This will be my post in response to the NY Times' series on Suboxone. This post originally ran on 7/19/13 and addressed a lot of our concerns. * * * I've been catching a lot of heat recently for posts about Suboxone and methadone. (For the sake of this post, lets refer to … Continue reading What makes treatment effective?
“manifestly unsuitable for (psychiatric) treatment”
Will Self reviews a recently published book on psychiatry and has some interesting observations on the relationships between addicts, mutual aid groups and psychiatry: Interestingly there is one large sector of the "mentally ill" that Burns believes are manifestly unsuitable for treatment – drug addicts and alcoholics. He points to the ineffectiveness of almost all … Continue reading “manifestly unsuitable for (psychiatric) treatment”
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?
The benefits of harm reduction are not as obvious as they seem
Theodore Dalrymple points out the inconsistency in the British Medical Journal's vigorous advocacy for harm reduction where heroin is concerned and its squeamishness with harm reduction for nicotine. He pulls a passage from BMJ and inserts comments: What, then, does the BMJ, so much in favour of harm reduction for heroin addicts, say about harm reduction … Continue reading The benefits of harm reduction are not as obvious as they seem
Balancing pain management and public health
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
Diagnosing ADHD in detox?
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?
Intellectual conflicts of interest
Allen Frances, Chair of the DSM-IV Task Force lets loose on the DSM-5. He acknowledges the noxious effects of professional interests on research and practice in a way that is rarely seen from leaders of his stature. [emphasis mine] This is the saddest moment in my 45 year career of studying, practicing, and teaching psychiatry. The Board of … Continue reading Intellectual conflicts of interest
More evidence for 12-step approaches
Another study finding the 12-step involvement is associated with continuous abstinence: Abstract A longitudinal analysis of 12-step involvement was conducted among a U.S. sample of patients exiting treatment for substance dependence. Categorical involvement in a set of 12-step activities and summary scores of involvement from the Alcoholics Anonymous Affiliation Scale were examined in relation to … Continue reading More evidence for 12-step approaches
Motivational Interviewing works, but no better than other treatments
Cochrane conducts a meta-analysis of motivational interviewing (MI) and concludes that it's no more effective than other treatments. More than 76 million people worldwide have alcohol problems, and another 15 million have drug problems. Motivational interviewing (MI) is a psychological treatment that aims to help people cut down or stop using drugs and alcohol. The … Continue reading Motivational Interviewing works, but no better than other treatments