Addiction and Recovery News

Trauma, Chemical Use and Addiction

Can't make the Dawn Farm Education Series? Catch the most recent presentation, Trauma, with the slidecast below.

Trauma, Chemical Use and Addiction - March 2010

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9 Medical Marijuana Ads

The Spread of Goodness

Jonah Lehrer reports on findings that human behavior is contagious whether it's obesity, optimism or generosity.

He added this postscript with a reader comment. I suspect it's one explanation for the healing and sustaining power of communities of recovery:

Update: I've gotten a few emails wondering what this means for free will. After all, if our decisions are so determined by the decisions of others, then where is there space for human autonomy? My first reaction is that the new science of social networks still leaves plenty of elbow room for individual decisions. We're talking about risk factors and tendencies and statistical correlations. Just because we're influenced by others doesn't mean we can't reject those influences. I asked James Fowler a related question last year and this was his eloquent response:
Everyone always tells me that this research is so depressing and that it means we don't have free will. But I think they're forgetting to look at the flipside. Because of social networks, your actions aren't just having an impact on what you do, or on what your friends do, but on thousands of other people too. So if I go home and I make an effort to be in a good mood, I'm not just making my wife happy, or my children happy. I'm also making the friends of my children happy. My choices have a ripple effect.

AA “unethical” says SMART recovery founder

I saw this article yesterday and chose not to comment, but now that PeaPod has, I'll join his chorus. I had a similar reaction. I was disappointed in two things:

It's too bad that this person can't just promote Smart Recovery as an alternative without bashing AA.
The author adopted the critics language, presenting it as fact without context.

Oh well. It's nothing new and it won't be the last time. I recognize that people in twelve step recovery can be just as judgmental. More recovery is a good thing. Too bad we can't all just get along.

Evidence for what?

Stanley Fish:

While secular discourse, in the form of statistical analyses, controlled experiments and rational decision-trees, can yield banks of data that can then be subdivided and refined in more ways than we can count, it cannot tell us what that data means or what to do with it. No matter how much information you pile up and how sophisticated are the analytical operations you perform, you will never get one millimeter closer to the moment when you can move from the piled-up information to some lesson or imperative it points to; for it doesn’t point anywhere; it just sits there, inert and empty.

He is arguing that discussions about weighty matters fall apart in a secular context. I couldn't disagree more. Though I do think he's onto something. Evidence, by itself, leads nowhere. It needs context and something else to give it meaning. I believe that "something else" that animates these discussions are our values. Further, I believe that this is the case whether our values are recognized or not and that it's important for all parties to put their values on the table for examination and discussion.

America's largest service provider for addicts

Unsurprising news from CASA:

Of the 2.3 million inmates crowding our nations prisons and jails, 1.5 million meet the DSM IV medical criteria for substance abuse or addiction, and another 458,000, while not meeting the strict DSM IV criteria, had histories of substance abuse; were under the influence of alcohol or other drugs at the time of their crime; committed their offense to get money to buy drugs; were incarcerated for an alcohol or drug law violation; or shared some combination of these characteristics, according to Behind Bars II: Substance Abuse and America’s Prison Population. Combined these two groups constitute 85 percent of the U.S. prison population.

Worst of the proposed DSM-V

The newly proposed substance use disorder diagnostic criteria made a "worst of" list for the DSM V.

Two takes on Insite and another on harm reduction

First, a columnist from the Calgary Herald says that Insite doesn't do enough to change addicts:

Corey Ogilvie wanted to document life in Vancouver's notorious downtown eastside (DTES) by spending 30 days living alongside the residents of North America's poorest, most destitute and drug-infested neighbourhood. Film clips of his journey are posted on the Internet and, as one would expect, are highly revealing.

In one clip, he determines he must do drugs to understand addiction. While coming down from a crack high, he decides to try heroin. So his street buddies send him to Insite, Vancouver's safe injection site.

Ogilvie's smuggled camera reveals Insite staff doing everything but stick the needle in his arm as they aid him in his quest. A staff member shows him how to prepare the heroin, fill the syringe and find a vein. He's clearly a novice and the worker asks the obvious question, "So, can I ask? Why the drug use?"

When Ogilvie fails to offer much of a response, the worker offers an upbeat, "It's OK. You don't have to say anything. It's not a big deal."

...

I was very impressed with the sincerity and concern that Insite staff have for those who come through their doors. They are truly kind and compassionate, and provide addicts with a very human (and humanizing) element to their day. For that, I offer kudos.

Yet I came away thinking that Insite's main gauge of success is engagement, not treating addiction, reducing numbers of addicts or providing addicts with a way out. Maybe social interaction is enough for some, but I remain unconvinced that facilitating drug injections and perpetuating a destructive lifestyle is the best way to afford someone their human dignity. These non-judgmental interactions may make addicts feel better about their behaviour, but I didn't sense that the Insite philosophy had any room for the notion that addicts could actually change their behaviour -- at least not the addicts in the DTES.

Insite does have 12 detox beds and 18 'transitional' beds for those who are hoping to get into treatment. They have daily programs such as yoga, health care or counselling for these residents. But, again, I never got the sense that they had much hope for addicts beyond the Insite facilities.

Insite leaders seemed uncertain about what treatment facilities existed and where they were located, but still insisted that they weren't the kind of facilities that would be a good fit for DTES addicts. I'm under no illusion that there are sufficient treatment facilities available, but isn't any addict going to be out-of-his-comfort zone in an addiction treatment facility? Since the intent is to change lifestyle patterns, I would certainly hope so.

Meanwhile, a blogger for Phoenix House gives them the benefit of the doubt:

...when I looked at Insite’s website, I was encouraged by the fact that the facility is actually part of a larger organization that provides “a complete continuum of services,” including prevention, opioid replacement therapy, residential treatment, and housing support. An addiction counselor is part of Insite’s staff and, in its second year of operation, it made 2,000 referrals to other services. A New England Journal of Medicine study found that, because Insite removes barriers to treatment, its clients—who may not be well connected to the health care system—have increased their use of detox and withdrawal programs.

If Insite’s advocates want a real shot at challenging critics, they should emphasize that it is not a stand-alone operation, but a “rung on the ladder” from “chronic drug addiction to recovery.” People suffering the devastating effects of substance abuse cannot change their lives overnight. But, getting off the street and coming to a place like Insite—where medical professionals can help them get the care they need—may be the first step in the process. I hope future media coverage of Insite offers this perspective.

Finally, the blog, The Art of Life Itself, describes ab approach to harm reduction that embraces recovery.