The conclusion of the two-parter. Part one is here. Professor Selman’s last five essentials: 6. Different therapies appear to produce similar treatment outcomes. Project MATCH, a huge psychotherapy trial showed similar outcomes for the techniques of motivational enhancement therapy, twelve step facilitation and cognitive behavioural therapy. Other trials including British ones have shown the same results. … Continue reading The ten most important things about addiction (part 2)
This is a version of a blog I published a few years ago, but thought it still relevant today. Doug Sellman is a professor of psychiatry and addiction medicine in New Zealand. In 2010 in the journal Addiction, he attempted the difficult task of distilling the ten things you need to know about addiction from the … Continue reading The ten most important things about addiction (part 1)
The majority of treatment for drug and alcohol problems is outpatient. Trying to achieve abstinence can be tough and some evidence suggests it is more likely to be the goal of clients than the aspiration of professionals for their clients. How well do clients do? This study by Gerald Cochrane and colleagues from New York looked at … Continue reading Add in mutual aid for better outcomes
Berlin, like many big cities has a heroin problem. People presenting for help are being prescribed opioid replacement therapy (ORT) - a form of medication assisted treatment (MAT) in greater numbers. That’s a good thing isn’t it? Yes, but it's not completely straightforward. A lot depends on what the professional and their patient think is … Continue reading Stuck on Methadone
Bankole Johnson, who was featured in HBO's Addiction documentary touting the use of Topiramate and wrote an anti-treatment screed years ago (my response here), has left his post after losing a whistleblower lawsuit. A University of Virginia department chairman nationally known for his addiction research has resigned less than 10 months after a subordinate won an $820,000 whistleblower lawsuit filed … Continue reading a “selfish” and “untrusted” professional attitude*
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
I was asked by a friend to comment on this article. Here's the response I sent him: Well, he's got a point. But he's also gotten a lot wrong, including the name of the NIAAA. It's National Institute on Alcohol Abuse and Alcohol-ism. What he's right about is that not everyone who has an alcohol … Continue reading “No” to rehab?
Popular Science has a chart with US overdose deaths by drug: ...the rate of reported overdoses the U.S. more than doubled between 1999 and 2010. About half of those additional deaths are in the pharmaceuticals category, which the CDC has written about before. Nearly three-quarters of the pharmaceuticals deaths are opioid analgesics—prescription painkillers like OxyContin and … Continue reading Prescription drug overdose statistics visually
I blogged before about the availability of opiates for pain management and the need to try to limit their diversion. While others have complained about draconian limitations on the prescribing of opiates and being too afraid to treat pain, I pointed out the explosion in opiate prescriptions and overdoses. It's a complex problem that demands a solution that balances the … Continue reading Balancing pain management and public health
Unreal. Someone's got an awful lot of faith in their diagnostic skills. Diagnosing ADHD with addicts in a detox unit? Really? And, now that it's published, it's "evidence". Rates of undiagnosed attention deficit hyperactivity disorder in London drug and alcohol detoxification units Background ADHD is a common childhood onset mental health disorder that persists into … Continue reading Diagnosing ADHD in detox?