Addictions Edited: the monthly take-home

Dr Nicky Kalk and Dr Caroline Copeland talk about their research into methadone- and buprenorphine-related deaths during the COVID-19 pandemic. Nicky and Caroline talk me through the number of deaths they would expect to see in an average year and the differences between that and what happened during COVID-19-related lockdowns. Nicky tells us how the UK has influenced the US response to Hurricane Katrina whereby people were given larger amounts of opioid agonist medication than they were used to.“Instead of most people in early treatment being directly supervised consumption….the majority of people were converted to 2 weeks' worth of take-home supply.” Caroline and Nicky then talk about possible explanations for the overdose rates found among people not in treatment, indicating the protective impact that treatment can have for people. They also talk about how their study challenged their thinking about the impact of diversion on the risk of overdose. Finally, they talk about the overall impact that the COVID-19 pandemic had on people seeking and accessing treatment.“There are things that make us sustain a behaviour and things that make us think that it’s time to make a change. And I suppose something as catastrophic as a lock-down with all the potential impacts that that might have on support or access to one's drug of choice, maybe changed the equation for people.”The opinions expressed in this podcast reflect the views of the author and do not necessarily represent the opinions or official positions of the SSA or the author’s academic institution.The SSA does not endorse or guarantee the accuracy of the information in external sources or links and accepts no responsibility or liability for any consequences arising from the use of such information.

This podcast is for anyone who wants to understand the experience of and feelings associated with relapse.Dr Maike Klein talks about her qualitative research into relapse, and about how different people conceptualise and perceive relapse. She talks about how, for some, it is a process rather than an event, whereas for others it is a shocking and immediate experience. There are also elements of self-actualisation and learning that can follow a relapse - as well as the real fear that relapse can cause.Maike talks about the feelings of powerlessness that can accompany relapse as well as the importance that some people place on gaining trust in themselves. Looking further into the language of relapse, Maike explores how relapse is sometimes seen as a location by some people and the implications this has for working with substance use.Maike also spoke to people who work in addiction treatment services about their experiences working with people who relapse and of second-hand trauma.“How does it feel like for a therapist to witness their client’s relapse and does that impact the way that they approach their therapeutic work?”“It feels almost like torture in their minds of having that internal fragmentation that’s almost more difficult than the relapse experience itself”. The opinions expressed in this podcast reflect the views of the author(s) and do not necessarily represent the opinions or official positions of the SSA.The SSA does not endorse or guarantee the accuracy of the information in external sources or links and accepts no responsibility or liability for any consequences arising from the use of such information.

In this two-part podcast the SSA's Rob Calder explores autism and addiction. He talks to Professors Julia Sinclair and Sam Chamberlain, Dr Janine Robinson and Chris Torry from the SABAA: Substance use, Alcohol and Behavioural addictions in Autism project that’s been funded by the SSA. In this second episode we explore treatment, policy and future research in relation to autism and addiction. We start by talking about the importance of co-producing publicity materials for addiction treatment services using universal design principles. Personalisation is always important and ever more so when working with autistic people, thus underlining the importance of involving autistic people in service design.We talk about the experience and expectations that autistic people might have when attending addiction treatment services, and why retention may not mean what you think it means. We then talk about the work of the SABAA project in identifying the gaps in our understanding of autism and addiction. The team talks about conducting a Delphi process and working out what the priorities are for policy, practice and research.They then discuss some of the problems with funding something that is often considered a niche issue within autism and addiction fields.“Things that are autism friendly will also be good quality for other people… By being autism friendly [promotion materials] are more likely to be more accessible by other people too” - Professor Julia Sinclair“With CBT you need to rate things, and some [autistic] people say to me ‘I don’t like rating things. I prefer having colour, blue means this, yellow means that’. They’re different things that mean something to them” - Dr Janine Robinson“The NHS has really changed in that sense, there’s still more work to do, but we’re seeing lived experience become part of the clinical models to a greater extent which is a good thing.” - Professor Sam Chamberlain“The neurology and basis of autism are poorly understood and then you have the neurological factors of addiction and compulsion, and trying to reconcile and differentiate those things is a really complex question” - Chris TorryProfessor Julia SinclairJulia Sinclair is Professor of Addiction Psychiatry in the Faculty of Medicine at the University of Southampton, and honorary consultant in alcohol liaison at University Hospital Southampton.Dr Janine RobinsonJanine Robinson is a Consultant Clinical Psychologist and a specialist in the field of autism in adults. She completed her DClinPsy at the Institute of Psychiatry, King’s College, London in 2000.Professor Sam ChamberlainSam Chamberlain is Professor of Psychiatry at the University of Southampton, and Honorary Consultant Psychiatrist at Southern Health NHS Foundation Trust.Chris Torry Chris Torry is autistic and has worked in addiction treatment services for many years. He is part of the SABAA projectThe opinions expressed in this post reflect the views of the author(s) and do not necessarily represent the opinions or official positions of the SSA. The SSA does not endorse or guarantee the accuracy of the information in external sources or links and accepts no responsibility or liability for any consequences arising from the use of such information.