Real voices: healthcare
Dr Khaldoon Ahmed, psychiatrist
What do you do?
I'm a psychiatrist at University College Hospital, London. I did a medical degree, then trained in psychiatry. As a doctor working in addiction, I have the opportunity to make a big impact on someone's life.
What is the hardest thing about treating addictions?
Working with people who don't realise that it is an addiction. The main psychological mechanism behind this is denial. Very often addictions build up over time; a person doesn't know the precise moment when they went from being a recreational user to somebody who's dependent - when the addiction is interfering with their life so much that they can't do their jobs, or maintain a relationship. And because the addiction itself is so powerful, they can't imagine life without the dependency, so they prefer not to see it as a problem.
What's the most rewarding part of your job?
People with addictions get taken over by something and very out of control and helpless. It's very rewarding to provide the mechanisms, advice and practical strategies that can help people get over this and see their lives change for the better.
Do people relapse after treatment often?
There is a strong likelihood of relapse, and that possibility is always there. But a lot of people completely overcome their addiction. Many factors help: a good family network, strong social support and access to services.
Are some people more prone to addiction than others?
Biologically, yes - you can give the same drug to lots of different people and only some of them will become addicted. Each drug has its own impact. Heroin is very dangerous in overdose, but in small amounts is not particularly damaging, either to the brain or to the body - it's used in hospitals to treat pain. It's the injecting and social chaos associated with heroin that are so damaging.
You have to put addiction in its social setting. People might be taking drugs because of the subgroup or subculture they belong to. Addiction is very closely connected to economics, too. The price of alcohol and cocaine has come down over the past ten years, and that's why we're seeing an explosion of drug-related problems.
This article is part of the online content for ‘Big Picture: Careers From Biology’ and originally appeared in ‘Big Picture: Addiction’ (2010). Find out more about the ‘Big Picture’ series.