Addiction and Recovery News

Trauma, Chemical Use and Addiction

noreply@blogger.com (Jason Schwartz) — Thu, 18 Mar 2010 18:01:00 +0000

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

View more presentations from jschwartz.

tab dump

noreply@blogger.com (Jason Schwartz) — Thu, 18 Mar 2010 01:47:00 +0000

9 Medical Marijuana Ads

noreply@blogger.com (Jason Schwartz) — Mon, 15 Mar 2010 15:23:00 +0000

9 Medical Marijuana Ads

The Spread of Goodness

noreply@blogger.com (Jason Schwartz) — Sun, 14 Mar 2010 14:56:00 +0000

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

noreply@blogger.com (Jason Schwartz) — Thu, 11 Mar 2010 23:15:00 +0000

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?

noreply@blogger.com (Jason Schwartz) — Tue, 09 Mar 2010 20:35:00 +0000

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

noreply@blogger.com (Jason Schwartz) — Mon, 08 Mar 2010 02:21:00 +0000

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

noreply@blogger.com (Jason Schwartz) — Mon, 08 Mar 2010 02:16:00 +0000

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

noreply@blogger.com (Jason Schwartz) — Mon, 08 Mar 2010 02:11:00 +0000

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.

Low-Tech Treatment May Be Best for Addiction

noreply@blogger.com (Jason Schwartz) — Sun, 07 Mar 2010 00:52:00 +0000

This Newsweek piece offers a little perspective on pharmacology and behavioral treatments for addiction:

Freud was a disaster for psychiatry, but not because his theory of the mind inspired his acolytes to exclude physical and chemical processes from explanations of thoughts, emotion, and behaviors. No, the disaster has been the extreme backlash against that nonmaterialist, touchy-feely approach. As neuroscience has blossomed in the last two decades, it has left virtually everything that smacks of psychiatry in the dust. In a nutshell, and not to get too Cartesian, but the brain has replaced the mind.
...

Consider the excitement over cocaine vaccines. Composed of a bacterial protein plus a molecule that is a coke look-alike, they train the immune system to produce antibodies against both. The antibodies also bind to cocaine, preventing it from entering the brain and causing a high. The good news is that the vaccine makes crack less pleasurable, notes Meg Haney of Columbia University, who led a 2010 vaccine study. That suggests the vaccine indeed kept the drug out of the brain. The bad news is that the level of antibodies in the volunteers (55 coke users in a 2009 study, 10 crack users in Haney's) varied widely. Only 38 percent of the coke users produced enough antibodies to dull the effects of cocaine, and, of those, only half stayed clean more than half the time.

In contrast, a 2008 analysis of 34 studies of behavioral treatments for addiction to cocaine, marijuana, and other drugs showed impressive efficacy. "There is still no generally effective [medication]" for coke, pot, and meth addictions, notes psychiatry professor Kathleen Carroll of Yale University. "But the behavioral therapies we have are quite good," bringing a 67 percent improvement. Yet that research gets the response of the proverbial tree falling in an empty forest.

...the National Institute on Drug Abuse, which has been terrific in funding behavioral approaches to addiction. It has had so much success in developing and validating behavioral therapies "that we don't need more research to show they work," says NIDA director Nora Volkow. Consider a new study she led with colleagues at Brookhaven National Laboratory. They showed cocaine users pictures of coke and coke paraphernalia, which usually makes activity in the brain's limbic (emotion) regions spike, causing intense craving. The scientists taught the users to suppress that activity. That success, says Volkow, "provides enormous hope," implying that cognitive interventions might enable cocaine abusers to "block the drug-craving response to help them avoid relapse." The problem is implementation, and Volkow is "trying to direct more funding to that." One wonders how much more could be accomplished if it got more than table scraps. Especially if cognitive and behavioral approaches can overcome their lack of sex appeal.

