Wednesday, April 24, 2013

Obama's White House Announce Brain Mapping Initiative

White House Announces Brain Mapping Initiative
Mark Willenbring, MD at Substance Matters: Science and Addiction - 3 weeks ago

*Whew! Long drought! I was caught a bit off guard by the response to Jane Brody's column about Inside Rehab, which generated a lot of inquiries and new patients for Alltyr! All good things, plus opening the new office in downtown St. Paul and many other activities have left me a bit overwhelmed. Today's blog is written by Ian McLoone, a graduate student at the University of Minnesota Master of Professional Studies in Integrated Behavioral Health. Ian has been working with me learning about clinical work, as well as helping with Alltyr Clinic and other activities. He's going to be a... more »

Some books and articles on Science and lack of it in Mental Health Treatment.

Distinction between Science and Pseudoscience.

1. Wikepedia Pseudoscience

Skeptics Quack Watch
2. Article by Rory Coker, Ph.D. "Distinguishing Science and Pseudoscience"

3. Scott O. Lilienfeld, Steven Jay Lynn, Jeffrey M. Lohr "Science and pseudoscience in clinical psychology" here is a little --Youtube I have not hear yet, but seems to be accurate

4. "The Great Ideas of Clinical Science: 17 Principles that Every Mental Health Professional Should Understand"  Scott O. Lilienfeld, William T. O'Donohue

5. One final article which is very important is "Why Bogus Therapies Seem to Work" by Barry L. Beyerstein PhD.
I feel shamed and betrayed by my own profession. I have read each and every one of this books
and articles. I have become such an skeptic about mental health and substance use disorder
treatment that each time I hear a claim be made by even some of this authors I check and double
check most of their work. It is tiring but nevertheless I have been hot aired so much I feel that
treatment has devastated my life both economically and socially. Before I die, I have made my
commitment to assure that patients learn about the need for science and the fact that we
are being bamboozled by people who maybe nice some times, but are nevertheless quacks.

Tuesday, April 2, 2013

New Report Outlines Global Strategy to Reduce Harmful Drinking



I provide and support certain specific articles that I think is consistent with the goals of this blog. If you see any time that I do not give credit where it is due, please inform me via email right away at worsetrreatmentihad@gmailcom so that I can provide the credit where it is due.  Your support and following is always appreciated, so do respond to the article, if you agree disagree, or best of all if
you are familiar with scientific studies that may be inconsistent with the question at hand. That is the way science works. One of the defiition or description of science is "bend over backwards trying to prove your most beloved theory wrong"

New Report Outlines Global Strategy to Reduce Harmful Drinking
Mark Willenbring, MD at Substance Matters: Science and Addiction - 6 days ago

New Report Recommends Public Health Focus on Harmful Drinking vs. Eliminating Consumption**** Tuesday, February 26, 2013**** International Center for Alcohol Policies (ICAP) **** Findings Run Counter to Current Public Health Approach, Discredit Traditional Perspectives**** WASHINGTON, DC--(Marketwire) - The traditional public health perspective on alcohol and noncommunicable diseases is indicted in a new report from the International Center for Alcohol Policies (ICAP). "Alcohol misuse and global health: The case for an inclusive approach to harmful drinking" discredits the tradi... more »

The Narcotic Farm: A Bit of History

And here is about my pet peeve.  Also from Janaburson's Blog All about opioid addiction and its treatment with medication


