We've been talking about talking about peer supports and recovery coaches for more than a decade. The use of para-professionals in the field goes back several decades. Now, a new study evaluates a similar role for enhancing management of other chronic diseases. Disease Management Care Blog provides a little analysis: There is increasing interest in incorporating lay-persons in the outpatient … Continue reading Recovery coaches for chronic disease management
Category: Treatment
“It works!”, Ctd
A new study of buprenorphine implants find that implants work as well as oral dosing and outperform placebo. What does that mean? If I'm reading it correctly, it means that the average subject receiving the implant tested positive for opioids 68.8% of the time compared to 86.6% for the placebo subjects. (If I'm misreading it, … Continue reading “It works!”, Ctd
Buprenorphine + therapy = ?
Ian McLoone directs us to another study (the 4th in a row) finding that buprenorphine patients receive no benefit from added behavioral treatments. Where does this leave us? We've seen criticism of the devolution of methadone maintenance (MMT) into dosing clinics with calls for a new recovery orientation to MMT and a return to methadone being … Continue reading Buprenorphine + therapy = ?
Buprenorphine and emotional reactivity
The following article was shared with me by a reader. Not surprisingly, the emphasized portion below caught my eye. [emphasis mine] Abstract Addictions to illicit drugs are among the nation’s most critical public health and societal problems. The current opioid prescription epidemic and the need for buprenorphine/naloxone (Suboxone®; SUBX) as an opioid maintenance substance, and its … Continue reading Buprenorphine and emotional reactivity
What makes treatment effective?
I've been catching a lot of heat recently for posts about Suboxone and methadone. (For the sake of this post, lets refer to them as opioid replacement therapy, or ORT, for the rest of this post. One commenter who blogs for an ORT provider challenged my arguments that we should offer everyone the same kind … Continue reading What makes treatment effective?
Thanks for the evidence
Anna David points us toward some positive press for AA. One of the articles focuses on a lecture by Marc Galanter Galanter said that AA uses many of the psychosocial features that operate in any charismatic membership group: social cohesion through attendance at regular meetings; a belief system embodied in the book Alcoholics Anonymous; a behavioral program … Continue reading Thanks for the evidence
Solving the prescription opioid problem
I've posted several times recently on the problem of opioid over-prescription and overdose. Some might assume that I want some regulatory or statutory intervention to address the issue. Truth is, I've got more questions than answers and I would not support a response that forces us to choose between treating pain and preventing addiction and … Continue reading Solving the prescription opioid problem
Less is more – Antipsychotics and Recovery from First-Episode Psychosis
A very interesting finding with profound implications for addicts who experience a psychotic episode. (Particularly since it's so difficult to tease out whether it was substance -induced.) Importance Short-term outcome studies of antipsychotic dose-reduction/discontinuation strategies in patients with remitted first-episode psychosis (FEP) showed higher relapse rates but no other disadvantages compared with maintenance treatment; however, long-term effects … Continue reading Less is more – Antipsychotics and Recovery from First-Episode Psychosis
Not available?
Another study finds no benefit from cognitive behavioral therapy and contingency management with opiate replacement treatment. [CORRECTED: See below] Background and aims The Controlled Substances Act requires physicians in the United States to provide or refer to behavioral treatment when treating opioid-dependent individuals with buprenorphine; however no research has examined the combination of buprenorphine with … Continue reading Not available?
How would we react to a CURE?
Howard Wetsman has been part of a workgroup challenging the dominance of pharmacological treatments and promoting psychosocial treatments. He's had some unsettling feelings and engaged in a thought experiment about what might happen if a real cure was developed. What we’re imagining is a complete cure. This is not a method for, let’s say, alcoholics … Continue reading How would we react to a CURE?
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