ABSTINENCE VERSUS HARM REDUCTION
© C Y A Chen 2006 Tibet
There is no one right way to recover from addiction. I tailor my treatment plan to the specific needs of each unique individual patient, informed by scientific evidence and clinical experience, gained from years of treating patients with addiction.
Recovery is a continuum from harm reduction to abstinence. My personal philosophy is that for patients with significant loss of control over one's life due to chemical dependency (i.e. severe use disorder), the prudent course is lifelong abstinence from all substances. I base this philosophy in part on the knowledge gained from neuroscience, which teaches us that once the reward mechanism in the brain is compromised or maladjusted, any chemical that triggers that pathway can fan the flames of a life-threatening relapse. Therefore, it is my hope that you will aim for this gold-standard of eventual, if not immediate, abstinence. If however, your use disorder is mild or moderate and you are looking for a way to reduce harmful use and feel that abstinence is not your path, we can also work together on making sure you stay healthy.
Using substances or what is commonly referred to as "relapse" is not cause for discharge from my practice; however, recurrent negative behaviors associated with active addiction (e.g. persistent lying about use, drug-seeking behavior in the absence of an authentic desire for recovery) and / or violation of written agreements are reasons for referral to a higher level of care or to another provider or rehabilitation center that can better serve you.
Medicinal cannabis is a controversial topic. Marijuana is not prescribed in this practice. It is generally true that if an individual is having difficulty with one or more substances other than cannabis and is also using cannabis regularly, then chances are there is also a problem with the cannabis use. There are those who believe in using cannabis as a treatment for addiction; my practice does not follow that model as there is still much research to be done in this area. With that said, there are indications for FDA approved cannabinoids for certain indications, and some have found CBD formulations useful.
The long-term use of cannabis can be harmful especially when started during adolescence and continued through adulthood because of interferences with brain development that happen well into the mid 20’s. Cannabis also interferes with acquiring and mastering new coping skills during the recovery process.
Recovery is a continuum from harm reduction to abstinence. My personal philosophy is that for patients with significant loss of control over one's life due to chemical dependency (i.e. severe use disorder), the prudent course is lifelong abstinence from all substances. I base this philosophy in part on the knowledge gained from neuroscience, which teaches us that once the reward mechanism in the brain is compromised or maladjusted, any chemical that triggers that pathway can fan the flames of a life-threatening relapse. Therefore, it is my hope that you will aim for this gold-standard of eventual, if not immediate, abstinence. If however, your use disorder is mild or moderate and you are looking for a way to reduce harmful use and feel that abstinence is not your path, we can also work together on making sure you stay healthy.
Using substances or what is commonly referred to as "relapse" is not cause for discharge from my practice; however, recurrent negative behaviors associated with active addiction (e.g. persistent lying about use, drug-seeking behavior in the absence of an authentic desire for recovery) and / or violation of written agreements are reasons for referral to a higher level of care or to another provider or rehabilitation center that can better serve you.
Medicinal cannabis is a controversial topic. Marijuana is not prescribed in this practice. It is generally true that if an individual is having difficulty with one or more substances other than cannabis and is also using cannabis regularly, then chances are there is also a problem with the cannabis use. There are those who believe in using cannabis as a treatment for addiction; my practice does not follow that model as there is still much research to be done in this area. With that said, there are indications for FDA approved cannabinoids for certain indications, and some have found CBD formulations useful.
The long-term use of cannabis can be harmful especially when started during adolescence and continued through adulthood because of interferences with brain development that happen well into the mid 20’s. Cannabis also interferes with acquiring and mastering new coping skills during the recovery process.
TRANSFER OF CARE
If for some reasons there is a need to refer you to another practice, I will continue care for up to 30 days after written notice of discharge and provide you a referral to another addiction specialist in the area who might better serve you. This does not necessarily include continued prescribing of buprenorphine during this 30 day period.
As I mentioned above, relapse is not cause for discharge from my practice--however, recurrent negative behaviors associated with active addiction (e.g. lying about use, drug-seeking behavior in the absence of an authentic desire for recovery, inappropriate behavior towards me or my staff) and / or violation of written agreements are grounds for referral to another provider or rehabilitation center that may be needed in order for you to recover.
As I mentioned above, relapse is not cause for discharge from my practice--however, recurrent negative behaviors associated with active addiction (e.g. lying about use, drug-seeking behavior in the absence of an authentic desire for recovery, inappropriate behavior towards me or my staff) and / or violation of written agreements are grounds for referral to another provider or rehabilitation center that may be needed in order for you to recover.
RESOURCES
Alcoholics Anonymous: http://www.aa.org/
Food Addicts Anonymous: http://www.foodaddictsanonymous.org/
Narcotics Anonymous: https://www.na.org/
Refuge Recovery: http://www.refugerecovery.org/
Smart Recovery: http://www.smartrecovery.org/
Francine Farrell's Pacifica Assistance Group: https://pacificassistancegroup.net/
National Institute on Drug Abuse: http://www.drugabuse.gov/
National Institute on Alcohol Abuse and Alcoholism: https://www.niaaa.nih.gov/
California Society of Addiction Medicine: http://www.csam-asam.org/
American Society of Addiction Medicine: http://www.asam.org/
Substance Abuse and Mental Health Services Administration: http://www.samhsa.gov/
El Camino Hospital Chemical Dependency Services:
http://www.elcaminohospital.org/Programs_and_Services/Behavioral_Health/Addiction_Services_Program
The Addictions Institute: 445 Burgess Drive,Suite 150, Menlo Park, Ca 94025 - 650-329-9779 http://www.stephaniebrownphd.com/contact.html
Camtech: Dale O'Brien https://camtechmonitoring.com/
Olympia House Recovery Center: https://olympiahouserehab.com/
Copyright © Chwen-Yuen Angie Chen, MD 2013-2021. All Rights Reserved.