The Relationships of Addiction

I would like to thank the ever gracious Marc Lewis for his input and commentary. Please visit Marc's blog site, Memoirs of an Addicted Brain. Parts of this talk have been taken from my own piece A Christian and an Addict Walk Into a Meeting

Those of you who grew up in the eighties will know that Roxy Music had a song called “Love is the Drug”, and indeed, as we shall see, some research shows that being in love is much the same as being in the throes of active addiction. But tonight I want to look at this from another angle as well – addiction as a relationship. This thought started with my looking at a particular definition of addiction:

Addiction is a pathological relationship with a substance or activity at the expense of more beneficial relationships. 

Now I am very much opposed to the anthropomorphisms that are so common in the addiction field where we often hear about “the disease talking”, but being a child of the 70’s and 80’s I was exposed to Frank Zappa’s rock opera Joe’s Garage where Joe forms an intimate relationship with a household appliance, so maybe my mind has been open to the idea of forming a relationship with inanimate objects – such as drugs, gambling or money!

August 2013 Newsletter

This newsletter was delayed, but I have a reasonably good excuse. I had a heart attack. Not to be put down by something minor, I used the opportunity to find out how much emergency room personnel know about addiction. Not very much it appears! I wrote about it in this piece: Substance Use Knowledge Amongst Emergency Room and General Medical Personnel. I am back at the office and its business as usual, which in the addiction field is anything but usual. Hope you enjoy this months newsletter, because it very nearly didn't happen!

This time we talk about: The Reward Pathway of Opioid Addiction, Does Maintenance Therapy Need Counselling?, The Scottish Review of Methadone Treatment, Is One Too many?, The Multistep Theory of Transition to Addiction, Internet Addiction, Scott Kellogg.

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.

The neurobiological underpinnings of addiction.

A brief overview of our current understanding of the neurobiological processes that underlie addiction.

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It is only recently that the idea that addiction is a brain disease has begun to be accepted by the general population. The disease model was at the centre of the AA/NA message long before it became accepted by even the medical field. As we make advances in neuroscience we are finding that many of the conclusions drawn from anecdotal evidence have, in fact, a sound neurobiological basis. There is indeed a strong neurological underpinning for addiction, and in this essay I will summarise the current understanding of this.

The Common Reward Pathway

The common reward pathway for substances of abuse, specifically relating to neuroanatomy and neurophysiology.

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Although substances of abuse have varied and diverse primary targets and acute effects neurochemically, research has shown that almost all substances of abuse lead to an increase in dopamine in the mesocorticolimbic dopaminergic system. The understanding of this common reward pathway is important as it could (i) lead to the development of a single medication that works for various classes of substances of abuse in addiction treatment; and (ii) give a better understanding as to why all those suffering from addiction experience similar psycho-social devastation in spite of the variety of drugs of choice.