By Nina Cork and Hattie Lockwood (University of Sussex students)

In April this year, SARIC (Sussex Addiction Research and Intervention Centre) hosted a public panel as part of the British Neuroscience Association’s International Festival of Neuroscience 2023, discussing the need to bridge the gap between academia and the community regarding the study, prevention, and treatment of addictions. 

In the spirit of starting an honest and open conversation on this issue, the panel was made up of a diverse range of experts: 

Pablo Romero Sanchiz, clinical psychologist and lecturer at the University of Sussex; Becky Marshall, dual diagnosis nurse consultant at the Sussex Partnership NHS Foundation Trust; Clare Kennedy, CEO of Kennedy Street Recovery; James Murphy, manager of Brighton & Hove’s adolescent substance use and sexual health service, ru-ok?; and Ken Checinski, addiction psychiatrist at West Sussex’s drug and alcohol wellbeing network, Change Grow Live.  

The atmosphere was warm and intimate, with audience and panel members facing each other as if in everyday conversation. The breadth of expertise on the panel set the tone for the meeting and brought a range of perspectives to the table, creating an open discussion which welcomed contributions from audience members. Some of the audience members were individuals with lived experience; it was great to see that they felt comfortable coming into this space to share their stories and offer their valuable perspectives. Despite the distinct panel of professionals, both panel member and audience contributions were made to feel equally valued. 

We started off discussing the first question: what are the current challenges facing holistic health care for people who are seeking help for drug addiction? Panellists and audience members suggested several factors: the complexity of the problem, the existence of co-occurring mental health conditions, access and coordination of services, the urgency of treatment, an inability to access adequate treatment, and ultimately not knowing where to start. Everyone attending agreed that standard treatment referrals and services do not currently address the complex nature of addiction. Many addiction treatments are centred around detox and sustained abstinence – a linear approach which neglects other areas of life influenced by addiction.

Prompted by ru-ok? manager, James Murphy, the panel then discussed the need for a holistic approach to treatment. Such an approach would treat the individual in many ways, addressing not only their physical symptoms, but also the mental, spiritual, and socio-environmental factors underlying their addiction. Such an approach would involve support with housing, education, employment, mental health, and wellbeing. It would also provide support to the individual’s loved ones and the wider community, acknowledging that the impacts of addiction extend beyond the individual. Ken Checkinski then highlighted the fact that recovery is an individual journey. As such, treatment should be individualised, and an action plan formulated on a case-by-case basis. There is no one size fits all approach.

The group then moved on to discuss the need for individualised treatment plans to involve the management of co-occurring mental health conditions alongside treatment for addiction. Becky Marshall, whose job is precisely this, highlighted that in the past, individuals would only have access to treatment for co-occurring mental health conditions when they had recovered from addiction, or stopped using the substance. Now, in some regions in England, individuals can be treated for both addiction and mental health conditions at the same time. This allows individuals to be treated based on their personal needs and tackles addiction from multiple angles, allowing recovery to happen more quickly. 

Following on from this, Pablo Romero Sanchiz introduced the idea that addiction often arises as a form of self-medication. Initially, it serves the purpose of numbing or lessening some form of emotional pain, hence the high level of comorbidity between addiction and other mental health disorders such as anxiety, depression, and PTSD. Addiction treatment must address the underlying cause of emotional pain or trauma, replacing the addictive substance or behaviour with healthier, adaptive strategies. Pablo’s point highlighted the need to involve psychological therapies in addiction management and treatment, and how mental health conditions must be addressed for an individual to effectively recover from addiction.  

As the event began to wrap up, an interesting discussion was sparked when an individual from the audience shared their positive experience with Change Grow Live. They spoke highly of the treatment that they received and emphasised that becoming educated in the science and psychology behind addiction played a vital role in their recovery. This led the audience and panel members to discuss the importance of having individuals with lived experience work closely with addiction services and prompted a few panel members to share their own experiences with addiction. From this, it was suggested that SARIC should involve more individuals with lived experience in their work, to which all panel members agreed.

By the end of the discussion, a clear question had surfaced: Why does the current system fail individuals with addiction and how do we change it to provide better help? Becky Marshall pointed out that the current approach to addiction treatment stems from an outdated view of addiction and mental health conditions. Other panel members agreed that the whole system needs rethinking, and while this would be ideal, it is not feasible. After this was addressed, it was reiterated that small changes across a range of addiction services contribute to large-scale change. Attention was brought back to the progresses made within each of the represented services, and the positive influence they have had. This also emphasised the need for meetings which gather representatives from many services to discuss exactly these questions, and again, how it is vital to have individuals with lived experience directly contribute to decision-making within these services. 

Overall, the meeting was very informative for both audience and panel members alike. A wide range of perspectives created an inclusive atmosphere where open discussion could take place, which highlighted many of the issues and progresses seen in addiction services today. Despite discussing some difficult and emotional topics, the session ended on a positive note, with many individuals feeling inspired and hopeful for the potential changes to come.

The Sussex Addiction Research and Intervention Centre (SARIC) aims to improve understanding of addiction by investigating all aspects of drug and alcohol misuse, including behavioural addictions. Find out more about SARIC on the research centre website.