Navigating Substance Use Services

Rosalie Genova

01 Mar 2026 — 2 min read

Lenormand again. Crossroads is about decision points and different contingent scenarios. (Anna K Lenormand.)

I've taken a pause on weekly posting to preserve time for revising my book manuscript and activities related to ICE/CBP response here in Maine. Thank you for sticking around in the meantime!

I realized I might as well share a presentation I developed (for the Health Care Worker Solidarity Collective) on navigating substance use services. Generally, A Cure For Addiction is about exploring the many dysfunctions of the treatment industry and envisioning its obsolescence. But in practical terms, right now, with the options available, what are you supposed to do if you...

Want care and support for a substance use issue?
Are working with a patient or client struggling with substance use?
Have a loved one struggling with substance use?

A lot critiques of addiction treatment never address this question–and I don't blame them. The answer is not obvious at all! Some harm reductionists position their approach as the only alternative, but people have a wide variety of needs and goals, and harm reduction alone does not meet all of them.

This practical guide begins with my 5 models of addiction. Addiction is not one kind of problem, but potentially several different problems or combinations thereof depending on the addicted person's subjective experience. Forcing people into treatment when they don't even agree that they have a problem is common but often disastrous, and the presentation briefly summarizes why. It then walks through what a service uptake decision or service referral should look like based on 4 foundational questions:

Who determines whether my substance use is a problem?
How is it understood and talked about?
What resources/services might be helpful to me?
What are my goals in using those resources/services?

Here is the handout (slides) from my 20-minute presentation. Knowledge is power, which is why I'm providing it for free, and you may share the handout in any way you like (especially with a plug for the author and newsletter whose name is all over it). Questions or feedback are always welcome, and I offer educational workshops for groups that want to learn more.

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One large, gilded book faces front with stacks of books in the background.

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Diagnosis Just Got Even Less Rigorous