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PostPosted: Wed May 04, 2016 1:32 am 
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Hey all, it's been a while! Dr. Junig's recent post about counseling and MAT got me fired up as its been something that's bothered me since I've started researching the topic, not to mention my personal experiences, and those of many people I've known. Although SAMHSA, ASAM, etc, also trumpet the need for counseling in MAT the data says otherwise. Even the 21 million dollar Project MATCH study of counseling effects on alcohol use disorder only found a positive effect on treatment outcomes by counseling of about 6%. Most studies of the effects of counseling on treatment outcomes with methadone or buprenorphine find no difference in the counseling or non-counseling groups. This includes a meta-analysis on methadone treatment and counseling by the esteemed Cochrane Collaboration and can be found on their website here http://www.cochrane.org/CD004147/ADDICT ... dependence
There's also a few studies of counseling and buprenorphine treatment vs buprenorphine treatment without counseling here https://www.researchgate.net/publicatio ... Dependence
You can get a free account with ResearchGate, it's a pretty good website actually and there's 4 or 5 studies of the effects of counseling on MAT outcomes and they all say the same, it doesn't have an effect. I'm sure for some it does and this has been proven in some small studies but the larger studies have proven for most, counseling does not effect MAT treatment outcomes. Yet it's trumpeted by addiction science organizations as a necessity for successful medication assisted treatment.


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PostPosted: Wed May 04, 2016 12:39 pm 
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Thank u for that info Jiva. Very interesting information!

Nice to see u post again :)

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PostPosted: Wed May 04, 2016 6:27 pm 
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Whether someone is going to find recovery has nothing to do with whether they are on suboxone, go to counseling, have psychiatrist, etc.etc. if you addict isn't ready to be sober and if the addict is not willing to do EVERYTHING and AMYTHING to get sober.

My Suboxone doctor makes everyone do 2 counseling sessions and then you can stop. I have chosen to keep going because I find it extremely helpful. I finally foun a counselor that I click with and I actually look forward to going and always come out with some type of insight.

Counseling or counseling, it is all on the addict whether they will make it or not.


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PostPosted: Wed May 04, 2016 8:39 pm 
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Damn, Jiva-- you could have said it better than I did!! Thanks for the links; I saw them at some point in the past but I lost them. The most frustrating thing is the way people use the studies that support their beliefs, and disregard those that don't. Without opening a huge can of worms, I see the same thing happen with studies of 'global warming'. I saw an article the other day that said that the Earth MUST be warming because out of every 100 papers, 98 found that the Earth WAS warming, and only 2 found it wasn't. But anyone who has applied for grant money knows that the grants go to the people who propose finding the effect that the government wants you to find! I have no idea if the Earth is getting colder or getting warmer, but I do know two things, for absolute certain... first, that as I grew up in the 1970's, the media touted stories about the dangers of global cooling. I have copies of the newsweek story about shortened grown cycles and famines that would affect all of mankind. Second, I know that because of the way grant monies are awarded, the science is so tainted that nothing can be trusted on either side of the debate.

I used to have a web site about the faulty science, but it never got much traffic, so I quit adding to it.

Something funny though... I put ads on the 20 web sites that I have made about different topics.. and a major internet company pays for clicks on those ads. When I had ads on the site making fun of 'anthropomorphic climate change', that company said I violated their user policies, and the ads were removed. That pretty much made my point...

Now that I've lost readers from the left side of the political spectrum... I'll just say that whatever side you're from, I encourage people to keep questioning everything that they read or hear. You will eventually learn whether or not information is from a good source---but even in those cases, keep your mind open, and always challenge what you read or hear. If you do that, I guarantee you will be surprised by all of the BS out there-- no matter what side you are from!!

On buprenorphine alone, I am always disappointed by what I hear from other docs-- comments about how 'buprenorphine is just like heroin', or 'the narcan adds a ceiling effect', or 'they all sell suboxone to get heroin.' I recently got an email from a doc who wrote, to a bunch of people, that patients often sell half their prescription and use the money to pay for their appointments. The people he wrote to were not doctors-- and unfortunately, non-doctors tend to think that doctors are correct when they write about this type of thing. So that one doctor put a twisted opinion in the minds of about 20 people. I wrote a response that essentially said that he was full of crap.... but some people will believe him, and some people will believe me, and there is nothing else I can do about that.

I've written way too much on this post... I'm going to go watch 'Survivor'. Anyone watch that? It was SO good to see that NBA jerk voted off a week or two ago....


