The Washington Post recently published an editorial expressing concern about vaping. The original promise of vaping, that it could help adults ease off combustible tobacco, is being eclipsed by the damage being inflicted on young people. The status quo is unacceptable.Nicotine, highly addictive, has a deleterious effect on young people’s developing brains — exposure can reduce attention, … Continue reading Vaping and Gaslighting

We've got an interesting collection of ideas forming on this blog in recent months. What is recovery? In a post discussing recovery and harm reduction, I laid out a few competing definitions of recovery and discussed how these competing definitions may define recovery as a process, a direction, or an outcome. This post also explored … Continue reading Recovery? Stages of Healing? How to move forward?

The FDA issued a warning letter today to the manufacturer of Vivitrol for "for misbranding the drug Vivitrol (an extended-release injection formulation of naltrexone) by omitting warnings about the most serious risks associated with the drug from promotional materials." Here's the salient portion of the letter. . . . the print ad fails to communicate … Continue reading FDA issues warning letter to Vivitrol manufacturer

Some people have responded to the information in this weekend's post with reactions approximating, "Okay, Purdue played a role in the crisis. Purdue is bad. But, what good does your attention to them do us? This hasn't been a prescription crisis for years now. We're in a fentanyl crisis now and focusing on pharma does … Continue reading Follow up: Origins of the Opioid Crisis

David Juurlink posted a tweetstorm based on a new report from the National Bureau of Economic Research entitled Origins of the Opioid Crisis and Its Enduring Impacts. It's important because it challenges a few common claims about the opioid crisis: That rx opioids were not an especially important driver of the crisis.That regulatory reform would … Continue reading Origins of the Opioid Crisis

Tufts University announced Thursday it will strip the Sackler name from a graduate school, buildings, and health programs . . . amid allegations the family and company sought to generate goodwill and gain influence at Tufts — particularly its pain research and education program — through philanthropy . . . No longer will programs and facilities … Continue reading Sentences to ponder

A friend responded to my recent post on Bill White's paper on MAT and noted that I did not distinguish between OTPs (Opioid Treatment Programs) and OBOT (Office-Based Opioid Treatment). He pointed to the oversight and more comprehensive nature of OTPs vs OBOTs, adding that there will be significant variation in retention and other outcomes … Continue reading Follow-up on seeking more, not less

From ProPublica: In 2004, Purdue Pharma was facing a threat to sales of its blockbuster opioid painkiller OxyContin, which were approaching $2 billion a year. With abuse of the drug on the rise, prosecutors were bringing criminal charges against some doctors for prescribing massive amounts of OxyContin.That October, an essay ran across the top of … Continue reading Purdue Pharma fingerprints all over NYT column questioning relationship between Rx opioids and crisis

In recent years it's become more and more common to see advocates criticize treatment and mutual aid groups. These critics question the alleged orthodoxy and motives of treatment providers, but they do not engage in criticism of medication-assisted treatment (MAT). It appears that this would be perceived as punching down, despite the fact that it's … Continue reading Seeking more, not less, from MAT

There are a lot of problems in addiction treatment, but 12 step hegemony is not the problem that advocates and media coverage would lead one to believe. (Keep in mind that 12 step facilitation is an evidence-based treatment.) National Survey of Substance Abuse Treatment Services (N-SSATS): 2018 It's worth asking why this is so frequently … Continue reading 12 step facilitation used always or often in 45% of facilities