Addiction Recovery Bulletin

The vast majority of these deaths, about 70 percent, were among men between the ages of 25 and 54. And while the opioid crisis has been characterized as one primarily impacting white Americans, a growing number of Black Americans have been affected as well.

There were regional variations in the death counts, with the largest year-over-year increases — exceeding 50 percent — in California, Tennessee, Louisiana, Mississippi, West Virginia and Kentucky. Vermont’s toll was small, but increased by 85 percent during the reporting period.

Increases of about 40 percent or greater were seen in Washington State, Oregon, Nevada, Colorado, Minnesota, Alaska, Nebraska, Virginia and the Carolinas. Deaths actually dropped in New Hampshire, New Jersey and South Dakota.

“If we had talked a year ago, I would have told you, ‘Deaths are skyrocketing.’ But I would not have guessed it would get to this,” said Dr. Andrew Kolodny, medical director of the Opioid Policy Research Collaborative at Brandeis University’s Heller School for Social Policy and Management.

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Addiction Recovery Bulletin

Ashley was at Joshi’s office for a telehealth therapy appointment with her psychologist when Drug Enforcement Agency (DEA) agents arrived with a search warrant.

At the time, Joshi was unaware that an undercover DEA agent had posed as a patient at his office to build a drug trafficking case against him. Agents took Joshi to a local police station for hours of questioning, where Joshi surrendered his DEA registration that allowed him to prescribe controlled substances — including buprenorphine. When he returned from the police station, Joshi said Ashley was deeply traumatized. Ashley told Joshi that she protested the interruption of her therapy appointment, so a DEA agent pulled out a gun and ordered her onto the ground.

In grand jury testimony, former employees-turned-witnesses described the young primary care physician’s practice as sloppy and his patients as “addicts,” a deeply harmful and stigmatizing term for patients in recovery. Joshi was accused of operating a “pill mill” in the local media, a claim Joshi says was manufactured by the DEA. Ashley and other patients were blacklisted by other local doctors, and without a buprenorphine prescription, Ashley relapsed and suffered fatal overdose. Stephanie, another patient who had stabilized and quit using heroin under Joshi’s care, also lost her prescription to buprenorphine. She soon died of an overdose after returning to heroin.

The post The War on Drugs Comes to the Doctor’s Office appeared first on TruthOut.org.

Addiction Recovery Bulletin

Purdue had allegedly paid doctors to write more opioid prescriptions, according to the three federal criminal charges the company pleaded guilty to in November. Purdue was to pay more than $8 billion and agreed to close down the company.

The company didn’t have $8 billion in cash, so Purdue agreed to dissolve itself and use its assets to create a new “public benefit company” controlled by a trust or similar entity designed for the benefit of the American public. The plan was swiftly criticized by dozens of state attorneys general.

Members of the Sackler family have made a fortune off of the sales of Oxycontin. In October, they paid $225 million in damages, but did not take responsibility for the opioid crisis.

Family members have already paid $225 million under an initial settlement framework to satisfy their civil settlement with the US Department of Justice, and persons associated with the Sackler entities have agreed to be “prohibited from engaging in the manufacturing or sale of opioids, subject to exceptions to be agreed,” court documents state.

The post OXY Maker Agrees to Pay BILLION$ appeared first on CNN.com.

Addiction Recovery Bulletin

Delaware, Tennessee, Louisiana and Maryland followed next, rounding out the top five states that the epidemic has hit. Kansas, meanwhile, was the least affected, and while more than 1,800 out of 100,000 residents were diagnosed with illicit substance use disorder, drug-related arrests were down to about 76 while overdose deaths were just under 14.

“The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard,” said then-CDC Director Robert Redfield in a release from December. “As we continue the fight to end this pandemic, it’s important to not lose sight of different groups being affected in other ways. We need to take care of people suffering from unintended consequences.”

Data on the epidemic’s reach and toll is limited, but 37 of the 38 U.S. jurisdictions with available synthetic opioid data reported increases in synthetic opioid-involved overdose deaths, the CDC reported, and 18 of those saw deaths increase by more than half. Ten states reported more than a 98-percent increase in synthetic opioid-involved deaths.

