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Review of research and news on addiction treatment and recovery with a particular focus on routes out of treatment & the interface between harm reduction and recovery
DJMac
44 posts
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- November 2, 2014
- 12:17 PM
- 706 views
What is recovery?
by DJMac in Recovery Review
A stumbling block to moving forward with recovery in the UK is lack of agreement about what recovery actually is. Highly specific definitions (e.g. recovery = abstinence) can lead to exclusion and fierce disagreement while non-specific definitions are too woolly to measure in services which are being asked to deliver measurable outcomes. Professionals and recovering people Professionals are [...]
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Kaskutas LA, Borkman TJ, Laudet A, Ritter LA, Witbrodt J, Subbaraman MS, Stunz A, & Bond J. (2014) Elements that define recovery: the experiential perspective. Journal of studies on alcohol and drugs, 75(6), 999-1010. PMID: 25343658
- October 13, 2014
- 07:01 PM
- 666 views
What do clinicians make of addiction recovery?
by DJMac in Recovery Review
Which teachers were the best when you were at school? Likely the ones who believed in you, connected with you, who had a vision for where you could go and who enthusiastically helped you get there. The same characteristics are likely to define the best clinicians too. In a study, published a few days ago, [...]
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Pillay, I., Best, D., & Lubman, D. (2014) Exploring Clinician Attitudes to Addiction Recovery in Victoria, Australia. Alcoholism Treatment Quarterly, 32(4), 375-392. DOI: 10.1080/07347324.2014.949126
- October 5, 2014
- 04:30 AM
- 798 views
Pain needs painkillers – right?
by DJMac in Recovery Review
Overprescribing of opioid painkillers has caused harm to many people including addiction, loss of social functioning and, increasingly though still relatively uncommonly in the UK, to death. Concerns have been raised about deaths associated with tramadol. I’ve written before about the lack of evidence of effectiveness for opiates in chronic pain, but it is hard for [...]
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Franklin, G. (2014) Opioids for chronic noncancer pain: A position paper of the American Academy of Neurology. Neurology, 83(14), 1277-1284. DOI: 10.1212/WNL.0000000000000839
- September 22, 2014
- 02:55 PM
- 740 views
Spice, Kryptonite, Black Mamba – legal high marketing
by DJMac in Recovery Review
That the market for ‘legal highs’, or more accurately, new psychoactive substances (NPS) has grown there is no doubt. What’s also growing, in terms of sophistication and technique, is the marketing of these products. With NPS, things are changing so fast that the research is well behind what’s happening in real time. Business is way [...]
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Corazza, O., Valeriani, G., Bersani, F., Corkery, J., Martinotti, G., Bersani, G., & Schifano, F. (2014) “Spice,” “Kryptonite,” “Black Mamba”: An Overview of Brand Names and Marketing Strategies of Novel Psychoactive Substances on the Web. Journal of Psychoactive Drugs, 46(4), 287-294. DOI: 10.1080/02791072.2014.944291
- September 10, 2014
- 11:36 AM
- 680 views
Altruism and AlAnon: in helping we are helped
by DJMac in Recovery Review
“Giving implies to make the other person a giver also.” So said Eric Fromm whose quote starts this research paper which travels to the heart of mutual aid. The clear message? In helping other, we help ourselves. The recovery saying “We only keep what we have by giving it away” hits the mark in this respect. What [...]
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Kuuluvainen, V., & Isotalus, P. (2014) Supporting others – Supporting oneself: Members’ evaluations of supportive communication in Al-Anon mutual-aid groups. Studies in Communication Sciences. DOI: 10.1016/j.scoms.2014.03.009
- August 26, 2014
- 07:01 PM
- 642 views
Narcotics Anonymous for military veterans
by DJMac in Recovery Review
A few years back in a city far, far away, I asked a consultant addiction psychiatrist why he did not refer any of his patients to NA. “There’s not a shred of evidence that it works,” he said. Even then he was misinformed, but I’ve thought many times since then about how his patients were [...]
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Galanter M, Dermatis H, & Sampson C. (2014) Narcotics anonymous: a comparison of military veterans and non-veterans. Journal of addictive diseases. PMID: 25115224
- August 20, 2014
- 07:01 PM
- 543 views
Stigma – a good thing?
by DJMac in Recovery Review
Stigma discredits individuals and groups, reducing social status and creating ‘spoiled identities’, says Goffman. It’s not a good thing. But hang on a minute - might it have a positive function? Could it actually help in terms of public health? Help by changing behaviour through societal pressure. If so, that would be a good thing, [...]
