While opioids get all the attention (justifiably, due to the death rates), Marc Schuckit discusses findings from a recently published study of alcohol use and alcohol use disorders (AUD): The results documented substantial increases in the prevalence of past 12-month drinking, high-risk drinking, and AUDs. The largest increase related to the rate of the most … Continue reading Meanwhile . . .

. . . the clinicians of the future, really need to be oriented in a counselor mode, where they are not just telling you what the options are, but also eliciting from you very clearly what your goals are, and then making a recommendation about what most matches your goals. What are your priorities for your quality of life … Continue reading Sentences to Ponder

. . . in the end, the federal government has very little control over criminal justice. About 90 percent of all prisoners—and a far greater percentage of those in jails, on probation, or who are arrested every year—are handled by states and counties, not by the federal government. And the federal government cannot directly tell … Continue reading Sentences to ponder

I usually bristle at attempts to correct and manage other people's well-meaning speech. However, this headline from the Washington Post grabbed me. It doesn’t take a warrior to beat cancer. It takes a treatment that works. How true this is for addiction, too. There is a treatment that delivers long term abstinence rates north of … Continue reading It takes a treatment that works.

There has been a lot of discussion about the use of buprenorphine to treat addiction and prevent overdose. I've pointed out that weak retention rates weaken this rationale. One common response is that the treatment system and recovering community reinforce stigma associated with maintenance medications and undermine outcomes, including retention. This makes retention findings from other … Continue reading Another buprenorphine retention finding

Blue Cross Blue Shield issued a report on the opioid crisis with their data from all members in their commercial plans. Early in the document, they report a pair of striking numbers. First, that 21% of members filled a prescription for an opioid in 2015. I've heard these kinds of numbers before, but I never … Continue reading Blue Cross Blue Shield Publishes Major Opioid Report

National Affairs recently published an article on the complexity and importance or taxing marijuana correctly: While marijuana has tens of millions of happy occasional users, they account for a trivial share of industry sales. Consumption is concentrated among the smaller number of high-frequency users; half of marijuana is consumed by people with a medically diagnosable … Continue reading Getting the cannabis tax right

Residential treatment has received a lot of criticism and skepticism over the last several years, especially for opioid use disorders. (Some of it is deserved. Too many providers are hustlers and others provide little more than detox with inadequate follow-up. Of course, many of the same criticisms have been directed at medication-assisted treatment. But, that's … Continue reading Opioid users complete residential at higher rates than other patients

The title of this post is taken directly from a press release for a recently published study. Here's the summary: Buprenorphine reduces mortality for those with opioid use disorder, but periods off treatment are associated with much higher mortality rates. A study of 713 new outpatient users of buprenorphine was conducted in France, where patients … Continue reading Buprenorphine: Being out of treatment increases risk of death nearly 30-fold