Photo by Brett Jordan on Pexels.com For most of my career, I've been responsible for managing treatment programs. I believed strongly in those programs. At one of those programs, we developed a continuum of care that provided treatment and substantial, structural recovery support for more than 2 years for people with high severity, high chronicity, … Continue reading Treatment as usual isn’t cutting it (same for research as usual)

Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com I think the future rests in seeing harm reduction and recovery as strategies to be uniquely combined and sequenced across the stages/styles of drug use / drug addiction and the stages of recovery rather than as warring ideologies. William White from Bamber, S. & White, W. (2011). Bamber-White … Continue reading Sentences to Ponder

("Wrong Way" by Jack Zalium is licensed under CC BY-NC 2.0.) More and more frequently I'm hearing self-identified and publicly recognized recovery advocates state that providing harm reduction services with the goal of moving people toward recovery or treatment constitutes "doing it wrong." This perspective isn't limited to a few outliers, I heard it voiced at a SAMHSA … Continue reading Doing it wrong?

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 Addiction, Stigma, and Liberation

For 28 years, an important part of my professional identity has been "addiction professional." Over that 28 years, addiction professionals have never been a very harmonious group. There have always been disagreements about things like policy, the best treatment models, credentialing, and many other controversies. Despite these disagreements, I never really questioned whether we all … Continue reading Addiction professionals? Substance use professionals? Recovery professionals?

Photo by Pixabay on Pexels.com The common name addiction is reserved for severe SUD, defined by 6 or more symptoms and found in approximately 4% to 5% of adults. Those with mild to moderate SUD (ie, 2-5 symptoms) comprise a much larger proportion of the adult population (13%) and thus account for far more substance … Continue reading Sentences to Ponder

Photo by Pixabay on Pexels.com To what extent does this tendency influence discussions around addiction and drug policy -- elevating counterintuitive and novel ideas? “Human attention is drawn to novelty, to things that are new and unexpected,” says Aral. “We gain in status when we share novel information because it looks like we're in the … Continue reading Sentences to ponder

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?