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Williamson L, Thom B, Stimson GV, & Uhl A. (2014) Stigma as a public health tool: implications for health promotion and citizen involvement. The International journal on drug policy, 25(3), 333-5. PMID: 24810060
- August 17, 2014
- 07:01 PM
- 939 views
Young people and 12-step – what’s not to like?
by DJMac in Recovery Review
Recent research suggests AA works as well for young people as it does for older adults, although maybe in different ways. Referring to 12-step mutual aid is embodied in our National Clinical Guidelines, National Drugs Policies and by NICE. Getting people to go is a different story as a leaflet and a recommendation has a [...]
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Labbe, A., Slaymaker, V., & Kelly, J. (2014) Toward Enhancing Twelve-Step Facilitation among young people: A systematic qualitative investigation of Young Adults' 12-step Experiences. Substance Abuse. DOI: 10.1080/08897077.2014.950001
- August 10, 2014
- 07:01 PM
- 711 views
“You’re all going to hate the word ‘recovery’”
by DJMac in Recovery Review
One of the problems with an aspirational and non-prescriptive definition of recovery is that it is hard to measure. The definitions most commonly featured in the literature share some elements including wellbeing or health, abstinence and citizenship. Clearly if you can’t define it precisely, then it’s hard to commission services to deliver on it. In [...]
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Neale, J., Tompkins, C., Wheeler, C., Finch, E., Marsden, J., Mitcheson, L., Rose, D., Wykes, T., & Strang, J. (2014) “You’re all going to hate the word ‘recovery’ by the end of this”: Service users’ views of measuring addiction recovery. Drugs: Education, Prevention, and Policy, 1-9. DOI: 10.3109/09687637.2014.947564
- August 6, 2014
- 02:27 AM
- 764 views
Does AA work for young people?
by DJMac in Recovery Review
Evidence has accumulated over the last couple of decades of the association between attendance at Alcoholics Anonymous and improved drinking outcomes, including abstinence. AA is sometimes seen as an organisation that is better suited to older drinkers seeking sobriety than to folk under thirty, though there are in fact young people’s meetings in various large [...]
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Hoeppner, B., Hoeppner, S., & Kelly, J. (2014) Do young people benefit from AA as much, and in the same ways, as adult aged 30 ? A moderated multiple mediation analysis. Drug and Alcohol Dependence. DOI: 10.1016/j.drugalcdep.2014.07.023
- July 29, 2014
- 07:01 PM
- 1,104 views
Gabapentin and pregabalin misuse
by DJMac in Recovery Review
Gabapentin and pregabalin misuse are problems that are not going to go away. My post on gabapentin is one of the most-read on this site. While these are useful medicines, workers in drug treatment and support see patients regularly on gabapentin or pregabalin who have misused the drugs or who are misusing them. Guidance is [...]
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Schifano, F. (2014) Misuse and Abuse of Pregabalin and Gabapentin: Cause for Concern?. CNS Drugs, 28(6), 491-496. DOI: 10.1007/s40263-014-0164-4
- July 22, 2014
- 07:04 PM
- 577 views
Over the counter drug addiction
by DJMac in Recovery Review
In many countries around the world, codeine is available only on prescription. It’s a weak opioid, but can still cause addiction. Low dose codeine is also available in the UK, over-the-counter (OTC) in pharmacies. It’s sold in combination with paracetamol (co-codamol, e.g. Solpadol), in combination with ibuprofen (e.g. Nurofen Plus), and in combination with dihydrocodeine (co-dydramol, e.g. [...]
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Cooper, R. (2013) 'I can't be an addict. I am.' Over-the-counter medicine abuse: a qualitative study. BMJ Open, 3(6). DOI: 10.1136/bmjopen-2013-002913
- July 12, 2014
- 07:02 PM
- 760 views
Legal highs – not for human consumption
by DJMac in Recovery Review
Legal highs in Lothian The UK has the largest market for new psychoactive substances (NSP or “legal highs”) in Europe. Scotland is no stranger to them and, as a seminar in Edinburgh heard last week, the Lothian area is seeing a surge in demand, some worrying trends in injecting and significant new presentations due to problems [...]
