The Insanity of Addiction Medicine

“It ain’t what you know that gets you into trouble.” It’s what you know for sure that just ain’t so.”
-Mark Twain

When I first saw this quote from Mark twain, I immediately thought of the people who have died from opioid addiction because their provider thought all they had to do was want it bad enough. I have heard too many times those who have passed away “just didn’t find their bottom.” Or even worse from others in recovery, “I guess others had to die so that I may live.” Both of these statements are complete crap. For too long, I did not speak up. Now, 16 years into my own recovery, and I am tired of watching people die and hearing these tired clichés spoken over their graves.


Many people suffering from addiction are met with a closed-mindedness that has dominated the treatment field for decades. Many people working in addiction treatment think that the only path to recovery is the one that worked for them. They never mention other evidence-based treatments such as medication used to treat Opioid Use Disorder. In most cases, medications are not even offered as an option at many inpatient and outpatient treatment facilities, despite being the only treatment proven to save lives. Someone suffering from Opioid Use Disorder can go to treatment ten times and all ten times receive the exact same treatment that has failed nine times already. It is likely that medication will never be mentioned as an option for most patients. This is malpractice. The only rationale is that the providers “know for sure something that just ain’t so.” Sadly, people die because of the belief that they just didn’t want it bad enough.


Early in my own recovery, I heard the definition of insanity: doing the same thing over and over and expecting a different result. The “one size fits all” approach to treatment is insane. People die because treatment providers believe that medication assisted treatment is just switching one drug for another. Despite the mountain of medical literature that proves the validity of medication to treat opioid use disorder, they continue to ignore it. This is, by definition, insanity.


Before finding help for a loved one with opioid addiction, please make sure their provider will look at all treatment options and be open to the one which best fits your situation.


The only thing I know for sure is in the treatment of opioid addiction, people die when they don’t have to. My job is to meet the hurting person where they are with kindness, compassion, and love in order to help them find the path to recovery that is right for them, for me. There is a lot that I don’t know for sure, but I do know that I will not let someone lose their battle with opioid addiction because I refuse to let go of something “that just ain’t so.”

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© 2020 by Dr. Stephen Loyd.