In recent months I've been spending a lot of time working with systems, caregivers and patients with severe and persistent mental illness. I've been thinking a lot about the role of recovery and what a recovery orientation looks like in that context. I stumbled upon the University of Melbourne's recovery library and, under the category … Continue reading What does it mean to be recovery-oriented?

Here's the conclusion of an interesting new paper: Treatment with buprenorphine or methadone was associated with reductions in overdose and serious opioid-related acute care use compared with other treatments. Strategies to address the underuse of MOUD are needed. Seems pretty straightforward, right? Buprenorphine and methadone protect patients from OD. But, I added an asterisk. Why? … Continue reading buprenorphine or methadone associated with reductions in overdose *

Bill White has a great post on anonymity and advocacy. He examines the changing cultural context for anonymity and the different functions of anonymity. On anonymity as a spiritual principle: When AA literature speaks of anonymity as a “spiritual principle,” it does so out of a profound understanding of the importance of self-transcendence as the […]

Yesterday's post included some discussion of a NEJM piece on treating addiction as a terminal illness. The article prevented the very sad case of a woman with a long history of addiction, multiple treatment episodes, and a current case of endocarditis. The patient declined surgery and opted for hospice. The author presented this as a … Continue reading One more thought on addiction as a terminal illness

The range of what we think and do is limited by what we fail to notice. And because we fail to notice that we fail to notice, there is little we can do to change; until we notice how failing to notice shapes our thoughts and deeds.R. D. Laing A few items I've seen circulating … Continue reading What the hell is water?

I spotted this article about what's missing from Philadelphia's approach to the opioid crisis. A few things leap out at me: 0 = number of times the word "recover" or "recovery" appear.The only treatments specifically mentioned were agonist medications, and the only treatment providers mentioned were primary care physicians, emergency departments, and methadone programs. The … Continue reading A poverty of ideas from experts

I'm not sure why, but I've been missing Roger Ebert recently. I've posted about him a few times before and commented on my appreciation that he was a film lover first and a film critic second. I think it's safe to say that social media has multiplied and elevated critics. I've been thinking about the … Continue reading On advocacy and criticism