Recovery-oriented Methadone Maintenance, part 5

Bill cites a methadone advocate making an important distinction–treating dependence vs. treating addiction. The stigma attached to methadone is also shaped by the expectations of methadone treatment as a system of care. Methadone advocate Walter Ginter comments on such expectations: Patients, former patients, staff, policy makers, and the public expect the methadone treatment program to treat addiction. While that … Continue reading Recovery-oriented Methadone Maintenance, part 5

Recovery-oriented Methadone Maintenance, part 4

Bill summarizes criticism of MM as follows: Critics of medication-assisted treatment, many of whom were competing for cultural and economic ownership of the problem of heroin addiction, alleged that MM: 1) substitutes one drug/addiction for another; 2) conveys a societal attitude of permissiveness toward drug use; 3) fails to address the characterological or social roots of heroin addiction; 4) … Continue reading Recovery-oriented Methadone Maintenance, part 4

Recovery-oriented Methadone Maintenance, part 3

Bill White on efforts to broaden the definition of recovery: Consistent with Newman’s and Dole’s views are definitions of recovery that focus on health and functionality without reference to cessation of medical use of methadone. The examples below illustrate such definitions: Recovery is the process of pursuing a fulfilling and contributing life regardless of the difficulties one has faced. … Continue reading Recovery-oriented Methadone Maintenance, part 3

Recovery-oriented Methadone Maintenance, part 2

Here Bill describes the devolution that troubled early advocates of MM: The regulation and mass diffusion of MM in the 1970s and 1980s was accompanied by changes in treatment philosophy and clinical protocols. The most significant of these changes in terms of recovery orientation included a shift in emphasis from personal recovery to reduction of social harm; increased … Continue reading Recovery-oriented Methadone Maintenance, part 2

Comments on SAMHSA recovery housing guidelines

Below are my comments for SAMHSA in response to their request for comments on your proposed recovery housing guidelines. The deadline is 5pm today. Send your comments, whatever they are. To whom it may concern: I am writing in response to your request for comments on your proposed recovery housing guidelines. I commend your efforts … Continue reading Comments on SAMHSA recovery housing guidelines

Drug-free recovery as fantasy?

There is MUCH less tension these days between harm reduction (HR) advocates and treatment providers. HR advocates confronted treatment providers with legitimate questions about their thresholds for accessing and staying in care. More recently, the opioid overdose crisis pretty dramatically changed the calculus. As a result, most treatment providers are using harm reduction approaches and … Continue reading Drug-free recovery as fantasy?