation as a style reminded me of a paper I’ve been meaning to blog. The paper reports on the findings from a study of men currently participating in treatment for opioid use disorder (OUD) seeking to understand their motivators for seeking help with their OUD. The researchers, … Continue reading Transformation grounded in the reconciliation of identity, values, and belonging