Myths of Addiction

This is a recent talk I presented at the South African College of Applied Psychology Festival of Learning and at the University of Cape Town Department of Psychiatry and Mental Health addictions forum.

In it I dispel the myths that: 

• Addiction is caused by drugs, 
• once an addict always an addict, 
• addiction is progressive 
• abstinence is required to initiate treatment or for remission.

I feel strongly that if we allow these myths to continue, we will not develop practical and helpful treatment modalities or public policies. At the end of the talk I made some suggestions regarding treatment. Comments and criticisms are welcome!

Injecting Drug Use and Harm Reduction

I was recently quoted, along with a colleague and some of our out-reach workers in an article on increased levels of injecting drug use in the Western Cape.

The message is important, and unless substitution therapies are introduced it is likely that there will be a significant increase in overdose deaths and a spread in HIV and other infectious diseases.

This article was originally published on Ground Up and then on allAfrica. The article is by Ian Broughton, and the photo is by Andrea Schneider.

Healthcare workers worry injecting heroin on increase

Sunday 31 August was International Overdose Awareness Day. Health workers in Cape Town have warned of a possible increase in drug overdoses and the spread of infectious diseases, including HIV, if the use of needles to inject drugs increases.

August 2014 Newsletter

The recent death of Robin Williams is incredibly sad. As always, when a celebrity dies, especially when substance use is somehow involved, there is a lot of talk about the dangers of drug use and how addiction so often leads to death. I have a slightly different take on the issue: life long substance use disorders, where there is a constant battle against relapse - are usually the sign of something severe that underlies the SUD.

In this case, it seems, the monster below the surface was unresolved pathological depression. Of course, that mixed with an alcohol use disorder is a recipe for disaster. But the alcohol is an adjunct - it is both the (temporary) solution, and the (long-term) catalyst. It is not the primary disease.

I often see how by focusing on the SUD the real pathology is missed. Each relapse brings around renewed focus on the SUD rather than sparking the question: "Well, we know that SUDs die a natural death in most cases, unless there is a contributing factor, this person is not getting better, so what is the contributing factor, and how do we resolve that?"

It is sad that complex problems get reduced to the simple statement "Oh, he was an alcoholic".

In this newsletter I bring together some information from different types of addiction and drug use. When put together much of the research seems to be stating the obvious and, in my opinion, addiction looks more like a learning disorder or adaptive process and not a primary disease of the brain. It seems that Maia Szalavitz agrees with me.

We look at Marijuana and brain changes and schizophrenia, methamphetamine and brain changes, porn and brain changes, internet addiction (and brain changes), Tom Hovarth and SMART Recovery, the results of the Global Drug Survey. I hope you enjoy, and please feel free to comment! Please click HERE to find out more about the Cape Town Recovery Film Festival 2014.