This guest post is by Lee Holley, LCSW, LCDC, PSS. Lee is a psychotherapist based in Texas. He specializes in therapy for people with alcohol and other drug problems through a recovery-oriented harm reduction lens, combining clinical expertise with lived experience in long-term recovery. As a psychotherapist who bases my philosophy of treating alcohol and … Continue reading 7-OH and the Question of Harm Production
Author: Jason Schwartz
I have been an addiction professional and social worker since 1994. I started blogging in 2005 as the Clinical Director at Dawn Farm. I currently serve as the Director of Social Work and Spiritual Care for a healthcare system. I've also served as the Director of Behavioral Health at another hospital. I'm also a lecturer at Eastern Michigan University’s School of Social Work.
Views expressed here are my own.
Keep in mind that the field, the contexts in which the field operates, and my views have changed over time.
Drug Innovation or Contamination?
As harm reduction has risen in prominence and influence in the addiction, treatment, and recovery spaces, one of its contributions to discussions about public policy related to drug use has been the suggestion that prohibition creates a drug supply with unpredictable potency that is vulnerable to contamination, and that these factors drive overdose. This leads … Continue reading Drug Innovation or Contamination?
The AI Mirror: “take that small hit, and you’ll be fine”
I published the post below last month, which resulted in an invitation to speak with DeAnn and Craig Knighton on their podcast, Recovery Discovery. It was a fun conversation and I thought I'd share that with you here. https://open.spotify.com/episode/5YYECT2NeBogNVSehvQm6w?si=auerM5dAQfenEQ6Xn_zN5w I also want to share a couple of things that have come up since the interview. … Continue reading The AI Mirror: “take that small hit, and you’ll be fine”
Private Pain and Public Performance
The Fall of Icarus by Jacob Peeter Gowy I recently read a moving and, sadly, familiar story. It's about a person with addiction who finds recovery and pours himself into advocacy. He seeks an audience and influence, finds an opportunity in harm reduction, distance grows between him and the foundations of his recovery, he relapses, … Continue reading Private Pain and Public Performance
Why won’t the acute care paradigm die?
Recently, I posted about a study finding significant declines in the duration of treatment for MOUD patients in Ontario, Canada. The post focused on the persistence of the acute care paradigm, now appearing in MOUD. The post prompted some discussion on LinkedIn, during which I was struck by how this is really just a cycle … Continue reading Why won’t the acute care paradigm die?
“further research is needed to improve treatment retention”
Kleinman RA, Kurdyak P. Duration of Methadone and Buprenorphine-Naloxone Treatment. JAMA Network Open. 2025;8(7):e2518389. doi:10.1001/jamanetworkopen.2025.18389 An eye-popping article was just published in JAMA about trends in the duration of methadone and buprenorphine treatment in Ontario, Canada, including more than 72,000 new recipients of opioid agonist treatments. The median duration of buprenorphine treatment declined by 25%, … Continue reading “further research is needed to improve treatment retention”
What to make of nicotine addiction?
Brian has recently posted about nicotine, vaping, nicotine pouches, and 6-methyl nicotine. A LinkedIn exchange brought me back to this post on the topic from several years ago. It looks at the role of nicotine in addiction and recovery, and the weirdness of the drug. It seemed relevant. Enjoy! Background David McCartney wrote a great … Continue reading What to make of nicotine addiction?
Addiction system at risk
The Washington Post on the potential impact of SAMHSA and Medicaid cuts: SAMHSA’s future is complicated by other factors in Washington. Republicans hashing out Trump’s signature domestic policy bill have targeted cuts to Medicaid, which pays for mental health and addiction treatment for millions of people. SAMHSA grants help pay for treatment for people without … Continue reading Addiction system at risk
The AI Mirror: “take that small hit, and you’ll be fine”
A few weeks ago, an article in Futurism described a troubling exchange between an AI chatbot and a user identifying as Pedro, a person identified as having methamphetamine addiction seeking advice about how to make it through his work shifts when he's feeling exhausted and has abstained from methamphetamine for 3 days. The chatbot encourages … Continue reading The AI Mirror: “take that small hit, and you’ll be fine”
3-in-4 current fentanyl users started with prescription opioids
For years, many experts have "well, actually-ed", arguing that prescribing patterns had little to do with the opioid crisis. Of course, the opioid crisis is a complex and wicked problem, but we are poorly served by experts who scold the public and tell us not to believe our lying eyes. JAMA Health Forum provides some … Continue reading 3-in-4 current fentanyl users started with prescription opioids
Recovery Review 