The Natural History of Recovery – Cannabis
That reminded me of the advice given to newcomers who thought they didn’t need treatment, to “give it your best shot, and if things don’t work out, come back and see us.”
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Twenty-Eight Days
As any case manager knows, making a referral can be a challenge, since many fall by the wayside during transition to another provider, different therapist, etc.
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Focus on Demand
Many new programs are started in the hopeful expectation that they’ll become self-supporting within a few years.
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Pharmaceutical “Cures”
From a patient’s viewpoint, physicians can be somewhat blase’ about risks associated with a medication.
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In the News: Kaos Around Kratom
It may be that kratom is a drug that some can use without much difficulty, while for others, it becomes pathological.
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Methadone Maintenance and Crime
So even if drug use decreases, and clients continue on methadone, they don’t necessarily make the other much-desired (by society) changes — such as giving up crime.
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Medication Assisted Treatment
In terms of a comfortable detox, Suboxone was a success. In terms of a return to opiate use, it was a failure.
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The Last Dose
Reliable stats on relapse can be hard to come by, but return-to-heroin rates appear to run above 80% (and in some cases, higher).
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Reducing Harm vs… Well, Reducing Harm
My longstanding rule is to design your program to treat your population, not some idealized group of subjects who did well in a research setting with a significantly different structure.
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The Monitoring Model
We spend a great deal of time in treatment seeking to increase patient motivation, but these programs do not rely on a motivated patient.
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Opioids and the Assumption of Failure
It also suggests that the ‘return to heroin’ rate among former maintenance clients may be even higher.
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The EBP Conundrum
When a clinician uses an EBP, she’s reassuring herself that it’s likely to be more helpful than if she sat on her hands and did nothing.
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Groups That Work: Climate
When a group has been mired in the hostile or helpless mode, and breaks through into work, you’ll see an almost tangible change in tone.
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