Addicts often afflicted with brain disorders, not low moral standards: S'pore psychiatrist

PHOTO: Addicts often afflicted with brain disorders, not low moral standards: S'pore psychiatrist

SINGAPORE - When Dr Guo Song took up a clinical posting treating patients with addictions in Beijing Anding Hospital about 15 years ago, he thought he had them pegged.

In fact, he dismissed them as having low moral standards and only themselves to blame for being addicts.

That changed after he talked to patients, met their families and embarked on research projects on addiction.

He said: "I realised... there are neurological mechanisms involved and these people need help to break free from their addictions."

He holds a doctorate of philosophy in psychopharmacology - the study of drugs that affect mood, thought and behaviour - from the Peking University in Beijing, China.

He moved to Singapore in 2004 and joined the Institute of Mental Health (IMH) the same year because he felt his knowledge of addictions would contribute to the work there. He became a citizen two years ago.

The Head of the research unit and consultant psychiatrist at the National Addictions Management Service under IMH has published more than 30 academic research papers and helped write several textbooks.

I specialise in treating addictions because...

I am compelled by the fact that people with addiction disorders really need help. There are also many mysteries in this field of medicine which I can study and explore.

The body is fascinating because...

Of the seemingly inexplicable desire to continue using drugs or engage in other types of addictive behaviour in spite of negative consequences.

But it is largely due to the abnormal functioning of areas in the brain associated with motivation, memory and impulse control.

One little known fact about addictions is...

They are disorders which have their roots in the nervous system and are not due to low moral standards.

Research has shown that engaging in addictive behaviour repetitively brings about changes in the brain that heightens the feeling of pleasure.

This then perpetuates the behaviour and eventually makes it compulsive, in spite of the obvious negative consequences.

If I were to give an analogy for what I do, I would be...

A detective who tries to understand what is happening in a patient's brain based on his behaviour and then decides how best to help him.

A typical day for me starts...

At 5am when I get up to read and plan my day's schedule.

I start my morning ward rounds at 8am before I attend to patients in the outpatient clinic.

I helm the addictions inpatient programme and research unit, so I have to attend regular meetings and discussions with both teams. About once or twice a week during the university's school term, I teach medical students and junior doctors in the Institute of Mental Health.

A workday usually ends at 6pm, but it can sometimes stretch beyond 8pm. I make sure I spend quality time with my wife, who understands the demands of my work and is extremely supportive.

In my leisure time, I enjoy swimming, playing tennis, listening to music and attending theatre performances.

I have come across all types of cases...

That span drug, alcohol, sex, Internet and gambling addictions, with patients who are in their adolescence right up to those in their twilight years.

The length of recovery differs, depending on factors such as a patient's commitment to follow through with treatment and the level of family support, among others.

It is generally recognised that addiction is a chronic disease and the road to recovery is often saddled with relapses, similar to other conditions such as hypertension and depression.

I see people who have suffered because of their loved one's addiction, yet use inappropriate ways - quarrelling, physical punishment or financial bailouts - to deal with the patient, rather than employ the healthy methods our counsellors have taught them.

These include encouraging the patient to follow up with treatment or cutting off the supply of money that feeds his addiction.

I love patients who are...

Willing to help other patients when they themselves have recovered from addiction disorders.

They help by attending support groups run by the National Addictions Management Service or self-help groups such as Alcoholics Anonymous.

They may also handle calls from recovering patients to give peer support in overcoming cravings.

Patients who get my goat are...

Very rare. Having worked in the addictions field for more than 15 years, none of the patients can really upset me as I am able to recognise certain types of behaviour related to addictions.

One of these is a lack of motivation to stop the addictive behaviour despite significant negative consequences.

Things that put a smile on my face are...

Watching patients recover after treatment, under the care of our multi-disciplinary team - psychiatrists, psychologists, counsellors, nurses and medical social workers.

Seeing young doctors or medical students change their perceptions of addiction after my teaching sessions or discussions is also satisfying.

It breaks my heart when...

Patients are treated inappropriately because their behaviour is not well understood.

For example, when patients show a strong craving for their addiction or tell lies to hide their addiction, people may attribute these actions to choice or low moral standards.

In doing so, people may miss the patients' need for treatment and overlook the severity of the conditions.

I wouldn't trade places for the world because...

My medical knowledge in addictions is useful for patients and the community. I know I am making a difference in patients' lives.

My best tip is...

Do not try any addictive substances in childhood or adolescence, as the brain is vulnerable to the influence of external substances then.

Also, seek professional help promptly if you, or people you know, suffer from an addiction that is affecting life or health. This will minimise the impact of the addiction on the patients' families.

Recovery is possible.

joanchew@sph.com.sg

This article was first published on January 26, 2012. Get a copy of Mind Your Body, The Straits Times or go to straitstimes.com for more stories.