“Not everything that can be counted counts and not everything that counts can be counted.”Albert Einstein These last few weeks I've seen several people writing on the subject of substance use disorder treatment calling for us 'to stick with the evidence' of what works. Research evidence should, quite rightly, inform policy and practice. There's an … Continue reading Recovery-focused interventions: too messy to study?
Author: Dr David McCartney
Addiction Medicine Specialist
Reducing the risks of opioid detox
When discussing the goal of abstinence for opioid use disorder, it sometimes comes up that it's much safer to stay in medication assisted treatment (most often methadone or buprenorphine) than to detox. I agree, but I would never advise a patient just to detox. Detox is a procedure, not a treatment as such. If all … Continue reading Reducing the risks of opioid detox
Growing older and more stigmatised on methadone
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
Need rehab? How can we hinder you?
Although the signs are good that journeys to residential rehabilitation in Scotland are about to get a lot easier, there are still some challenges to face. We could quadruple capacity, but if the pathways are not there or blocks exist, more places will make little difference. Not everyone is a fan of rehab and in … Continue reading Need rehab? How can we hinder you?
Addiction in animation
An oddly affecting video from Studio Filmbilder that captures some of the elements of substance dependence that will strike a chord with many. https://youtu.be/HUngLgGRJpo
Wiping out stigma
Reducing the stigma associated with addiction – the word itself now tagged with a degree of stigma – is a priority in drugs policy. Stigmatising attitudes contribute to drug harms and deaths through delaying access to treatment, leaving treatment early and increased risk-taking behaviour. Brea Perry and her colleagues at Indiana University took a look[1] at … Continue reading Wiping out stigma
Opioid replacement treatment. Great! What’s next?
In opioid use disorder treatment, there’s been a persistent (though not always acknowledged) tension between what’s good for public health and what individuals and their families want from treatment. I’ve written about it before. For public health, there’s plenty of evidence that MAT (medication assisted treatment) reduces illicit drug use, improves health and reduces crude mortality … Continue reading Opioid replacement treatment. Great! What’s next?
Loneliness in the pandemic: risky times
Loneliness and isolation are bedfellows of addiction. Anything that intensifies loneliness will come with increased risks in tow. Of course, it’s not just those with substance use disorders who suffer from loneliness. In 2014, Professor John Cacioppo presented at a conference in Chicago, pointing out that that the impact of loneliness on premature death ‘is nearly as strong … Continue reading Loneliness in the pandemic: risky times
Is the winter over for rehab in Scotland?
In the midst of winter here in Scotland when days are short, snow is on the ground and we’re in lockdown, it’s easy to get low. I’ve been thinking a lot recently about residential rehabilitation and where it fits into treatment options. I think it's true to say that rehab has felt a bit stuck … Continue reading Is the winter over for rehab in Scotland?
Clinicians’ attitudes to recovery
Which teachers were the best when you were at school? Likely the ones who believed in you, connected with you, who had a vision for where you could go and who enthusiastically helped you get there. I remember struggling with maths at school - I was always a writer, not an adder. Unfortunately I needed … Continue reading Clinicians’ attitudes to recovery
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