Tag: recovery

Reading of the Week: Cannabinoids for Therapeutic Use – the New JAMA Paper; Also, ECT and Szalavitz on Her Recovery & Substance Use

December 4, 2025 /

From the Editor

Cannabis for chronic pain? What about insomnia or seizures? Patients often ask about the therapeutic use of cannabis. And your patients aren’t the only ones thinking about it; more than one in four Americans have used cannabis for medicinal purposes. But what does the literature actually say?

In an impressive, new review paper just published in JAMA, Dr. Michael Hsu (of the University of California, Los Angeles) and his co-authors seek to answer that question. With 124 citations, they are thorough and thoughtful, drawing on studies, clinical guidelines, and more. They are also clear in their conclusion. “Despite the accumulation of new studies, evidence is insufficient for the use of cannabis or cannabinoids for most medical conditions.” We consider the paper and its implications.

In the second selection from The Lancet Psychiatry, Dr. Richard Braithwaite (of the Sussex Partnership NHS Foundation Trust) and his co-authors comment on ketamine for depression. Though some new studies have reported solid results comparable to ECT, they remain skeptical. “The claim that ketamine is equivalent to ECT is not supported by credible evidence. It is a narrative constructed on a foundation of a small number of inadequately designed trials and flawed meta-analyses.”

Is sobriety required for recovery from substance misuse? In a personal essay for The New York Times, writer Maia Szalavitz argues that it isn’t. She notes her own journey which has spanned 40 years. “In reality, most people who resolve addictions – including me – do not reject all substance use forever.”

DG

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Reading of the Week: Homelessness with Papers from Lancet and JAMA; Also, Kinsella on His Recovery

October 30, 2025 /

From the Editor

The loss of her job. A couple of poorly timed moves, motivated by her need to help care for an ailing parent. Financial woes. These problems converged, and my patient found herself ill and homeless. What were the potential implications for mortality?

In a new paper published by The Lancet Public Health, Sandra Feodor Nilsson (of Copenhagen University) and her co-authors attempt to answer that question. Drawing on Danish data involving more than six million adults, they found that men and women live far fewer years when experiencing homelessness, 15.9 years and 15.3 years, respectively. Though past work has examined the topic, Nilsson et al. offer a more comprehensive look. “Life-years lost exceeded those observed in individuals with schizophrenia, alcohol use disorder (for males), and drug use disorder.” We consider the paper and its implications.

In the second selection, from JAMA, Drs. Kirk B. Fetters and Joshua A. Barocas (both of the University of Colorado) describe recent cuts to Housing First programs in the United States and weigh its impact. They note the evidence for this approach. “Because the health care system is already overburdened and the homelessness crisis is worsening, maintaining and expanding Housing First is not only compassionate but also imperative.”

And in the third selection, Sean Kinsella writes personally about homelessness and addiction. In an essay for the Irish Examiner, he discusses his deep problems – and his recovery. He advocates that we do more for those who are homeless. “I wasn’t seen. I wasn’t heard. I was a file. A risk to be managed.”

DG



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