The post What state has the biggest drug problem? appeared first on TheHill.com.

Addiction Recovery Bulletin

SO IS SLOWLY – 

March 8, 2021 – It wasn’t too long after that last bout of drinking before the cracks in my dependencies started to show themselves. A friend is playing a show at a bar downtown and your friend group will be there, but also you know it’s a room full of strangers. What are you going to be holding in your hand that will help keep all your anxieties in check? You’ve been invited to speak on a panel about mental health in creative industries and the conversation gets difficult. How are you going to calm your nerves and your heart after an hour of hard questions you don’t have an answer to? These were the types of questions I would ask myself, stray thoughts rattling around my brain desperate for a solution. Drinking, for me, was part of a comprehensive anxiety management system—a toolkit I kept in my closet full of broken tools and the end of a roll of tape, but one I kept telling myself was sufficient to suit my needs. This is all I’ll ever need, I’d tell myself, just me and this rusty hammer with a broken handle against the world.

The post Sobriety is a Verb appeared first on This.org.

Addiction Recovery Bulletin

Opioid addiction has deep, troubling roots in American history. Not merely a plague of recent decades, the phenomenon of widespread opioid addiction dates back to the 19th century, when the Civil War sparked the United States’ first opiate addiction epidemic among ailing veterans. Nineteenth-century opiate addiction cases usually originated in doctors’ prescriptions, a disturbing parallel with today’s ongoing opioid crisis, which has roots in opioid overprescribing during the 1990s. The alarming parallels between the 19th- and 21st-century opioid crises in the United States are not limited to iatrogenesis, however.

Both crises exhibit a history of troubling racial inequalities in access to opioids as well. Addiction was far more common among white Civil War veterans than Black veterans, who lacked equitable access to opiates, a pattern that presaged the opioid underprescribing experienced by Black Americans in recent decades.1 Thus, the history of the Civil War-era opiate addiction epidemic not only reveals the deep historical origins of iatrogenic opioid addiction in the United States, but also underscores how Black Americans have experienced longstanding racial inequalities in access to opioid medicines.

Historical Opioid Use Patterns in the Civil War Era

During the antebellum decades, addiction to rudimentary opiates such as laudanum and opium in gum, pill, and powdered forms was common among white Americans. Discussion of opiate addiction, often dubbed the “opium habit” or “slavery” to opiates, frequently appeared in medical journals, monographs, textbooks, and even newspapers beginning in the 1830s. Psychiatrists, physicians, and other Americans widely attributed opiate addiction to the sufferers’ mental illness, constitutional weakness, or moral failings. Consequently, Americans afflicted by the so-called opium habit were frequently victim-blamed, stigmatized, and even institutionalized.1

In reality, Americans addicted to opiates could usually trace their troubles to medical care. Most opiate addiction in the 19th-century was iatrogenic, stemming from physicians’ prescriptions or medical advice.2 Opiates were standard remedies for hundreds of ailments, including dysentery, cholera, malaria, pneumonia, menstrual pain, painful injuries and wounds, and more. Surveying 30 antebellum American medical textbooks, materia medica commentaries and formularies, medical handbooks, medical dictionaries, and home health guides published between 1813 and 1858, I identified approximately 150 distinct ailments for which opiates were indicated. The figure fluctuates slightly depending on how one classifies certain illnesses, as many nineteenth-century medical diagnoses do not map precisely on to modern diagnoses.1 Contemporary hospital3 and pharmacy records4 indicate that opiates were among the most commonly prescribed medicines of the 19th century. In a pre-germ theory era when typical medical interventions failed to effectively address the microorganisms at the root of many sicknesses, doctors and patients prized opiates as utilitarian remedies that effectively mitigated a legion of symptoms, regardless of cause. Indeed, as one enthusiastic medical student at the University of South Carolina explained, opium was “the ‘Magnum Dei Donum’”—or, the great gift of God—“of the Materia Medica.”5

