Cheltenham Science Festival 2011 – Understanding Excess

British Association for Psychopharmacology (BAP) in association with Society of Biology proudly sponsored an informative and educative public engagement event titled “Understanding Excess”, a discussion on compulsive
and addictive behaviour at this year’s Cheltenham Science Festival.

Science Festival Director and popular science broadcaster Prof. Kathy Sykes chaired the “sold out” evening session in a packed town hall auditorium. Prof. Naomi Fineberg, Consultant Psychiatrist and Medical Director at the National OCD Treatment Service, Welwyn Garden City was joined by Dr. Jeff Dally, Behavioural Neuroscientist from the University of Cambridge and Ashraf X from Bristol in a panel discussion. Over 300 people gathered to listen and interact with the panellists in the hour long event. There was an opportunity to continue the discussion after the event in a “Talking Point” in one of the festival tents. The audience ranged from people who were curious to understand compulsive and addictive behaviour to ex-addicts and OCD sufferers. Many were interested in the science behind addictions and some of them wanted to explore treatment options for their suffering relatives.

After introductions by Prof. Sykes, Ashraf X gave a moving account of his personal life experience as a heroin addict growing up in a deprived part of East London. He gave an emotional account of his first encounter with “gear” as a teenager and how the habit destroyed his school and family life. He described his difficulty in understanding and managing his habit which introduced him to dangerous company and got him several custodial sentences. Ashraf also gave a detailed account of how he found himself in risky situations, feeling powerless even when he fully understood the consequences of his actions. He said that he was suffering from a disease, over which he had no control. The way he managed to turn around his life by conquering his illness and returned to university while abstaining from all illicit substances was truly inspirational. His story gave a clear insight into the difficult life of an addict and hope for those who are addicts. [Listen]

Prof. Naomi Fineberg talked about the mechanisms underlying compulsive and addictive behaviours and gave a clinician’s perspective on the intriguing group of disorders in the obsessive compulsive spectrum. According to her, 25 % of the EU population suffered from a substance or behavioural addiction and up to 3 years of someone’s wages could be lost as a result of ritualistic compulsive behaviour. She described how a positive reward seeking behaviour sometimes “morphs” into compulsions designed to reduce discomfort. Many people would have occasionally engaged in some form of excessive behaviours, but OCD suffers engage in a cycle of avoidance compulsions related to specific harm related obsessions. A recent study at the University of Cambridge concluded that OCD suffers may
have a high risk of habit formation. She illustrated the experience of an OCD sufferer through a succinct case example which struck a chord with some in the audience. There is professional help available for OCD sufferers
and OCD action could be a useful point of contact. [Listen]

Dr. Jeff Dally presented the neuroscience behind addiction and compulsive behaviour by showing some interesting pictures of the brain cells and describing findings from animal studies. He asserted that the people who engage in
an addictive behaviour are fully aware of the adverse consequences of their actions. He also observed that the “legal high” drugs based on stimulants, particularly cocaine available on the internet market place unregulated by the legal system can lead to a serious health and social problem. He explained the triad of agent, host and environment in the development and maintenance of addictive behaviour. About 20 % of cocaine abusers are susceptible to addiction and the addictive behaviour in up to 50% of the sufferers can be attributed to the environment. He described the close link between ADHD and addiction and the paradox of treating ADHD with a stimulant. He showed PET images of reduced D2 dopamine receptors in the brains of people who were previously addicted to cocaine. There was also a reduction in frontal lobe activity. He introduced “zippy” the naturally high-impulsive rat which help his team to understand the complex neurobiology of compulsive and addictive behaviour. He gave examples on naturally occurring excessive ritualistic behaviour in animals. [Listen]

A quick show of hands showed that majority of the audience either suffered from or had a relative who suffered from addiction or OCD. After the hour long panel discussion [listen to Q&A], we reconvened at the talking booth for a less informal discussion. There were several thought provoking questions and comments on the genetics and demography of addictions. Some were keen to share their experience while others were looking for answers to their problems.

Overall, the event was a great success and in terms of number of people attended, it was one of the most popular events on the 9th June 2011. Many members of the audience commented on the need for more such events to engage
the public in understanding some of the most complex and disabling mental health disorders. It was felt that the public would benefit from listening to and discussing different perspectives and sharing experiences. This was
clearly demonstrated in the general feedback form the audience and the panelists.  The session concluded with the sentiment that compulsive and addictive disorders are stigmatising disorders, but they talk a lot about our common humanity. Help and services are increasingly available for individuals with these disorders and for those who care for them.

Presentation slides (in pdf)

Understanding excess; from compulsive behaviour to compulsive disorders – a clinician’s perspective. Naomi A Fineberg | Download
Talk by Dr Jeff Dalley | Download

Audio (mp3 files)

Introduction by Professor
Kathy Sykes, followed by Ashraf X

Professor Naomi Fineberg
Dr Jeff Dalley
Q&A and conclusion

Sources for further information and support

National OCD Treatment Service
Mental Health Unit, Queen Elizabeth II Hospital
Welwyn Garden City Al7 4HQ
Tel: 01707 365085
Fax: 01707 365582
Email: kim.fox@hertspartsft.nhs.uk

www.ocdaction.org.uk

www.gamcare.org.uk

CNWL National Problem Gambling Clinic
4th Floor Soho Centre for Health & Care
1 Frith Street
London
W1D 3HZ
Tel: 0207 534 6699
Fax: 0207 534 6700
Email: gambling.cnwl@nhs.net

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