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PostPosted: Wed May 04, 2016 9:42 pm 
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You're so cute even though you're a conservative who doesn't believe in climate change! :D

Amy

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PostPosted: Thu May 05, 2016 8:46 am 
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Good morning all, Even though I am usually a very far to the left social worker, I know talk therapy is not for everyone! It works to support those with addiction issues in staying clean if they feel it is a part of their treatment and they think it helps! The problem always starts when we put a "cookie cutter stamp" on anything! Now, as far as climate change goes, I get so frustrated with the extremists! They push away any other way of looking at it other than we are destroying our plant and we are all going to die!This is just my personal opinion, but it seems that the most successful people are always the ones who are able to look around and see outside of the box! Enjoy today!


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PostPosted: Fri May 06, 2016 12:32 am 
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Thank you Dr. Junig that means a lot coming from you! I really enjoy reading your blogs and really junked out on the archives when I first started suboxone treatment and it helped me quite a bit. It is nice to find something people from different sides can come together on! I'm somewhere between a nihilist and an anarchist but I found myself friends with all these middle aged, white, christian, women when I was organizing an event last year for International Overdose Awareness Day. Now we're working together on an event for this year as well. I have to mention another of the "facts" about buprenorphine which is thrown around sometimes and came from the Times story Addiction Treatment with a Dark Side. I'm talking about the "over 400 deaths in which buprenorphine was a primary suspect". As if an autopsy is a murder investigation anyway. In France, where they actually track buprenorphine deaths, and have an oddly high rate of buprenorphine injectors, and have been prescribing low threshold buprenorphine since 1996, has only had 17 deaths attributed to buprenorphine. Utah, which is surprisingly a mid range state when it comes to the amount of buprenorphine prescribed, tracked deaths from buprenorphine over a ten year period and only found 3 deaths in that time. One was a suicide, one was an injector, and all three had combined buprenorphine with another depressant. So I don't just think it's poor reporting on the Times part, I think it's downright deceit.
I watched the first season of Survivor but it was during a prison stay in California for selling heroin and I think that's given the show too much of a negative connotation in my mind to watch it again! I'm a big zombie nerd, I like watching the Walking Dead, Fear the Walking Dead(although not so much) and my new favorite Ash vs Evil Dead. If anyone is a fan of the Evil Dead movies and hasn't seen Ash vs Evil Dead get on Netflix and hold on to your seat!


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PostPosted: Fri May 06, 2016 7:50 am 
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I'm a big walking dead nerd. I have all the comics and even the walking dead action figures....huge walking dead nerd. I've tried really hard to love fear the walking dead but I just can't totally get there. It's just not filling twd void. They could have made that spin off a really awesome show and to me it's kinda fell flat. I do watch it, don't get me wrong, but I'm disappointed. I don't watch the ash evil dead but saw it on The People's Couch show (a show on Bravo that shows ppl's reactions to tv shows lol). Anyway just wanted to tell u I'm a "dead head" too :)

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PostPosted: Fri May 06, 2016 8:36 am 
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I've had trouble watching Fear the Walking Dead as well. I wish they would get off that damn boat already!


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PostPosted: Fri May 06, 2016 9:47 am 
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Yes! And to be in the middle of the ocean, they get lot's of visitors.

Ok I'll hush now. I get caught up in talking about twd and I can't stop.

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PostPosted: Fri May 06, 2016 10:02 am 
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Sorry, I had to jump in here...did somebody say The Walking Dead? My FAVORITE! Have the comics as well. Posters all over the walls lol. Love it! Fear is getting a little better, but I agree, it doesn't exactly fill the void waiting until October.

Ok, sorry to interrupt the conversation here...but I have to when it involves TWD. :D


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PostPosted: Fri May 06, 2016 11:13 pm 
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I am not embarrassed to admit that I have several Daryl Dixson and Norman Reedus items, including a wallet that says, "If Daryl Dies we riot!!"

Does anyone have guesses about who "bought" it in the finale? I'm hoping it's Eugene. It had better NOT be Daryl!!!

Amy

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PostPosted: Sat May 07, 2016 11:18 am 
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I know who died in that exact scene in the comics, but of course they like to shake it up and change things in the show so it's not a guarantee. Actually when Denise the dr died, in the comics that was supposed to be Abraham but they changed it in the show. Everything this season has followed the comics to a T except the switching of Abraham to Denise. But in the comics it's ***spoiler alert**** Glenn. But I'm having doubts since they made such a huge deal out of Glenn dying earlier and then finding out episodes later that he was alive...so really I don't know. Surly to goodness it won't be Daryl....please don't let it be Daryl! Also, Negan supposedly doesn't kill kids or women...But they can change all that up away from the comics. If I was just going to guess and just purely guess, I think Eugene or Glenn. I love them all so whoever it is, I'll be sad but Eugene would be the better of the rest if I absolutely had to choose. I'd love to hear others opinions on who they think :)

Also I was watching The Actors Studio and Robert Kirkman said that he already knows how TWD will end when that time comes. I always wonder what he has in store for that.....a cure, a dream while Rick is in the hospital....what could it be???? Gosh sorry guys I could go all day.

Amy awesome wallet btw :)

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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