In 2012 heroin was responsible for 30% of all drug deaths in Australia. People who are addicted to heroin are more than four times to die than the general population with the three commonest causes of death being polysubstance overdose, trauma and suicide. We know that people who use heroin or illicit opioids are 5 times more likely to die prematurely than the general population.
Opioid replacement therapy (ORT) is the replacement of a drug of dependence such as heroin with a legally prescribed opioid substitute with a stable and long half life such as Methadone or Suboxone which helps reduce cravings and the cycles of withdrawal. The use of Methadone and Suboxone in ORT is a form of harm reduction and it realises that for a number of reasons there are some people who are unable to remain abstinent of drugs and replacement therapy is a safer alternative.
Methadone maintenance therapy reduces heroin use, injecting behaviours and mortality and we know that by commencing ORT patients are:
more likely engage in healthcare
results in improved physical and psychological health
decreases criminal behaviour
increases social and community engagement
decreases harms associated with injecting drug behaviour
ORT has been present and used for a number of decades and has been extensively researched and has a good evidence base for it’s effectiveness. It is something that is within the realm of all general practitioners and doctors and something that should be thought about and utilised more frequently than it currently is.
The highs and the lows of the “Low Carb High Fat” diet.
Many people tend to subscribe to the famous “Low Carb High Fat” diet and others swear by it but a pertinent question to ask is whether these individuals do it well or if they are successful? Can the diet really improve diabetes control?
This week on Lifestyle Matters, Dr Ferghal and I take a deeper dive into the “Low Carb High Fat” diet”.
Before insulin was discovered in the 1920s, a low carbohydrate diet was commonly prescribed to patients with diabetes. The logic was that the lower the carbohydrates consumed, the lower the glucose levels in our bodies. The prescription of this diet for diabetes control persisted despite the discovery of insulin! They were not wrong; there have been many studies demonstrating the efficacy of this diet in weight loss and reduction in insulin resistance. Insulin resistance is one of the underlying factors in the development of diabetes.
When we eat carbohydrates, these get broken down into sugar molecules which then triggers off insulin release for it to be taken up by our cells. If we have diabetes, insulin does not work very effectively, thus our glucose (sugar) levels rise. So, we can see why a low carbohydrate diet was prescribed for diabetes control.
However, long term studies have shown that this diet is not as sustainable as we may think it is. Further, their potential adverse effects from this diet which we will explore below.
Firstly, let us study the amount of energy we should obtain from various macronutrients.
As seen in the chart above, 45-65% of energy intake = 225-325gm of carbohydrate / day.
There are a few different types of low carb diets:
• Very low: 20-50gm of carbs/ day (most effective, almost ketogenic)
• Low: < 130gm / day
• Moderate: < 230gm/ day
The reality is this; it is not easy to sustain a very low carbohydrate diet beyond 6-12 months. Many people fall back onto a low and moderate carbohydrate intake which does not produce results as effective as a very low carbohydrate diet. Further, people tend to increase their protein intake while on this diet which commonly is achieved through a higher meat intake i.e. saturated fat.
It is imperative to keep the saturated fat to < 10 % if one were to follow this diet. This is also extremely important for those who suffer with hypertriglyceridemia (where their triglycerides > 500 mg / dL ) as the ability to remove triglyceride enriched lipoproteins are saturated and can lead to pancreatitis. This shows the indirect effects of going on a low-carb diet.
There are other adverse outcomes from consuming a low carbohydrate diet over long term such as:
• Osteoporosis: Various mechanisms have been identified in rat models (watch this space!)
• Deficiency in vitamins and minerals: Dietary fibre, Magnesium, Phytochemicals that are usually found in complex carbohydrates.
In summary, the key message from this is that if a low carbohydrate high fat diet suits one’s lifestyle it is a reasonable choice as it certainly does demonstrate several benefits. However, due to issues with its sustainability and potential negative implications on our health, it may make it less than an ideal diet to stick to beyond a year.
