It is an age-old question in medical and substance use disorder (SUD) treatment circles: Does a patient have to WANT treatment, that is, want to get better, for treatment to work? Conversely, if someone does not want to change their behavior, can treatment still be effective?

This question can apply to countless medical issues — from heart disease to diabetes to mental illness to SUD — and opinions are widespread on whether you can coerce someone into getting well. …

A controversy currently exists that many believe pits the use of Medication-Assisted Treatment against Alcoholics Anonymous (“AA”) and their Twelve Steps and Twelve Traditions that explain the 24 basic principles of the AA program. Behind this controversy is the national opioid crisis and the existence of differing approaches to treatment and support for recovery from opioid use disorder. In reality, both methods of helping people get into and maintain recovery are essential.

The basic textbook of Alcoholics Anonymous (AA) was first published in 1939 to explain AA’s philosophy and methods. AA’s Twelve Steps and Twelve Traditions book was then written…

I’ve worked in substance use disorder treatment, research, and policy for over 30 years. In that time, I’ve had over 350 treatment programs participate in my federally funded studies, I’ve helped 20 countries develop treatment systems, and I’ve worked clinically in numerous systems of care. These treatment providers have been for-profit and nonprofit. They have relied on Medicaid and block grant funding, self-pay, and commercial insurance. They have all worked to keep up with the latest research on evidence-based treatment practices including psycho-social treatments and medication-assisted treatment. I am proud to have worked with all of them.

And while many…

Addiction — The most stigmatized of diseases.

This stigma may be the result of a lack of understanding that addiction (more appropriately called substance use disorder, or SUD) is a disease, the “War on Drugs” intended to incite fear of substance use, or what happens when derogatory opinions, words and phrases are passed down through generations of families, politicians, and the media. But no matter the reason, the fact is, people with SUDs are routinely stigmatized.

They are referred to as “dirty” or “clean” depending on their current condition, a “user” or a “junkie” while under the influence, or forever…

Deni Carise, Ph.D.

Dr. Deni Carise is a nationally recognized expert in substance abuse, treatment, and recovery & Chief Scientific Officer at Recovery Centers of America.

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