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Baumann, M. (2014) Awash in a sea of ‘bath salts’: implications for biomedical research and public health. Addiction. DOI: 10.1111/add.12601
- July 12, 2014
- 04:31 AM
- 774 views
Gold standard addiction treatment
by DJMac in Recovery Review
Gold standard addiction treatment Addiction to alcohol or other drugs is not easy to recover from. However there are many pathways to recovery, including through treatment. One group of patients does far better than most other groups. In fact their results are so impressive that many commentators have urged us to learn from what’s [...]
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DuPont, R., McLellan, A., White, W., Merlo, L., & Gold, M. (2009) Setting the standard for recovery: Physicians' Health Programs. Journal of Substance Abuse Treatment, 36(2), 159-171. DOI: 10.1016/j.jsat.2008.01.004
- July 3, 2014
- 09:48 AM
- 770 views
Addicted Doctors
by DJMac in Recovery Review
Doctors get addicted to drugs. There’s not much contention about that. Whether they do so at a higher rate than the general population is a matter of debate. The authors of a new discussion paper suggest that they do, although no evidence is produced in this regard. I’m not so convinced on that point. There [...]
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George, S., & Kohli, S. (2014) Addicted Doctors. Addictive Disorders , 13(1), 25-29. DOI: 10.1097/ADT.0b013e31827b4440
- July 1, 2014
- 03:43 PM
- 627 views
What is recovery and how do we measure it?
by DJMac in Recovery Review
What is recovery and how do we measure it? One problem with asking services to deliver recovery outcomes is that we actually do need to measure something to see if taxpayers are getting value for money. In a recently published paper, John F Kelly and Bettina Hoeppner from Harvard, take a look at the problems [...]
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Kelly, J., & Hoeppner, B. (2014) A biaxial formulation of the recovery construct. Addiction Research , 1-5. DOI: 10.3109/16066359.2014.930132
- June 29, 2014
- 11:18 AM
- 704 views
Evidence based medicine – holding things back?
by DJMac in Recovery Review
A drugs worker told me a few years back that he would never refer a patient to a recovery service on the basis that he would not be following the evidence base. I did ask him at the time ‘but what if that’s not what the client wants?’ It seemed the evidence base came first. [...]
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Greenhalgh T, Howick J, Maskrey N, & Evidence Based Medicine Renaissance Group. (2014) Evidence based medicine: a movement in crisis?. BMJ (Clinical research ed.). PMID: 24927763
- June 23, 2014
- 02:59 PM
- 717 views
Methadone side effects – practising harm reduction on the harm reduction
by DJMac in Recovery Review
Methadone, evidenced in harm reduction outcomes, is not without its potential pitfalls. It looks like one of these is osteoporosis, or thinning of the bones. All men on methadone maintenance programmes should be having bone checkups. That was the conclusion of a past paper in the journal Addiction. Why? It looks like taking methadone long [...]
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Grey, A., Rix-Trott, K., Horne, A., Gamble, G., Bolland, M., & Reid, I. (2011) Decreased bone density in men on methadone maintenance therapy. Addiction, 106(2), 349-354. DOI: 10.1111/j.1360-0443.2010.03159.x
- June 22, 2014
- 02:01 PM
- 765 views
Solution to alcoholism? Get sober friends!
by DJMac in Recovery Review
A solution to alcoholism? If you want to live long and healthily, get loads of friends. That was the finding of a massive meta-analysis of around 150 studies involving over a third of a million people. Good social connections predict longevity. Dependent drinking shortens lives. Is the process of finding sober friends helpful as a solution [...]
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Litt, M., Kadden, R., Kabela-Cormier, E., & Petry, N. (2007) Changing network support for drinking: Initial findings from the Network Support Project. Journal of Consulting and Clinical Psychology, 75(4), 542-555. DOI: 10.1037/0022-006X.75.4.542
Litt, M., Kadden, R., Kabela-Cormier, E., & Petry, N. (2009) Changing network support for drinking: Network Support Project 2-year follow-up. Journal of Consulting and Clinical Psychology, 77(2), 229-242. DOI: 10.1037/a0015252
- June 18, 2014
- 02:43 AM
- 750 views
Tramadol Abuse – death toll rising
by DJMac in Recovery Review
Drug treatment used to seem so simple. Clients had a drug of choice, lets say alcohol, heroin or cocaine, and they came to treatment for help for that drug. Now they have a drug of choice AND whatever medication they are being prescribed. Treatment is suddenly so much more complicated. Those drugs are things like pregabalin, [...]
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Winstock, A., Borschmann, R., & Bell, J. (2014) The non-medical use of tramadol in the UK: findings from a large community sample. International Journal of Clinical Practice. DOI: 10.1111/ijcp.12429
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