All of us working in the field of alcohol and drug treatment will likely be facing the greatest challenges we have ever faced. Scottish Health Action on Alcohol Problems (SHAAP), a partnership of the medical Royal Colleges and Faculties, has issued some new guidance for services which is well worth a read. Points that caught … Continue reading Alcohol Services in the Pandemic
Does mutual aid work? If you are a member of a mutual aid group that you believe is keeping you sober or drug-free, then it's pretty much assured you will say ‘yes’. That’s understandably not good enough for researchers and some others. Nearly two decades ago, I asked a consultant addiction psychiatrist why he didn’t recommend … Continue reading Alcoholics Anonymous – the evidence
An open paper published by the Journal of the American Medical Association this month berates residential treatment providers for not following guidance on the treatment of opioid use disorder (OUD). A study with impressive numbers (over quarter of a million admissions to residential treatment centres in the USA) seems to me to make some errors … Continue reading Residential Treatment and Medications for Opioid Use Disorder
Holly Whitaker, quoted in the Guardian newspaper, talks about AA and her impression that it doesn't have much to offer women: The programme’s guidelines, created in 1939, centre on appealing to a higher power and renouncing the ego. How, she wondered, could this possibly serve women or minorities who historically have been powerless? “These are … Continue reading How can AA possibly serve women?
I liked my fellow blogger – Austin McNeil Brown’s reflections on the role of the clinician in recovery: “Most recovery occurs through social relationships that have nothing to do with clinical technique” And his observation from lived experience: “So where did the majority of the momentum for my recovery come from if not through professional … Continue reading Mutual aid – steaming ahead
I was reminded of how important it is to ensure the family members of patients/clients with addictions realise that they need to recover too. This blog by a doctor on the British Medical Journal's website captures the harrowing sense of loss as a partner's alcohol dependence takes hold and then the dawning of hope as … Continue reading Family Recovery
Smoking and other addictions go hand in hand. In treatment populations, it’s usual to find that about 80-90% of clients are current smokers, compared to, for example, 16% of the Scottish population and 14% of US citizens. Out of interest 25% of German adults smoke, 27% do in France and, incredibly, half of all Chinese … Continue reading Smoking and Recovery
Quetiapine (branded as Seroquel in the US) is an antipsychotic drug used for schizophrenia and bipolar disorder. It’s also prescribed off-license in the UK for anxiety. That means that some people with substance use disorders who don’t have a major mental health diagnosis end up on it. The National Institute for Health and Care Excellence … Continue reading Quetiapine Abuse
Influencers It’s no coincidence that my best subjects at school were the ones where my teachers taught enthusiastically, connected me up to useful resources, had high expectations of me and who gave affirmation and encouraged progress. From my experience of working in addiction treatment, while accepting teaching is not the same as treatment, I think … Continue reading Mutual Aid: Must Do Better
In many places peer support has been integrated into addiction treatment services, often with enthusiasm. What do we know about the effect of peer support though? In my own service, introduction of a structured peer support programme was associated with a sharp increase in retention (treatment completion) rates – but that’s not evidence in the … Continue reading Peer Support – does it make a difference?