It's not too late to save 'normal'

noreply@blogger.com (Jason Schwartz) — Wed, 03 Mar 2010 00:32:00 +0000

A chairperson from the DSM-IV makes a plea to avoid what she has now concluded were mistakes:

Our panel tried hard to be conservative and careful but inadvertently contributed to three false "epidemics" -- attention deficit disorder, autism and childhood bipolar disorder. Clearly, our net was cast too wide and captured many "patients" who might have been far better off never entering the mental health system.

The first draft of the next edition of the DSM, posted for comment with much fanfare last month, is filled with suggestions that would multiply our mistakes and extend the reach of psychiatry dramatically deeper into the ever-shrinking domain of the normal. This wholesale medical imperialization of normality could potentially create tens of millions of innocent bystanders who would be mislabeled as having a mental disorder. The pharmaceutical industry would have a field day -- despite the lack of solid evidence of any effective treatments for these newly proposed diagnoses.

Willpower as an exhaustible resource

noreply@blogger.com (Jason Schwartz) — Tue, 02 Mar 2010 01:38:00 +0000

A new book called Switch targeting business types has a lot of food for thought about addiction.

First, the authors explore the tension between the emotional brain and the rational brain:

The unavoidable conclusion is this: Your brain isn’t of one mind.
...

But, to us, the duo’s tension is captured best by an analogy used by University of Virginia psychologist Jonathan Haidt in his wonderful book The Happiness Hypothesis. Haidt says that our emotional side is an Elephant and our rational side is its Rider. Perched atop the Elephant, the Rider holds the reins and seems to be the leader. But the Rider’s control is precarious because the Rider is so small relative to the Elephant. Anytime the six-ton Elephant and the Rider disagree about which direction to go, the Rider is going to lose. He’s completely overmatched. Most of us are all too familiar with situations in which our Elephant overpowers our Rider.

You’ve experienced this if you’ve ever slept in, overeaten, dialed up your ex at midnight, procrastinated, tried to quit smoking and failed, skipped the gym, gotten angry and said something you regretted, abandoned your Spanish or piano lessons, refused to speak up in a meeting because you were scared, and so on. Good thing no one is keeping score.

The weakness of the Elephant, our emotional and instinctive side, is clear: It’s lazy and skittish, often looking for the quick payoff (ice cream cone) over the long-term payoff (being thin). When change efforts fail, it’s usually the Elephant’s fault, since the kinds of change we want typically involve short-term sacrifices for long-term payoffs. (We cut back on expenses today to yield a better balance sheet next year. We avoid ice cream today for a better body next year.) Changes often fail because the Rider simply can’t keep the Elephant on the road long enough to reach the destination.

The Elephant’s hunger for instant gratification is the opposite of the Rider’s strength, which is the ability to think long-term, to plan, to think beyond the moment (all those things that your pet can’t do).

But what may surprise you is that the Elephant also has enormous strengths and that the Rider has crippling weaknesses. The Elephant isn’t always the bad guy. Emotion is the Elephant’s turf—love and compassion and sympathy and loyalty. That fierce instinct you have to protect your kids against harm—that’s the Elephant. That spine-stiffening you feel when you need to stand up for yourself—that’s the Elephant.

And even more important if you’re contemplating a change, the Elephant is the one who gets things done. To make progress toward a goal, whether it’s noble or crass, requires the energy and drive of the Elephant. And this strength is the mirror image of the Rider’s great weakness: spinning his wheels. The Rider tends to overanalyze and overthink things. Chances are, you know people with Rider problems: your friend who can agonize for twenty minutes about what to eat for dinner; your colleague who can brainstorm about new ideas for hours but can’t ever seem to make a decision.

If you want to change things, you’ve got to appeal to both. The Rider provides the planning and direction, and the Elephant provides the energy. So if you reach the Riders of your team but not the Elephants, team members will have understanding without motivation. If you reach their Elephants but not their Riders, they’ll have passion without direction. In both cases, the flaws can be paralyzing. A reluctant Elephant and a wheel-spinning Rider can both ensure that nothing changes. But when Elephants and Riders move together, change can come easily.