Can we generate a super fuel in our bodies by eating differently? This week we look at the popular keto diet from a medical perspective.
This diet was originally founded in the 1920s by Russel Wilder to treat epilepsy and it worked! Once anti-epileptic medications were discovered, this diet became less popular until recent times when it became evident that it also helps with weight loss. Truth be told, this diet is still used for some refractory epileptic patients under medical guidance.
A keto diet is essentially a diet we consume to put our body in a state of ketosis. But first, what is ketosis? To understand that we must understand what ketones are.
Ketones are products of fatty acid breakdown e.g., acetoacetate, beta hydroxybutyrate and acetone. These molecules are continuously produced in our bodies in small amounts as part of normal physiological processes.
Ketosis or ketogenesis is a process when our body uses these ketone bodies to provide energy for our cells.
When we eat a well-balanced diet, our body uses carbohydrates as the main source of fuel. So, reducing our consumption of carbohydrates and increasing protein (amino acids) and fat intake allows our body to break down these macronutrients to provide us with energy via processes called gluconeogenesis and ketogenesis respectively.
Ketosis can also happen as part of disease processes e. g . starvation, alcoholism, poorly controlled diabetes and even extreme prolonged exercising. This is obviously dangerous to our health and requires treatment.
Most cells in our body can utilise ketones as a source of energy except our red blood cells and liver. The brain is really good at doing this!
This is how a Keto Diet looks like:
Ketones are called a super fuel because:
100 gm of glucose we can generate 8700 gm ATP
100gm of beta hydroxybutyrate generates 10 500 gm ATP
100gm of acetoacetate generates 9400gm ATP
Apart from being a super fuel, it has various other benefits such as:
Treating difficult to control epilepsy
Reduce the risk of neurodegenerative conditions e.g. Alzheimer’s Disease
Reduces insulin production
Increases leptin levels (hormone that tells us we are full hence suppressing our appetite) -> weight loss
However, there are some limitations to the Keto diet that suggest that it may not be suitable for everyone.
Those who have certain enzyme deficiencies e. g. pyruvate kinase deficiency, liver failure, and pancreatitis, should not be on this diet due to the high levels of fat and protein intake. There has been also some research to suggest this diet may result in osteoporosis, kidney stones, fatty liver and gout. Further, most studies on the Keto diet have only been conducted over 6 months which means the long-term implications of the diet are still being investigated.
The main point to note is that this is undoubtedly a great diet to follow if it suits one’s lifestyle provided there are no medical contra-indications to it. However, once again it is a diet that we would suggest one to adhere to for a short period (6-12 months) as we have sufficient evidence to support this recommendation, for now at least. Post that period, transitioning to a normal well-balanced diet would be advisable. Ideally, following a whole food predominantly plant-based diet would produce the best outcome.
Benjamin Franklin said that “The best of all medicines are resting and fasting” and we know today that his words have been supported by scientific evidence. Intermittent fasting has been found to reverse early Type 2 diabetes.
The concept of fasting is not new to many especially if we look at the various cultures and religions around the world e.g., Muslims fast during Ramadan, or the various fasts practiced by Hindus and Buddhists. Even Greek philosophers such as Hippocrates and Aristotle have prescribed fasting for various ailments. This week, we look at how and why intermittent fasting works.
We must first understand what happens during the fed and fasted state. When we eat – (predominantly) carbohydrates get broken down into simple sugar molecules. This triggers an insulin response which promotes the uptake of sugar into our cells. Extra sugar (glucose) gets stored in our muscle and fat as glycogen. Leptin levels (which is our satiety hormone) also increases.
When we fast, glucose and insulin levels reduce. This causes our body to search for an alternate source of energy hence processes such as lipolysis and gluconeogenesis begins.
