Should addiction treatment prefer abstinence (however we define it)?

The is a post was initially published in 2018. Please note that abstinence can mean abstinence from illicit drugs, or abstinence from all drugs that produce euphoria or are commonly misused (including agonist medications, benzodiazepines, etc.). For the purposes of this post, this distinction is irrelevant because the arguments in the second article really apply … Continue reading Should addiction treatment prefer abstinence (however we define it)?

Revisiting recovery-oriented harm reduction (part 3)

So . . . we’ve dusted off and reviewed my history with recovery-oriented harm reduction. We’ve also explored why I believe recovery and harm reduction should remain distinct constructs. This sets the stage to revisit and update the concept. What is recovery-oriented harm reduction? Recovery-oriented harm reduction (ROHR) seeks to address the historical failings of … Continue reading Revisiting recovery-oriented harm reduction (part 3)

Revisiting recovery-oriented harm reduction (part 2)

Yesterday, we began to revisit the concept of recovery-oriented harm reduction. Why recovery-oriented harm reduction and not just recovery? 13 years ago, recovery-oriented harm reduction was thought of as a bridge between harm reduction and treatment or recovery. Today, in some circles, it might invite questions about why one would want to maintain a distinction … Continue reading Revisiting recovery-oriented harm reduction (part 2)

Should addiction treatment prefer abstinence?

I was perusing past year’s articles in Alcoholism Treatment Quarterly and came across these two: Achieving a 15% Relapse Rate: A Review of Collegiate Recovery and Physician Health Programs A Perspective from the Field: The Disconnect between Abstinence-Based Programs and the Use of Motivational Interviewing in Treating Substance Use Disorders Achieving a 15% relapse rate … Continue reading Should addiction treatment prefer abstinence?

What would things look like if we believed they could recover?

Over the last week, there have been two noteworthy stories on supervised injection sites. NYC planning supervised injection sites The first story was in the New York Times and reported on NYC considering supervised injection sites and looking to Toronto for their experience. The scouts from NYC are seeking to learn what they can to … Continue reading What would things look like if we believed they could recover?

Drug-free recovery as fantasy?

There is MUCH less tension these days between harm reduction (HR) advocates and treatment providers. HR advocates confronted treatment providers with legitimate questions about their thresholds for accessing and staying in care. More recently, the opioid overdose crisis pretty dramatically changed the calculus. As a result, most treatment providers are using harm reduction approaches and … Continue reading Drug-free recovery as fantasy?

Missing the point

The American Journal of Public Heath (behind a paywall) has a new study looking at 2 year trajectories of residents in a “wet shelter”.  The found that the residents reduced their drinking by 40%. Reducing drinking in these cases is a very good thing. To me, there are several important questions but the first might … Continue reading Missing the point