They then frame willpower as an "exhaustible resource":

To see this point more clearly, consider the behavior of some college students who participated in a study about “food perception” (or so they were told). They reported to the lab a bit hungry; they’d been asked not to eat for at least three hours beforehand. They were led to a room that smelled amazing— the researchers had just baked chocolate-chip cookies. On a table in the center of the room were two bowls. One held a sampling of chocolates, along with the warm, fresh-baked chocolate-chip cookies they’d smelled. The other bowl held a bunch of radishes.

The researchers had prepped a cover story: We’ve selected chocolates and radishes because they have highly distinctive tastes. Tomorrow, we’ll contact you and ask about your memory of the taste sensations you experienced while eating them.

Half the participants were asked to eat two or three cookies and some chocolate candies, but no radishes. The other half were asked to eat at least two or three radishes, but no cookies. While they ate, the researchers left the room, intending, rather sadistically, to induce temptation: They wanted those poor radish-eaters to sit there, alone, nibbling on rabbit food, glancing enviously at the fresh-baked cookies. (It probably goes without saying that the cookie-eaters experienced no great struggle in resisting the radishes.) Despite the temptation, all participants ate what they were asked to eat, and none of the radish-eaters snuck a cookie. That’s willpower at work.

At that point, the “taste study” was officially over, and another group of researchers entered with a second, supposedly unrelated study: We’re trying to find who’s better at solving problems, college students or high school students. This framing was intended to get the college students to puff out their chests and take the forthcoming task seriously.

The college students were presented with a series of puzzles that required them to trace a complicated geometric shape without retracing any lines and without lifting their pencils from the paper. They were given multiple sheets of paper so they could try over and over. In reality, the puzzles were designed to be unsolvable. The researchers wanted to see how long the college students would persist in a difficult, frustrating task before they finally gave up.

The “untempted” students, who had not had to resist eating the chocolate-chip cookies, spent 19 minutes on the task, making 34 well-intentioned attempts to solve the problem. The radish-eaters were less persistent. They gave up after only 8 minutes—less than half the time spent by the cookie-eaters—and they managed only 19 solution attempts. Why did they quit so easily?

The answer may surprise you: They ran out of self-control. In studies like this one, psychologists have discovered that self-control is an exhaustible resource. It’s like doing bench presses at the gym. The first one is easy, when your muscles are fresh. But with each additional repetition, your muscles get more exhausted, until you can’t lift the bar again. The radish-eaters had drained their self-control by resisting the cookies. So when their Elephants, inevitably, started complaining about the puzzle task—it’s too hard, it’s no fun, we’re no good at this—their Riders didn’t have enough strength to yank on the reins for more than 8 minutes. Meanwhile, the cookie-eaters had a fresh, untaxed Rider, who fought off the Elephant for 19 minutes.

Book Review: Thinking Simply About Addiction

noreply@blogger.com (Jason Schwartz) — Mon, 01 Mar 2010 12:07:00 +0000

Dirk Hansen reviews Thinking Simply About Addiction: A Handbook for Recovery and describes its interesting spin on the concept of powerlessness:

While acknowledging that addiction is “correctly understood as a disease,” Sandor diverges a bit from the mainstream disease theory of addiction, believing that addictions are “diseases of automaticity—automatisms—developments in the central nervous system that cannot be eliminated but can be rendered dormant.”

As examples of simple automatisms, Sandor cites bicycle riding and swimming, two behaviors it is impossible to “unlearn.” Consider swimming: If, for some reason, it became extremely dangerous for you to swim (pollution, a heart condition, sharks), the problem is that “you literally cannot choose not to swim. Your only reliable choice is to stay out of the water, to become abstinent.”

Much of the confusion over addiction, the author maintains, is that “we miss the essential quality that defines addiction as a disease: Something someone has rather than something they’re doing.”

