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
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
Low Expectations Yield Low Rates of Recovery from Addiction
The primary limitation in life is our low expectations for ourselves and others. When we expect minimum results, that's usually what we get.” - John C. Maxwell How are we measuring our war against addiction in the United States? We have one single metric in the arena of public discourse on our progress. The increase … Continue reading Low Expectations Yield Low Rates of Recovery from Addiction
Who calls themselves a “former alumni” and what exactly does that mean?
If someone graduates from an academic degree program then that person is an alumnus of that institution, by definition. And of course, by definition, the status of being an alumnus is permanent. But concerning an addiction treatment program, some people might claim they are no longer an alumnus. At some point in the future they … Continue reading Who calls themselves a “former alumni” and what exactly does that mean?
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
Macro Level Moral Injury Within the SUD Care System – Our Unaddressed Imperative
Authors note - I first wrote on this topic in Recovery Review in 2021. It was also picked up by Treatment Magazine. Since then, overall overdose mortality rates have decreased slightly which is being reported quite broadly despite the fact that they are dramatically increasing in African American communities. Alcohol death rates have increased at … Continue reading Macro Level Moral Injury Within the SUD Care System – Our Unaddressed Imperative
A fresh look at “The Four Pests”
A shift in the zeitgeist seems to be happening in recent years, such that four particular things are becoming regarded as pests: Recovery, both as a goal and as a process Sobriety (its functional significance) and Abstinence (its efficacy and value, vs. its safety and vs. one’s ability to tolerate it) Addiction illness (the construct) Treatment (its indications and its … Continue reading A fresh look at “The Four Pests”
A fresh look at the “Harms of Use”
By 2019 I had grown concerned enough about the occasionally all-encompassing nature of Harm Reduction as an activist ideology (rather than the set of sound clinical practices in harm reduction I've literally seen and been involved in across my entire career since 1988), that I coined a term for the sake of my own clarity. … Continue reading A fresh look at the “Harms of Use”
A Fresh Look at the Topic of “Addiction Hospice”
We seem to be moving toward formalizing what I have called “Addiction Hospice” (palliative SUD care, both as a clinical process and as an endpoint goal). Toward supplying a back story, I’ll say that I started to identify this trend and called it “Addiction Hospice” around 2007 or so (during the final years of our … Continue reading A Fresh Look at the Topic of “Addiction Hospice”
A Fresh Look at the Topic of “Recovery Orphans”
Back in 2021 I wrote a post consisting of four separate essays, each approaching the topic of "Recovery Orphans" from a different perspective. I coined the term "Recovery Orphan" some years ago after struggling with various events I've witnessed across the decades of my career. And while struggling to make sense of various things concerning … Continue reading A Fresh Look at the Topic of “Recovery Orphans”
Recovery Review 