The Hopeworks Community blog has an outstanding post contrasting recovery and disease management. His focus is on mental illness, but the parallels are clear. One can't help but reflect on the fact that the addiction recovery movement rose in response to the failure of the mental health system to help addicts recover. There's a lot … Continue reading Recovery vs. Disease Management
Category: Harm Reduction
Personal Failure or System Failure?
Bill White explaining why inadequate treatment may be worse than no treatment: What we know from primary medicine is that ineffective treatments (via placebo effects) or an inadequate dose of a potentially effective treatment (e.g., as in antibiotic treatment of bacterial infections) may temporarily suppress symptoms. Such treatments create the illusion of resumed health, but … Continue reading Personal Failure or System Failure?
The Unintended Consequences Of Medical “Maximalism”
The Health Affairs blog questions the American Heart Association's maximalist approach with the use of statins. The issues sound familiar. The policy implications of these guidelines are staggering. Estimates show that if these recommendations are fully implemented, close to a third of all Americans will be placed on a statin. But these developments beg the … Continue reading The Unintended Consequences Of Medical “Maximalism”
Buprenorphine Overseas
“The history of the treatment of narcotic withdrawal is a long and dishonorable one. The trail is strewn with cures enthusiastically received and then quietly discarded when they turned out to be relatively ineffective or even worse, productive of greater morbidity and mortality… Any claim for a new method should be put forward modestly and … Continue reading Buprenorphine Overseas
Treat The Symptoms Or The Cause?
This article was a good reminder that we're not the only profession struggling with whether harm-reduction should be the de facto treatment. However, it's worth noting that the statement here ("cut in half") provides considerably more information than most addicts get. A huge new study out today in The Lancet shows that reducing three … Continue reading Treat The Symptoms Or The Cause?
Pediatric use of buprenorphine
Drugfree.org has a piece advocating more use of buprenorphine with children. Medication-Assisted Treatment (MAT) for opioid dependence is a science-based and proven-effective option for teens and young adults. It should be administered with age appropriate psychosocial therapy and drug testing. Unfortunately, it has been subject to controversy and stigma. Yet the neuroscience of addiction and … Continue reading Pediatric use of buprenorphine
Recovery capital and capital
From the UK Advisory Council on the Misuse of Drugs second report of the recovery committee [emphasis mine]: ...our optimism about recovery should be tempered. Evidence suggests that different groups are more or less likely to achieve recovery outcomes. For some people, with high levels of recovery capital (e.g. good education, secure positive relationships, a job), recovery … Continue reading Recovery capital and capital
…let us work together
"If you have come here to help me, then you are wasting your time… But if you have come because your liberation is bound up with mine, then let us work together." - Lila Watson Obviously, I've been thinking a lot about the buprenorphine maintenance, the NY Times series and the reactions since it was published. … Continue reading …let us work together
Two more defenses of Suboxone
In the Washington Post, Harold Pollack interviewed Peter Friedmann about buprenorphine and the NY Times series on buprenorphine. We're fortunate that that they share their premises. HP: Buprenorphine provides a “substitution therapy” for people with opiate disorders. PF: Correct. For many years, opiate addiction was considered an incurable illness. It was Dole and Nyswander in New York who proposed … Continue reading Two more defenses of Suboxone
NY Times / Suboxone redux
I thought I was done, but here are a couple more smart takes. Both support maintenance but appreciate the article raising awareness of important problems. From The Institute Blog: And as the articles (and the comment section) demonstrate, the use of buprenorphine to treat addiction and prevent substance use-related harms is messy. Interlacing text and video, … Continue reading NY Times / Suboxone redux
Recovery Review 