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Few Points to Share from Working in Addiction Psychiatry

Mon, 06 Mar 2017 14:21:13 +0000

One year ago, I went back to working in addictions psychiatry. I think I have few points that I would like to share with everyone. And since so many people use drugs perhaps I can help answer some of your questions:

Addiction can be worse than cancer. If cancer eats away parts of the body, addiction eats away your life and the life of people surrounding you.

Addiction is a chronic psychiatric condition that varies in severity. Not everyone who uses drugs or alcohol will become addicted.

It is a psychiatric condition that demonstrates the complex interplay between biological, social and psychological factors and affects the person's thoughts, emotions, behaviours and physical health. No other psychiatric disorder demonstrates this as much.

All drugs are the same if the person develops an addiction. Alcohol included.

Some drugs can directly kill you. Overdose is an inaccurate term. Heroin, for example, stops the basic centres in the brain responsible for your breathing (it was originally marketed as a cough suppressant). It is very hard to predict which dose will make this happen. There is no pre-set dose to go over. Cocaine on the other hand directly damages your heart which can lead to sudden death. Again hard to predict when this will happen. Mixing drugs is a recipe for faster damage.

Addiction to socially accepted drugs such as alcohol and cannabis can have the same destruction of a person's life as hard drugs.

Drugs work differently on the brain but ultimately they all affect the reward pathway. The reward pathway is how we feel pleasure from our senses and actions (i.e. eating a nice meal or sex, etc..). Our senses and actions can give us limited reward. Drugs offer unlimited reward.

Reward is essentially how all fairly complex animals learn. Young age is when we learn very quickly. Taking drugs to deal with life is similar to using video game cheat codes to finish a level. It offers a short cut to dealing with problems.

If you learn this short cut at a young age, it becomes very difficult to unlearn it and then start learning new ways of dealing with life from scratch.

The critical age for developing an addiction is 12-24 years old. So if you're interested in altering your mental state try to do so after that age. Be very worried if you like the drug (more than anything else). You can still develop an addiction at any age but it is less common.

We will always have the drive to alter our mind. Either to experience pleasure or escape unpleasant feelings. Therefore, trying to prevent access to drugs is futile. The money could be better spent on treatment and research.

Only very few people can afford treatment and addiction treatment is still in the dark ages. Treatment from addiction is not just withdrawal from the drug. That is the easiest part. Many people recover but it is important to understand that recovery from a chronic condition is about improvement in a person's functioning and quality of life.

One reason that makes treatment difficult is that addiction is difficult and frustrating for other people to understand. Which makes it hard to empathise with someone who is destroying his or her life. This is part of the stigma surrounding the condition and that is why recovered addicts have a major role in helping people recover and helping society change.

University Psychology Exam Asked Students to Assess Politicians From TV

Thu, 08 Oct 2015 21:19:20 +0000

Today, I received a copy of the psychology exam for the masters in neurology and psychiatry at Ain Shams university. The students were given this brief essay question "You are asked to assess the thinking of a famous politician through watching him in TV show. Discuss briefly the standards you will look for during your assessments." (see photo above Q3.B) My gosh! This comes almost a week after I wrote an article explaining why psychiatrists shouldn't comment on the mental state or diagnose politicians from a distance. Why are they asking students to imagine being requested to do something that is clearly unethical? What standards are they talking about? When there are clear standards against doing so. The American Psychiatric Association has an ethical principle known as the Goldwater rule. In 1964, a political magazine in the US asked 12,000 psychiatrists for their opinion regarding the presidential candidate Barry Goldwater's fitness to be President of the US. None of them examined Goldwater and none had permission from him to issue public comments. Goldwater sued the magazine for libel and won. Following that the APA added this to its ethical principles (section 7.3): "On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement." This was done to "to protect public figures from psychiatric speculation that harms the reputation of the profession and of the unsuspecting public figure." Similarly, Dr. Manal Omar was subject to libel lawsuit by the presidency following her comments on Mohammed Morsi during his presidency. After public pressure the suit was dropped. Another important principle is the philosophical principle of charity. Which means that when we try to understand someone's statement or point of view we try to understand the most powerful explanation and in a way that makes most sense. TV isn't the best medium for this. In my opinion that's one of the essences that differentiates a clinical interview from TV because you will then be able to ask more questions to understand what the person really means and not create a false understanding based on the one-way medium. For example, if someone says on TV that he believes he is being spied upon it is false to conclude that he is suffering from delusions of persecution because only in an interview that you will be able to question this further to understand how he or she reached this conclusion and the degree of conviction. It can be that he is truly being spied upon by some government because he received threats or that he found this information written on the seed of a mango fruit. Actually it's perfectly fine for psychiatrists to have political views and to express them in public. If it wasn't clear from my article, my objection is on the use of psychiatric terminology to describe particular politicians or political groups. In fact the ethical rules of the Egyptian Psychiatric association, which Dr. Ahmed Okasha is its head, states that "If a psychiatrist has private views on general issues (politically or otherwise) he should clarify in what capacity he is speaking. And in this case he is like all other citizens without a professional title or specialisation." This is point number 8 in 10 points about psychiatrists and the media. Essentially, psychiatrists should be very careful when speaking to the media. Englishpsychiatryethicspoliticsegypt[...]

