A version of this post was originally published in January 2018. [Cross-posted at williamwhitepapers.com] Addiction counseling has become an increasingly professional and pristine affair, and service relationships reflect a more detached process than in years gone by. And yet one worries about the loss of something precious in our current fixation on the technical mastery … Continue reading Love and Addiction Counseling (Bill White and Jason Schwartz)
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Nora Volkow on More Realistic And Pragmatic Addiction Treatment
(This post was originally published on 2/6/2022) Source: NIDA There is and can be no ultimate solution for us to discover, but instead a permanent need for balancing contradictory claims, for careful trade-offs between conflicting values, toleration of difference, consideration of the specific factors at play when a choice is needed, not reliance on an … Continue reading Nora Volkow on More Realistic And Pragmatic Addiction Treatment
Unpacking “drug policy”
It seems like more is being said about drug policy than ever before. I've been posting thoughts about drug policy here for years. However, as I read comments from others, I often wonder whether we're talking about the same things. To be honest, I haven't given a lot of thought to the conceptual boundaries of … Continue reading Unpacking “drug policy”
The Politicization of Harm Reduction
(Credit: Fred Murphy) A friend shared this interview with Susan Stellin and Graham MacIndoe with me yesterday. Susan and Graham do a lot of public education about addiction and drug problems, including their traveling exhibition Reframing Recovery. It's rare to hear a lengthy discussion that communicates such sincere respect for both recovery and harm reduction. … Continue reading The Politicization of Harm Reduction
Every response is incomplete
Over the last decade, as faith in the effectiveness of drug policy, addiction treatment, and drug enforcement diminished, interest and hope in harm reduction grew. Harm reduction was once a last resort response to drug problems and in recent years has become the first line response to drug problems. Harm reduction is now receiving the … Continue reading Every response is incomplete
Follow the science . . .
Zeynep Tufecki's analysis of the damage to public trust from misleading public health messaging during the pandemic reminded me of this post. She describes problems of omission, misrepresentation of confidence levels in information, a desire to be a counterforce to misinformation, and hubris leading officials into squandering public trust and, in some cases, becoming a … Continue reading Follow the science . . .
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 12-Step Facilitation is the eighth most frequently used therapeutic approach in treatment facilities
Addiction, Stigma, and Liberation
(Originally posted August 14, 2022) I recently stumbled on this educational page about stigma from the National Harm Reduction Coalition. It's well done and illuminates the assumptions and goals for their stigma reduction efforts. They frame responding to drug use as a choice between liberation and stigma, with harm reduction as the path to liberation. … Continue reading Addiction, Stigma, and Liberation
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 Multiple pathways as a disruptor: from what to what?
Unanswered Questions on the Evolving Role of Lived Experience
Lived experience has long been a significant component of addiction treatment and recovery. In recent years, its prominence has only grown as mainstream medicine seeks to infuse lived experience into the standard of care for not only substance use disorder (SUD) treatment, but across the larger behavioral health field. However, as the field evolves, determining … Continue reading Unanswered Questions on the Evolving Role of Lived Experience
Recovery Review 