A new article in JAMA Psychiatry reports on demographic differences in heroin use since the 1960s. These findings are entirely congruent with Dawn Farm's experience: And the “type” who’s addicted to heroin has shifted considerably over the years, according to the new study. In the 1960s, the average heroin beginner was 16 years old, … Continue reading Demographics of heroin
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.
Privileged access
Peg O'Connor offers an interesting perspective on self-trust in addiction. Complicating the matter is the belief that each person knows herself better than others can know her. In philosophy we call this “privileged access.” On this view, each person has an access to her beliefs, desires, thoughts, emotions that no one else can have. Each of us can … Continue reading Privileged access
Another buprenorphine study with poor outcomes for young patients
A recent study looks at buprenorphine retention and frames young adult retention as a problem. Emerging adults (18-25 years old) are often poorly retained in substance use disorder treatment. Office-based buprenorphine often enhances treatment retention among people with opioid dependence. In this study, we examined the records of a collaborative care buprenorphine treatment program … Continue reading Another buprenorphine study with poor outcomes for young patients
A waste of human (and recovery) capital
From a UK foundation looking for opportunities to improve addiction services in London: . . . there is one crucial area in which people in treatment are possibly being failed, and that is employment. While we found that almost every participant wanted to work either in the future or right now, most people in treatment for … Continue reading A waste of human (and recovery) capital
Avoiding potential misuses of addiction brain science – TBS
Originally posted in 2006. ============ The scientific journal Addiction has an editorial on the potential unintended consequences of addiction brain science. Here are some of the current and potential problems that they identified: Simplistic interpretations of this model of addiction have been used to justify heroic treatment interventions in the brain's function, such as ultra-rapid … Continue reading Avoiding potential misuses of addiction brain science – TBS
Addiction and Treatment Careers
Bill White on addiction and treatment careers: The odds of stable recovery increase with the accumulation of years of substance dependence. Sustainable recovery is often preceded by years of cycling in and out of sobriety experiments until multiple interventions generate enough cumulative recovery capital to tip the scales to stable recovery maintenance. The majority of persons who recover … Continue reading Addiction and Treatment Careers
sustained guidance into full cultural participation
I've posted recently on the role of class in addiction, policy, treatment and recovery. Here are a couple of sentences from Bill White on the topic. Those individuals needing professionally directed addiction treatment suffer from more than a singular, encapsulated problem with alcohol or other drugs. Need for addiction treatment—particularly prolonged or repeated treatment—is often a proxy … Continue reading sustained guidance into full cultural participation
Treatment dose
From Bill White's Recovery Management monograph: The best single predictor of post-treatment outcome across all modalities is length of time in treatment. There is a dose effect of both treatment and recovery mutual aid participation, with recovery outcomes improving as dose increases. . . . Treatment duration in methadone and non-methadone treatment units has declined nationally … Continue reading Treatment dose
Gabapentin high
DJ Mac recently posted about something I'd never heard of, gabapentin misuse. Sure enough, when I type gabapentin into google, one of the first suggested searches is "gabapentin high". There are reports of these drugs being used to maximise the effects of methadone and being misused by heroin users. In Scotland, a BJGP paper from 2012 reported: Unfortunately, our … Continue reading Gabapentin high
Faith of a different sort
DJ Mac wraps up a series of posts on pharmacology with a post focused on our faith in pharmacology. Holy grails are few and far between. Pharmaceutical holy grails are no different. They are as rare as a moderate position in the Scottish independence debate. We have a few prescription drugs licensed to treat addiction … Continue reading Faith of a different sort
Recovery Review 