Later on, ketogenesis occurs whereby ketones are produced from the breakdown of fatty acids which is then used a source of energy i.e. ‘the super fuel’
When we fast for prolonged periods of time, our body enters a state of stress adaption whereby it begins certain processes such as cleaning and repairing e.g. DNA repair, protein quality control, increasing expression of anti-oxidant defences etc. As the body enters a fed state, tissue growth and plasticity then begin. However, when we eat ‘normally’ we do not allow our body to switch from a fed to fasting state. Several evidence have pointed the benefits of allowing our body to go through this metabolic switch and these range from:
• Neurodegenerative health: Potentially reducing the risk of dementia as there is an increase in brain derived neurotrophic factor, increased GABA sensitivity etc. • Improved heart disease profile: Increases HDL (good cholesterol) reduces LDL (bad cholesterol), reduces resting heart rate and blood pressure. • Reduces risk of diabetes: Reduced insulin resistance as adiponectin levels are increased and leptin levels reduced • Reduces cancer growth: Mainly documented in glioblastoma multiforme which is an aggressive type of brain tumor, but other cancers are being studied too e.g. breast, ovarian, prostate.
While most studies have been carried out on animals, there are several others underway involving humans. We have observed over time that the profound benefit of this diet is the metabolic switch that occurs and the benefits we can gain from it whether or not there has been weight loss!
It is important to note that this diet is reasonably sustainable and allows us to eat foods we enjoy in moderation. However, no diet is superior if it is not one that suits our lifestyle, and we must always remember that exercise augments the benefits of any diet we follow.
This week Dr Ferghal and I discuss stress. Some regard it as the modern-day trash which needs to be regularly disposed of to prevent over piling.
13% of Australians above the age of 18 years old describe moderate to high stress levels and there is a lower socioeconomic predominance to this.
But first, what is stress? There are many ways to define it but put simply, it really comes about when the demands placed on a person is so overwhelming that she/he is thrown into a state of worry. The right amount of stress can sometimes lead a person to being more productive. However, when the factors that cause stress are ongoing, this leads to distress whereby one can experience feelings of headaches, nausea and insomnia etc.
The Yerkes-Dodson Law (the inverted U model of arousal) describes this quite well. This is a law that describes the relationship between stress and work performance as pictured below:
Stress at unhealthy levels can have a negative impact on our health such as:
When one undergoes stress, they can also develop some maladaptive patterns to cope. These include an erratic eating pattern. e.g over or undereating and substance abuse. 38% of people engage in emotional over- eating, while another 38% are ‘starvers’. The remainder have unaffected eating pattern. Women tend to turn to food whilst men on the other hand use tobacco or alcohol to cope with stress. We know the effects of these substances on our health which have been discussed in the previous episodes.
A British study in 2007 demonstrated that people who responded to stress with a higher cortisol level tend to be emotional eaters. The food group of choice is usually a highly caloric food such as simple sugars or carbohydrates as they increase good feeling hormones (endorphins)
As outlined, stress has many effects on our health, and we ought to learn how to manage it better so that we can find a way to use it as a positive influence in our lives. We will discuss this further in the next episode.
From Fear to Freedom: How Reiki Can Transform Recovery
Introduction:
In a world where addiction and its underlying causes are complex and multifaceted, alternative healing practices like Reiki offer a unique approach to addressing the emotional and spiritual aspects of recovery. In a recent episode of “Cracking Addiction,” Dr Ferghal Armstrong delved into the world of Reiki with guest Helen Kaynes, a Reiki master. This blog post will provide a detailed exploration of Reiki, its origins, the process of a Reiki session, its potential benefits in addiction recovery, and the various levels of Reiki practice.
Ask not why the drug, but why the pain.” – Dr Ferghal Armstrong
Origins of Reiki
Reiki, a form of energy healing, traces its roots back to the mid-1800s when Mikao Usui, a Buddhist monk in Japan, discovered the ancient healing method. Usui found the formula for Reiki in a Tibetan script and underwent a transformative experience on Mount Kurama, where he received attunements from a source of light. This marked the beginning of Reiki as a channeling of source energy to promote healing and balance in the body.
