In recent years we have seen how a new type of revolutionary non-invasive method is being applied to treat different brain diseases, known as transcranial magnetic stimulation (rTMS), which has been used to treat diseases such as depression. At Newline we currently apply this method to treat cocaine addiction. rTMS is a procedure that uses magnetic fields to stimulate certain areas of the brain that directly affect addictive behaviors, activating neurons in the areas that control the desire to consume cocaine and restore their original functionality.
The person who leads the Newline Addiction Center, specialized in cocaine addiction, is Dr. Antoni Gual, who is also head of the Addictive Behaviors Unit of the Psychiatry Service of the Hospital Clínic of Barcelona. Dr. Antoni Gual has a long career in alcohol and drug research, both in the clinical and public health fields. He is currently involved in multiple research projects funded by the European Union and in international clinical trials. He is vice-president of INEBRIA (International Network on Brief Interventions for Alcohol) and president of GETEM (Spanish Working Group on Motivational Interviewing). He is also past president of EUFAS (European Union Federation of Addiction Societies), and past president of the Spanish Scientific Society for the Study of Alcohol and Alcoholism. He is also the author of more than 150 articles published in journals in the sector and is a professor of several master’s degrees and director of several doctoral theses.
Dr. Gual explains a little about cocaine addiction and the cocaine cessation treatment currently applied at Newline to combat this disease.
How do drugs, in this case cocaine, work at a psychological level in the addict?
In all cases, drugs act by stimulating the brain’s reward circuits. When consuming, the addict experiences a very important pleasure, to the point that cocaine progressively becomes the person’s number one priority. The self-deception mechanisms inherent to addiction lead the addict to overestimate the pleasurable effects of the drug and underestimate its negative effects. In this way, the person changes his lifestyle, abandoning his professional obligations, neglects his family and, in short, makes his daily activities more and more dependent on obtaining and consuming drugs. Thus, everything that keeps him away from drugs becomes a hindrance, which necessarily leads to problems with the people he loves the most.
What effect does cocaine have on our body?
Cocaine is a powerful psychostimulant. Its consumption leads to a generalized activation of the organism, resulting in euphoria and disinhibition. Under its effect, the person feels tireless, full of energy and almost omnipotent. Logically, when the effects wear off, we find ourselves with the other side of the coin, and the person sinks physically and mentally, which incites him to make new consumptions.
What is the difference between physical dependence, tolerance and addiction?
They are different concepts. Tolerance or neuroadaptation is the physiological process by which the body adapts to tolerate increasingly higher doses of a drug. It is precisely this neuroadaptation that is responsible for the intense discomfort that occurs when the drug is abruptly withdrawn, known as withdrawal syndrome. Not all drugs produce withdrawal symptoms, with alcohol and opiates being the substances that cause the most severe syndromes.
Spain is at the head of cocaine and cannabis consumption in Europe, with Barcelona being one of the cities where they are most consumed. Why do you think this circumstance has arisen?
It is difficult to give a convincing explanation for this phenomenon. There are undoubtedly multiple causes, among which we can highlight the permissive environment, nearby drug trafficking routes, the large influx of tourists, etc.
What is the profile of an addict who enters the clinic to treat his or her cocaine addiction?
They are generally middle-aged adults who are already being negatively affected by cocaine in their emotional life and work, but who still have good work and family ties. In fact, fear of losing them is often the main reason for seeking treatment.
What would you say is the right way to treat the problem?
Treatment should be comprehensive, addressing medical, psychological and socio-familial aspects, as they all have a major impact on the evolution of the disease. It is essential to use motivational techniques to achieve maximum patient involvement. In short, the aim is to ensure that the patient becomes the active protagonist of the entire therapeutic process.
How does the treatment you propose differ from other treatments on the market?
On the one hand, the motivational approach is something we introduced in Spain in 1998. Secondly, the use of rTMS allows very rapid changes in patients, who in a matter of days observe how the desire to consume is reduced and their inner balance increases rapidly. This allows the treatment to be outpatient, and in fact many of our patients could not consider a long hospitalization due to their family and professional responsibilities.
What is the procedure to follow for each patient once their case has been diagnosed?
Once the medical evaluation visit is completed, the patient is scheduled to begin treatment on Monday. The first week he/she receives a total of 10 stimulations in 5 double sessions from Monday to Friday. Each session starts with a stimulation, followed by a session of individual psychotherapy and a second session of rTMS. The following weeks the patient only performs a weekly double stimulation, until 12 weeks of treatment are reached. At this point (between weeks 8 and 12) the patient has already experienced a marked improvement and is in a position to consolidate the changes obtained through psychological therapies, whether individual or group, which are maintained until complete recovery.
What role does the addict’s closest circle play in his or her recovery?
The immediate environment is fundamental, and conditions (for better or worse) the evolution of the patient. We attach great importance to it, and in fact we carry out specific group therapies for family members, with the aim of helping them to better understand the addiction and to relate constructively with the patient.
According to Dr. Gual, since cocaine is a potent psychostimulant, when its effects wear off, the patient feels physically and psychologically destroyed, so in order to treat an addict it is essential that a comprehensive treatment be carried out. The treatment proposed by Newline offers just this: an evaluation of the case, magnetic stimulation and individual psychotherapeutic follow-up during the period required for each particular case.
If you feel that you have tried several treatments and none have worked for you or if you know someone who could benefit from this type of therapy, contact Newline.
We offer you the opportunity to know personally how the treatment based on Transcranial Magnetic Stimulation works to treat addictions and to see the machine with which we perform the therapy. Contact us at [email protected] or by phone 931513922.