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(……)

In 2005, my colleagues Christy Scott, Michael Dennis, Michael Boyle and I co-authored an article entitled It’s Time to Stop Kicking People out of Addiction Treatment.  The latest (2002) data then available confirmed that 18% (288,000) of all persons admitted to specialized addiction treatment in the U.S. were administratively discharged (“kicked out”) prior to treatment(……)

The acute care (AC) model of intervention that, with few exceptions, has dominated the modern treatment of addiction involves a brief–and seemingly ever-briefer–period of professional intervention followed by cessation of the service relationship.  As addiction professionals working within this model, we are trained to screen, assess, admit, treat and discharge each person we serve.   And(……)

For years, the following quote has rested over my writing desk:  “The Phoenix does not mourn what lies in its ashes; the serpent does not mourn its old skin.”–Arthur Frank Addiction recovery involves a progressive unpeeling of the self and focused efforts of self-construction.  It is helpful in thinking of this to distinguish between remission(……)

The American Society of Addiction Medicine (ASAM) recently released Standards of Care:  For the Addiction Specialist Physician.  The Standards outline the responsibilities of addiction medicine specialists in the areas of assessment and diagnosis, withdrawal management, treatment planning, treatment management, care transitions and care coordination, and continuing care management.  There is one sentence in the Standards(……)

Interventions into severe alcohol and other (AOD) problems have focused primarily upon altering the character, thoughts, feelings, and behaviors of individuals.  Far less attention has been given to influencing the environment in which such factors are birthed, sustained or changed.  But interest in the geography of recovery is increasing.  Researchers are beginning to suggest that(……)

The major media outlets have long been chastised for the content and style of their coverage of alcohol- and drug-related problems.  Such criticisms include the glamorization of drug use, the demonization of drug users, and charges that the media is complicit in ineffective drug policies.  Few have raised parallel concerns that popular media coverage of(……)

Words are important. If you want to care for something, you call it a “flower”; if you want to kill something, you call it a “weed.” –Don Coyhis Whether alcohol- and other drug (AOD)-related problems are viewed through the lens of medicine (illnesses), psychology (habits), sociology (norms), morality (vices), religion (sins), or law (crimes) rests(……)

“There is nothing about a caterpillar which would suggest that it will become a butterfly” – Buckminster Fuller Recovery from a life-threatening condition can bring far more than the removal of pain and sickness from an otherwise unchanged life.  Confronting one’s mortality through the experiences of illness and recovery can bring unexpected gifts.  Surviving heart(……)

Philip Seymour Hoffman died February 2, 2014 of an apparent heroin overdose.  On that day, like every day in the United States, between 75-100 less known individuals also died of a drug overdose.  One of the factors distinguishing Philip Seymour Hoffman’s death, other than his fame, was that the recurrence of his addiction and its(……)