Our Blogs

JAN
01
0

Have You Ever Stepped on a Nail?

Ask people if they’ve ever stepped on a nail and most will say yes. It can happen to anyone, although the odds go up when lots of boards with nails in them are lying around and people are not paying attention. No one wants or expects to step on a nail. It’s a no-fault wound. Addiction is more likely to develop when lots of addictive substances are within easy reach and people are not paying attention. Some people are more susceptible than others, but it can happen to anyone. No one wants or expects to develop addiction. It’s another no-fault wound. Concern and individualized assistance are appropriate responses to no-fault wounds. Blame and judgment are not. Our responses to people with addiction ought to be like our responses to people who step on a nail. We might begin by expressing concern for the injured person and then proceed to administer the...
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  67 Hits
67 Hits
OCT
31
0

Fuel the Recovery of Others—with Acceptance and Accountability

After looking the other way for far too long, people and institutions in the United States are starting to face addiction. Respect for individuals in active addiction and resources to assist them into recovery are gradually becoming the norm. Previous Addiction Medicine Updates have identified two core responsibilities, stated as calls to action, that most individuals in active addiction need to adopt in order to achieve lasting recovery. Keep Your Distance! advocates modifying routines and lifestyles to minimize the risk of resuming substance use. Ask for Help! advocates repairing and creating relationships based on honesty and mutual respect. The latest neuroscience, as well as decades of practical experience, support the relevance of these actions, which I call The Two Pillars of Recovery ®. But what about everyone else? What about all those who live with, care for, and work beside people in active addiction? What actions should family, friends, healthcare providers,...
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  125 Hits
125 Hits
OCT
31
0

Fuel the Recovery of Others—with Acceptance and Accountability

After looking the other way for far too long, people and institutions in the United States are starting to face addiction. Respect for individuals in active addiction and resources to assist them into recovery are gradually becoming the norm. Previous Addiction Medicine Updates have identified two core responsibilities, stated as calls to action, that most individuals in active addiction need to adopt in order to achieve lasting recovery. Keep Your Distance! advocates modifying routines and lifestyles to minimize the risk of resuming substance use. Ask for Help! advocates repairing and creating relationships based on honesty and mutual respect. The latest neuroscience, as well as decades of practical experience, support the relevance of these actions, which I call The Two Pillars of Recovery ®. But what about everyone else? What about all those who live with, care for, and work beside people in active addiction? What actions should family, friends, healthcare providers,...
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  27 Hits
27 Hits
SEP
09
0

Finding Your Place in Mutual Help Groups

In the United States and elsewhere, addiction treatment programs routinely recommend that patients make use of mutual support groups, also known as “self-help” groups.  Twelve-Step programs, particularly Alcoholics Anonymous (AA) and programs modeled after it such as Narcotics Anonymous (NA), are recommended most often.  They are widely available and have been central to the recoveries of many individuals with addiction, some having achieved success with 12-Step or other mutual help programs as their sole support. Most often, however, peer assistance by itself is not sufficient.  To stabilize and emerge from active addiction, many individuals require formal addiction treatment programs that feature professional counseling in individual and group settings.  These programs may be brief or long-term and some provide residential separation from common relapse triggers.  Medications may be necessary for detoxification, medical or psychiatric problems, and/or relapse prevention.  Medications often are needed beyond the initial treatment episode, some indefinitely. Formal treatment is...
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  381 Hits
381 Hits
SEP
09
0

Finding Your Place in Mutual Help Groups

In the United States and elsewhere, addiction treatment programs routinely recommend that patients make use of mutual support groups, also known as “self-help” groups.  Twelve-Step programs, particularly Alcoholics Anonymous (AA) and programs modeled after it such as Narcotics Anonymous (NA), are recommended most often.  They are widely available and have been central to the recoveries of many individuals with addiction, some having achieved success with 12-Step or other mutual help programs as their sole support. Most often, however, peer assistance by itself is not sufficient.  To stabilize and emerge from active addiction, many individuals require formal addiction treatment programs that feature professional counseling in individual and group settings.  These programs may be brief or long-term and some provide residential separation from common relapse triggers.  Medications may be necessary for detoxification, medical or psychiatric problems, and/or relapse prevention.  Medications often are needed beyond the initial treatment episode, some indefinitely. Formal treatment is...
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  33 Hits
33 Hits
JUL
02
0

