From Bias to Balance

Disagreements around the use of medication are symptomatic of larger ideological and philosophical views around substance use, SUD’s, addiction and recovery. From where I am sitting, it seems like we are becoming increasingly tribal and more entrenched. It also seems that conversations often veer into personal attacks. There are good motives and smart people doing recovery work on “both sides” of these debates and there is a ton of common ground. It also seems that there are some intractable disagreements but we are often not as far apart on things as it seems. We would all be better if we took a little of this advice or that  advice and make an attempt to understand where the people we might disagree with are coming from

In this new paper, Bill White attempts to address some of the polarization in the field by offering a balanced perspective on the use of medication in addiction treatment and recovery by exploring some of the history and context that informs the debate.

Bill begins the paper by offering up his extensive record of working to expand and legitimize the use of medication in the addiction treatment and recovery realm. I assume he felt the need to remind us of his record in order to minimize any discord that the paper might provoke. Given Bill’s status in the field, I think he is the best messenger for this stuff.

As Bill frames it:

“The intended goal of this paper is to help recovery advocates understand some of the complexities and limitations involved in the use of medications and to better understand the positions of some who reject the use of medications as a panacea for opioid and alcohol use disorders. The hope is that recovery advocates can help educate affected individuals and families on the limitations of medications at the same time they assert their potential value.”

The whole paper is worth reading and there is a ton worth reflecting on. I looked carefully for something to complain about and did not find anything, which is entirely rare for me.

I do want to offer this quote from page 4 because I think it’s something we should all be talking more about:

“Treatments for opioid use disorders in the U.S.—those with and without medication support—do not maintain continuity of professional contact remotely close to the established period of recovery stability, which for opioid use disorders is five years of continuous remission.”