Sentences to Ponder

~ Jason Schwartz
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The common name addiction is reserved for severe SUD, defined by 6 or more symptoms and found in approximately 4% to 5% of adults. Those with mild to moderate SUD (ie, 2-5 symptoms) comprise a much larger proportion of the adult population (13%) and thus account for far more substance use-related harms to society than those with severe SUD (ie, addiction).

McLellan AT, Koob GF, Volkow ND. Preaddiction—A Missing Concept for Treating Substance Use Disorders. JAMA Psychiatry. Published online July 06, 2022. doi:10.1001/jamapsychiatry.2022.1652

Published by Jason Schwartz

I have been an addiction professional and social worker since 1994. I started blogging in 2005 as the Clinical Director at Dawn Farm. I no longer work at Dawn Farm and am now the Director of Behavioral Medicine at a community hospital, and a lecturer at Eastern Michigan University’s School of Social Work. Views expressed here are my own. Keep in mind that the field, the contexts in which the field operates, and my views have changed over time.

8 thoughts on “Sentences to Ponder”

  2. Where do you darw the line between SUD and full blown addiction? By definition, the one must be the fore runner of the other, thus an easy line to cross?

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    1. The hallmark of addiction is impaired control over use (distinguished from efforts to avoid withdrawal). I was going to direct you to “the big 5” but Brian beat me to it.

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    2. That’s exactly right!! Major difference between abusing opiates or recreational use and physical dependency. Although of course it’s precursor to one hell of a condition. One the person will regret for the rest of their lives. Seems like even most experts don’t make this distinction between crossing the threshold! And worth mentioning…
      You can never go back

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      1. That is the most poignant statement “You can never go back”. what may have started as a bit of recreational fun, but developed into full blown addiction, can never be drawn back, so that (in my humble opinion) abstinece based recovery is the only sure way to get a life back. I have seen too many who have relapsed, then died of this illness; good people who just needed a bit more support to maintain their abstinence. I also believe that peer, and group support are the most helpful routes, as these are offered by those who have personal experience of the power that the illness exerts over us.

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  3. That’s where I also stand in regards to opioid addiction. The focus should first be on prevention and when at all possible abstinence based doesn’t allow for mishaps!!! I know it sounds cruel sometimes. I hear myself saying it and I understand that’s it’s very very difficult to accomplish. But it’s certainly not impossible. If the human race can survive terrible conditions like concentration camps than we’re resilient enough to just say no and keep on saying it! Say NO as much and as often as necessary for your body’s sake! You’ll be so glad you toughed it out. Believe me. I know

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  4. Also I might add that medicated assisted treatments should be used under the right circumstances. However when there’s even a chance a person can cope in any other way, they should take the opportunity to get off their opiate train ride.

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