What his addicted patients frequently tell him, Sandor writes, is that “the core experience of being addicted is powerlessness, the experience of having lost control over the use of alcohol or a drug.” As one addiction expert put it, addicts “have lost the freedom to abstain.” Like other forms of rehabilitation, says Sandor, “treatment doesn’t work or not work. The patient works. It seems obvious. If the very nature of addiction is automaticity—the loss of control—then recovery is the restoration of choice, not handing choices over to someone else.”

Not a Tiger Woods post

noreply@blogger.com (Jason Schwartz) — Fri, 26 Feb 2010 11:43:00 +0000

I've always struggled with how to talk about "process addictions" and other compulsive behaviors. More specifiically, how to distinguish them from AOD addiction.

A psychiatrist wrestles with sexual addiction and wonders if obsessive compulsive disorder (OCD) is the best way to conceptualize sexual addiction:

It seems difficult to me to distinguish OCD from so-called sexual addiction; perhaps the main difference would be that the individual is bothered by his behavior in one case (OCD) and not the other (addiction); yet this single minor subjective difference would seem to be a small feature upon which to base an entire diagnostic entity. Indeed, there appear to exist many cases of OCD without insight, that is, OCD in which the patient is not much bothered by his or her symptoms. OCD is not, traditional teaching notwithstanding, uniformly characterized by presence of insight (better phrasing than the old ego-dystonic term, in my view).

One reputable website defines sexual addiction as "a progressive intimacy disorder characterized by compulsive sexual thoughts and acts." DSM's definition, under paraphilias, as sexual disorders NOS includes the following ideas: "compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship." This kind of definition seems quite hard to distinguish from OCD with sexual content.

Who are you calling square?

noreply@blogger.com (Jason Schwartz) — Fri, 26 Feb 2010 10:56:00 +0000

On more thought from the author of the book I referenced last night:

One of the things I’ve become most aware of while working on this book is the degree to which cultural critics inside and outside of the academy write about phenomena that reflect and reinforce their own tastes and worldviews. There’s a lot of writing out there about addiction, because addiction, despite its tragic dimension, retains a sheen of cool. Drug and alcohol use and abuse are dis-inhibiting; they de-stabilize social norms. Without too much effort, we can see them as heroic challenges to the staid routines of our uptight bourgeois lives.

Recovery culture, by contrast, is really square, both as aesthetics and as politics. ... It’s this squareness, I think, that has led critics to overlook the complexity of recovery—its existence as a cultural formation with a genuine intellectual and social history that both reflects and helps to construct the larger economic, political, and psychic realities around it.

Those who are predisposed to disagree will dismiss this (and vice versa), but I think that this speaks directly to the coolness many in recovery feel toward "empirical" knowledge of the issue. I think it also speaks to the appeal of harm reduction for many (not all, by any stretch) practitioners.

terra incognita?

noreply@blogger.com (Jason Schwartz) — Fri, 26 Feb 2010 01:53:00 +0000

A new book offers a wide ranging look at addiction as a cultural phenomena. The description of the tension with academia is interesting:

At another level, however, this book addresses a blind spot that seems particularly to affect academic researchers. Many recovering people have good reasons for not inquiring into the intellectual genealogies of their programs. For good or ill, their interests in recovery philosophy are primarily practical. Later chapters discuss the fact that they may even be urged by those around them not to take an overly analytical or intellectual view of their program lest they derail their quests for sobriety. The same is not true, however, for academics, whose lack of knowledge of and incuriosity about recovery is often so complete as to seem decidedly willful. While the well-educated humanist or qualitative social scientist is expected to have at least a passing familiarity with the standard premises of psychoanalysis, the recovery movement’s most basic history and its structuring ideas are, for all intents and purposes, a terra incognita to most such scholars. Therefore, a second aim of this book is to establish recovery—its history, its organizing principles, and its culture, among other things—as a legitimate subject for sustained scholarly analysis.

