Dopamine and addiction – the difference between wanting and liking

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Dopamine is important for reward, but is it directly related to pleasure? Research suggests that dopamine is more important for ‘wanting’ (motivational drive) than for liking. You might have a pathological ‘wanting’ your drug of choice, even after you have long stopped ‘liking’ it. Opioids and endocannabinoids may be more important for liking. In this […]

Methadone improves mental health; what’s next?

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Good to see some research from Aberdeen focusing on mental health in patients on methadone and other opiate replacement therapy. Academics in Primary Care conducted a systematic review looking at twenty-two studies where mental health had been assessed at baseline and again at follow up. What did they find? “Mental health significantly improved for all groups receiving […]

Time-limited methadone – guest blog by Paul Molyneux

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The topic of time-limited opioid prescriptions has been discussed before on Recovery Review. More recently, the issue has garnered increased attention after Liberal Democrat MP Norman Baker wrote to the ACMD on behalf of the Inter-Ministerial Group on Drugs. In the letter, Norman Baker requested that the ACMD review “whether the evidence supports the case […]

Quetiapine abuse

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Quetiapine (often branded as Seroquel) is an antipsychotic drug used for schizophrenia and bipolar disorder. It’s also prescribed off-license in the UK for anxiety. That means that a fair few people with alcohol and other drug dependence end up on it. Recent experience makes me wonder if prescribers are as aware of the risks as they […]

Narcotics Anonymous for military veterans

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A few years back in a city far, far away, I asked a consultant addiction psychiatrist why he did not refer any of his patients to NA. “There’s not a shred of evidence that it works,” he said. Even then he was misinformed, but I’ve thought many times since then about how his patients were […]

Gabapentin and pregabalin misuse

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  Gabapentin and pregabalin misuse are problems that are not going to go away. My post on gabapentin is one of the most-read on this site. While these are useful medicines, workers in drug treatment and support see patients regularly on gabapentin or pregabalin who have misused the drugs or who are misusing them. Guidance is […]

Cannabis-like new psychoactive substances – warnings

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In Europe drug seekers have the luxury of 651 websites from which to buy their ‘legal highs’ or NPS. Alternatively in many towns and cities you can just pop down to the nearest head shop or indeed the nearest corner shop. NPS are more accessible than most drugs. Cannabis-like new psychoactive substances are popular and […]

Benzodiazepine Guidance

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SMMGP has published guidance for using benzodiazepines and benzo-like drugs in primary care. It’s a comprehensive 60+ page document which covers most (but not all) of the bases and reinforces the need for caution when prescribing the drugs. The guidance is so long in coming because consensus could not be reached. Benzo prescribing is an […]

Drug treatment is not delivering on recovery

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This hot-off-the-press paper starts with a financial bent. The costs to the UK taxpayer of illicit drug use are £15.4 billion ($26.1 billion) annually, most of it from crime. Quite a bill. How ought we reduce this? Medication assisted treatment (MAT) say Dale-Perera and colleagues, because strategies associated with rapid abstinence are associated with poor […]