October 2013 Newsletter

It's almost the end of the year. In our setting, because we are moving into summer and festivities, this usually sees a drop in those seeking help for their substance use issues, but often their is a brief spike shortly after new year as resolutions are made and the after-effects of the partying are felt! I recently attended the Dan Siegel Interpersonal Neurobiology workshop that was held in Cape Town, hence the photo. In this month's edition of Addiction Information we hope to spark some thought around some controversial topics, but one topic that should become less controversial is that of opioid substitution therapy, for which their seems to be mounting evidence as a stand-alone treatment modality.

We look at: An opioid addiction switch, Behavioural Interventions and Buprenorphine Maintenance, Chronic Care, Remission Rates, Choice and Will Power, Dr Dan Siegel and the Mind & Life Conference.

Sex, Drugs, and No Control

Sex as Addiction and the Treatment Thereof

There is much controversy around the use of the term "sex addiction." This article gives a brief overview of the arguments against this term, and then shows some of the aspects as to why sex may indeed be an addiction and how it may be treated. There is certainly a need for further research in this area before anything definitive can be proclaimed, but perhaps the study of behaviours that present as addiction can give us further insight and understanding of exogenous addictions.

PDF Version (Printable)

According to the DSM-V Sex Addiction is not a diagnosable condition. Sexual addiction was mentioned in the DSM-III-R, but disappeared in the DSM-IV, threatened a come-back in the DSM-V but has now been discarded. Sex, however, has long been described as addictive. In the late 1800s Freud described masturbation as the “original addiction.” Rado in the 20’s described addiction as “compulsive” and made the reward/pleasure/sex link. We saw words such as nymphomania (Ellis) and the clumsy “Don Juanism”(Stoller). In the 70’s Mac Dougall spoke of “addictive sexuality”. It was originally proposed that sex be included under the heading of addiction in the DSM-5, and then that was discarded and the idea of hyper-sexuality was introduced as a possibility. Eventually none of these proposals was accepted, and so sexual addiction has ceased to exist, according to the DSM, that is.

Addiction Information January Newsletter

Introduction

Welcome to the first Addiction Information Newsletter. The object of this newsletter is to give you a monthly overview of what is happening in the world of addiction across a number of fields. You can subscribe to this newsletter and receive an e-mail version by joining our mailing list. Your suggestions are most welcome, and articles for the website or that you would like to have linked to this newsletter can be directly submitted to me by e-mailing shaun.shelly@yahoo.com.

In this issue:

The Motivated Addict, Dual-process models, CBT Ineffective?, Drug Policy, Brain Structure, Meth Psychosis, Transcriptional Mechanisms, Nepicastat & 18-MC Trials, Neuroscientist Marc Lewis, Dr Frankenstein's Cure and "beating addiction"

An Overview of Bipolar Disorders

A brief overview of bipolar disorders for addictions counsellors
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“Compared to bipolar's magic, reality seems a raw deal. It's not just the boredom that makes recovery so difficult, it's the slow dawning pain that comes with sanity - the realization of illnesss, the humiliating scenes, the blown money and friendships and confidence. Depression seems almost inevitable. The pendulum swings back from transcendence in shards, a bloody, dangerous mess. Crazy high is better than crazy low. So we gamble, dump the pills, and stick it to the control freaks and doctors. They don't understand, we say. They just don't get it. They'll never be artists.”

-David Lovelace, Scattershot: My Bipolar Family

Obsessive Compulsive Disorder

A brief overview of Obsessive Compulsive Disorder for addictions counsellors

PDF Version
When you attempt to eliminate risk from your life, you eliminate along with it, your ability to function.

- Fred Penzel

I once watched a man attempt to cross Belgravia Road. He approached the traffic light, turned away. He approached it again, and again he turned away. He repeated this process at least six times. Eventually he reached out to touch the button that would activate the pedestrian crossing light. Then he withdrew his hand, wiped it vigorously on his shirt and attempted to do it again. Again he withdrew. The next time he covered his figure with his shirt, but still he could not touch the button. The car behind me hooted, and I was forced to pull off. I was not convinced that this man would ever make it across the road. Such is the nature of OCD – obsessive, compulsive and utterly debilitating.