Background: Alcohol and other drug (AOD) problems confer a global, prodigious burden of disease, disability, and premature mortality. Even so, little is known regarding how, and by what means, individuals successfully resolve AOD problems. Greater knowledge would inform policy and guide service provision.
Method: Probability-based survey of US adult population estimating: 1) AOD problem resolution prevalence; 2) lifetime use of “assisted” (i.e., treatment/medication, recovery services/mutual help) vs. “unassisted” resolution pathways; 3) correlates of assisted pathway use. Participants (response = 63.4% of 39,809) responding “yes” to, “Did you use to have a problem with alcohol or drugs but no longer do?” assessed on substance use, clinical histories, problem resolution.
Conclusions: Tens of millions of Americans have successfully resolved an AOD problem using a variety of traditional and non-traditional means. Findings suggest a need for a broadening of the menu of self-change and community-based options that can facilitate and support long-term AOD problem resolution.
Cannabis Use Is Associated With Suicidal Ideation Among Individuals With Opioid Use Disorder Receiving Opioid Agonist Therapy: Cannabis use is associated with suicidal behavior in the general population. This Canadian study investigated the association between cannabis use and suicidal ideation in cohort of participants aged 16 or older with opioid use disorder who were receiving opioid agonist therapy. This study raises concerns about the potential effect of cannabis on the psychological health of individuals with opioid use disorder.
There are about 10,000 people on Methadone Maintenance Therapy in Ireland. Photograph: iStock
Methadone users who wish to become drug free are being discouraged by doctors, who are often more interested in increasing patients’ doses, a new study claims. Those prescribed methadone to help them stay off heroin describe themselves as “lifers” bound in “liquid handcuffs” which prevents them from becoming drug-free.
According to the study, which was carried out by Trinity College academics and published in the International Journal of Drug Policy, users view methadone as a “ball and chain” and doctors rarely assist in helping patients come off the drug. “Those who aspired to reducing their daily methadone dose or becoming drug free reported not merely that they were not assisted in striving towards these goals, but that clinicians did not permit them to discuss such an aspiration,” authors Paula Mayock and Shane Butler wrote.
The authors conducted in-depth interviews with 25 long-term recipients of Methadone Maintenance Therapy (MMT), 16 of whom had been on methadone for more than 20 years. Indefinite MMT, along with needle exchanges and other harm reduction initiatives, was introduced in Ireland in the late 1980s to combat the heroin epidemic which had taken hold in urban areas. There are about 10,000 people on MMT in Ireland, including a large portion who have been taking the drug for many years. Although recent drug policy documents use language such as “pathways” and “progression” to a drug-free lifestyle, many MMT recipients who took part in the study felt methadone left them “trapped in a cycle that did not lead to progress or change”.
‘Held hostage’ - The majority of participants felt MMT had a positive impact on their lives in at least one respect, including increased stability, the opportunity to rebuild family relationships and less contact with the criminal justice system as they did not have to steal to feed their addiction.
But this was almost always juxtaposed with the feeling that MMT prevented users from moving forward. One of the participants, identified as Dillon, said MMT stalled but did not fix the problem. “It’s only just keeping it at a certain stage, it’s not getting any better, you know what I mean. I just feel like [methadone] is holding everyone.”
Preference for non-chemical assisted treatments for dealing with substance use disorders.
Such vehicle may be an option as a ‘circuit breaker’ in very extreme cases of addiction, but always with a ‘sunset’ clause on use, with definite goals to decrease and then cease medically assisted treatment in a specified time.
Conclusions: Most individuals achieve an increasing number of achievements with time since AOD problem resolution, and these are associated with gains in measures of well-being that may support ongoing AOD problem remission, and recovery.
This happened to me last week when, after nearly two years of sobriety, I finally found myself an Alcoholics Anonymous home group…
Upon further reflection, I was forced to acknowledge that I was sounding like an angry person claiming to no longer be angry — rather like an obviously wasted individual claiming to be sober. Within hours of publishing the piece I was already doubting its veracity.
But then the real apocalypse descended on me — one which I describe in greater detail in an August follow-up to the aforementioned article, entitled When Your Addiction Recovery Stories Backfire. Within a week or so of publishing the original piece, I descended into a debilitating anxiety attack that brought back just about everything I thought I had overcome. Well, not everything — I didn’t drink, but I came dangerously close a couple of times. But otherwise, the angry hyena was back in the living room and everything once again felt like utter chaos. Less than a month after I arrogantly declared myself “recovered” it was painfully obvious that I was anything but.