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2.19.2012 Guest of the Week: Professor Hamid Ghodse St. George Univrsity, London Host: Dr. Kamran Abedini

Hamid Ghodse, is the Director of the International Centre for Drug Policy at St. George’s University of London, Director of the UK National Patient Safety Agency , and President of the UN International Narcotics Control Board. Born in Iran, he is an internationally distinguished leader in the field of Psychiatry and Public Health and in Addictive Behaviour.In his talk Dr. Ghodse will discuss psychoactive drugs, improving medical and public education about them, physician education, medicalization of social problems and internet pharmacy.The rational use of all drugs is important – that is the use of the right drug for a particular condition, in the correct dosage and for the right period of time. It is particularly important when psychoactive drugs are being prescribed because inappropriate, non-rational prescription contributes to a vast pool of these drugs within the community, acting as a source of drugs for abuse and dependence.
This is undoubtedly the case in some parts of the world where statistics demonstrate significant over-consumption of psychoactive drugs. Unfortunately, in other parts of the world, there are major problems of access to these drugs, resulting in patients being denied treatment that they desperately need – for pain, for example or mental illness.In the course of their training, doctors learn about psychiatric illnesses and the psychoactive drugs available for their treatment. Once qualified, however, they see many patients with symptoms suggestive of psychiatric illness such as depression, anxiety, sleeplessness, inability to cope and headache, but who are not suffering from an identifiable disease state. These are normal responses to a difficult situation, and if the situation is very difficult, the symptoms too may be very severe. Although well intentioned, a medicalization of social problems, with associated lax prescribing of psychoactive drugs, often has unintended effects on the individual concerned and has become so widespread that it has far reaching consequences for society as a whole. Medical education on rational prescribing is therefore essential and doctors also need to acquire the skills necessary to evaluate information about new drugs, so that they can critically assess claims for effectiveness and lack of dependence liability. Public education, so that individuals no longer expect a “pill for every ill” is also important although efforts to limit the inappropriate use of drugs in general and of psychoactive drugs in particular must not develop into a general condemnation of all drug taking. Psychoactive drugs have revolutionized the care of the mentally ill during the last 50 years or so, permitting many who would otherwise have been confined to institutions to live within the community and have removed much of the stigma of mental illness.In addition to improving medical and public education, governments require appropriate policies to ensure that psychoactive drugs are available in adequate amounts for their correct purposes and to control their inappropriate use. The nature and speed of modern travel and communication requires that countries cooperate in these endeavours, not least because the Internet does not recognise international borders. Illegal Internet pharmacy websites may be hosted from many places in the world; dealing with them is challenging and requires co-operation between national authorities and many international bodies. Public education about the risks associated with the purchase of medicines from Internet pharmacies is also essential.