mortiz095

Very excited to feature a post written by Paula DeSanto, Founder and President of Minnesota Alternatives  and a leader in the movement to bring paradigm change to chemical dependency and mental health treatment in Minnesota. Thank you, Paula We Still Have a Ways to Go Four years ago I was inspired to open a clinic to help people with substance use issues because of the many, many stories I was hearing about ineffective and often times, harmful treatment. While we are making progress with embracing more person-centered, stage matched interventions; I continue to have experiences that affirm how far we still have to go.  For example: I was training a large group of clinicians and practitioners about person-centered care, and we were having a very spirited discussion about why drug and alcohol counselors seem compelled to report their clients use to probation officers.  I have worked as a mental health professional for over 2 decades and mental health clinicians don’t sha...

It hasn’t been a good couple years for counseling in the buprenorphine treatment literature. Yet another study, authored by a team led by the venerable Walter Ling, and currently available in Addiction Journa l’s “early view” section online, has shown that counseling adds nothing to buprenorphine maintenance, in terms of measured outcomes. By our count, this makes four consecutive studies to show basically the same thing: counseling, while by no means harmful, has not been shown to add anything to buprenorphine maintenance in opioid-dependent patients without significant co-occurring psychiatric disorders. Ling, et al.’s study is arguably the most convincing study yet. The team performed a randomized control trial in which patients were randomized to one of four behavioral treatment conditions, as adjuncts to buprenorphine maintenance: cognitive behavioral therapy (CBT), contingency management (CM), both CBT and CM, and no behavioral treatment. Counselors were master’s-level trained ...

Ian McLoone 6:30 PM (4 hours ago) to  me Mark I have been having some heated discussions lately about maintenance and the science around it. A lot of people say, "well reduced drug use is great, but what about quality of life?" For example, the studies comparing buprenorphine with and without counseling - there's no difference in outcomes, but those outcomes don't measure QoL. I did some research, and most of the studies I saw found improvements, but in the case of methadone, the improvements all occurred in the first 30days of Tx. Just wondering what you say about this perceived lack of QoL in the literature.  Thanks Mark Willenbring   10:57 PM (3 minutes ago) to  Ian QOL measurement is a conundrum, very difficult to measure, since it's a perception, an interpretation, and doesn't correlate well with more objective measures of function or discomfort.  I think their argument is simply a defensive one. The counterargument is that many more people who are treate...