There are exceptions to this rule of academic neglect, of course. Existing scholarly research on recovery falls into two general categories, and though neither type of work has sought to answer the cultural questions that I find most compelling, I have drawn heavily on both while writing this book. First and not surprisingly, an abundant body of research has explored the medical/psychological and public health dimensions of 12-Step approaches to alcoholism and other addictions. Since it began to be generated during the late 1940s, the vast bulk of this scholarship has centered on questions of efficacy: does 12-Step recovery, with its focus on abstinence and spirituality, successfully break addictive habits? This practical question would seem well suited to empirical social scientific inquiry, but the ‘‘Anonymous’’ nature of 12-Step culture means that collecting meaningful data on the topic is and always has been difficult. Moreover, much research on this question is fiercely partisan, undertaken by scholars whose stakes in particular treatment protocols (and the private and governmental funds that legitimate them) often seem to predetermine their research outcomes. As a result, the question of whether, how, and to what degree 12-Step approaches to addiction are effective remains largely unresolved.

The Wisdom of Cochrane

noreply@blogger.com (Jason Schwartz) — Tue, 23 Feb 2010 01:35:00 +0000

The group that reached this conclusion:

The available experimental studies did not demonstrate the effectiveness of AA or other 12-step approaches in reducing alcohol use and achieving abstinence compared with other treatments, but there were some limitations with these studies. Furthermore, many different interventions were often compared in the same study and too many hypotheses were tested at the same time to identify factors which determine treatment success.

strikes again:

Psychostimulants did not improve cocaine use, had an unclear beneficial effect over sustained cocaine abstinence and were not associated with higher retention in treatment. Psychostimulants did not increase risk of serious adverse events. It was found that psychostimulants could be efficacious for some groups of patients, such as methadone maintained dual heroin-cocaine addicts. Therefore, psychostimulants, though have not proved yet their efficacy for cocaine dependence, deserve further investigation.

A Review of Alcoholics Anonymous/ Narcotics Anonymous Programs for Teens

noreply@blogger.com (Jason Schwartz) — Mon, 22 Feb 2010 01:28:00 +0000

Recently published:

The investigation of the applicability of Alcoholics Anonymous/Narcotics Anonymous (AA/NA) for teens has only been a subject of empirical research investigation since the early 1990s. In the present review, the author describes teen involvement in AA/NA programming, provides an exhaustive review of the outcomes of 19 studies that used an AA/NA model as part of their formal teen substance abuse treatment programs, and provides data on the effects of AA/NA attendance on abstinence at follow-up, on which youth tend to become involved in AA/NA, and on mediation of the benefits of AA/NA participation. In addition, the author suggests the reasons for somewhat limited participation by teens in more informal, community-based 12-step meetings, and makes suggestions for maximizing participation at meetings in the community. The author concludes that AA/NA participation is a valuable modality of substance abuse treatment for teens and that much can be done to increase teen participation, though more research is needed.

Farm staff that want the entire article can email me.

Inside the "addiction cure"

noreply@blogger.com (Jason Schwartz) — Fri, 19 Feb 2010 11:33:00 +0000

What is there to say?

Putting substance "abuse" to rest

noreply@blogger.com (Jason Schwartz) — Fri, 19 Feb 2010 11:30:00 +0000

Bill White makes the case for ending the use of the word "abuse", as in substance abuse. He make's 5 arguments:

The term abuse applied to substance use disorders is technically inaccurate
The terms alcohol/drug/substance abuse/abuser reflect the misapplication of a morality-based language to depict a medical condition.
The terms abuse/abuser contribute to the social and professional stigma attached to substance use disorders and may inhibit help-seeking.
The terms abuse/abuser inaccurately portray the role of personal volition in substance use disorders.
The use of the abuse diagnosis by the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-IV) perpetuates and legitimizes the continued stigmatization of people with AOD problems.

