Expert advice about treating drug and alcohol addiction

Prof. Dr. M. Soyka, director of private clinic Meiringen, shares his insights on substance abuse and the treatment options for addressing drug and alcohol addiction.
Prof. Dr. M. Soyka is the head of the addiction treatment department of the Swiss private clinic Meiringen and is an eminent expert in the field of addicition therapy. In this interview, he shares his expert knowledge of addictive diseases, their causes, therapy and prognosis. 

Addiction to alcohol, drugs, pills, and many others is probably more common than we think. Are there many people who have problems with addictive disorders?

Definitely. About 3% of the adult population are dependent on alcohol, and about 5% of heavy alcohol users are mis-users. The rate of people dependent on illegal drugs is far less, about 0.5-1% for opioids and psychostimulants/cocaie. 5% of adults are regular cannabis users.

The number of patients dependent on legal or prescription drugs is difficult to evaluate, probably equal to those for alcohol. The drugs most frequently abused are sedatives/hypnotics and analgetics, drugs that are commonly known as pain killers.

What causes addiction to develop?

This is a question worthy of a Nobel Prize! For alcoholism, a strong genetic influence (about 50%) is proven, mostly mediated by different individual tolerance and the effect of alcohol on body and brain.

There is no such thing as an "addictive personality", but childhood trauma or certain "deficient" personality traits, as well as family background and the social arena, play a role. Age of onset is also a factor.

Most addictive processes start in early adulthood. There also is a certain association of substance use with psychiatric disorders. Manic-depressive illness or schizophrenia are associated with an increased risk of addiction.

How does an addictive disease develop? Can you be born with one?

Nobody is born with it, except for babys with opioid-dependent mothers... Certain risk factors are inherited. This process is still poorly understood, though.

For alcoholism, there is a considerable variation between individuals of the enzymes that metabolize alcohol. This is relevant when it comes to considering an individual‘s risk of alcoholism.

Do you treat certain forms of addictive disorders or all kinds?

Treatment can be differentiated into withdrawal and rehabilitation. In general, we treat all kinds of patients but we specialise in treating people who have addiction problems with alcohol, "legal" drugs including psychotropic drugs and painkillers and psychostimulants. 
The hospital offers an individualized, scientific treatment program with group and individual therapy, relapse prevention, social skills training, psychoeducation, among many others. 

Prof. Soyka

You are famous for your successful therapy concept for addiction. Can you explain your programme?

Thank you. I have worked extensively in the addiction field for ---not ages, but about 25 years.

I have seen thousands of patients, and each is different. I believe in evidence-based, but individually-tailored therapies.

We just have reopened a new ward dedicated to treating substance abuse patients.

The hospital offers an individualized, scientific treatment program with group and individual therapy, relapse prevention, social skills training, psychoeducation, among many others.

Is there a realistic chance of curing addiction?

Cure is a strong word. Most addictive disorders can be treated, but probably not cured in the definitive sense of the word, like antibiotics may do with an infection, or the surgeon does every now and then with his knife.

This is a topic that clinicians, patients and scientists find plenty to argue about. Am I cured when I do not drink alcohol any more and shall not do so for the future? Most addiction disorders can be effectively treated, and the prognosis is better than many believe.

But treatment and relapse prevention remains a long-term, and sometimes lifelong challenge. In that sense: There is no final cure, but extensive hope...

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