49th Middle East Medical Assembly (MEMA) 2018 focus on mental health is in line with the proper recognition of the challenges of a complex humanitarian emergency that has evolved to become one of the leading causes of disability worldwide. In addition, and since we are living in a conflict zone with an enormous array of mental health concerns, it has become a pressing need to raise awareness on mental health issues and enforce mental well-being strategies that would scale up responses to improve the mental health and psychosocial well-being of the population. Insight into mental health also requires the incorporation of neuroscience into both the mechanisms and mitigating factors for mental disorders, as well as where and how to focus research and treatment.
Professor Baldacchino will present current neurocognitive research insights into the consequences of chronic opioid use and also, in another session, present clinical guidelines following 15 years experience on one of the first Pain and Dependency Clinic in the UK. [link]
1 Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
2 South London and Maudsley NHS Foundation Trust, UK
3 Norwich Medical School, University of East Anglia, Norwich, UK
4 Surrey and Borders Partnership NHS Foundation Trust, UK
5 Department of Medicine, Division of Brain Sciences, Imperial College London, UK
6 National Addiction Centre, Addiction Sciences Building, King’s College London, UK
Background. Evidence suggests that cannabis-induced psychotic-like experiences may be a marker of psychosis proneness. The effect of such experiences on cannabis use has not systematically been examined.
Methods. We undertook a mixed-methods online survey of 1231 cannabis users (including 926 continued users) using the Cannabis Experiences Questionnaire. We examined the effect of psychotic-like and pleasurable experiences on cessation of cannabis and intention to quit. Socio-demographic variables, cannabis use parameters and substance misuse history were included as covariates. Free-text data explored subjective reasons for changes in use. Results. Cessation of cannabis use was associated with greater psychotic-like experiences [ p <0.001, Exp(B) 1.262, 95% confidence interval (CI) 1.179–1.351], whilst continued cannabis users were more likely to report pleasurable experiences [ p < 0.001, Exp(B) 0.717, 95% CI 0.662–0.776]. Intention to quit cannabis in continued users was associated with greater psychotic-like experiences [ p < 0.003, Exp(B) 1.131, 95% CI 1.044–1.225], whilst intention to not quit was significantly associated with increased pleasurable experiences [ p < 0.015, Exp(B) 0.892, 95% CI 0.814–0.978]. Whereas former users clearly ascribed cessation to negative experiences, continued users who expressed intention to quit less readily ascribed the intention to negative experiences.
Conclusions. Elucidation of psychotic-like experiences may form the basis of a therapeutic intervention for those who wish to quit. Cessation in those with cannabis-induced psychotomimetic experiences may offset the risk for the development of a psychotic disorder, in this higher risk group.
Improve patient safety by increasing access to specialist prescribing in the treatment of people with substance use disorders.
Provide a forum where non-medical prescribers can exchange experiences and share and disseminate good practice, to explore problems and challenges and enable peer support and extend professional networks.
Contribute to the continued professional development of its members via educational presentations and facilitating peer learning by discussion and reflection.
Provide a forum for consultation on documents and concepts pertaining to the development of non-medical prescribing in the substance misuse field.
Influence policy makers and other professional organisations to promote non-medical prescribing in the substance misuse field.
The Charter provides a guide to what families can expect from services with GaIA Healthcare Ltd.
Families will be actively included in a loved one’s treatment and they will have access to adequate and appropriate support services. The Charter is needed because families and individual family members affected by another’s substance use, drugs and/or alcohol, have the same right to advice and support as everyone else. However, it is widely acknowledged that they, in addition to the impact of substance use, face the additional barriers of shame and stigma to accessing this support. The overall aim of this Charter is to increase support to families affected by substance use through the empowerment of families to ensure their rights are recognised and respected.
The Charter aims to build on the GaIA Healthcare Ltd’s existing work and the growing recognition of not only the impact of substance use on families but the importance of their role in the recovery process. However, families have needs for services in their own right, not just to assist with achieving positive treatment outcomes for a loved one and where we can, we signpost to existing family support in addition to offering 1:1 sessions with GaIA clinicians and therapists.
Dr Christos Kouimtsidis and his colleagues from University College London have completed a feasibility randomised controlled trial, the first in the UK, on an alcohol intervention for people with mild to moderate intellectual disability living in the community.
Kouimtsidis C, Scior K, Baio G, Hunter R, Pezzoni V, Hassiotis A. 2017. Development of a manual for Extended Brief Intervention for alcohol misuse for adults with mild to moderate intellectual disabilities living in the community. Journal of Applied Research in Intellectual Disabilities. (DOI: 10.1111/jar.12409 https://www.researchgate.net/publication/319530129_
Kouimtsidis C, Bosco A, Scior K, Baio G, Hunter R, Pezzoni V, Mcnamara E, Hassiotis A. 2017. A feasibility randomised controlled trial of extended brief intervention for alcohol misuse in adults with mild to moderate intellectual disabilities living in the community. TRIALS, 12;18(1):216. DOI: 10.1186/s13063-017-1953-0 https://www.researchgate.net/publication/316982221