Mark Kleiman responds to the question, why is fentanyl use becoming widespread now? He describes the increase in availability of prescription opioids and the role of price in leading users to transition to heroin. Then, he describes the expansion of fentanyl. At the same time, people in the U.S. were learning how to buy chemicals … Continue reading Why is fentanyl use becoming widespread now?

CNN Money has a pretty inspiring story: This past winter, John Stroup had a problem. Roughly one out of 10 applicants for jobs at his factory in Richmond, Indiana, had failed their drug tests, disqualifying them for employment at the safety-conscious company. A handful of the 450 people already working there had failed random drug … Continue reading Recovery is good business

A typically thought provoking take from Tyler Cowan: I propose that cities and suburbs restrict the sale and usage of marijuana to the same areas we use for garbage disposal and other “zoned out of sight” enterprises. We needn’t throw anyone in jail: If people or businesses violate these strictures, keep hitting them with the … Continue reading “Legalize Pot, But Don’t Normalize It”

This weekend, John Oliver spent nearly 2o minutes describing several of the treatment industry's biggest hustles. https://youtu.be/hWQiXv0sn9Y Is this a sign of the times? Maybe, but it's not new. In Recovery Rising, Bill White describes the business landscape in the 1980s: The trend of private insurance companies paying for the treatment of alcoholism and subsequently … Continue reading The treatment hustle makes Last Week Tonight

Why is BCN launching these pilots? "Cost is one factor. We also look at quality of life. Our goal is to help people stay well," said Beecroft, a psychiatrist, geriatrician and substance abuse specialist. "We have looked at return on investment and if you just treat the individual, you get 2-1 investment return. You spend … Continue reading Blue Care Network of Michigan tests new opioid treatment with 2 mental health facilities

There's actually an interesting discussion happening in congress right now: A question some lawmakers and journalists often ask is whether Congress is too closely targeting opioids, as the epidemic is a problem of polydrug misuse. Bloomberg’s editorial board warned “lawmakers need to take benzodiazepines seriously, before it’s too late.” (Overdose deaths associated with benzodiazepines are fewer than opioids, … Continue reading Congress is hyperfocused on opioids. Is it focusing enough on addiction?

Recovery from opioid addiction is also more than remission, with remission defined as the sustained cessation or deceleration of opioid and other drug use/problems to a subclinical level—no longer meeting diagnostic criteria for opioid dependence or another substance use disorder. Remission is about the subtraction of pathology; recovery is ultimately about the achievement of global (physical, emotional, relational, … Continue reading Effects of MAT on functional outcomes

"We've been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. . . . whatever we can offer, our interventions, and the risks and … Continue reading Sentences to ponder

British Columbia has long been cited as a model for North American drug policy and harm reduction implementation. BC has established a Death Review Panel in response to the overdose crisis. The panel recently issued a report with 3 recommendations. The first recommendation to regulate recovery homes, which currently require only a simple inspection of … Continue reading Overdose crisis? Or, addiction crisis?

From a press release about newly published research. The title of the press release is Fentanyl overdose survivors require little if any hospital treatment "Our protocol should give emergency physicians and nurses the confidence to allocate the appropriate resources to the patients who truly need them, especially when there is a wave of fentanyl overdoses … Continue reading “safely discharged”?