The typical coverage of addiction treatment and recovery tends to obscure the fact that many people recover from addiction. While the pain and anguish experienced by the families and friends of those who do not recover is undeniable, it is likewise undeniable that many do recover. To the casual observer, who only follows popular depictions, this might not be apparent.
The national government website designed to help people find addiction treatment contains inaccurate and outdated information, addiction experts tell Kaiser Health News. The site, Findtreatment.gov, has information about more than 13,000 state-licensed treatment facilities, including what types of services are provided, which insurance plans the facilities accept and what ages they serve.
Global consulting leader McKinsey & Company drew unwanted attention in 2020 when a bankruptcy proceeding revealed that it guided the marketing strategy for disgraced opioid seller Purdue Pharma. Now McKinsey is under scrutiny from Congress after revelations that at least 22 employees who were consulting for Purdue and other opioid producers were also doing work for government agencies tasked with regulating opioid use.
WASHINGTON — It got a lot easier for patients with opioid addiction to get their medication remotely during the pandemic — and now addiction doctors and telehealth companies are pushing Congress to make those flexibilities permanent. Before Covid-19, patients had to see a doctor in person for prescriptions to help them with their addictions, like buprenorphine. Now, at least temporarily, they can get them via telehealth appointments. Experts say loosening the rules helped eliminate longstanding barriers to addiction care, like a lack of transportation or a shortage of clinicians who prescribe medically assisted treatment, especially in rural communities. But the changes are temporary, tied to the state of “emergency” associated with the pandemic — and proponents want them made permanent.
The study is titled: Natural recovery from alcohol and drug problems: methodological review of the research with suggestions for future directions and published in PubMed.gov. Aims: The methodology of studies that reported data on individuals who recovered from an alcohol or other drug problem (cigarette smokers were excluded) without formal help or treatment were reviewed. Conclusions: Based on this review, future natural recovery studies should: (a) report respondents' demographic characteristics at the time of their recovery; (b) describe respondents' pre-recovery problem severity; (c) explore in some depth what factors, events or processes are associated with the self-change process; (d) provide corroboration of respondents' self-reports; (e) examine factors related to the maintenance of recoveries; (f) conduct interviews with individuals who have naturally recovered from cocaine, marijuana and polydrug abuse; (g) include a second interview at a later time to examine stability of natural recoveries; and (h) require a minimum 5-year recovery time frame.
Now officials at the Substance Abuse and Mental Health Services Administration are considering permanent changes to federal methadone rules. A National Academy of Medicine workshop on methadone regulations on March 3 and 4 may signal an inflection point.
Any changes to federal rules, however, could face significant resistance from methadone clinics — many of them for-profit — whose financial models are built on daily patient encounters, counseling, and regular drug tests. “There are some entities who have a financial interest in keeping things the way that they are,” Ryan said. “Change costs money.”
Our treatments for this polydrug epidemic fall into 2 distinctive categories. One started at the Hazelden Foundation in Center City, Minnesota in the late 1950s, with a 28-day residential program followed by patients going to Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) and other recovery support for years, often for their lifetimes. This approach is common in private, often insurance-funded, addiction treatment programs.
The other approach is medication-assisted treatment (MAT) which started with methadone in the late 1960s. MAT now includes buprenorphine and naltrexone. MAT is the major strategy for most public sector addiction treatment programs.
Those two approaches often battle one another in this war between treatment modalities. That war is destructive and unnecessary. It diminishes both approaches. The big losers are our patients and the public health.
This article was authored by Dr. Stanton Peele, a psychologist who has pioneered, among other things, the idea that addiction occurs with a range of experiences and a recognition of natural recovery from addiction. The article highlights several stories of real people who have recovered from drug addiction without any specific interventions. He makes the point that we rarely seem to hear these kinds of stories in the major media, certainly at the level of public debate. Peele mentions the study of Vietnam veterans experience with heroin addiction where over 90 percent of veterans who reported being addicted to heroin in Vietnam ceased their addiction within a short period on their return, almost always without treatment. The Vietnam experience demonstrates that some people can move past addiction when their surroundings improve, that they are no more likely to use one drug compulsively than any other, and that having fewer positive life options obstructs natural recovery.
The authors of the article are Hal Arkowitz and Sscott O. Lilienfeld serve on the board of advisers for Scientific American Mind. Arkowitz is a psychology professor at the University of Arizona and Lilienfeld is a psychology professor at Emory University. The authors conclude that more and better research is needed on the potential for self-change to conquer problem drinking and other addictions. Studies suffer from differences in the definitions of important terms such as “addiction,” “treatment” and “recovery.” We also do not know of any studies on self-change with prescription drug addiction.
Per the article, the most common approach to recovery is natural recovery. Citing a report from the National Institute on Alcohol Abuse and Alcoholism, the article defines natural recovery as recovery that occurs without treatment or support groups (NIAAA, 2012). When people recognize the cost of their addiction exceeds the benefits and correct this, they become the "heroes" of addiction recovery. The articles notes that we don't hear about these folks too often. Specifically, it proposes that there four key ingredients in any successful recovery process. These are 1) humility, 2) motivation, 3) sustained effort and 4) the restoration of meaning and purpose. These are discussed in detail in the article.
