Kratom (Mitagyna speciose) is a tropical evergreen tree in the coffee family whose leaves have been used for centuries in South Asian countries as a stimulant and pain reliever. Recently, kratom has entered US and European markets and is now sold in various forms, both online and at local head shops.

Opioid withdrawal protocols often rely on a buprenorphine taper, but other medications are regularly used either in addition to or in the place of buprenorphine. In particular, tramadol ER, a mild opiate, may be effective and was recently studied at Johns Hopkins University School of Medicine.

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 2 CME credits.

Everyone knows about Alcoholics Anonymous (AA), the original 12-step group. There are more than 60,000 weekly AA meetings in the U.S. alone. Despite this near-monopoly, however, many patients object to some of the most basic tenets of 12-step groups. This article presents alternatives, such as SMART Recovery.

Online programs to provide substance abuse treatment? Phone apps that can measure someone’s blood alcohol level? Welcome to the future­—in some cases, the very near future. Dr. Nunes, the deputy director for intervention studies at the Center for Technology and Behavioral Health, sheds light on technology-assisted care.

Contingency management (CM) programs are often effective, but they can be expensive, with typical incentives costing $900–$3,000 for a 12-week program. Expensive CM programs are referred to as “high magnitude.” In this new study, researchers tested an “ultra-low magnitude” program (basically, a very cheap program) to see if offering inexpensive reinforcers would be effective for an opioid-abusing clientele.

The post-test for this issue is available for one year after the publication date to subscribers. By successfully completing the test you will be awarded a certificate for 2 CME credits.

How can you help increase the odds that Robert, or any of your patients, will succeed in recovery? Here are eight key strategies that support long-term recovery.

Addiction treatment often begins with high hopes and apparent success, but it’s important to remember that addiction is a disease with a relapse rate of 40%–60%. Be realistic: Expect that patients will go through cycles of relapse and recovery. Learn the warning signs for relapse, the measures you can take to prevent it, and what to do after it has occurred.

For many people, the word “recovery” means being in AA or another 12-step program where the goal is to stay abstinent. It’s a culture of mutual support where people help and assist each other toward the goal of sobriety.