الطب النفسي والسياسة والدعاية الحكومية

Fri, 02 Oct 2015 11:54:48 +0000

مقالي عن قيام بعض الأطباء النفسيين بتشخيص سياسين من عن بعد ومشكلة فحص المرشحين الرئاسيين نفسيا.

Psychiatrist Mostafa Hussein writes about the dangers of asking renowned psychiatrists to profile politicians, political groups and society at large on television shows.

Koftagate: Dashed Hopes and Wasted Resources

Sat, 09 Aug 2014 15:09:52 +0000

The nice and patient people at the Tahrir Institute for Middle East Policy (TIMEP) invited me to write a piece on the Koftagate scandal. You can read it here.

النصباية الأصلية: فتح علبة جهاز جوفر للبحث عن كرات الجولف -- تحديث: الآن بالفيديو

Sat, 12 Jul 2014 10:40:47 +0000

أشتريت من موقع إيباي جهاز عجيب جداً، في رحلتي لفضح جهاز الهيئة الهندسية للكشف عن الفيروسات عرفت ان جهاز جوفر للكشف عن كرات الجولف هو الجهاز الأصلي الّ بعد كده أعاد إبتكاره رجل الأعمال البريطاني النصاب ال باعه للعراق بملايين الدولارات وبعد كده أتحبس واتحكم عليه بعشر سنوات سجن. الجهاز تمنه 20 دولار وشحنه أتكلف 20 دولار والبريد المصري أخد 61 جنية تكاليف طرد. البريد المصري بيفتح أي طرد ومكانش فيه أي اعتراضات أمنية على دخول الجهاز. الجهاز من التسعينيات و مكتوب عليه صنع في الولايات المتحدة الأمريكية. مكتوب على العلبة أن جهاز جوفر مدهش في قدرته على إكتشاف كرات الجولف، وأنك لن تفقد كرة جولف واحدة بعد الآن. مكتوب انه يستخدم تقنية متطورة حديثة ومبرمج للكشف عن مواد موجودة داخل تلك الكرات. مكتوب على العلبة أيضا أن الجهاز سيحسن من لعبك للجولف عن طريق: * الحفاظ على ضرباتك * يقضي على الإحباط بسبب فقدان الكرات * يجعل الجولف أكثر إمتاعاً * يوفر المال (أشك) * والجهاز هو أفضل هدية للاعب الجولف الذي يمتلك كل شيئ الجهاز بيجي معاه شهادة تسجيل الضمان وإستبيان عن المنتج، كنالوج لشرح طريقة الإستخدام وشريط فيديو VHS. width="640" height="480" src="//" frameborder="0" allowfullscreen=""> الكتالوج بيشرح طريقة إستخدام الجهاز. وبيقول انه بيشتغل بطريقة مماثلة للبوصلة. ولكن بينبه أكتر من مرة أنك لازم تتحرك وتتنفس بشكل طبيعي وماتمسكش الجهاز بقوة مفرطة علشان يشتغل وبيقول ان الجهاز لا ينبعث منه إشاعة ضارة وأنه بيتحرك تجاه الإشارات النابعة من كرات الجولف فقط. نفس الإدعاء بتاع جهاز سي-فاست أن الجهاز بيتحرك بإستخدام الكهرباء الإستاتيكية بتاعة جسمك. بقية الكتالوج بيشرح أزاي تتحرك وانت ماسك الجهاز علشان تلاقي كرات الجولف. في نهاية الكتالوج بيشرح أن الجهاز سيكتشف الكرات تحت الماء أو وراء الأسوار, وأن الجهاز شديد الحساسية، وان حساسيته تقل أثناء الأمطار أو الضباب. وبعض الأوقات الجهاز سيرشدك لأماكن ليس بها كرات جولف، لو أستخدمت فأس وحفرت في الأغلب ستجد كرات تم ردمها! بالرغم من إشتياقي للجهاز بشدة صدمت أول ما لمسته، فهو مصنع من بلاستك رديئ وشكله حقير بعض الشيئ، كأنه مصنوع في ورشة تحت السلم. المهم أن المفصلة ناعمة جدا. الجهاز لا يحتاج إلى بطارية ولا يوجد به أي إلكترونيات. بالمقارنة مع جهاز سي فاست فالمفصلة لها تقريباً نفس التصميم الجهاز يعمل! فعلا بيكتشف أي حاجة أنت بتفكر فيها، ودي صورتي وأنا بجربه على متطوعة مسكينة! في حقيقة الأمر: الجهاز يعمل بالتأثير الفكرحركي ideomotor effect، وهو ظاهرة نفسية يحدث فيها ردود أ[...]

