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

There is MUCH less tension these days between harm reduction (HR) advocates and treatment providers. HR advocates confronted treatment providers with legitimate questions about their thresholds for accessing and staying in care. More recently, the opioid overdose crisis pretty dramatically changed the calculus. As a result, most treatment providers are using harm reduction approaches and … Continue reading Drug-free recovery as fantasy?

Back in February, I shared an article from JAMA, reviewing the role of Joint Commission's pain standards in the current opioid epidemic and some of the lessons learned. The fourth lesson was this: Fourth, carefully review the primary literature on issues of critical importance and do not simply repeat the claims of experts in previous … Continue reading Zombie statistic contributed to opioid crisis

Naloxone is not enough, but it is important. From the press release: Gov. Rick Snyder today authorized the Michigan Department of Health and Human Services to issue a standing order pre-authorizing the distribution of naloxone by pharmacists to eligible individuals. “Naloxone is a tool in the fight against opioid addiction that can save lives immediately … Continue reading OTC Naloxone in Michigan

From the ATTC/NIATx blog (emphasis mine): Today public health leaders think using marijuana together with alcohol increases the risk for impaired driving. Tomorrow leaders of multinational corporations will think selling marijuana together with alcohol – and tobacco – increases the opportunity for enhanced profits. One hundred and forty years ago the invention of machines for rolling … Continue reading Sentences to ponder

This will be interesting to watch. President Trump’s pick to run federal mental health services has called for a bold reordering of priorities — shifting money away from education and support services and toward a more aggressive treatment of patients with severe psychiatric disorders. The proposal has some psychiatrists — a generally liberal bunch — … Continue reading What will mental health look like under the Trump administration?

Bill White has a great post on anonymity and advocacy. He examines the changing cultural context for anonymity and the different functions of anonymity. On anonymity as a spiritual principle: When AA literature speaks of anonymity as a “spiritual principle,” it does so out of a profound understanding of the importance of self-transcendence as the […]

Design/creative blog 99U looks at rebranding efforts in the cannabis industry: In the last few months, Christopher Simmons, creative director for MINE, has designed branding and packaging for several dispensaries in San Francisco, including BASA, Dutchman’s Flat, Petra, and Prophet. “With Prophet, the question was: How do you get away from the dominant paradigm in … Continue reading Design, Rebranding and Cannabis