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PostPosted: Sun Dec 03, 2017 8:35 am 
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Here's a video featuring Dr Judianne Jensen Gerber, the controversial NY psychiatrist who started Odyssey House, debating with a proponent of methadone maintenance.

What strikes me about this debate and feature, focusing on heroin addiction treatment modalities, is how little has changed from the 1980's to present. The ONLY new treatment that's come about since then is the advent of buprenorphine treatment, which is really not much different to methadone in the aim of treatment, Both in the 80's and present, lifelong maintenance on opioid replacement was considered the gold standard. Today, despite huge advances in other fields of medicine, treatment for opioid dependence has changed so little. I'm personally surprised by how much these debating psychiatrists new back then. They knew just as much as any present day addiction specialists.

Even the rehab success rates back then (one in ten heroin addicts remaining clean long term after completing the 2 year Odyssey program) hasn't improved at all since then.

We really need more resources put into addiction treatment. Because it saddens me how little things have changed since the 80's.



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PostPosted: Tue Dec 05, 2017 2:08 pm 
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The one good thing is that the American Society for Addiction Medicine has finally come out with the 'chronic disease' model of addiction-- i.e. that addiction is not an event to be fixed, but an illness that requires long-term management.

The abstinence movement has a great deal of power. Look at what programs charge-- $20,000-80,000 per month, for stays of 1-6 months! Some treatment programs offer therapies that have no established benefit for addiction. And some programs in Florida have been busted recently for taking halfway houses and filling them with addiction patients, then providing lectures during the day-- and calling it 'treatment'.

The barriers to entry for buprenorphine have come from the people who have the most to lose-- NOT from people concerned that abstinence treatment is 'better'. There is no way to argue that a treatment with a 6% success rate is better- than anything!


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PostPosted: Tue Dec 05, 2017 11:58 pm 
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Enjoyed the video TeeJay! :D


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PostPosted: Fri Dec 15, 2017 2:00 pm 
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suboxdoc wrote:
The one good thing is that the American Society for Addiction Medicine has finally come out with the 'chronic disease' model of addiction-- i.e. that addiction is not an event to be fixed, but an illness that requires long-term management.

The abstinence movement has a great deal of power. Look at what programs charge-- $20,000-80,000 per month, for stays of 1-6 months! Some treatment programs offer therapies that have no established benefit for addiction. And some programs in Florida have been busted recently for taking halfway houses and filling them with addiction patients, then providing lectures during the day-- and calling it 'treatment'.

The barriers to entry for buprenorphine have come from the people who have the most to lose-- NOT from people concerned that abstinence treatment is 'better'. There is no way to argue that a treatment with a 6% success rate is better- than anything!


Exactly!! And I've tried to bring this type of thing up in my grad school classes and no one wants to touch it. Not fellow students and not professors. People in the addiction treatment industry are scared to say outright, "Your abstinence-based residential treatment is not effective." The relapse rate continues to be in the 90% range from these money pits.

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