The question of how to describe and categorize addiction has been the subject of several of my recent posts. Some people scratch their heads about why I care so much about whether we think of it as a disease. Bill White summarized the stakes well here: If AOD problems could be solved by physically unraveling … Continue reading Is it harmful to frame addiction as a disease?

An interesting discussion with a passionate advocate for MAT expansion and the most prominent advocate for the "new paradigm": What is the process for successfully integrating these 2 approaches? What are the biggest hurdles providers face when accomplishing this goal?Dr DuPont: The biggest hurdle is the staff reluctance, even the staff distaste, for the integration of … Continue reading Integrating MAT, Abstinence-Based Approaches to Recovery 

https://twitter.com/KeithNHumphreys/status/1447351509658718210 As substance-free definitions of recovery are challenged, this article on Stanford's substance-free student housing community made me wonder if some recovering students will find more safety and support, and have more in common with fellow students in these communities than in collegiate recovery programs (CRP) that include students whose definition of recovery includes ongoing … Continue reading What’s the relationship between recovery, collegiate recovery, and substance-free student housing?

The DrugWise Daily newsletter noted the passing of Sara McGrail. I never met Ms. McGrail and I didn't follow her work, but her name rang a bell. I knew I'd interacted with her years ago but couldn't remember the details. It turns out we interacted around some posts related to harm reduction in 2008. I … Continue reading Thank you, Sara McGrail

The risk of transmission is complex and multi-dimensional. It depends on many factors: contact pattern (duration, proximity, activity), individual factors, environment (i.e. outdoor, indoor) & socioeconomic factors (i.e. crowded housing, job insecurity).Tweeted by Muge Cevik on September 21, 2020 One argument against the disease model of addiction is that it advances a narrow medical model … Continue reading Thinking about “disease” as complex and multi-dimensional

A version of this post was originally published in September 2019. It speaks to some questions about yesterday's post. This NPR headline demonstrates the problem with the concept of "opioid recovery" rather than "addiction recovery." Fortunately, there's been growing concern that advocates, policymakers, and media have too narrowly focused on the opioid crisis. Up to … Continue reading What we miss when we focus on opioid treatment and recovery

If AOD problems could be solved by physically unraveling the person-drug relationship, only physicians and nurses trained in the mechanics of detoxification would be needed to address these problems. If AOD problems were simply a symptom of untreated psychiatric illness, more psychiatrists, not addiction counselors would be needed. If these problems were only a reflection … Continue reading The historical essence of addiction counseling

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 abstract blueprint claimed to be applicable everywhere, … Continue reading Nora Volkow on More Realistic And Pragmatic Addiction Treatment

A version of this post was originally published in 2016 and is part of an ongoing review of past posts about the conceptual boundaries of addiction and its relationship to the disease model and recovery. I've had a lot requests to respond to this recent piece in the NY Times. A Personal Narrative or Universal … Continue reading Addiction is disordered learning AND much more.