by Tom Horvath, Ph.D. “Everyone is entitled to his own opinion, but not his own facts.” Ironically, I have not been able to confirm (the fact of) who first expressed this idea. It is widely attributed to Daniel Patrick Moynihan, four-time US Senator from Massachusetts (1927-2003). What are the primary “facts” or findings about addiction and recovery, of which any theory of them, and any approach to treatment and recovery, would need to take into account? I will propose a few facts (and opinions too). Of course, even our selection of “facts” can be biased. However, only by making the effort to understand the foundations of one’s own opinions can these opinions be improved. 1) Prohibition will be of limited effectiveness in preventing addiction. Alcohol prohibition in the US (...

Confidentiality is of major importance in addiction treatment. Our clients need to know that what they tell us, and even their presence in our services, is a secret. We act in a number of ways to protect your confidentiality, some of which may seem strange until you understand them. In addition to all the protection of records (locks on cabinets, passwords and rapid timeouts on computers, document shredders, etc.), in our outpatient offices we take additional measures as well. The sign on our suite says "PRPG" rather than "Practical Recovery Psychology Group." If I enter the waiting room to greet a new client I say "My name is Tom Horvath. Who is here to see me?" rather than "Are you John Brown?" Even if there is only one person in the waiting room, it might NOT be John Brown. There ...

Brainwashed: The Seductive Appeal of Mindless Neuroscience By Sally Satel and Scott D. Lillienfeld (New York: Basic, 2013) Review by Tom Horvath, Ph.D. The prominent authors of Brainwashed challenge the widely held view that neuroscience will soon dramatically improve human life. They thoroughly support continued neuroscience research and applaud the knowledge gained thus far. However, they believe the limitations of neuroscience need to be better understood. They begin by reminding us that vision is the most developed human sense. Therefore pictures of our brains in action, via fMRI (functional magnetic resonance imaging), are compelling. It is as if we opened a window into our skulls and merely needed to look in, in order to understand what happens there. This well-reasoned...

For Professionals (or anyone) Article on collaborative addiction care written for the Addiction Professional website

The statistic Practical Recovery would most like to publicize is how many of our clients return here after a relapse. When some treatment centers are publicizing “cure rates,” publicizing “return rates” would not appear to be good marketing!  However, the reality of addiction treatment is that after any particular episode the most likely outcome is a slip or relapse. The slip or relapse does not necessarily mean that more treatment is needed, but in some cases it does.  We have had clients who were previously in treatment at many of the “brand-name” treatment centers in the country. When they relapsed they elected to come to Practical Recovery, perhaps because if they returned (to most treatment centers) they would have gone through the same “program” they experienced previously. Every ...

Psychiatric pharmacogenetics refers to the use of genetic testing to predict the effectiveness of pharmacotherapy for individuals with psychiatric illnesses, including alcohol, drug and addiction problems. Some individuals, for instance, may have a genetic variation that interferes with or enhances the metabolism of a particular drug. Researchers from Baylor College of Medicine recently published an article that reviews psychiatric pharmacogenetics for drug and alcohol treatment (Haile, Kosten & Kosten, 2008). Most FDA-approved pharmacotherapies for addiction treatment are for either alcohol or opiates, and the current study focused on these two addictive substances. The researchers used Medline to conduct a literature review, searching terms related to alcohol and opiates and th...

By Tom Hovath, Ph.D., ABPP Congratulations to Anne M. Fletcher, MS, RD, on the release of the paperback edition of Inside Rehab: The Surprising Truth About Addiction Treatment—and How to Get Help That Works. This book has a been a major contribution to the US discussion about who needs rehab, what is less than desirable about the US rehab system, and how that system might be changed. During the nearly five years that Inside Rehab was in preparation, Fletcher visited 15 addiction treatment facilities across the US, and interviewed several hundred professionals and addiction treatment consumers. Practical Recovery is pleased to note we were one of the facilities she visited, and that she interviewed numerous staff and clients. We are proud that a summary of our work is included i...