The Reiki Session Experience
During a Reiki session, clients engage in a dialogue with the Reiki practitioner to identify areas of physical or emotional distress they wish to address. The client then lies down as the practitioner channels Reiki energy through light touch or hovering over specific areas of the body. The energy flow is described as a warm, soothing sensation that helps induce deep relaxation. Through this process, the client may experience the release of fear and emotional blockages, leading to a sense of renewal and healing.
Emotional Causes of Disease
One of the core principles of Reiki is the understanding that emotional imbalances can manifest as physical ailments. For example, feelings of overwhelm and busyness may contribute to cold or flu symptoms, while unresolved emotional traumas can manifest as chronic pain. By addressing the emotional roots of disease, Reiki aims to restore harmony and balance within the body, promoting holistic healing.
Reiki in Addiction Recovery
In the realm of addiction recovery, Reiki can serve as a valuable tool in addressing the underlying pain and fear that often drive addictive behaviors. By creating a safe space for clients to release emotional burdens and traumatic experiences, Reiki helps individuals in recovery reconnect with their sense of wholeness and inner peace. The relaxation and energy-balancing effects of Reiki can support clients in managing anxiety, cravings, and emotional turmoil during the recovery process.
Levels of Reiki Practice
Reiki practice is divided into three levels, each offering a deeper understanding and connection to the healing energy. Reiki Level 1 focuses on self-healing and basic energy channeling techniques, while Level 2 introduces symbols for emotional healing and power enhancement. Reiki Level 3, or Reiki Master, enables practitioners to attune others to Reiki energy, pass on healing knowledge, and deepen their spiritual connection to universal light.
Conclusion
In conclusion, Reiki represents a gentle yet powerful approach to healing that addresses the mind, body, and spirit connection. As highlighted in the conversation between Dr Ferghal Armstrong and Helen Kaynes, Reiki holds immense potential in addiction recovery by releasing fear, promoting relaxation, and supporting emotional healing. By incorporating Reiki into holistic recovery programs, individuals struggling with addiction can access a transformative pathway to healing and self-discovery.
Understanding Thiamine Deficiency and Its Impact on Alcohol-Related Brain Disorders
Introduction:
Alcohol consumption has long been linked with various health issues, but one area that is often overlooked is its relationship with thiamine deficiency. Thiamine, or Vitamin B1, plays a critical role in brain function and cellular energy production. In this blog post, we delve into the nexus between alcohol, thiamine deficiency, and the resultant neurological disorders such as Wernicke’s Encephalopathy and Beriberi. With insights from the podcast episode “Cracking Addiction,” featuring Dr. Ferghal Armstrong and Dr. Richard Bradlow, we will explore these critical topics in depth.
Really, you’ve got to have a low threshold for giving bucket loads of thiamine… the chance of preventing irreversible brain damage outweighs a lot of those considerations.” – Dr Ferghal Armstrong
The Role of Thiamine in the Body
Thiamine is a vital nutrient essential for glucose metabolism. It acts as a cofactor for several enzymes, including pyruvate dehydrogenase, alpha-ketoglutarate dehydrogenase, and transketolase. These enzymes are crucial in the energy production pathway, which fuels cellular functions. Thiamine is stored in the liver and absorbed through the gut. A deficiency in thiamine disrupts these metabolic pathways, leading to severe neurological and physiological symptoms.
Alcohol’s Impact on Thiamine Absorption
Contrary to the common belief that alcohol directly reduces thiamine levels, Dr. Richard Bradlow explains that the issue is multifaceted. Chronic alcohol consumption leads to a poor diet, liver dysfunction, and damage to the gut wall—all of which contribute to thiamine deficiency. Therefore, it’s not merely the alcohol itself, but rather the lifestyle and physiological changes it induces that impair thiamine absorption and storage.
