JAMA published new research on buprenorphine initiation and retention and the findings are disappointing. The study looked at a database of retail pharmacy records from 2016 to 2022 that includes 92% of all retail pharmacies. (93, 713, 163 prescriptions) If I understand correctly, this excludes buprenorphine dispensed in emergency settings. Those patients would only be included if … Continue reading Buprenorphine and retention

["Megaphon" by floeschie is licensed under CC BY 2.0.] "Safe supply" is a promotional term, when what is needed is careful evaluation of the risk of such initiatives to increase addiction, toxicity, and overdose. Roberts, E., Humpreys, K. (2023) “Safe Supply” initiatives: Are they a recipe for harm through reduced healthcare input and supply induced toxicity and overdose? … Continue reading Promotional Practices in Drug Policy Advocacy

In a recent post, I tried to unpack "drug policy" to look beyond legal/illegal and think through the kinds of things that drug policies determine and influence. Historically, it seems that concerns about the harms associated with drugs have overshadowed the harm associated with policies that seek to prevent those harms. It seems particularly important … Continue reading There’s more to drug policy than legal or illegal

It seems like more is being said about drug policy than ever before. I've been posting thoughts about drug policy here for years. However, as I read comments from others, I often wonder whether we're talking about the same things. To be honest, I haven't given a lot of thought to the conceptual boundaries of … Continue reading Unpacking “drug policy”

There are a lot of problems in addiction treatment, but 12-step hegemony is not the problem that advocates and media coverage would lead one to believe. (Keep in mind that 12-step facilitation is an evidence-based treatment.) It's worth asking why this is so frequently misrepresented. National Survey of Substance Abuse Treatment Services (N-SSATS): 2020

Photo by Yelena Odintsova on Pexels.com Yesterday, I attended a memorial service for a former co-worker of many years. We worked together at Dawn Farm, an addiction treatment and recovery support program, where one of Robin's roles was to teach GED classes. She was kind, warm, patient, and never harbored any doubt about our clients' … Continue reading Reflections on GED classes as part of Recovery Management

(Screen captured from https://ophelia.com/rehab-relapse on 01/21/2022) Ok... let's talk. A company called Ophelia Health has launched a new marketing campaign focusing on the message "F*CK REHAB". On the one hand, there's A LOT to criticize in the addiction treatment world. At the provider level, there is a long history of really bad, predatory, poor quality, … Continue reading Zero Sum, Destructive Treatment Marketing

(This post was originally published on 2/6/2022) Source: NIDA There is and can be no ultimate solution for us to discover, but instead a permanent need for balancing contradictory claims, for careful trade-offs between conflicting values, toleration of difference, consideration of the specific factors at play when a choice is needed, not reliance on an … Continue reading Nora Volkow on More Realistic And Pragmatic Addiction Treatment

Results from the 2021 National Survey on Drug Use and Health were released this week. Here are a few of the highlights. Substance Use Disorder Prevalence 46.3 million people aged 12 or older (or 16.5 percent of the population) met the applicable DSM-5 criteria for having a substance use disorder in the past year, including … Continue reading What to make of the 2021 National Survey on Substance Use and Health report?

The New York Times published a guest essay this weekend challenging the disease model of addiction. I've read several similar pieces over the years and frequently have the same experience. I agree with most of the writer's points, but disagree with his conclusions. Let's walk through it. Annual U.S. overdose deaths recently topped 100,000, a record … Continue reading 2022’s #3 post: Is it misleading to call addiction a disease?