Tag: Szalavitz

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: An Exercise App for Burnout – the New JAMA Psych Paper; Also, Pandemic Mental Health Use and Szalavitz on Portugal

September 7, 2023 /

From the Editor

A recent CMA survey found that more than half of physicians report high levels of burnout; surveys of other health care disciplines show a similar result. Not surprisingly, burnout is much discussed. What can be done for health care workers?

In the first selection, Vincent Gosselin Boucher (of the University of British Columbia) and his co-authors consider that question, offering an app-based intervention featuring exercises that can be done at home. The resulting study, just published in JAMA Psychiatry, included 288 health care workers in an RCT. “[A] 12-week app-based exercise intervention yielded significant reductions in depressive symptoms among HCWs that became more pronounced as time progressed.” We review the paper and its implications.

In the second selection, Jonathan H. Cantor (of the RAND Corporation) and his co-authors look at mental health utilization and spending before and during the pandemic, drawing on almost 1.6 million mental health insurance claims in the US. “[U]tilization and spending rates for mental health care services among commercially insured adults increased by 38.8% and 53.7%, respectively, between 2019 and 2022.” 

Finally, in the third selection, author Maia Szalavitz writes about the decriminalization of low-level drug crimes in Portugal. In a New York Times essay, she argues that critics don’t understand what Portugal accomplished – and, in contrast, how many Americans go untreated in correctional facilities. She concludes: “Shifting priorities and funding to provide high-quality treatment and other supports for recovery like housing takes time. Our failure is a century of criminalization – not much-needed attempts to end it.”

DG

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