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.

This post was originally published in 2016. By now, the DSM-IV is a distant memory but this post seemed relevant to our recent discussion about the conceptual boundaries of addiction and its relationship to the disease model and recovery. There's been a big change in the way professionals and advocates talk and think about drug … Continue reading Substance Use Disorders as a category

Yesterday's post and the discussion around it brought up a lot of good questions. Among them was the question, does it really matter whether we call it a disease? It prompted me to look at some old posts. I'll share versions of a few of them in the coming days. A few variations of this … Continue reading Defining addiction and problem ownership