A few days ago David McCartney posted an interesting piece titled “Choice in addiction treatment.” That post got me recollecting about clinical practices in our outpatient methadone maintenance program that I thought I would briefly share – in case this historical information is somehow helpful or interesting to someone. Our methadone maintenance program began operation … Continue reading Choice in addiction treatment: A little more. Recovery-Oriented Methadone Maintenance?
Below are my comments for SAMHSA in response to their request for comments on your proposed recovery housing guidelines. The deadline is 5pm today. Send your comments, whatever they are. To whom it may concern: I am writing in response to your request for comments on your proposed recovery housing guidelines. I commend your efforts … Continue reading Comments on SAMHSA recovery housing guidelines
In a compelling study from Dublin, Paula Mayock and Shane Butler (Trinity College) make the point that little is known about the stigma experienced by individuals attending drug treatment services over prolonged periods. They explored this through the lived-experience narratives of 25 people prescribed long-term methadone. Their findings ‘reveal the intersection of stigma with age … Continue reading Growing older and more stigmatised on methadone
Recovery Review is a community of recovery-oriented experts on addiction and addiction recovery. Our backgrounds include public policy, research, physician health programs, methadone maintenance, collegiate recovery, urban crisis services, hospital-based mental health and substance use disorder services, and teaching at undergraduate and graduate levels. History of this blog This blog started in 2005, while I … Continue reading About
Berlin, like many big cities has a heroin problem. People presenting for help are being prescribed opioid replacement therapy (ORT) – a form of medication assisted treatment (MAT) in greater numbers. That’s a good thing isn’t it? Yes, but it’s not completely straightforward. A lot depends on what the professional and their patient think is … Continue reading Stuck on Methadone
Both problematic substance use and substance use disorders vary overall, and they vary widely – in terms of whether they present or not, and in their severity. But something that is clearly understood is addiction illness. Even though the current DSM (DSM-5) describes addiction illness in the narrative text fairly succinctly and sufficiently, and even … Continue reading Addiction and the Stages of Healing, Part 2: GETTING WELL IS LONG; MEASURING IS SHORT
Earlier today Jason Schwartz posted about the active ingredients and basic framework of a multi-year clinical and recovery support model. The information he shared included elements from Robert DuPont, MD and William White, MA. Jason included a statement Dr. DuPont made about the short length of even our longest treatments (such as outpatient methadone or … Continue reading What should be the gold standard for addiction treatment: A little more.
CURRENT PRACTICAL PROBLEMS Hopefully it is clear by now that there are current practical problems in our field (including the context within our field); I would like to discuss those a bit. One major problem is that the length of the disorder is long and most care is short. Various key problems are secondary to … Continue reading Addiction and the Stages of Healing, Part 7: CURRENT PRACTICAL PROBLEMS; PRACTICAL EXAMPLES
I’ve posted before about maintenance medications, like buprenorphine, that are frequently referred to as the gold standard. I’ve also posted about how there may be a discrepancy between the kinds of outcomes people with opioid addiction are seeking and the outcomes found in the evidence-base for maintenance treatments. I’ve also pointed out that, while many … Continue reading “bad doctors are not going to become good doctors because you give them more rules”
Recovery Review does not edit contributor posts. Each contributors speaks for themselves only. Contributors were selected for their well-established recovery-orientation. We welcome disagreement and criticism of policies, treatments, research, models, philosophies, and approaches, but we all agree to do so in ways that do not blame people with addiction for the shortcomings of policies, treatments, … Continue reading Contributors