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?

The Recovery Research Institute recently posted a review of a study examining patient and physician definitions of success for opioid treatment beyond treatment retention. The Study The researchers conducted semi-structured qualitative interviews with prescribers and patients from 2 family medicine clinics. Interviews were conducted by phone and lasted 20-30 minutes. Physicians 14 physicians All waivered … Continue reading How do patients and prescribers define “success”?

https://open.spotify.com/episode/4f5ncBsokkw9d7bqVX10pJ?si=MfWgOaXWRLeq2L-ATkgTYg I recently listened to this interview with Maike Klein discussing her qualitative research on the experience of relapse in people with addiction who have experienced repeated relapses. Here are a few take-aways: Klein, M., Dixon, J., & Butler, C. (2022). Multiple relapses into opiate and crack misuse among people in recovery: An interpretative phenomenological analysis. Journal of Addictions & … Continue reading The experience of addiction relapse

I've often felt very confused about the direction of US drug policy debates have taken over the last decade. I've worked in addictions and recovery since 1994 and have consistently sought to change social responses to alcohol and drug problems from punitive and stigmatizing to therapeutic and recovery-oriented. This happened to put me in alignment … Continue reading Liberalism? Or, libertarianism?

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 2022’s #9 post: Is it harmful to frame addiction as a disease?

I recently stumbled on this educational page about stigma from the National Harm Reduction Coalition. It's well done and illuminates the assumptions and goals for their stigma reduction efforts. They frame responding to drug use as a choice between liberation and stigma, with harm reduction as the path to liberation. While it may work for … Continue reading 2022’s #10 post: Addiction, Stigma, and Liberation

I recently read this article envisioning minimally disruptive treatment for opioid use disorder. People who use drugs have long called for reforms to make opioid use disorder (OUD) care more patient-centered and less disruptive. Their calls align with broader healthcare transformation efforts, particularly to create “minimally disruptive” systems. Minimally disruptive medicine (MDM) is a “patient-centered … Continue reading *Strategically* disruptive treatment?

Yesterday's post about efforts to support recovery in San Francisco brought some of Bill White's blog posts and this video from the HBO Addiction series to mind. (The video is showing its age with respect to some of the language and content, but it conveys some very salient lessons that haven't changed.) https://youtu.be/WXxxcElL7Cs?t=94 From Bill … Continue reading “addiction and recovery are a reflection of the ecologies in which they are nested”

This article from the San Francisco Chronicle caught my attention this week. It illustrates the challenges big cities are facing with the combination of the behavioral health crisis, the aftermath of the pandemic's disruption, noncarceral responses to drugs, the lack of affordable housing, social responses that frame addiction as secondary to other problems, and the … Continue reading “doing damage control as best we can… but we’re out of ideas”

Brian Coon posted a reaction to the NIAAA definition yesterday. I also recently watched the NIH webinar on the definition. “Recovery is a process through which an individual pursues both remission from AUD and cessation from heavy drinking. Recovery can also be considered an outcome such that an individual may be considered ‘recovered’ if both … Continue reading More on the NIAAA definition of recovery