In the aftermath of the Civil War (1861-1865), the phenomenon of opiate addiction reached epidemic levels for the first time in American history, developing into a major public health crisis with alarming social implications. This epidemic, the earliest opioid crisis in U.S. history, was driven initially by sick and injured Civil War veterans, who became the first distinct cohort in the nation to be widely associated with opiate addiction. The Civil War presented the greatest health disaster of the 19th century, prompting surgeons to rely more heavily than ever on opiates, including newly available hypodermic morphine injections.6 A Confederate medical handbook summed up the medical consensus of the day when it described opium as the most “indispensable drug on the battlefield—important to the surgeon, as gunpowder to the ordinance.”7

Accordingly, military surgeons North and South prescribed opium pills and morphine injections liberally to ease pain stemming from gunshot wounds, amputations, and traumatic nerve injuries. Surgeons also doled out opium and laudanum to treat dysentery and diarrheal sicknesses, the most common health complaints of the war. Many soldiers, taking their cue from army surgeons, continued purchasing and consuming opiates after leaving the military, there being few legal restrictions on narcotics until the early 20th century. The Civil War thus sparked an unprecedented surge in iatrogenic opiate addiction, resulting in tens of thousands of cases of chronic addiction among veterans. Predictably, overdose deaths were frequent among veterans, and the medical literature of the period is littered with cases of men whose lives were upended by addiction.8

Black Civil War Soldiers and Opiate Addiction

Racial disparities were evident among Civil War veterans addicted to opiates, the majority of whom were disproportionately white. Although Black soldiers comprised approximately 10% of the U.S. army during the Civil War, they were not equally represented among the cohort of veterans who were addicted. In a sample of approximately 150 Civil War veterans who experienced opiate addiction in their postwar lives—the largest sample of any study to date, compiled from spotty, extant Civil War-era medical records—I could identify only 1 Black Civil War veteran who suffered from an opium habit.1

Contemporary physicians and psychiatrists likewise noted a distinct racial gap in opiate addiction. In 1885, a physician reported that the Eastern North Carolina Insane Asylum had admitted an exceedingly rare case of “colored insane man” of whom “it was alleged that his insanity was caused from the opium habit.” The man’s case was worthy of note because “this was the only case of opium habit he [the doctor] had ever seen in the negro.”9 The next year, a white Alabama physician also observed that “the opium habit is rare” among the Black population after the Civil War.10This racial gap persisted for decades.

Surveying the records of morphine maintenance clinics that dotted the United States from 1910s to 1920, historian David Courtwright observes that while the southern white population experienced the highest rate of opiate addiction in the nation, few Black southerners appeared in the clinics’ records, although the facilities were ostensibly open to Black patients.11 This enduring racial gap in the opiate addiction rate stemmed largely from racist 19th-century medical beliefs about Black bodies, coupled with substandard medical care provided to Black Civil War troops. Nineteenth-century psychiatry posited that, among other causes, opiate addiction stemmed from mental overstimulation, which led to insanity and substance abuse. Such overstimulation could only occur among intelligent, sensitive white Americans, according to Civil War-era psychiatrists. In contrast, white medical authorities claimed that Black Americans were too “simple-minded” to experience mental overstimulation, precluding them from insanity and opiate addiction.10

According to J.D. Roberts, a North Carolina doctor, Black bodies lacked “the same delicate nervous organization” as whites, and thus “d[id] not demand the form of stimulant conveyed in opium” as did whites. Black people, Roberts claimed, also had a “general ignorance” of medical care, an assertion implying that Black Americans lacked the knowledge to care for their health needs by self-medicating with opiates, as whites often did.9 This constellation of racist beliefs was developed by antebellum white southerners to justify keeping Black people enslaved and to ward off abolitionist critiques.12 After the Civil War, apologists of Jim Crow fine-tuned these beliefs and used them to explain why white Civil War veterans had opiate addiction more often than Black veterans.

