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Informed Consent in Opioid Addiction Treatment: An Ethical Obligation This article was originally published in  The Carlat Addiction Treatment Report ,  Volume 2, #3, May 2014 Source:   CATR, May 2014, Vol 2, Issue 3,  Opioid Addiction Mark Willenbring, MD Founder and CEO, Alltyr Clinic, St. Paul, MN, Former Director, Division of Treatment and Recovery Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD Dr. Willenbring has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity. Informed consent—whether it be for psychotherapy, prescribing a medication, or performing a surgical procedure—is an ethical principle firmly established in law and medicine. While there has been no formal research on this subject, my experience suggests that many addiction treatment programs fail to obtain valid informed consent. The starkest example occurs in the treatment of opioid addict...

Alltyr Clinic is featured on  NPR's Weekend Edition Sunday  today, June 8, 2014. We are positioned as an alternative to traditional rehab, in this case  Hazelden . One of our patients, Shane Linehan, was brave enough to share his experience with both Hazelden (where he went first) and Alltyr Clinic (where he is being treated now.) I want to thank him and applaud his courage for speaking out. (For the record, Alltyr Clinic gave him no incentive; we simply offered the opportunity to many of our patients.) We are honored to be compared to arguably the best known traditional rehab in the country (if not the world.) Unfortunately, in the summary on the program's landing page, our approach is described as being almost totally oriented around prescribing anti-relapse medications. Although we use every proven anti-relapse medication, we also use every evidence-based behavioral/psychosocial approach . This includes individual and group therapy using motivational, cognitive-behavi...

The authors of a new paper , published ahead of a special issue of Neuropharmacology , give the reader a good look at the current state of psychostimulant substance use disorder treatment - and the results are disappointing. Starting with behavioral treatments and ending with a review of medications, the clear fact remains that there is no single treatment that outperforms most others. Meta-analyses of behavioral interventions for the treatment of cocaine use disorder have shown modest benef its ; while  one review found , "there is currently no evidence for a differential treatment effect of any psychosocial treatment in the management of" cocaine or amphetamine use disorders. CBT and Contingency Management (CM) remain the mainstay of psychostimulant treatment, and the authors cite data suggesting a combination of CM plus Community Reinforcement Approach might produce the best outcomes. In terms of pharmacological treatments, researched medications include antagonist therapy...