Yesterday, I posted about the epidemiological crisis being reported regarding an explosion in substance use disorders resulting in increases in untreated SUDs and low rates of problem recognition. (There's been a parallel explosion in recovery prevalence.) All of this was predictable. In fact, we were writing about it here 13 years ago. Despite the foreseeability … Continue reading Substance Use Disorders – The epidemiological mess more than a decade in the making
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.
Substance use disorder sets off a cascade of category errors
A recent letter to JAMA analyzes the National Survey of Drug Use and Health regarding the need for treatment: Among 657 583 participants, the prevalence of individuals needing SUD treatment increased from 8.2% in 2013 to 17.1% in 2023. AUD increased from 6.6% to 10.2%, while DUD increased from 2.6% to 9.6%. OUD more than doubled … Continue reading Substance use disorder sets off a cascade of category errors
Drugs and alcohol in the NY Times
The NY Times had a couple of pieces on alcohol and drug problems this week. (credit: Jonas Bengtsson) First, an audio story about a Maine doctor operating a MOUD clinic in a county jail. Her commitment and advocacy are admirable. There are a couple of striking things to the story. First, she makes a case for … Continue reading Drugs and alcohol in the NY Times
Recovery Redefined: Shifts Across Domains and Contexts
I've posted several times about the changing boundaries of recovery. A recovery science pioneer's thoughts on the boundaries of recovery. On typologies for recovery. On questions about the boundaries of recovery-oriented models of care. On the changing definitions. On research regarding some college students being assigned a recovery label and questioning whether it's appropriate for … Continue reading Recovery Redefined: Shifts Across Domains and Contexts
Cannabis policy: A road not taken
I'm writing from Michigan, where cannabis has been legal for medical use since 2008 and legal for recreational use since 2018. Michigan municipalities permitting cannabis sales in their boundaries get state cannabis tax revenue; municipalities that opt-out do not. There's been very little regulation of marketing and zoning of cannabis retailers, an approach that is … Continue reading Cannabis policy: A road not taken
Language, social justice, access to care, symbolic capital, and recovery advocacy
(source: cultural iceberg from lcw) Many times over the years I've expressed frustration with the field's emphasis on language while it's not clear to me that a whole lot of progress has been made in access to recovery-oriented care of adequate quality, intensity, and duration. (See here, here, here, here, and here.) I just finished … Continue reading Language, social justice, access to care, symbolic capital, and recovery advocacy
2024’s Top Posts – #1 – 12-Step Facilitation is the eighth most frequently used therapeutic approach in treatment facilities
There are a lot of problems in addiction treatment, but 12-step hegemony is not the problem that advocates and media coverage would lead one to believe. There's a widely held belief that 12-step culture exerts a smothering pro-abstinence stranglehold on public health and policy responses to substance use. It's a strange phenomenon when one considers … Continue reading 2024’s Top Posts – #1 – 12-Step Facilitation is the eighth most frequently used therapeutic approach in treatment facilities
2024’s Top Posts – #2 – Multiple pathways as a disruptor: from what to what?
"Multiple pathways to recovery" has been popularized by the new recovery advocacy movement (NRAM) and Recovery Oriented Systems of Care (ROSC), but the concept has been around since at least 1944. The September 1944 issue of Alcoholics Anonymous' Grapevine published an article by Philip Wylie, describing his solo recovery supported by psychologists and reading. Bill … Continue reading 2024’s Top Posts – #2 – Multiple pathways as a disruptor: from what to what?
Moderation or abstinence? The right endpoint for the right problem type
https://www.youtube.com/watch?v=Vb2-R6nDzDc I've seen this segment from the PBS News Hour get some attention recently. Segment Summary The focus of the segment is the use, more specifically the lack of use, of naltrexone for alcohol problems. It rightly points out that the scale and toll of alcohol problems dwarf most other drugs. Deaths attributed to heavy … Continue reading Moderation or abstinence? The right endpoint for the right problem type
2024’s Top Posts – #9 – A War on Recovery?
STAT just ran another article in its "War on Recovery" series and continues its narrative of casting recovering people in Narcotics Anonymous and non-agonist recovery pathways as the villains. There's an important story undergirding this article (and the previous article attacking recovering people in NA) -- that there are important gaps in social support for … Continue reading 2024’s Top Posts – #9 – A War on Recovery?
Recovery Review 