Wernicke’s Encephalopathy: Symptoms and Diagnosis
Wernicke’s Encephalopathy is a severe neurological condition resulting from acute thiamine deficiency. It is characterised by a triad of symptoms: ataxia, ophthalmoplegia, and confusion. However, as Dr. Ferghal Armstrong points out, this classic triad is present in only about 10% of cases. Therefore, any new neurological symptoms in the context of alcohol withdrawal should be considered as potential Wernicke’s and treated immediately. Delayed treatment can lead to irreversible brain damage known as Korsakoff syndrome.
Preventing Wernicke’s: The Importance of High-Dose Parenteral Thiamine
In clinical settings, healthcare providers administer high-dose parenteral thiamine to individuals undergoing alcohol detoxification. This approach ensures rapid replenishment of thiamine levels and helps in preventing the onset of Wernicke’s Encephalopathy. Oral thiamine supplementation is less effective due to poor bioavailability, making parenteral administration the gold standard for acute cases.
Beriberi: Understanding Peripheral and Central Manifestations
Beriberi, another consequence of thiamine deficiency, can manifest in both peripheral and central forms. Peripheral Beriberi affects the cardiovascular and nervous systems, leading to symptoms such as heart failure (wet Beriberi) or neuropathy and muscle wasting (dry Beriberi). Central Beriberi primarily impacts the brain, manifesting as Wernicke’s Encephalopathy. A look into the history reveals that Beriberi was first identified by Jacobus Bontius, a Dutch physician, who associated its symptoms to that of sheep, leading to its name.
Global Variations in Thiamine Deficiency and Wernicke’s Incidence
One fascinating insight from the podcast episode is the global disparity in Wernicke’s Encephalopathy incidence rates. Countries like France, despite high alcohol consumption, have lower incidences compared to countries like Australia. This discrepancy may be attributable to differences in diet and lifestyle, suggesting that nutritional habits play a significant role in mitigating thiamine deficiency risks.
Dietary Sources and Supplementation of Thiamine
To maintain adequate thiamine levels, it’s crucial to consume foods rich in this vitamin. Common dietary sources include cereals, pork, fish, beans, lentils, and fortified grains. For individuals with alcohol use disorder, healthcare providers often recommend thiamine supplementation. Thiamine tablets, typically taken multiple times a day, offer a straightforward way to combat deficiency. Harm reduction strategies, such as encouraging the use of multivitamin supplements, can also be beneficial, although they provide lower thiamine doses compared to specialised B1 supplements.
Conclusion
Thiamine deficiency is a serious consequence of chronic alcohol consumption, leading to disorders such as Wernicke’s Encephalopathy and Beriberi. Understanding its critical role in energy production and neurological function underscores the importance of early detection and treatment. Adequate dietary intake, supplemented by high-dose parenteral thiamine when necessary, can significantly mitigate these risks. Awareness and knowledge dissemination, as exemplified by experts like Dr. Ferghal Armstrong and Dr. Richard Bradlow, are key to addressing this pressing health issue.
Unmasking the Threat: Nitazenes and Their Deadly Impact
Introduction:
In the episode linked below, Dr. Ferghal Armstrong engages in a compelling discussion with Prof Suzanne Neilsen, deputy director of the Monash Addiction Research Centre, to unpack the rising concern of nitazenes—potent synthetic opioids re-emerging in the illicit drug market. This blog delves deeper into the topics discussed, offering insights into the potency of nitazenes, their impact, and the importance of naloxone and harm reduction strategies.
“Wherever you go, keep some naloxone.” – Dr Ferghal Armstrong
What Are Nitazenes?
Nitazenes are synthetic opioids, comparable in many ways to fentanyl. Initially developed in the 1950s for medicinal use, they were sidelined due to severe side effects, including profound respiratory depression. However, in recent years, these compounds have resurfaced in the illicit drug market. Researchers and healthcare professionals are increasingly concerned about their high potency and associated risks, which bring profound challenges to public health.
