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“Failing Up” – and the ASAM Criteria

It has become common in the treatment of substance use disorders to accept the idea of treating an individual at a lower (and less expensive) level of care with the plan that if they fail (i.e. relapse) that then, and only then, is a higher level of care warranted. This concept of “failing up” isRead More

Phone Intervention: Every Word Matters

During this time of social distancing, it seems appropriate to discuss remote (telephone) intervention. In 2011, we at the Alabama Physician Health Program, where I was then medical director, examined intervention outcomes over the previous 10 years. We found that of the 328 interventions that had been conducted, almost half, 161, were telephone interventions. InRead More

A Crisis of Physician Health in California

California was one of the first states to develop a program for early detection and treatment of physicians with substance abuse problems, but the program was closed in 2007. Now, California is one of the only states lacking such a program. The result has been catastrophic for many physicians and their patients. Substance use disordersRead More

Physician Health Programs Are Important: Encouraging Early Referrals

(While addressing Physician Health Programs specifically in this blog, the same principles can apply to all types of professional health programs for all the other health professions (dentists, nurses, judges, attorneys, pilots, etc)). Not everyone knows why Physician Health Programs are important. A medical board in a neighboring state without a PHP once asked meRead More

Specificity of Phosphatidylethanol as a Marker for Alcoholic Beverage Consumption

Utilizing blood phosphatidylethanol (PEth) testing as a means to detect beverage alcohol use vs abstinence among licensed professionals and others is a relatively new development. Phosphatidylethanol is a minor metabolite of ethanol formed when an enzyme, phospholipase D (PLD), binds ethanol to phosphatidylcholine lipids in cell membranes, including red blood cells. Over 48 homologues (similarRead More

Addiction and Crime

It is not a good idea to treat someone for an illness they do not have. In fact, it could be considered unethical. We have a successful model now in the professional health world for treating addiction as an illness. And if someone has that illness they should be diagnosed and treated. And there areRead More

Does AA Work?

Google AA (Alcoholics Anonymous) and you find a lot of negative opinions about it online. “AA is a cult.” “AA only has a 5% success rate.” “AA is an irrational “faith based” program.” “AA is a dangerous playground for violence-prone members.” “AA doesn’t work.” “The pseudo-science of AA.” So, if it does not work thenRead More

CPR’s Trial by Fire

“Mandatory evacuation now!” the police commanded. In my last 30 years working in addiction and treatment, I have seen my fair share of challenges. There have been cross country moves, changing facilities and staff changes that were really hard, but the last year has been extraordinary. It all started in November last year when weRead More

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Center for Professional Recovery