The Narcotic Farm: A Bit of History

We don’t have to keep re-inventing the wheel.
We can investigate the success rates of addiction treatment methods used over the past century, see what worked, and what didn’t work. We can use programs of proven benefit or we can continue to spend money on programs repeatedly shown to have little benefit.
From 1935 until 1962, drug addicts were treated at a unique facility, part jail and part treatment hospital. Initially named the United States Narcotic Farm, it was later changed to the U.S. Public Health Service Narcotics Hospital. Even after this name change, most people still called it the Narcotic Farm.
This facility was located on twelve acres of Kentucky farmland. The facility was created by the Public Health Service and the Bureau of Prisons, meant to serve a dual purpose. It was a treatment hospital, where drug addicts could voluntarily be admitted for treatment of their addiction, and it was also a federal prison, where drug offenders were sent to serve their sentences. About two thirds of the inpatients were prisoners and the other third were addicts, voluntarily seeking help for opioid addiction. Both types of patients were treated side by side. For over forty years, it was the main drug addiction treatment center in the United States, along with a similar facility in Ft. Worth, Texas, which opened in 1937.
The Narcotic Farm was a massive institution for its time. It had fifteen-hundred beds, and housed tens of thousands of patients over its forty years of operation. It was located in a rural area of Kentucky, which gave it space for numerous operations to engage the prisoners – now called patients – in all types of job training. (1)
The Narcotic Farm really was a farm. Besides growing many types of vegetables, there was a working dairy, and livestock including pigs and chickens. These operations provided food for the patients and staff of the facility and provided work for the patients. The patients provided the labor to keep the farm going and it was hoped they would simultaneously learn useful trades. In addition to farming, they learned skills in sewing, auto repair, carpentry, and other trades. Besides teaching new job skills, it was hoped that fresh air, sunshine, and wholesome work would be beneficial to the addicts. (1)
For its time, the Narcotic Farm was surprisingly progressive in its willingness to try multiple new treatments. For the forty years it operated, many different treatments were tried for opioid addicts. It offered individual and group talk therapies, job training, psychiatric analysis, treatment for physical medical issues, Alcoholics Anonymous meetings, art therapy, shock therapy, music therapy, and even hydrotherapy, with flow baths to soothe the nerves. Despite these options, the Farm apparently retained many of the characteristics of a prison, with barred windows and strict security procedures. (1)
The Narcotic Farm had its own research division, the Addiction Research Center (ARC), which became the forerunner of today’s National Institute on Drug Abuse (NIDA). The Narcotic Farm did pioneering work, using methadone to assist patients through withdrawal, and helped establish the doses used to treat opioid addiction. Methadone was used only short term, for the management of withdrawal symptoms, and not for maintenance dosing at the Narcotic Farm. The Farm also trained a dedicated group of doctors and nurses, who were pioneers in the field of addiction treatment. It provided new information on the nature of addiction.
Admission to the Narcotic Farm allowed an opioid addict some time to go through opioid withdrawal, eat regular meals, work in one of the farm’s many industries, and have some form of counseling. However, after leaving the hospital, the addicts were entirely released from care and supervision, with no assistance to help re-enter their communities. Most times, they returned to their same living situation and old circumstances encouraged relapse back to drug use and addiction. As a result, two follow up studies of the addicts treated at the Narcotic Farm showed a ninety-three percent and ninety-seven percent relapse rate within six months, with most of the relapses occurring almost immediately upon returning home. Many addicts cycled through the Public Health Hospital multiple times. (1)
The Narcotic Farm was eventually turned over to the Bureau of Prisons in 1974, as the treatment for addiction was de-centralized. Since the studies found high relapse rates for addicts returning to their previous communities, it was hoped by moving treatment centers into communities, these addicts could have ongoing support after they left inpatient treatment.
  1. Nancy P. Campbell, The Narcotic Farm: The rise and fall of America’s first prison for drug addicts, (New York, Abrams, 2008)

Probuphine: the Injectable Suboxone

From Janaburson's Blog All about opioid addiction and its treatment with medication

Posted March 30, 2013 by janaburson
Last week, the FDA’s advisory committee voted to approve Titan Pharmaceutical’s Probuphine. This is an implantable form of buprenorphine, a drug more commonly known under the brand names of the sublingual forms Suboxone and Subutex.
Probuphine is a slender rod, as pictured above, containing buprenorphine that is released into the body over time. Probuphine is meant to be inserted a few days after the patient has stabilized on sublingual buprenorphine. Four of the Probuphine rods are inserted under the skin of the inner upper arm in a fan formation, just like birth control implants such as Norplant. Four rods contain 320mg of buprenorphine, released over six months.
Probuphine has been touted as the answer to this country’s problem with Suboxone and Subutex drug diversion. Even though studies show most people who buy Suboxone off the black market use it to stay out of withdrawal and not to get high, many officials are appalled at how the medication, intended to treat opioid addiction, seems to be a new favorite street drug. But implantable Probuphine, for obvious reasons, is highly unlikely to be diverted to anyone besides the patient for whom it was intended. With this implantable form of the medication, pediatric exposures would be practically non-existent.

To read the whole story

This is one of the Dr. I follow up.