In reality, the relative infrequency of opiate addiction among Black Civil War veterans and other African Americans during the late 19th century stemmed from structural racism in medicine and health care. Undertreatment for pain and subpar medical care in the military left Black veterans far less likely to become addicted to opiates than their white counterparts. Just as white doctors believed that Black Americans were less liable to mental overstimulation than whites, so too did these physicians believe that Black bodies were less sensitive to pain.13 Consequently, Black Americans were much less likely to be prescribed opiate painkillers during the Civil War.

Prescription records from the war are exceptionally rare, and none are extant for Black regiments. But anecdotal evidence suggests that army surgeons, who were overwhelmingly white, often refrained from prescribing opiates to wounded Black soldiers because they believed that Black men were not troubled by pain. One white surgeon assigned to a Black regiment refused to give painkillers to a soldier whose foot was partly severed by shrapnel. Under such circumstances the standard of care for white soldiers was morphine, given early and often. But when confronted, the surgeon claimed that the wounded man in question “was not suffering much pain,” despite the gruesome nature of the wound.14 The surgeon in this episode—and likely countless similar, unrecorded incidents—seems to have been motivated by the mainstream contemporary medical belief that Black men were impervious to painful injuries that would have debilitated white soldiers and warranted opiates.

Doctors also seem to have avoided giving opiates to Black soldiers debilitated by diarrhea, although surgeons usually administered opiates to white soldiers afflicted by the same illnesses. Surgeons knew that well-timed, liberal administration of opiates could, and often did, stave off soldiers’ deaths by dehydration, the risk of poisoning or addiction notwithstanding. Consequently, the mortality rate for diarrheal sicknesses among white troops—for whom surgeons prescribed opiates liberally—was a relatively low 17.3%. In contrast, the mortality among Black troops was 33.9%, nearly double that of white soldiers.15 This excessive mortality suggests that Black soldiers did not have access to prescription opiates, the standard of care for diarrheal ailments.

Black soldiers’ lack of access to opiate analgesics and antidiarrheals was typical, not exceptional, when considered within the broader scheme of Civil War medicine. Indeed, scholars have documented pervasive racism in Civil War military and humanitarian medicine, which diminished the quality of medical care accessible by Black Americans and resulted in thousands of avoidable Black deaths during the Civil War and its aftermath.16

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The post Race and Opioids: Lessons From the Civil War-Era Opioid Addiction Crisis appeared first on Psychiatrictimes.co.

Addiction Recovery Bulletin

Back in 2018, Millie Gooch launched Sober Girl Society as a way to stay connected to likeminded individuals giving up booze for good. What started as a small but dedicated safe space has expanded to become a tool for more than 100,000 women looking to stay sober, share #QuitLit, and navigate fomo. Right now, on top of growing her Instagram empire and working with alcohol-alternative brands such as Nexba, Gooch is also enjoying the thrill of being a first-time author with her book The Sober Girl Society Handbook.

Gooch’s debut book acts as a manual for sober and sober-curious females looking to improve their lives. The facts and figures she presents are astounding (for example, did you know the Scotch whisky industry produced 1.6 billion litres of waste liquids per year?), but it’s her personal account – along with those from other members of the tee-total sisterhood – that delve deepest into the reasons for giving up alcohol.

My own journey with sobriety really began to take shape in 2018 when I finally walked into an Alcoholic Anonymous meeting. Both Millie and I agree that what keeps us away from alcohol is human connection: surrounding ourselves with sober sisters, listening to their experiences, and learning from their strength and hope. We both found our tribes, me through AA and Millie through the Sober Girl Society.

As someone who spent hours crossing out the word “God” in AA’s Big Book and adding an “S” in front of every “He,” I considered myself a true 21st century addict. However, I still put my sobriety in the hands of older generations and traditions. Gooch, on the other hand, like a true millennial, went out and did it herself – she created a pretty-in-pink iteration of sobriety that’s easily digestible for Gen Z.

On Sober Girl Society, Gooch has also consciously removed words such as “addict” and “alcoholic” in an effort to create a space that’s free from the stigma associated with them. This is one point where Gooch and I differ: I identify as an addict/alcoholic, while she utilises the label “sober” to explain her situation. When we jump on a Zoom call, I start by asking about this.

