Topic: Medical Model
Posts related to the medical/disease model of addition and recovery.
Despite critics, is AA effective?
In March 2020, Stanford Medicine News Center released a report addressing that question. A Stanford researcher and two collaborators conducted an extensive review of AA studies. The findings were that the AA fellowship helps more people achieve sobriety than therapy does.
World Health Organization calls for end to human rights violations in mental health care
Globally, the majority of mental health care continues to be provided in psychiatric hospitals, and human rights abuses and coercive practices remain all too common. WHO’s new “Guidance on community mental health services: promoting person-centered and rights-based approaches” further affirms that mental health care must be grounded in a human rights-based approach.
A new movement to shift mainstream thinking away from medication and toward greater acceptance
Yet the evidence that the medications improve outcomes is murky. And it is countered by other studies suggesting that maintenance on the drugs may actually worsen outcomes and even cause brain atrophy, though these findings have been debated. The area is devoid of conclusive science, a failure that is a prominent part of a wider problem in biomedical psychiatry: its lack of progress in treating serious conditions, or even precisely diagnosing and comprehending them. “Something has gone wrong in contemporary academic and clinical psychiatry,” a 2019 lead opinion piece in The New England Journal of Medicine stated. “We are facing the stark limitations of biologic treatments,” it argued. “There is no comprehensive biologic understanding of either the causes or the treatments of psychiatric disorders.”
New study debunks “chemical imbalance” in the brain theory
Depression Is Not Caused by Chemical Imbalance in the Brain - KEY POINTS
- We don’t know how antidepressants work
- There is no convincing evidence that depression is caused by serotonin abnormalities.
- Many people take antidepressants believing their depression has a biochemical cause. Research does not support this belief.
- The notion that antidepressants work by elevating serotonin levels is not supported by the evidence.
NIDA-funded Study Concludes More MAT is Needed
As reported at drugfree.org: "Researchers from Columbia University analyzed 2019 national survey data on teens and adults who could benefit from medication for OUD. They found 57% received no treatment and 15% received only services without medication. Just 28% received medication such as methadone, buprenorphine or naltrexone, HealthDay reports. “Our nationally representative research revealed critical gaps in treatment engagement and use of medication for opioid use disorder. Increased efforts to address barriers to care are critically needed,” study lead author Pia Mauro, Ph.D., said in a news release. “Evidence supporting the effectiveness of medication for opioid use disorder such as methadone, buprenorphine, or naltrexone is unequivocal, but most people who needed OUD treatment in the US did not receive this gold standard treatment.”
The Harms of Constructing Addiction as a Chronic, Relapsing Brain Disease
As an international network of historians and social scientists who study approaches to the management of drugs across time and place, we have noticed the effort to redefine addiction as a chronic, relapsing brain disease (CRBD). The CRBD model is promoted as a route to destigmatize addiction and to empower individuals to access treatment that works within that model’s terms.1 CRBD usefully recognizes that brain-based neural adaptations place individual brains in chronic states of readiness to relapse. But brains are housed inside of people. Substance use is biological, social, and political; our concepts and approaches to complex questions surrounding substance use must be, too.2,3 By overlooking the sociopolitical dynamics and inequalities bound up with substance use, the CRBD model can paradoxically further marginalize people who use drugs by positing them as neurobiologically incapable of agency or choice. We are concerned that the CRBD model paints drug users as individuals whose exclusion from social, economic, and political participation is justified by their biological flaws and damaged brains.
Study of buprenorphine diversion cautions against its misuse
Buprenorphine is approved in many countries for the treatment of opioid use disorder (OUD), but problems with diversion and abuse exist. There is a need to understand how and why patients use diverted buprenorphine, and whether barriers to access contribute to illicit use.
58% reported a history of diverted buprenorphine use, with 37% never receiving a prescription. Approximately one-half (52%) reported using buprenorphine to get high or alter mood, but few (4%) indicated that it was their drug of choice.
Scientists Say Your “Mind” Isn’t Confined to Your Brain, or Even Your Body
What is a mind? Defining the concept is a surprisingly slippery task. The mind is the seat of consciousness, the essence of your being. Without a mind, you cannot be considered meaningfully alive. So what exactly, and where precisely, is it? This new understanding has potentially broad implications for the field of addiction and treatment.