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Transform director Danny Kushlick provides the introduction to a special supplement on addiction in this week's New Statesman magazine
"Addictive behaviour seems to be inextricably linked with reward. The behaviour that the addicted individual performs has to reward them and there need to be plenty of opportunities to perform it too. However, this also describes many of the behaviours that human beings do every day – eating, working and sleeping, for example.
This New Statesman supplement explores what we are currently prepared to do to address the issues of addiction – and what we may need to accept in the future if we are to make any further impact on it."
the supplement features the essay from Transform introducing a round table on addiction discussion featuring:Deborah Arnott, Director of Action on Smoking and Health
Dr Mark Griffiths, Chartered psychologist and professor of gambling studies, Nottingham Trent
University
Dr Raj Persaud, Consultant psychiatrist, Bethlem Royal and Maudsley NHS Hospitals Trust London
Nick Barton, Director, Joint chief executive of Action on Addiction
Prof Martin Jarvis, Clinical psychologist, UCL
Steve Rossell, Chief executive, Cranstoun Drug Services
Dr Alex Bobak, Managing partner, General practice in Wandsworth
Baroness Doreen Massey, Chair, National Treatment Agency for Substance Misuse
Dr Jack Watters, Vice-president, International External Medical Affairs, Pfizer
Deborah Cameron, Chief executive, Addaction
Sarah Mukherjee, (chair) Environment correspondent, BBC
Prof Robert West, Director, Tobacco Studies, Cancer Research UK Health Behaviour Unit, UCL
Prof Colin Drummond Professor of addiction psychiatry, St. George's Hospital Medical School
Dr Gurprit Singh Pannu, Chair, Psychiatry division, South Asian Health Foundation
Dr Kim Wolff Senior lecturer in addictions, King's College, London
Caroline Flint MP, Minister for public health
5 comments:
Is Transform ready to acknowledge that addiction as diagnosed by international criteria is an irreversible condition? If not, what is their view, of what is classified as a mental disorder, and how it should be addressed?
If they do agree are they in agreement that the most effective way to arrest the progress of addiction is abstinence?
If not what evidence, other than ancedotal and self reporting have they to support an alternative view?
I dont really follow the question. I understood it that there were various different models of and ways of understanding addiction, none of which can be determined to be authoritativley correct or absolute.
Transform do not claim expertise in mental health or addiction, and that is not what the new statesman piece is about anyway. We acknowledge that there are a range of physical, mental and emotional problems directly or indirectly associated with drug use, and we support various public health led efforts, based on evidence of effectiveness, to reduce the overall harm drugs cause to individuals and society whilst maximising broader measures of persoanl and social wellbeing. Thast can involve various approaches, including abstinence. So Im not sure what your getting at.
Transform's response to perfectly clear questions was predictable, inasmuch as they chose to avoid answering them.
The universally recognised authoritve criteria for drug addiction as a mental disorder, as Steve knows, or should know, is clearly stated by the World Health Organisation and published in their International Classification of Disease (ICD-10) and the American Psychiatric Association, in their Diagnostic Statistical Manual of Mental Disorders DSM-1V.
Both addiction, which is refered to in these publications as dependency, and Substance Misuse are classified as mental disorders, the essential difference is that the former is irreversible, and both bodies agree that abstinence is the only effective route to arrest the progression of this disease.
Steve's justification for failing to 'follow the question', and thus avoid answering it, that Transform 'does not claim experise in mental health', is an admission that he is not aware of either publication or that addiction is internationally recognised as a mental disorder. Does that mean that Transform is not aware that substance misuse can lead to addiction? Or is it that Transform prefer not to acknowledge that fact?
I dont dispute the WHO has a definition of addiction and I im certainly in no position to dispute it. I merely pointed out that different practitioners understand, diagnose and respond to 'addiction' (which desribes a spectrum of behaviours) in different ways. This is also beyond dispute.
http://www.divisiononaddictions.org
/html/whatisaddiction.htm
You would know more about that as you are a treatment provider and Im not. Setting a quiz on your area of expertise, that I, as a policy expert but non-doctor, freely admit non-expertise in, and then casting aspersions when I dont deliver what you want to hear is not reasonable.
Obviously I dont dispute that substance use can lead to addiction - as would be clear if you had ever read any of our literature, which given your comments I very much doubt you have - just as youve clearly ignored my previous, entirely reasonable post.
What, exactly, are you trying to get me to say?
Steve,
I'm not trying to get you to say anything, nor am I seeking to cast aspersions.
All that I was attempting to do was to obtain your views as to whether you consider the use of addictive psycho active drugs can and does lead to addiction, and that in such cases, you agree with the universal empirical evidence, that anstinence is the most effective way of arresting the progress of what is commonly acknowledged as a mental disorder.
The questions I framed to establish the answers are perfectly straightforward, and have no covert intentions.
The fact remains that you have only answered that you agree that addictive psycho active drugs does lead to addiction, but not your views, or those of Transform on abstinence. However I am delighted to read that Danny is urging the Government to get people off of drugs when they have become addicted. Of course if there were no propaganda, enticement, or coercion, to use them in the first place, we would not have that problem.
Insofar as reading your literature is concerned Steve, it is obvious from the interest that I take in comments from Transform that I do read much of what you have to say. Regrettably, I rarely see anything that highlights the dangers of substance abuse, and the devasting effects it has on users, their families and society.
I do however see a great deal of comment that seems to be pressing for the legislation of drugs, or as you have put it in the past 'beter regulation'.
Whatever one wants to call it, the outcome would be an increased availability of addictive psycho active substances, much as alcohol which is included in that category is freely available. Such an increase would lead to more widespread usage, more addiction and more misery. Further unless, unlike alcohol, such substances were available on the NHS, prices would rise and the greater numbers using it as the result of greater availability, would need to fund their habit in a manner similar to now, ie robbing, stealing and muggings. the latter is not an hypothesis, but a refelction of the history of drug addiction as witnessed by the cocaine epidemic that swept the USA in the late 1800s and early 1900s, when it was legal. It is a matter of historical record and fact that at the same time crime, especially violent crime, escalated.
History is already repeating itself here with the continuing increase in the use of cocaine, where London is acknowledge as the cocaine capital of the world, and where violent crime according to Police recorded figures has exploded from approximately 35,000 incidents in 2004-5 to 197,000 in 2005-6.
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