Mariella Agapiou: Let’s talk about labels. You opt for the word ‘sober’ instead of ‘alcoholic.’ Can you tell me about that decision?

Millie Gooch: “I do feel there is a lot of stigma around it and I did worry that if I said, ‘I’m an alcoholic’, there would be negative reactions. All I really wanted to say was ‘I’m a non-drinker now.’ I only adopted the label sober because it gave more weight to it.”

The stigma came from preconceived ideas from the media – a male over 40 on a park bench, and that’s what I thought an alcoholic looked like. That wasn’t me because I’m a binge drinker and I’m a party girl, and I just don’t know when to stop. I’m not against labels, and I have friends who label themselves as alcoholics, I just think everyone needs to do what’s right for them.”

MA: With so many of us stuck at home right now, any form of dependency or mental health problem is really heightened, whether that’s disordered eating, anxiety, or drinking. For example, we know sales of alcohol have risen by a third during the pandemic. Tell me about the thought process that led you to stop drinking in the first place.

MG: “I tried everything: I tried only drinking spirits, not drinking wine. Moderation is really hard because of the way alcohol affects your prefrontal cortex – which is the rational decision part of your brain. Even if you say, ‘I’m only going to have three,’ once you have those three, your willpower and resolve is not the same as it was before you had them.

At the end of my drinking, I was having bad blackouts. I was in a shame cycle of doing stupid things, feeling really awful, beating myself up, and drinking to forget. It was taking a bad toll on my mental health. So, I woke up after one particularly bad night, didn’t remember anything, and thought, ‘I don’t want to do this anymore. I can’t.’

The first thing I did was read The Unexpected Joy of Getting Sober by Catherine Gray. However, when I got to about six months sober, I started to feel that pull back to alcohol and set up the Sober Girl Society because at the time, I didn’t know a single other person like me – especially one my age – who was a non-drinker.

MA: You quote Peter Klein in your book, saying he summed up one of the fundamental things you’ve learned through your journey with his line “good mental health comes from facing and getting through testing times without a drink to take the edge off.” For me, getting sober meant anxiety attacks, but once I had ridden the wave, the clarity I felt was undeniable. What would you like people to truly understand about the relationship between drinking and anxiety?

MG: “Alcohol does affect you chemically to increase anxiety, it slows down your glutamate and then gives you a spike in everything the next day, making you more anxious. So, when I stopped drinking, there was almost an immediate relief of anxiety because I wasn’t putting myself in those dangerous situations.

I basically went through a mental breakdown when I was seven months sober because all of a sudden, I had all these feelings, all this overwhelm, and my body didn’t know how to manage because I had never processed my feelings without getting sh*tfaced. So, I went to therapy, and I had to work through a lot.”

MA: Talk to me about spiritual wellness. In AA, we’re told to meditate daily. Do you take time to check in with yourself?

MG: “I’m not completely transformed spiritually, but I’m so much more open to things now. Whereas when I was drinking, I would have been totally sceptical of things and I feel I’ve become much more attune and present. I feel like I wasn’t really an active participant in my own life, I was either hungover, or drunk, or in a spiral of my own thoughts, and I’m so much more open now.”

MA: You reference ladette culture and Sex and The City as reasons you began drinking excessively at university. Thankfully, cultural references to excessive drinking are becoming fewer and fewer and we have a sober movement on our hands. Why do you think the Gen Z are so focused on health and so many are labelling themselves as tee-total at such a young age?

MG: “I think it’s a mixture of things. They’re becoming more conscious of everything, and there is so much more information available to them in regard to their health and their mental health. But I do think social media has played a big part – it’s given us a view into the world and what we can achieve. And what’s more; there are so many more sober role models, celebrity-wise, influencer-wise, who are coming out and saying I don’t drink.”

The post The Handbook To Gen Z Sobriety appeared first on Bustle.com.

Earlier this week, Jamie Lee Curtis celebrated 22 years sober. In a post to her Instagram account, the actress wrote that “A LONG time ago… In a galaxy far, far away… I was a young STAR at WAR with herself.”

