Here's a presentation from Preserving the Message titled "The Narcotic Farm: Origins and Influences upon 12-Step Mutual-Aid for Individuals with Addiction". It was published on their YouTube channel on 07/08/2023. To me, this presentation is tremendous and fascinating. Consider leaving a comment on their channel or at the bottom of this post. For example, you … Continue reading Preserving the Message. “The Narcotic Farm: Origins and Influences upon 12-Step Mutual-Aid for Individuals with Addiction”

Disclaimer:  nothing in this post should be taken or held as clinical instruction, clinical supervision, or advisory concerning patient care.  The phenomena of struggling with one’s own identity is an associated feature of addiction illness.  Did you know addiction illness has this associated feature?  Until last Fall, I didn’t.  For the individual patient, this difficulty … Continue reading The Question of Identity

“I never trust a man who doesn't drink.” – John Wayne People do not trust people who moderate or abstain from substances, particularly alcohol. There is a sense that those of us who do so are looking at everyone else and judging them. I suppose some do, but I don’t think most of us do. … Continue reading Portraying Abstinence Recovery as Puritanical Is in the Interest of Those Who Sell Addictive Drugs

Disclaimer:  nothing in this post should be taken or held as clinical instruction, clinical supervision, or advisory concerning patient care.  A few years later in that same organization I was picked to be on a steering committee that would form and lead a new program.  The new program was going to be a buprenorphine-specific Intensive Outpatient … Continue reading Contingency Management Example 4 of 4: Forming a Buprenorphine-Specific IOP

Disclaimer:  nothing in this post should be taken or held as clinical instruction, clinical supervision, or advisory concerning patient care.  At my workplace in the early 2000's we were early adopters in various kinds of technology and clinical practices that were beyond "evidence-based". We aimed for best practice, promising practices, and those that were really … Continue reading Contingency Management Example 3 of 4: Mobile Device with Live Recovery Coaching

Disclaimer:  nothing in this post should be taken or held as clinical instruction, clinical supervision, or advisory concerning patient care.  In that same organization during those same years, we had a central screening and intake office for our various residential and outpatient chemical dependency programs.  These were publicly funded programs, and the vast majority of the … Continue reading Contingency Management Example 2 of 4: “Start Now” in Outpatient and Reduce the Wait for Residential

Disclaimer:  nothing in this post should be taken or held as clinical instruction, clinical supervision, or advisory concerning patient care.  At a previous workplace, in the early 2000's, we contracted a person who was a national leading expert in contingency management (CM) for substance use disorders (SUDs).  We contracted with them to write a practice guideline on … Continue reading Contingency Management Example 1 of 4: Prize Tickets to Increase Group Attendance

Disclaimer:  nothing in this post should be taken or held as clinical instruction, clinical supervision, or advisory concerning patient care.  A colleague in the field asked me to make some comments on Recovery Review about the use of contingency management (CM) within clinical services for substance use disorders (SUDs). This colleague expressed the concern to me that contingency management: … Continue reading Comments on the Practical Use of Contingency Management

Substance misuse and addiction is perhaps our most significant domestic challenge. In 2022, the U.S. Congress Joint Economic Committee (JEC) found that the opioid epidemic alone cost the United States nearly $1.5 trillion in 2020, or 7 percent of gross domestic product (GDP), an increase of about one-third since the cost was last measured in … Continue reading AI, Substance Misuse, Addiction, and the Tragedy of the Commons