The House Believes That Current Addiction Model Is Invalid

The case is brought forward that the currently accepted substance addiction model is invalid and harmful from the Public Health perspective.

Indictment:

It is widely held that the addiction is mainly mediated by the ‘reward’ pathway: Ventral Tegmental Area (VTA) to Nucleus Accumbens -> Increased dopamine release in response to positive outcomes -> Key role in learning what is good and what is bad -> Targeted directly by some drugs of abuse.

The reciprocal system of “reward” “drive” “control” and “memory” is thought to play the main role in drug abuse.

Arising from that theory is the current recommendation for treatment: substitution therapy of methadone maintenance (μ-opioid agonists) to stabilise and maintain or to stabilise and withdraw; buprenorphine (+naxolone) (partial agonist for sublingual administration); safe, controlled heroin supply.

Similar approaches, based on antibodies or binding-blocking agents constitute widely used pharmacotherapy for addiction to other substances.

The prosecution believes that the model is invalid and harmful –
i. it is based on inadequately conducted, biased experiments;
ii. it is not working in the long-term or eradicating the problem from the society;
iii. expenditures are higher year-on-year, with no significant improvement in the efficacy of addicts’ health care;
iv. continuing application of the model results in misguided Public Health approach, which prevents the recovery of addicts;

The prosecution wish to present evidence beyond reasonable doubt that the model is invalid and that the new model, based on data from last 30+ years of treatments should be implemented to improve the situation and lay foundation to eradicating the issue. Indeed, the new model has been implemented in some countries, with reasonable success. The prosecution shall thus make a positive case for the new model of treatment.

The prosecution shall make the opening statement in the next two weeks. The defendants have entered their arguments in the previous post. They may, however, wish to cross-examine the evidence presented by the prosecution.

Deadline: CLOSING SPEECHES & adjudication shall be held on: 

Firday, 1st April 2016 in Oxford.

If you wish to support either side, please contact secretary@neurologicalsociety.org for details or simply submit your arguments via email.
Please note that only Evidence-Based Medicine arguments can be admitted as an evidence. 

Presiding adjudicator:

Christopher Schpackenbaum, FNS
Praetor ad interim
Office of the Secretary General

Leading the prosecution:

Max Brzezicki, FNS
Honorary Praetor
Advisory board on ICT in Neurosciences

For the defence:

Emma Robinson, FNS
Praetor
Advisory board on Neuropharmacology

Przemyslaw Zakowicz, FNS
Honorary Praetor
Advisory board on Neuropharmacology & NDE

 

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