However, she continued, “With God’s grace and the support of MANY people who could relate to all the ‘feelings’ and a couple of sober angels…I’ve been able to stay sober, one day at a time, for 22 years.”

Curtis has been open about her addiction for many years. Her drug of choice was Vicodin, but I think that most addicts of any stripe will relate to her story. As a recovering alcoholic, I certainly did.

High-Functioning Addicts

Even at the height of her painkiller abuse, Curtis never fit the stereotypical image of an addict. She hadn’t lost her job, her marriage wasn’t falling apart, and she wasn’t struggling with money.

In a 2019 interview with Variety magazine, Curtis explained that her life was in fact just the opposite: “I was in a good stable marriage, writing books for children that were bestsellers. I was getting more and more work and more and more fame and attention and adulation.”

Curtis summed it up by saying that she “got more as [her] addiction got worse, not less.” Her experience is exactly the opposite of what most people would expect.

Although this not what the average person would imagine addiction to look like, I can actually relate to it far more than the traditional image. I certainly wasn’t a world-famous actor, but my life did seem to go extraordinarily well for someone with a daily drinking habit.

As my habit reached its peak, I was attending a top law school — and excelling there. I wondered how I could possibly be a real addict while experiencing so much outward success.

It can be almost impossible to take addiction seriously when you appear successful. As Curtis says, it makes “that denial much more pervasive.” It’s not just that we’re hiding our addictions from other people, we’re actually hiding them from ourselves.

For years, I went back and forth between desperately wanting to get sober and telling myself that I didn’t have any problem at all. Sometimes I’d flip between these two extremes several times in one night.

The danger is that an addiction is still real — and incredibly harmful — even if the effects are primarily internal. Curtis described herself as being trapped “in a prison of [her] own mind.”

I always appreciate when it high-profile celebrities like Curtis speak up about their addictions, because it helps demonstrate that addiction can take many shapes. The fact that certain aspects of an addict’s life are going well doesn’t mean that their addiction is any less real or dangerous.

The “Shameful Secret”

The other major benefit of celebrities speaking out about their addictions is that it helps break down the stigma surrounding the issue. For far too many years, addiction has been viewed as a moral failing — something to hide even after we’re in recovery.

In refreshing contrast, Curtis believes that “to call yourself an alcoholic or a drug addict is a badge of honor, because the secret — the shameful secret — is the reason that it is such a pervasive illness.”

Each time that a recovering addict opens up about their experiences, they do a little bit to eliminate the stigma and encourage others to seek help. When a celebrity like Curtis takes pride in her sobriety, she is showing others that they do not need to be ashamed.

It might be hard for a non-addict to understand just how strong the shame surrounding addiction can be, but I’m sure that every addict knows it well.

I’ve grown up in an age when the stigma is already disappearing, yet I was still deeply ashamed of my drinking for years. My embarrassment stood in the way of quitting alcohol and hindered my early attempts at sobriety.

Even though I rationally understood that alcoholism is not a moral issue, a part of me couldn’t help feeling like it was. It took over a year of sobriety before I let go of all the shame and guilt surrounding my drinking.

By candidly discussing her sobriety in front of a global audience, Curtis has done a lot to help reduce this shame for future generations of addicts. As the stigma continues to disappear, I hope we’ll see far more recovering addicts following her example.