The Danger of High Potency
Nitazenes vary in potency, with some compounds being equivalent to morphine while others exceed the potency of fentanyl. This variation in strength, coupled with the quick onset of action, reduces the window of opportunity for overdose intervention, heightening the risk to users. The complex and varying nature of these substances makes them particularly hazardous, as users often remain unaware of what they’re ingesting.
The Role of Novel Psychoactive Substances (NPS)
The proliferation of nitazenes can be attributed to the broader trend of Novel Psychoactive Substances (NPS). These compounds mimic the effects of controlled substances but evade existing drug laws due to their novel status. This legal grey area has made NPS, including nitazenes, attractive to manufacturers and dealers.
Staying Ahead of the Law
By evolving faster than regulatory frameworks, these substances can be manufactured and distributed without immediate legal repercussions. Additionally, the high potency of nitazenes and similar substances allows for easier smuggling and distribution. Small amounts can produce significant effects, making them easier to transport and hide compared to traditional plant-based drugs.
Accidental Contamination and Consumer Risk
One of the most alarming aspects of nitazenes is their inadvertent presence in various street drugs. Instances of nitazenes contaminating MDMA, ketamine, and cocaine have been documented. This contamination is often accidental, stemming from poor manufacturing and packaging practices in illicit drug production facilities.
Unintentional Overdoses
The unintentional mixing of highly potent opioids like nitazenes into recreational drugs poses a severe risk. Users expecting a stimulant effect from MDMA or cocaine might inadvertently consume a sedating opioid, leading to unexpected and dangerous respiratory depression. The so-called “sloppy drug dealer theory” suggests that cross-contamination occurs because of inadequate cleaning and decontamination procedures in these illicit operations.
Harm Reduction: The Importance of Naloxone
To mitigate the risk posed by nitazenes, naloxone—a life-saving opioid antagonist—is crucial. Naloxone works by competitively binding to opioid receptors, reversing the effects of opioid overdose. Given the higher potency of nitazenes, higher doses of naloxone might be required. Early data suggests that initial doses of up to two milligrams might be necessary compared to the standard 400 micrograms.
Broadening Naloxone Distribution
Given the widespread risk of accidental consumption of highly potent opioids, naloxone distribution should extend beyond traditional opioid users to all recreational drug users. Ensuring that people who use any illicit drugs carry naloxone can save lives. Policymakers and healthcare providers must consider increasing the stock and distribution volumes of naloxone, focusing on harm reduction..
The Future of Drug Checking Services
While naloxone offers a reactive solution to overdoses, proactive measures like drug checking services can prevent them. These services allow users to identify the contents of their drugs before use. Although Australia has limited drug checking facilities—primarily in Canberra and Queensland—expanding these services could significantly reduce the risk of accidental overdoses.
Political and Social Barriers
Despite the evident benefits, implementing widespread drug checking services faces political and social obstacles. States like New South Wales and Victoria have resisted establishing these services due to political pushback. Advocating for evidence-based harm reduction services is critical to prevent preventable deaths and enhance public health safety.
Conclusion
The episode with Prof Suzanne Neilsen on Cracking Addiction highlights the rising threat of nitazenes and underscores the importance of naloxone and harm reduction strategies. As the landscape of illicit substance use evolves, so must our approaches to health and safety. Expanding access to naloxone, promoting drug checking services, and supporting public policy changes will be vital in addressing this emerging crisis.
Discover how Jonathan Hunt-Glassman’s personal narrative sheds light on the broad topic of alcohol use disorder and the practical steps toward a life in recovery.
