Harvard Business Review examines the ways in which Pharma's employee and business unit incentives contributes to the opioid crisis. It's not as piercing as one might home, but it's interesting food for thought. Here's one portion: It isn’t news that rewarding sales volume rather than public health outcomes is a problem in the pharmaceutical industry. … Continue reading Pharma’s incentive problem

Senator Ron Wyden, with a focus on seniors, examines the problems Americans face with medical management of chronic diseases. The struggles that people with chronic illness face are manifold. One problem is coordinating care. It’s hard enough for somebody who’s perfectly healthy to assemble medical records for a new doctor; consider how difficult it must … Continue reading Medical management of chronic disease is a mess

Health Affairs has a great summary of a recent report on the opioid crisis. It identifies "six key components to develop a system-wide community solution." Recognize That Everyone In Your Community Has A Role To Play Work Together Work On Multiple Parts Of The System Simultaneously Be Unambiguous About The Risks Of Prescription Opioids Re-Train … Continue reading A Systems Approach Is The Only Way To Address The Opioid Crisis

On the Stanford rape case [emphasis mine]: When Brock Turner sexually assaulted the woman now famous for her seething court statement about the crime, at least two other men had also seen her lying unnaturally still behind a dumpster near a fraternity house on the Stanford University campus. But while much has been said in recent weeks about … Continue reading Sentences to ponder

HuffPo has a new article on ethically impaired treatment providers: The opioid epidemic, which just added Prince to its list of victims, has shoved the addiction industry into the spotlight, and many here at the National Association of Addiction Treatment Providers conference worried aloud how the industry’s lax ethical standards would look in the new … Continue reading Another day, another recovery hustle

Alcoholism and Drug Abuse Weekly (ADAW) posted an article that describes the system used by a Florida treatment program to fill beds with insured clients as an out-of-network provider. They want out-of-network admissions because they do not come with managed care restrictions. ADAW describes their approach as "not unusual for the field." The fact that … Continue reading Another hustle. “This is predatory.”

MAT advocates frequently accuse me of "cherry picking" articles that paint a distorted and negative view of MAT. The irony is that most of the articles I link to are pointed to as evidence of MAT's effectiveness. I'm just looking deeper into what the article actually says. BASIS just shared an analysis of a new article about methadone retention. I'm not … Continue reading Methadone retention

There's more attention on addiction, treatment and recovery than there has ever been. It's a good thing that brings some bad things. One of the bad things is the emergence of recovery hustlers. Some are exploiting it as an opportunity for profit and others are exploiting it as an opportunity for attention. NPR just ran … Continue reading Recovery hustlers

Seth Mnookin just published a must-read piece for anyone interested in the issue of recovery maintenance over the lifespan of people with a history of addiction. Mnookin is in recovery from opioid addiction and recently required surgery for kidney stones. That’s why, throughout the course of my 43-hour stay at MGH at the end of … Continue reading He’s a recovering addict. So why did his doctors give him opioids and leave him on his own?

From a new meta-analysis of gabapentin misuse: Gabapentin has been presumed to have no abuse potential historically [19-23]; however, this review reports evidence to the contrary. Of the 11 population-based studies and 23 case reports included here, nearly one-third report gabapentin misuse/abuse for recreational purposes and epidemiological studies from the United States and United Kingdom … Continue reading Gabapentin misuse, abuse and diversion