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.

March 2014 Newsletter

It has been a while since the last newsletter. What with holidays, the start of the new academic year, a revamp of the program I run and various other commitments time has been short. I will try to produce at least one newsletter per quarter for 2014, but can't guarantee it! Please feel free to forward any articles you feel should be included.

It has been a sad time for us in South Africa with the death of Nelson Mandela. Even though this was some months back his presence is very much evident. It is very difficult to explain to those without an intimate knowledge of our history just how much this man has come to symbolise. He is the figurehead that represents the struggle of many other great men, a nation and the political structures he represented. If it was not for the efforts of Mandela and these individuals, the treatment centre I run would not be legal. This is a thought that is truly bizarre,  and a sad indictment on those that allowed the apartheid system to flourish under the old regime. We miss Tata Madiba.

In the last news letter I spoke about the Mind & Life Conference on craving, desire and addiction. Well, that is now past, and it was indeed extremely interesting. I have summarised all the presentations, and they can be accessed through this post here.

Due to time constraints this is a shortened newsletter, but I'm sure you will find these articles and subjects as interesting as I have. These include: Addiction as Relationship, Stress and Addiction, Gabapentin, Buprenorphine, Rat Park, Mindfulness and addiction, Mike Ashton, Logical Fallacies.

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.

June 2013 Newsletter

After a busy two months I have finally managed to produce a newsletter. I recently gave a talk on the emerging divide between those who believe that opioid substitution is a treatment in itself, and those who believe that it is not really recovery. My talk, Opioid Substitution Therapy: Treatment vs. Recovery can be found here. This was prior to me being aware of the DSM qualification of "on maintenance therapy" for those in remission from Substance Use Disorders. I think we will see this argument developing in the States, and opinions will remain polarised. Hopefully we will see a more balanced approach in the South African setting. Comments are most welcome.

In this month's newsletter we talk about: Agonist Therapy for Stimulant Addiction, Is addiction a Disease?, The Anti-Reward System, Stimulant Addiction and Gray Matter, The Most Important Treatment Studies Matrix, Chris Arnade, Mindfulness and Improved RCTs in addiction.

Addiction Information March 2013 Newsletter

This month we celebrated Human Rights Day in South Africa. I was given the opportunity to share my opinion on why those suffering from addiction are seldom afforded the same rights as others. A copy of my speech can be found here: Human Rights Day: Addicts are also Human. This month saw the first International Conference on Behavioral Addictions taking place in Budapest and so it is fitting to talk a bit about gambling addiction. Also in this issue: 

The DeltaFOSB Feedforward Loop, Drug Court, The Portuguese Drug Policy, Russel Brand on Addiction, Discontinuation of Sublingual Buprenorphine and Possible Approval for Buprenorphine Implants

Addiction Information February 2013 Newsletter

This is Newsletter Number 2, which is a little late due to a crashed hard-drive. The only two documents I had not backed up were the talk I was due to present "Sex, Drugs and No Control", and this newsletter, so it was back to the keypad! But we've made it, although in a slightly shorter version. I hope you find this summary of addiction news from around the world useful. Your suggestions are again 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.

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In this issue: 
Inside Rehab, Celebrity Rehab, Recovery or Treatment?, Dr Mark Willenbring, OST, Naloxone, NMDA  Modulators, Epigenetics, Frankenstien Drugs, Local Research, Ibudilast for Meth addiction?, Policy in NZ, Columbia and Africa, Banker or Dealer?

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"