Introduction:
Alcohol use disorder (AUD) is a pervasive problem that affects millions globally. However, pathways to recovery and stories of hope often ignite the possibility of change for many. In a recent episode of our podcast, Cracking Addiction, Dr. Ferghal Armstrong interviewed Jonathan Hunt-Glassman, the CEO of Oar Health, who shared his personal journey and path to overcoming alcohol addiction. Their conversation offered instrumental insights into dealing with alcohol misuse, the importance of social connections, and strategies for sustained recovery.
I’m one example of that. But there are millions more.
Understanding the Pain Behind the Addiction
Jonathan Hunt-Glassman’s struggle with alcohol misuse began in his teenage years, extending well into his twenties. He detailed how his drinking evolved from binge drinking to multi-day blackouts, contributing to both physical and mental health issues. Tackling the “why” behind the addiction is crucial. Drawing inspiration from Gabor Mate’s philosophy, “Ask not why the drug, but why the pain,” Jonathan identified social anxiety and insecurity in fundamental relationships as significant triggers for his alcohol use.
The Post-Covid Impact and Social Anxiety
Dr. Armstrong emphasised a rising concern post-Covid. The pandemic fostered an environment where social interactions became predominantly digital, potentially exacerbating social anxiety, particularly among younger generations. Jonathan pointed to the book “The Anxious Generation” by Jonathan Haidt, which explores how pervasive social media and reduced real-world interactions are breeding anxiety and social disconnection. This scenario might fuel an increase in substance misuse, emphasizing the interconnectedness of social anxiety and alcohol use disorder.
Reaching Rock Bottom and the Importance of Medical Support
Often, individuals dealing with AUD need a nudge to seek help. For Jonathan, a physical health scare following a binge drinking session acted as a wake-up call. Medical intervention, particularly a compassionate and non-judgmental approach by healthcare professionals, played a pivotal role in his journey. Jonathan underlines how essential the first welcoming smile and a supportive healthcare environment are in breaking down barriers of fear, shame, and stigma.
Dr. Armstrong concurs, noting that often the most effective therapeutic intervention can simply be empathy and understanding from healthcare practitioners. Jonathan’s experience with a nurse practitioner and subsequently a clinician who specialized in addiction showed how medical support coupled with empathy can foster a conducive environment for initiating recovery.
Therapies and Self-Strategies: Crafting a Toolkit for Recovery
The journey to recovery is multifaceted and personalized. For Jonathan, the road began with a prescription that sat unused for two months. Changing his mindset to a more curious and less do-or-die attitude towards recovery helped him get started.
His toolkit for recovery included:
Setting clear goals: Avoiding blackout experiences became his bright line.
Personal strategies: Limiting alcohol intake based on prior experiences (e.g., no more than one drink before eating, no shots).
Medication and professional therapy:** Overcoming social anxiety through therapy and reframing cognitive thought patterns.
Support system: Engaging support from a partner and friends, who provided accountability and new social activities like morning hikes instead of late-night drinking..
Social Connection: The Antidote to Isolation in Recovery
Both Jonathan and Dr. Armstrong agree on the importance of a strong support network. Quoting Johann Hari, Dr. Armstrong reinforced the idea that “the opposite of addiction is not sobriety, but social connection.” Friends and supportive relationships play a critical role in maintaining recovery, providing non-judgmental support, and helping restructure social activities that no longer revolve around alcohol.
Message of Hope: Recovery is Possible
For anyone struggling with alcohol use disorder, Jonathan’s story offers a powerful message of hope: “Recovery is possible. There are millions of examples, and a wide range of tools are available to help you.” It’s crucial to explore options, build a supportive toolkit, and remember it’s never too late or too early to start the recovery journey.
Conclusion
Jonathan Hunt-Glassman’s journey from alcohol misuse to recovery underscores the importance of understanding the underlying pain, leveraging medical and therapeutic support, and maintaining strong social connections. His story offers hope and a practical framework for anyone looking to overcome alcohol addiction. The essence of recovery lies in the combined efforts of medical support, a solid personal strategy, and the unwavering support of loved ones.
