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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 15h

But the #addiction treatment industry has never been transparent about its own limitations. We've gone from claiming we have the "cure" to insisting there is none--whatever keeps the money coming!

Check out my newsletter if you want to know more...

A Cure For Addiction

Welcome! I’m Rosalie, or Rosey, and I’m a therapist in the specialty usually called “substance use disorders.” “Addiction” is a subjective experience, not a clinical label, and I find it more human th...

a-cure-for-addiction.ghost.io

Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 15h

What they don't tell you is that MOST PEOPLE who have had a substance use problem, resolved it on their own.

This is not to discourage treatment, and certainly not to reduce access even further. I'm a provider myself.

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 15h

If #substanceuse treatment wasn't helpful to you, the standard recommendation is...to do it again. The "chronic disease" model and findings on people getting sober after multiple treatments are used to support this recommendation.

#harmreduction #therapistsky #addictionmed

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 1d

At this point I think a lot of forced treatment advocates are not actually interested in efficacy. They just want people out of sight and under control (as in the July executive order). Lack of capacity isn't a problem if you're open to (more) penal-style facilities and warehousing.

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 1d

Clawing back payments and mysteriously dropping every one of my phone calls because no one can explain why

Hiring an outside company to "negotiate" "expedited" payment (Guess what the catch is?)

Feel free to add your own faves!

Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 1d

Trying to pay me in gift cards

Insisting they didn't receive my electronic claims

Requiring me to submit claims on paper (basically unheard of, and also hmm they didn't receive those ones either)

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 1d

Popular opinion: health insurance companies are always trying to get away with something!

Just when you think you know what you're
dealing with, there's some new game or new 3rd party entity involved.

Every provider has these stories, here are some of mine:
#therapistsky #m4a #healthcare

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Reposted by Rosalie Genova, LCPC, CCS

Kirsten Grady @mrskgrady.bsky.social · 2d

On the micro level, my job is to help real people survive impossible systems. Sometimes that means translating government-ese into human, other times it’s just sitting beside someone who’s about to give up. Access shouldn’t depend on having a social worker in your corner.

#SystemsUntangled

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 4d

I worked in mandated treatment for many years. I wanted to believe it "works"--but it usually doesn't.

See my roundup above and/or this report from @drugpolicy.org

#harmreduction #m4a #therapistsky #socialworkispolitical

Report: The Drug Treatment Debate: Why Accessible and Voluntary Treatment Wins - Drug Policy Alliance

For people to get the help they need, substance use disorder treatment must be voluntary, effective, affordable, accessible, and appealing.

drugpolicy.org

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 4d

If you're arguing for #addiction treatment over punishment, make sure it's voluntary treatment of the person's choice.

Otherwise, we'll just keep getting more of what we already have: people forced en masse into standardized programs that are basically incarceration by other means.

mandatory treatment for substance use disorders

People having to accept substance use treatment against their will due to legal, employer, medication or other requirements. Treatment providers are required to treat these people without their consen...

a-cure-for-addiction.ghost.io

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 4d

Thank you! Reminds me of this book:

McMindfulness by Ronald Purser: 9781912248315 | PenguinRandomHouse.com: Books

A lively and razor-sharp critique of mindfulness as it has been enthusiastically co-opted by corporations, public schools, and the US military. Mindfulness is now all the rage. From celebrity endorse...

www.penguinrandomhouse.com

Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 4d

Why is #addiction treatment always done in groups? Just kidding--you already know why. Here's the problem.

#socialworkispolitical #harmreduction #therapistsky #addictionmed

Group, Group, and More Group

The classic visual for addiction treatment is a circle of chairs, like so: As little as most people know about our world, pop culture has this one right! Just about everything is done in groups—same ...

a-cure-for-addiction.ghost.io

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Reposted by Rosalie Genova, LCPC, CCS

Christopher Hudson @chrishudsonjr.bsky.social · 6d

Messages Underpinning Backlash to U.S. #HarmReduction Policy

Stacey McKenna @rstreet.bsky.social

Messages Underpinning Backlash to U.S. Harm Reduction Policy - R Street Institute

Author Table of Contents Media Contact For general and media inquiries and to book our experts, please contact: [email protected] Decades of research demonstrate that harm reduction programs are benefici...

www.rstreet.org

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 5d

A sense of deliverance to safety that turns out to be false or deceptive.

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 6d

I haven’t seen a single treatment organization denounce the July Executive Order… which makes me think they’re open to it as additional revenue 👀

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 6d

I can’t access the article, but as to the lack of capacity I’m concerned that what will happen is a bunch of new explicitly penal “treatment” facilities opening up to accommodate lower standards for involuntary commitment.

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 6d

Applications get denied and fully deleted because, in the latest example, I left a space in my license number--which is as it appears on the document.

For all the hand-wringing about not having enough mental health providers taking Medicaid, they really make it hard to become one.

#M4a

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 6d

Credentialing as a mental health provider with private insurance companies is a pain. But I am having SO MUCH more trouble credentialing with my state's Medicaid system. I am on about my 10th attempt (not exaggerating).

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 7d

Totally! Sounds like these were people interested in change. I'm only saying we shouldn't be forcing treatment on anyone who is not.

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 7d

1) They articulate their interest in change, and can update it at any time, including my withdrawing consent to treatment. 2) Harm reduction interventions are ideally led by peers and include education for safer use, safer materials, and real-time overdose prevention.

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 7d

#Substanceuse treatment is only relevant for people interested in change--and even for them it's not the only option. I'm saying this as a treatment provider.

For people NOT looking to change their relationship with substances, #harmreduction is the only appropriate intervention.

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 7d

Thanks for posting. Odd that the article is current but did not mention the major rollback of these initiatives in Oregon over a year ago (linked below). It sounds like a similar backlash is underway in Vancouver, Canada.

Oregon Rolls Back New Drug War Strategy, Revert to Decades‐Old Approach Linked to Soaring Overdose Deaths

Oregon’s Measure 110, which decriminalized drug use and ramped up harm reduction, took effect in 2021 at the peak of the COVID-19 pandemic. After barely giving it a chance to have any effect, lawmaker...

www.acsh.org

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Reposted by Rosalie Genova, LCPC, CCS

Tim Reierson @holdspacefree.bsky.social · 8d

🔥#Consent is eroding all around us ( #MedTech, #WealthCare #AIHype #WrapAround #Surveillance #ConditionalCare ) and it is vital to recovery, authenticity of care, and human connection. So grateful for your highlight on this.

Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 8d

What gets called "resistance" in #substanceuse treatment is often in fact non-consent.

If someone enters treatment on a mandate--legal, employer, medication-related, etc--they did not consent freely, and it's no surprise if they act like it.

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 8d

Facts! Thanks for making those connections!

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Rosalie Genova, LCPC, CCS @rosalie-genova.bsky.social · 8d

Coming from substance use treatment, some of my patients sought it out because it was thought to enhance the effects of opioids. If they couldn’t get what they ideally wanted, or not enough of it, Gabapentin was supposed to be a stopgap. I can’t speak to whether it met that goal or not.

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