by Thaddeus Camlin, Psy.D. The Surgeon General's Report and the US Prescription Drug Epidemic Trusted Physician or Neighborhood Drug Dealer? It is no secret that the United States has a serious problem when it comes to prescription drugs.  Heroin’s renaissance is puzzling to many, but the trail of evidence leads back to our own medical community.  This week’s article explores the current prescription drug epidemic in light of the recent Surgeon General’s report. The Surgeon General’s Facing Addiction in America report includes startling statistics that paint a grave picture of the current epidemic in the United States.  Opioids alone account for nearly 300 million prescriptions every year and have accordingly taken the crown for most prescribed medications in the U.S.  The addicti...

David H. Jacobs, Ph.D. 1945-2016 In Memoriam Our brilliant and beloved colleague, David Jacobs, died last month. He had been with Practical Recovery since 2003. David was a therapist’s therapist. In our era most therapists rush to learn the latest evidence-based techniques. David was not opposed to new ideas, but his focus was on continually refining the basics of the psychotherapeutic art: listening well, responding authentically, developing a relationship that is simultaneously a working relationship and to some extent a personal one, all in service of fundamental change, perhaps in both parties. I believe that all of us at Practical Recovery benefited from our collaboration with this therapeutic sage. We will miss him deeply.   With the permission of his wife the home...

by Thaddeus Camlin, Psy.D. Defects of Character: Helpful or Hurtful? This week’s article explores the widely accepted, rarely contemplated idea that identifying defects of character is helpful in recovery.  Fault, failing, weakness, flaw, shortcoming, and inadequacy are all synonyms for the word defect.  Character refers to the mental and moral qualities of an individual.  Thus, the ubiquitous phrase in the recovery world defects of character implies moral and psychological flaws and failings in an individual.  I will assume, perhaps incorrectly, that the idea of emphasizing defects of character arose as a method of advocating for personal growth through self-reflection.  Indeed, looking at the imperfections we all have is a valuable tool for self-growth.  However, the problem with th...

Addiction as a Brain Disease? Cherry-Picking the Surgeon General’s Report by Thaddeus Camlin, Psy.D. The Surgeon General’s “landmark” report is generating a fair amount of media attention and discussion.  While it is valuable that substance use and related issues are receiving more attention, the aspects of the report receiving the lion’s share of the limelight are disappointing. Addiction as a Brain Disease? Yes it is true, as many media stories highlight, the report refers to addiction as a brain disease multiple times – 10 times in 428 pages by my count.  Unfortunately, the reporting stops there.  What is not covered in the media is that the Surgeon General’s report specifically states that addiction is a chronic brain disease, and the term addiction refers only to the most s...

by Thaddeus Camlin, Psy.D. Thansgiving and the Problem of Instant Gratification Somehow Thanksgiving, our holiday of gratitude, has morphed into a gluttonous melee of over-indulgence and excess.  If there is ever a time to practice coping with urges, resisting temptations, and moderate indulging, it is amidst the relentless onslaught of food and drink offerings that we are bombarded with throughout the celebratory festivities of November’s fourth Thursday. The P.I.G., or Problem of Instant Gratification, is a hallmark of the feverish consumer culture that abounds today.  As if the multitudinous dishes of the Thanksgiving meal weren’t enough, now we have trample-happy shopping sprees to add to the frenzied fervor of our most indulgent holiday.  One-click buying, drive-through “dinin...

by Thaddeus Camlin, Psy.D. One Person’s Recipe for Success in Addiction Recovery Arguably the most meaningful aspect of working in a helping profession is receiving updates of success.  With permission from the individual and after removing identifying information, this week’s article shares one person’s recipe for continued success in changing a problematic pattern of substance use.  The following paragraphs are elements of the individual’s success story verbatim, with some minor changes to protect the individual’s identity. I write to give you a recovery update.  I want you to know that I truly am following the after-care plan.  I have been maintaining balance since I left, an aspect my previous self underestimated but now am benefitting greatly from.  Before moving I would make ...

by Thaddeus Camlin, Psy.D. I often hear words of empathy from people struggling with the use of illegal substances offered to individuals struggling with the use of legal substances.  “I feel bad for you,” and “I can’t imagine having my drug of choice available in every store I go to,” are examples of the types of comments I hear.  The election this week brought more dents to the armor of substance prohibition, which raises important considerations for the world of recovery. Recreational cannabis use was legalized in Arizona, California, Maine, and Massachusetts on November 8, 2016, bringing the total number of states to legalize cannabis to eight.  The end of cannabis prohibition across the United States seems to be more a matter of how long it will take, not if it will happen.  ...

by Tom Horvath, Ph.D., ABPP How can the United States improve addiction treatment? The ultimate goal of support for overcoming problematic addictive behavior is to improve individual health and well-being while reducing societal costs associated with the behavior.  Several countries (e.g., Portugal, Switzerland, the Netherlands) are much more effective than the US in providing this support, which can include professional services (treatment) as well as a variety of non-professional and informal support. Calling for Change in US Addiction Treatment In the US a rational, medical and psychological approach would improve a system that has been overly influenced by the punitive aspects of drug prohibition and the diversity-suppressing dominance of the 12-step spiritual approach (which ha...

by Thaddeus Camlin, Psy.D. This week’s topic is the sixth and final installment in a series exploring lies that have permeated the recovery culture.  Thus far, lies about success, failure, everyone in recovery being the same, shaming, and labeling have been challenged.  While there are many more lies than six that have infiltrated the consciousness of recovery, I am forcing myself to stop here.  This final article may have saved the most controversial topic for last.  This article challenges the lie that we know “addiction” is a disease. There is no consensus amongst professionals or conclusive research that puts an end to the lively debate over whether or not “addiction” is a disease.  What research does show, however, is that believing “addiction” is a disease combined with a la...

by Thaddeus Camlin, Psy.D. Labels Can Actually Hurt the Recovery Process This week’s topic is the fifth installment in a series exploring lies that have permeated the recovery culture.  Thus far, lies about success, failure, everyone in recovery being the same, and shaming have been challenged.  This week’s article challenges the lie of labeling addiction, or that people have to label themselves as an addict or alcoholic to successfully recover. There is no research that indicates people are more likely to recover from a substance use disorder if they label themselves as anything.  However, there is research that shows forcing people to identify as an addict or alcoholic can actually be detrimental to their efforts to change.  The latest diagnostic manual for professionals (DSM-5) ...