Article first appeared at Medium.com here

Narcotic-addiction treatment, delivered digitally, is on the rise

The opioid epidemic is ravishing corners of the United States, with an average of 130 Americans dying every day due to overdoses. In San Francisco, an estimated 24,500 injection drug users live in the city.
One of the main issues in fighting the crisis: only about one-fifth of the people who need treatment actually get it, primarily due to a shortage of primary physicians trained to provide quality treatment and the hurdles addicts need to jump through in order to get help, like taking off from work or traveling several miles to the nearest clinic. As with any crisis these days, a slew of tech companies are trying to tackle the epidemic. The idea: use tech to reach more people and make it easier for them to get help. But legacy treatment centers and experts aren’t so sure a digital solution is the right one.
Workit Health, a startup founded in Oakland and now headquartered in Michigan, is one of the major new companies in the space, founded in 2015 by Robin McIntosh and Lisa McLaughlin. The two met in Alcoholics Anonymous in San Francisco and have lost several friends to substance abuse.
“In AA, they have this saying that you should buy a black dress because you’re going to be wearing it a lot,” McIntosh said.
The company offers people three different program options (ranging from $25 to $75 a week) that can include a variety of offerings, such as an interactive online curriculum that helps people work through self-defeating thoughts, peer coaching, group sessions, and drug counseling with a licensed mental health professional via video chat.
“Basically, we directly deliver everything that you can get from an outpatient service,” said McIntosh.
With the most popular option (at $75 a week), people are able to receive medication-assisted treatment (MAT) — now widely considered the most effective form of intervention — which involves the prescription of FDA-approved medications such as methadone, naltrexone, and buprenorphine to reduce the physical symptoms of opioid withdrawal.
The question the industry is asking: Should digital tools be treated as a source of support for patients in between visits to traditional in-person treatment facilities, or do they offer sufficient treatment by themselves?
Studies have shown that addicts are half as likely to die from an overdose when their treatment plan includes long-term access to a MAT drug. Los Angeles police are now even being given these types of medicines to distribute to help fight the crisis.
A slew of other digital addiction-treatment options, including sobriety trackers, reminder notifications, and interactive exercises to increase mindfulness around substance use, have cropped up. In 2018, Pear Therapeutics received FDA approval for their mobile tool, reSET-O, which provides interactive lessons and quizzes to help recovering addicts identify their craving triggers and practice drug-refusal skills. A-CHESS, a program by Geisinger Health System, also provides similar cognitive-behavioral exercises through a digital interface.
But Workit Health’s ability to give peer and professional counseling through primarily digital means, along with medication to treat addiction, is a relatively new concept.
The question the industry is asking: Should digital tools be treated as a source of support for patients in between visits to traditional in-person treatment facilities, or do they offer sufficient treatment by themselves?
Directors of conventional rehabilitation programs are wary of fully embracing online programs to treat various addiction problems. Keith Weber, marketing and development coordinator for Ohlhoff Rehab Programs of San Francisco, one of the oldest addiction treatment centers in the city, is cautious about the idea of people who are struggling with life-threatening addictions relying on technology.
“These tools might be helpful for some people, but what we’ve seen for the 68 years that we have been around is that [in-person treatment] is what works,” Weber said.
Arlene Stanich-Prince, executive director of the center, with over 14 years of experience as a drug and alcohol counselor, agrees.
“It’s hard enough in outpatient when a person isn’t there 24/7,” Stanich-Prince said. “I think you really need to work with a person face-to-face because honesty is huge.”
“I knew I couldn’t afford to take any downtime from my job, so an inpatient clinic was out of the question.”
Indeed, many addicts find that an in-person experience is essential to their recovery process. Sarah B., a 34-year-old education employee who wished to remain anonymous, has found success in using Workit Health for about six months so far after she found herself slipping into a burgeoning dependence on painkillers during post-surgery recovery. But she’s still considering supplementing the program with extra support by attending in-person events in her community.
Sarah B. found that the combination of services was useful for her, especially the ability to get MAT treatment. As of early June, she is 180 days sober and hasn’t had a relapse since she started MAT.
Despite the success of MAT programs, they’re relatively uncommon in legacy treatment models — 90 percent of treatment options are centered on a counseling-only abstinence-based model that’s been the gold standard for addiction recovery in the United States since the 1930s. Getting MAT drugs also often requires going through specialty clinics, which can be inconvenient to access, especially in rural parts of the US that have been hit the hardest by the opioid epidemic. People are also often expected to line up early in the morning each day outside regional clinics — a task that seems unmanageable for anyone, let alone those with a serious drug addiction.
Sarah B. also said that the ability to use Workit Health remotely was key.
“I knew I couldn’t afford to take any downtime from my job, so an inpatient clinic was out of the question,” she said. “Some clinics require daily check-ins, which can be impossible if you’re working.”
McIntosh says that that’s a common sentiment. While she wishes everyone battling addiction could enroll in a prolonged recovery program like the one Ohlhoff offers, it’s not realistic. People often have to choose between getting help or sacrificing jobs and daily routines for a prolonged period of time. Plus, there’s the issue of affordability.
Many insurance companies often get away with shirking coverage of drug rehabilitation, so these in-person programs can cost anywhere from $20,000 to $30,000 out of pocket, she said. In addition, addicts who get a moment of inspiration to quit are often disappointed to find out that the next appointment to see a drug counselor or therapist may be weeks away.
“We are asking the most vulnerable people to do the most difficult things,” McIntosh said. “Too many people need help because of the gravity of the opioid epidemic, and they are not getting it. Until now, we’ve never looked at addiction treatment and thought to modernize it.”

