"This seminar will explore what I believe is the greatest challenge in addiction treatment today – keeping people who have become abstinent drug free when they experience pressures to resume drug-taking," Professor David Nutt.
Addiction is a complex set of disorders in which both the entry factors and restraining factors are important. Entry factors include features such as drug enjoyment and reward but also self-medication for stress-related disorders such as depression and PTSD. Some people just find that taking drugs makes them "whole” or gives meaning to their lives so find it hard to stop. The mechanisms underlying these processes are beginning to be understood and new treatments are being developed based on these. It turns out that dopamine has much less of a role to play in reward and the initiation of drug use than was previously thought and our own research suggests that the endorphin system may be crucially involved in some patients.
Addiction also is a form of (aberrant) learning and recent research suggests that alterations in the GABA-A system, a critical moderator of glutamate-induced learning, is abnormal in people addiction, particularly a newly discovered subtype the a5 GABA-A receptor which has a largely limbic distribution in humans. This discovery too offers a new potential approach to treatment development.
This seminar will explore what I believe is the greatest challenge in addiction treatment today – keeping people who have become abstinent drug free when they experience pressures to resume drug-taking. Currently for opioid addiction, the only options are substitute medicines such as methadone and buprenorphine that reinstate addiction with a safer alternative drug or naltrexone which has low compliance. I will share data from our new large imaging study – ICCAM- that has used fMRI and drug challenge techniques to explore stress, reward and impulsivity systems in abstinent alcoholics and heroin and cocaine addicts. In this group we have tested a number of non-addictive drugs and shown some to moderate the fMRI brain responses in a manner that could indicate therapeutic potential.
David Nutt is currently the Edmund J Safra Professor of Neuropsychopharmacology and Head of the Centre for Neuropsychopharmacology in the Division of Brain Science, Dept of Medicine, Hammersmith Hospital, Imperial College London. He is also currently Chair of DrugScience (previously the Independent Scientific Committee on Drugs (ISCD), in addition to a number of other high profile appointments.
He broadcasts widely to the general public both on radio and television; highlights include being a subject for The Life Scientific on BBC radio 4, several BBC Horizon programs and the Channel 4 documentary Ecstasy-live. His research has been the subject of a film #magicmedicine and the play All you need is LSD. He is much in demand for public affairs programs on therapeutic as well as illicit drugs, their harms and their classification. He also lecturers widely to the public as well as to the scientific and medical communities, e.g. at the Cheltenham Science and Hay Literary Festivals, Café Scientifiques and Skeptics in the Pub. In 2010 The Times Eureka science magazine voted him one of the 100 most important figures in British Science, and the only psychiatrist in the list. In 2013 he was awarded the Nature/Sense about Science
Professor Nutt has published over 500 original research papers, a similar number of reviews and books chapters, eight government reports on drugs and 34 books, including one for the general public, ‘Drugs Without the Hot Air’, which won the Transmission book prize in 2014 for Communication of Ideas.