by Thaddeus Camlin, Psy.D. HBO’s hit television series, Euphoria, pushed the envelope on many important topics, except one – addiction.  The show depicted a biracial romance between two women, one of whom was transgender. The show offered gritty, raw depictions of sexual assault, teenage substance use, physical and emotional abuse, and abortion.  When it comes to addiction, however, the show somehow missed the memo that there are no experimental studies that unequivocally demonstrate the effectiveness of traditional addiction treatment.  Euphoria pushed boundaries on a number of important social issues, but when it comes to addiction, the show succeeded only in being yet another example of mainstream media perpetuating the harmful messages that all addicts are the same and thus, all de...

by Thaddeus Camlin, Psy.D. Addiction treatment needs improvement.  Exploring new methods is essential to advancing the field.  To imagine the latest radical approach to treating addiction one might envision an amalgamation of electro-shock therapy and trepanning.  Brain surgery for addiction is not a futuristic concept at the dawn of its conception.  On the contrary, brain surgery for addiction is happening now in China and a clinical trial is scheduled in West Virginia this year.  Like any emerging treatment, brain surgery to treat addiction is worth a closer look to consider potential costs, benefits, risks, rewards, and ethical delivery of services. The Technique The brain surgery technique used to treat addiction is deep brain stimulation (DBS).  DBS is already an established t...

by Thaddeus Camlin, Psy.D. The concentration of misinformation in the world of addiction is as dense as osmium.  One of the most well-known misconceptions in addiction is the idea of an addictive personality.  I hear references to someone with an addictive personality all the time from professionals and lay folk alike.  The idea of an addictive personality is reminiscent of an availability cascade, in that people talked about it long enough that it became “true.”  The reality, however, is that scientific evidence does not support the concept of an addictive personality. A Closer Look at the "Addictive Personality" Anti-social and depressive behavior frequently accompany addictive problems, but the keyword is behavior.  Behavior is not personality.  According to research, no persona...

by Tom Horvath, PhD., ABPP This blog is addressed to psychotherapists who do not view themselves as capable of providing addiction treatment. Many (if not most) therapists have this perspective. However, as I have suggested for many years, individual therapy (possibly supplemented by couple’s and family therapy) is the setting of choice for most individuals with addictive problems, and therapists should learn to address these problems. Unfortunately, many therapists lack the confidence even to learn about addiction treatment. Therapists already know most of what they need to know for basic addiction treatment. They also need some basic information about addiction and recovery. In an effort to boost the confidence of these therapists, below are the principles they would keep in min...

by Thaddeus Camlin, PsyD New England Journal of Medicine Article Says: Addiction is Learning, Not Disease One of the world’s most prestigious journals just published an article saying that addiction is not disease.  Not surprisingly, an uproar is underway.  Devotees to the disease model of addiction are not happy, but sometimes the truth hurts.  The article in the New England Journal of Medicine is a major step towards improving the standard of care in addiction treatment and deepening our understanding of the true nature of addictive behaviors. Including and Transcending the Disease Model of Addiction The article in the New England Journal of Medicine, written by Marc Lewis, Ph.D., does a masterful job of presenting the current state of the evidence about the etiology and maintenan...

By Thaddeus Camlin, Psy.D. Mental health professions are big on person-first language, and rightly so.  Defining people by their problems is widely agreed upon to be below the standard of care.  People are much more than their diagnoses, and thus, mental health professions now routinely opt for descriptions like, ‘a person with schizophrenia’ rather than, ‘a schizophrenic,’ or ‘a person with borderline personality’ rather than ‘a borderline.’  As sensitivity to mental health issues grew in recent years and person-first language became the standard of care, one notable category of diagnoses was conspicuously left behind: substance use disorders. Why is language in addiction treatment failing to catch up? Addiction Treatment and Double Standards While the frequency of hearing a psych...

The Streets Are No Place For Addicts by Thaddeus Camlin, Psy.D. Treating trauma with trauma isn’t helpful, it’s abusive. Turning away from loved ones in need deepens isolation and disconnection. Trauma and isolation cause addiction, connection cures it. Addiction, trauma, and mental illness occur amongst people without a home at much higher rates than the general population. The solution of casting our wounded into the shadows beneath the shoddy shelters of freeway overpasses is no solution at all – it only deepens the problem. Far from a naïve pipe-dream born in a hippie-haze, the story of the Portland Hotel Society in Vancouver, Canada is a hopeful example of a tangible solution - Housing First. As part of Vancouver’s adoption of the common sense ‘Four Pillars Approach’ to ...

Updated November 9, 2021 Addiction is a Social Construct by Thaddeus Camlin, Psy.D. The perpetually changing understanding of addiction provides clear evidence of its social construction. With rare exception, the infectious agents that cause a disease don’t change, the pathological biological processes of a disease don’t change, and the biologically degenerative conditions of a disease don’t change. If left untreated, diseases generally worsen. Addiction has no infectious agent, no biologically degenerative condition, there is no agreed upon definition, the diagnostic criteria constantly change, and perhaps most strikingly, when left untreated most people recover from addiction. However, when addiction is treated with leading methods – criminal records, jail time, and shame-based r...

Persistence in Life and Recovery So we are now about two weeks into the New Year. That’s long enough that the great enthusiasm we had for our 2018 goals has dimmed a bit, or worse. So now what? Life is a continuing challenge of balancing short-term and long-term satisfactions, as SMART Recovery’s 4th Point, Lifestyle Balance, reminds us. Your goals for the year were very likely about enhancing your long-term satisfactions. Of course, we easily get side-tracked. Something shiny, fun, escapist, or whatever side-tracks us, and off we go, setting aside, for now, the long-term goal. This brief blog is a reminder that even if it is set aside, the long-term goal, and the satisfaction it will bring, is still there, still worth pursuing, and still worth having even if it takes us a long t...

Hollywood Scandals Remind Us of Addiction's Roots by Thaddeus Camlin, Psy.D. What does Hollywood have to do with addiction's roots? The recent wave of sexual abuse revelations in Hollywood is simultaneously tragic and inspiring.  The courage, resilience, and fortitude demonstrated by victims publicly disclosing some of the most disturbing and traumatic details of their lives in the hope of catalyzing positive change reveal the best of human nature.  The details the courageous victims continue to share expose the darkest underbelly of humanity’s depravity.  The attention generated by the Hollywood sexual abuse scandals is finally pushing the issue of sexual abuse into the forefront of our consciousness, which will hopefully manifest change across many levels of society. Addictio...