A 1976 national survey of addiction treatment programs in the United States revealed a workforce of nearly 60,000 workers.  The treatment workforce at that time consisted of 31,000 full-time workers and 15,000 part-time paid workers.  The paid professional workforce included 20,000 counselors, 5,000 nurses, 3,000 social workers, 2,500 psychologists, and a small and slowly growing(……)

Through my early tenure in the addictions field, the question of readiness for treatment and recovery was thought to be a pain quotient.  We then believed that people didn’t enter recovery until they had “hit bottom.”  If a person did not show evidence of such pain-induced readiness, they were often refused admission to treatment.  Then(……)

Much of what is known about the modern evolution of addiction treatment and recovery exists as oral history.  The ephemeral nature of that knowledge became clear to me while researching my book on the history of addiction treatment and recovery in the U.S.  There were several cases in which a key informant died in the(……)

A new book, Experiencing Spirituality, co-authored by Ernest Kurtz and Katherine Ketcham, has just been released.  It will find a broad and appreciative audience and will be of particular interest to addiction professionals, recovery support specialists, and people in recovery.  It is not a treatise on how to recover, but it offers profound insights about(……)

In 1935–the founding year of Alcoholics Anonymous, Portuguese neurologist Egas Moniz introduced a surgical procedure into psychiatry that came to be known as the prefrontal lobotomy (recall One Flew Over the Cuckoo’s Nest).   Drs. Walter Freeman and James Watts pioneered the use of this technique in the United States in 1936.  By 1960, 100,000 psychosurgery(……)

Attacking Alcoholics Anonymous (A.A.) and 12-step oriented addiction treatment has become a specialized industry with its own genre of literature, celebrity authors and speakers, single-focus websites, and promoted alternatives.  Collectively, these critics suggest that A.A. is an anachronism whose effectiveness has been exaggerated and whose time in the sun has passed.  A.A.’s institutional response to(……)

In 2004, I penned an essay that opened with the following sentences:  “Something is reawakening inside America. People whose stigmatized condition left them hiding alone or cloistered in subterranean subcultures are stepping into the light to tell the stories of their wounds and their redemption. They are offering their time, talents, and testimonies to address(……)

My 2009 monograph outlined in considerable detail the history, theory and status of peer recovery support services (PRSS) in the United States.  In the years since the monograph’s publication, voluntary and paid recovery support services have dramatically increased in the US and internationally.  Such growth has recently prompted me to reflect on the pre-professional days(……)

Parents who have lost children to addiction are speaking publicly in unprecedented numbers.  Their stories provide a biting critique of addiction treatment as a system of care–and suggestions that addiction treatment has yet to operate as a “system of care”.  They also provide painful accounts of how fiscal gatekeepers operate to restrict access to care(……)