Medication Assisted Treatment (M.A.T.) for opioid addiction is being vigorously touted and expanded across the country in response to the opioid crisis. The Substance Abuse Disorder treatment system is taking a page from the bio-medical model of disease that asserts that addictions are life-long, incurable brain disorders that require long-term (with no exit strategy) treatment with medications (Buprenorphine, Methadone, Naltrexone) Similar to the current bio-psychiatric, decontextualized...

“We treat people’s solutions as problems.” Vincent Felitti MD, eminent author of the original ACE’s (Adverse Childhood Experiences) study, often makes this point when discussing how we focus on eliminating people’s desperate means of coping, without recognizing their adaptive functions. When addressing substance abuse (the most common method of tolerating overwhelming fear and pain) do we commit the same error of attempting to control the “solution” while largely ignoring the underlying core...

When a foster youth encounters a psychiatrist, chances are high that s/he will get medicated. Traumatized foster youth are often prescribed powerful psychotropics due to exhibiting a wide variety of “normal reactions to abnormal events”, such as despair, agitation, anxiety and self-harm. The practice has been well documented; foster children are prescribed psychotropics at a 2.7 to 4.5 times higher rate than non-foster youth[1]. The National Center for Youth Law aptly summarizes the problem...

What would happen if the mental health system fully recognized the pervasive and profound impacts of trauma on their clients?  How might a deeper appreciation of the multi-faceted sequelae of childhood maltreatment and toxic stressors reshape...