CUOMO ANNOUNCES CHARGES AGAINST FORMER UB RESEARCHER FOR HIRING ACTORS TO TESTIFY DURING MISCONDUCT HEARING AND ATTEMPTING TO SIPHON $4 MILLION IN TAXPAYER FUNDS

noreply@blogger.com (Jason Schwartz) — Thu, 18 Feb 2010 16:17:00 +0000

Wow. This guy has written extensively on substance use disorders and domestic violence.

In September 2004, William Fals-Stewart, 48, of Eden, was accused of scientific misconduct for allegedly fabricating data in federally funded studies he was undertaking as an employee at the University at Buffalo and Research Institute on Addictions. According to court papers, the allegations were based upon discrepancies between the number of volunteers he reported to the National Institute for Drug Addiction relating to grants for which Fals-Stewart was the Principal Investigator, and the actual number of volunteers who participated in his studies.

According to the felony complaint, during a subsequent formal investigation launched by the University, three witnesses testified by telephone because Fals-Stewart claimed they were out of town. In reality, they were actors who thought they were taking part in a mock-trial. Fals-Stewart paid the actors to testify. He also provided them with scripts to use during the proceedings that were riddled with inaccuracies regarding his research. Fals-Stewart told the three actors, who he had hired before for legitimate training videos, that they would be performing in a mock trial training exercise. They were not aware that they were testifying at a real administrative hearing, nor did they know they were impersonating real people. Because of these false testimonies, Fals-Stewart was exonerated at the administrative hearing.

Claiming that the misconduct allegations tarnished his reputation, Fals-Stewart sued the University, seeking $4 million from the state in damages. The Office of the Attorney General, in its role of defending the University and the state in the court action, conducted a thorough investigation of the claims against the University. It was during this investigation that Cuomo’s office discovered the alleged fraud, forced Fals-Stewart to withdraw his lawsuit and initiated a criminal investigation.

Fals-Stewart was arrested today and charged in Buffalo City Court with Attempted Grand Larceny in the First Degree (class C felony); three counts of Perjury in the First Degree (class D felony); three counts of Identity Theft in the First Degree (class D felony); two counts of Offering a False Instrument for Filing in the First Degree (class E felony); and three counts of Falsifying Business Records in the First Degree (class E felony). The maximum permissible sentence for a class C felony is 15 years in prison.

The sociology of drinking

noreply@blogger.com (Jason Schwartz) — Tue, 16 Feb 2010 00:47:00 +0000

A lot of people have sent this to me. I don't know what to say about it.

I have an attraction/aversion thing with Gladwell. He's a great writer and fascinating, but I can't read him without thinking of this Mencken quote, "For every complex problem there is an answer that is clear, simple, and wrong."

I also tend to think this a situation of the exception proving the rule. Looking to an isolated culture with aberrant drinking patterns for universal truths doesn't seem to make a lot of sense.

It's a Bird, It's a Plane, It's... Methadone Man?

noreply@blogger.com (Jason Schwartz) — Sat, 13 Feb 2010 14:57:00 +0000

Hmmm.

I'm open to harm reduction, but I'm troubled by the culture of many harm reductionists.

Needle exchange raises weighty Catholic moral questions

noreply@blogger.com (Jason Schwartz) — Thu, 11 Feb 2010 00:01:00 +0000

It will be interesting to watch the Catholic church wrestle with the ethics of needle exchange.

Psychotropic prescribing

noreply@blogger.com (Jason Schwartz) — Wed, 10 Feb 2010 23:55:00 +0000

Two stories from recent news:

This NPR story reports that antipsychotics are Medicaid's largest drug expense. That's astonishing.

A friend sent this story on the potential for harm when people without severe depression are prescribed antidepressants:

Half of patients do not respond when they are given the medications, which can be powerful tool in helping the depressed to feel better. Instead of raising levels of a "happiness chemical", called serotonin, in their brain, they lower them.
The researchers found with some brain cells "the more antidepressants try to increase serotonin production, the less serotonin (they) actually produce,” said Dr Rene Hen, from Columbia University in New York and a researcher at the New York State Psychiatric Institute, who led the study.