WRITTEN BY Liz Zarka at TheBoldItalic.com

Addiction Recovery Bulletin

 

As one of the worst health crises in a century intersects with sustained uprisings for racial justice, the United States is at a perilous crossroads—and it’s easy to be distracted by superficial solutions rather than digging deeper to address the underlying issues that created these conditions. And yet, for those of us working in drug policy, criminal justice, and the broader social justice movements, these recent crises have simply exposed something long known that our culture often sweeps under the rug: Drug-war-fueled over-policing and systemic divestment in community resources—such as low-income health clinics and after-school programs—have targeted and plundered our most marginalized communities, which has left them even more vulnerable to the challenges this year brought.

But when we say that drug-policy reform is more important than ever, social justice groups, including the Drug Policy Alliance, the organization I have the honor of leading, are repeatedly told by policymakers to wait. We’re told to wait, as we were told with the long-awaited MORE (Marijuana Opportunity Reinvestment and Expungement) Act vote that was set to take place in September. If passed, this bill would expunge marijuana convictions that currently prevent millions of people from getting jobs. It would begin repairing the extensive damage the drug war has done to communities of color.

Nearly 40% of arrests in America are still for marijuana possession, according to FBI data. And a disproportionate number of those arrested are people of color. So the MORE Act is a beacon of hope for the Black, Latinx, Indigenous, and low-income communities that marijuana prohibition has devastated for decades. The bill not only completely de-schedules marijuana from the Controlled Substances Act, but also aims to begin addressing this harm by expunging past records and provides guarantees that people of color will be able to benefit from the new legal marijuana economy.

But the vote was delayed because legislators were more concerned about the election (and, supposedly, providing more COVID-19 relief) than taking a principled stand against one of the most egregious harms that continues to haunt this country. Now that the election is over, we still don’t have COVID-19 relief. And House leadership says a vote on the MORE Act will be held in December—but we need to hold them to it.

The truth of the matter is that we’ve already been waiting for decades. And you can’t solve today’s crises without addressing the foundation they were built on.

The drug war sits at the nexus of the most critical issues facing society today: health care inequities, racial injustice, police brutality, economic disparities, and government waste. Without serious drug-policy reform, we will continue to see avoidable loss of life, unwarranted and punitive criminalization, and disproportionate targeting of Black, Latinx, Indigenous, LGBTQ+, and low-income communities. The war on drugs has woven a fundamentally flawed, punitive, dehumanizing system into the fabric of our society in ways that are both obvious and covert. And after over $1 trillion of government spending during the last 50 years, we are no closer to the drug war’s stated goal of reducing supply, yet we continue to throw away money and ruin lives to keep it going. It is clear we need to unravel this system—and all of its tentacles—if we hope to achieve any of the lasting changes we need.

At the most immediate level, the COVID-19 pandemic has exacerbated the obstacles that people who use drugs face on a daily basis. We were already in the midst of the overdose crisis, one of the worst public health crises in U.S. history, causing approximately 70,000 deaths a year. Early estimates suggest that number has only increased since the pandemic began.

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