“We can work with that,” a phrase resonated deeply throughout Jonathan’s recovery journey, serves as a reminder that no matter where you start, there is always a path to a brighter tomorrow.
Exploring Medications, Therapies, and Digital Interventions
Today, we delve into the critical discussion from the “Cracking Addiction” show featuring Dr. Ferghal Armstrong and Mr. Jonathan Hunt-Glassman, CEO of Oar Health. This episode provides valuable insights into the management of Alcohol Use Disorder (AUD), exploring various treatment options and the role of digital technologies in improving access to care.
Multi-Pronged Approach to AUD
Alcohol Use Disorder is a complex condition requiring a comprehensive treatment approach. As highlighted by Dr. Armstrong and Mr. Hunt-Glassman, effective management includes:
Medication: Several prescription medications can help reduce alcohol consumption or achieve abstinence. The frontline medications often recommended are naltrexone and acamprosate. Other medications like disulfiram, topiramate, and gabapentin also play roles, especially when first-line treatments are ineffective.
Therapy: Behavioural therapies are crucial, complementing medication by addressing underlying thought patterns and behaviours associated with AUD.
Digital Solutions: Digital health platforms, like Oar Health, offer innovative ways to access treatment, providing privacy and reducing barriers to care.
Choosing the Right Medication
The choice of medication for AUD should be guided by a healthcare professional’s clinical experience and established guidelines. Naltrexone and acamprosate are commonly prescribed, but they may not work for everyone. Alternatives like disulfiram (which induces unpleasant effects when alcohol is consumed) or newer options like GLP-1 agonists (typically used for diabetes or obesity) show promise. Each medication has a specific use case, whether it’s for controlled drinking or aiming for complete abstinence.
The Role of Digital Health in AUD Treatment
Oar Health exemplifies how digital platforms can revolutionise AUD treatment by offering accessible, judgment-free environments. Their services include:
Remote Consultations: Patients can consult with licensed healthcare professionals online, reducing the stigma and inconvenience of in-person visits.
Medication Delivery: Prescribed medications are shipped directly to patients, ensuring timely access to necessary treatments.
Support Systems: Digital tools and apps, such as Sunny side, provide continuous support through tracking, feedback, and coaching, available 24/7.
Therapy and Behavioural Interventions
Therapy remains a cornerstone of AUD treatment. It can be effective alone or alongside medication. Cognitive-behavioral therapy (CBT), motivational interviewing, and other approaches help reframe harmful thought patterns and build coping strategies.
Oar Health focuses on the medication aspect but encourages patients to seek therapy, whether digitally or in-person. The goal is to provide a holistic treatment approach that addresses both the biological and psychological aspects of AUD.
Overcoming Barriers to Treatment
One significant barrier to AUD treatment is the misconception that abstinence is the only legitimate goal. As Mr. Hunt-Glassman emphasises, moderation can be a practical and effective goal for many. Reducing alcohol consumption, even without complete abstinence, can significantly improve health and well-being.
Social Connection and Digital Technology
Social connection is vital in overcoming addiction. While some argue that digital spaces can hinder social cohesion, when used correctly, they can enhance it. Digital platforms can initiate the first steps towards real-world interactions and support systems, helping individuals build social muscles incrementally.
A Message of Hope
The barriers to starting treatment for AUD are lower than ever. Digital health services offer unprecedented access to support and care. Whether it’s connecting with a healthcare professional or engaging in supportive communities, help is readily available. Recovery does not always require a dramatic change; sometimes, small, consistent steps make all the difference.
In conclusion, managing Alcohol Use Disorder is a multifaceted challenge that requires a blend of medication, therapy, and innovative digital solutions. Platforms like Oar Health are paving the way for more accessible, compassionate care, making it easier for individuals to take the first steps towards recovery.
Stay tuned for more insights and updates from the Meducate team, and remember, seeking help is a sign of strength and the first step towards a healthier, happier life.
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