Addiction is among our most significant public health problems, which is why I am so excited that the Obama/Biden Administration has named A. Thomas McLellan to the post of Deputy Director of the Office of National Drug Control Policy. Tom brings tremendous talent and experience as an addiction researcher to the position, and from my experience and… [Continue Reading]
Childhood Trauma – The Gift that Keeps on Giving
Estimates of the co-occurrence of trauma and addiction are quite high, and depending on how trauma is defined, one could argue that most who struggle with addiction have experienced some type of trauma in their life. In my clinical work, most patients had histories of traumatic events that shaped their life in significant ways, even… [Continue Reading]
What Do You Call Addiction? You Call it Addiction
As I mentioned in my previous post on diagnostic categories, the next edition of the Diagnostic Statistics Manual (DSM5) of Mental Disorders will significantly change diagnoses related to alcohol and drugs. No longer will the diagnosis of abuse exist, but instead we will have one category or diagnosis of problematic substance use behavior with varying degrees of severity. At… [Continue Reading]
Abuse Diagnosis in DSM Soon to be Gone
This past week I attended the 71st Annual Scientific Meeting of the College on Problems of Drug Dependence in Reno, Nevada. As usual, many of the world’s leading addiction scientists attended the conference to bat around the latest ideas in the field. One of the most memorable sessions for me was focused on the work… [Continue Reading]
Making Addiction Education Stick
Once a year I am fortunate to have the opportunity to teach a graduate level class at the university on the foundations of addiction treatment. And every year I struggle with how best to organize the class time, materials, and lectures in a way that optimizes students retention and likelihood that they will “act” on what… [Continue Reading]
Leverage Points for Successful Change
When working with those who wish to change addictive behavior I am often struck by how many issues require attention after conducting an evaluation. Not only do most struggle with multiple addictions, but there are often mental health, legal, financial, social, housing, and employment issues to grapple with as well. Combined, these problems can easily seem overwhelming, particularly… [Continue Reading]
Why Treatment Fails Patients
I wrote a paper about this topic some time ago, but thought I would post a more parsimonious version of the top 10 reasons treatment fails patients. The point is not to suggest that treatment is always ineffective, just that we have a long way to go to optimizing it for those who struggle overcoming addictive… [Continue Reading]
Addiction: Not the Package You Want for Christmas
Addiction comes in packages – not the type of packages you want on your birthday or for Christmas, but packages that develop over periods of time and involve excessive behavior with more than one object of addiction. Rarely in my clinical work and research have I experienced patients that struggle with only one addiction, typically… [Continue Reading]
Can Medications Solve the Problem of Addiction?
One of my most memorable patients was a middle-aged man named Mike who came to treatment for his third drinking and driving offense. At the time, I was a young intern just learning how to connect with patients. He sat down in my office and before I could even begin my customary introduction to the… [Continue Reading]
Life is Transitory
This past Friday I took a rare day off from work and visited Our Lady of Guadalupe Trappist Abbey in Lafayette, Oregon. This beautiful monastery was built in 1955 and is nestled among green fields in the heart of the wine country. Having never been to a Trappist monastery before, and having had a number… [Continue Reading]
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