"Prescribing” Mutual-Help Meetings: A Primer

All physician recommendations to patients are, in a sense, prescriptions. Obvious prescriptions are written or electronic orders for treatments or procedures, including medications, diagnostic tests, and physical therapy. Prior to executing these orders for particular patients, physicians typically weigh the relevance of the medication or procedure to the individual based on factors such as cost, availability, accessibility, and patients’ physical and mental abilities. Prescribers routinely order a medication only if there are no special precautions or contraindications for that patient, and they educate the patient regarding potential adverse effects. Less obvious as prescriptions, but no less deserving of foresight and care, are the recommendations to patients receiving addiction treatment that they attend and gain support from mutual-help meetings, particularly 12-step programs. Providers make these recommendations often, but unfortunately make them without reflecting on their relevance to individuals and without educating patients regarding potential adverse effects. These omissions occur in primary care,...
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0
  355 Hits
355 Hits
JUL
02
0

"Prescribing” Mutual-Help Meetings: A Primer

All physician recommendations to patients are, in a sense, prescriptions. Obvious prescriptions are written or electronic orders for treatments or procedures, including medications, diagnostic tests, and physical therapy. Prior to executing these orders for particular patients, physicians typically weigh the relevance of the medication or procedure to the individual based on factors such as cost, availability, accessibility, and patients’ physical and mental abilities. Prescribers routinely order a medication only if there are no special precautions or contraindications for that patient, and they educate the patient regarding potential adverse effects. Less obvious as prescriptions, but no less deserving of foresight and care, are the recommendations to patients receiving addiction treatment that they attend and gain support from mutual-help meetings, particularly 12-step programs. Providers make these recommendations often, but unfortunately make them without reflecting on their relevance to individuals and without educating patients regarding potential adverse effects. These omissions occur in primary care,...
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0
  24 Hits
24 Hits
MAY
05
0

All about Medications for Opioid Use Disorder—In One Place

In the face of our national opioid crisis communities across the United States are taking notice and taking action. They’re proactively addressing opioid misuse, opioid addiction, and overdose deaths by distributing naloxone nasal injectors to counteract overdoses, contriving ways to move individuals treated for overdoses directly into treatment, and making treatment for opioid use disorder (OUD) more accessible. Treatment for OUD has several potential components, one of which is use of three FDA-approved OUD medications: Methadone, buprenorphine, and naltrexone. Use of medication to treat opioid addiction has been controversial since the 1960s when methadone was first shown to help individuals addicted to heroin. But controversy is being replaced with acceptance as OUD medications are increasingly recognized as a potent tool to combat the opioid crisis. Treatment Improvement Protocol (TIP) 63 released by the Substance Abuse and Mental Health Services Administration (SAMHSA) in February 2018, Medications for Opioid Use Disorder, is an...
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  401 Hits
401 Hits
MAY
05
0

All About Medications for Opioid Use Disorder—In One Place

In the face of our national opioid crisis communities across the United States are taking notice and taking action. They’re proactively addressing opioid misuse, opioid addiction, and overdose deaths by distributing naloxone nasal injectors to counteract overdoses, contriving ways to move individuals treated for overdoses directly into treatment, and making treatment for opioid use disorder (OUD) more accessible. Treatment for OUD has several potential components, one of which is use of three FDA-approved OUD medications: Methadone, buprenorphine, and naltrexone. Use of medication to treat opioid addiction has been controversial since the 1960s when methadone was first shown to help individuals addicted to heroin. But controversy is being replaced with acceptance as OUD medications are increasingly recognized as a potent tool to combat the opioid crisis. Treatment Improvement Protocol (TIP) 63 released by the Substance Abuse and Mental Health Services Administration (SAMHSA) in February 2018, Medications for Opioid Use Disorder, is an...
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0
  27 Hits
27 Hits
FEB
27
0

It’s Not the Rehab—It’s the Relationships!

Individuals in active addiction sometimes say, “I don’t need another rehab, I could teach those groups.” Outpatient counselors sometimes say, “So-and-so isn’t doing well: S/he needs to go to rehab.” The first position discounts the value of addiction rehabilitation by equating it with the content of psychoeducational groups. The second elevates its value to that of a panacea for faltering recoveries. Rehabs—and, for that matter, outpatient addiction treatment programs that incorporate similar elements—are neither of these. Research has consistently shown that psychoeducation provides little or no benefit to those seeking addiction recovery. But interpersonal connection, such as an alliance with an empathic therapist, provides even more benefit than the actual method of treatment employed by the therapist. The wisdom of spirituality as well as the findings of science indicate that the way of recovery is not alone. Essential tasks for those seeking addiction recovery are to make sufficient lifestyle changes that...
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  255 Hits
255 Hits

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