ملخص سريع عن مؤتمر الهيئة الهندسية الأخير

Sat, 28 Jun 2014 14:35:51 +0000

دخول المؤتمر الصحفي كان للصحفيين ال الشؤون المعنوية محددة أساميهم. صحفيين سكاي نيوز أرابيا وجريدة الغد منعوهم من الدخول. أنا قلت أني دكتور وطلب مني البطاقة وأتصلت بلينا عطااللة لأنها كانت جاية تحضر وأتفقنا نتقابل هناك. بعد 5 دقائق قال لي ممكن أدخل ولينا دخلت معايا من غير ما حد ياخد باله. المهم بعد ساعة من الانتظار داخل القاعة، بدأ فيلم كله دراما. موسيقى درامية جدا عاملة زي أفلام هوليود الأكشن. الفيلم أخدنا لرحلة داخل معامل أكتر من 5 جهات تابعة للقوات المسلحة وجهات مدنية أخرى زي معامل هيئة الرقابة النووية و الفنية العسكرية والمعهد القومي للبحوث ومركز بحوث البترول. وفي الفيلم كان في لقائات مع أشخاص كتيرة جدا من الجهات دي متصورين بجوار الأجهزة الفنية بتاعتهم الحديثة، وبيتكلموا عن تفاصيل زي سلامة الجهاز من الناحية الكهربية والاشعاعية وسلامة الأقراص المستخدمة ومعرفة ان كانت تحتوي على معادن ثقيلة. الفيديو اتكلم عن انشاء المركز الوطني لعلاج الفيروسات في الاسماعيلية، وأنها مستشفى هاتكون مجهزة لعلاج المرضى بالاختراع الجديد. تتطرق أيضا بعد كده لجهاز سي-فاست وعن أزاي انهم هايتعاونوا مع وزارة الصحة و لإستخدامة للتأكد من تعقيم الغرف والأدوات الطبية وفي بنوك الدم. مخترع جهاز سي فاست العقيد أحمد الأمين ابراهيم قال انهم قدموا الجهاز في مؤتمرات في أمريكا وهولندا واليابان وانجلترا وتايلند. وأتكلمت في الفيديو الدكتورة هالة عدلي من خدمات نقل الدم ان في بعض الأجهزة ما يقدروش يعملوا عليها التحاليل التقليدية ولذلك جهاز سي فاست هايكون مفيد. كل ده وفي الفيديو كان في صور لموافقات ومستندات من وزارة الصحة وجهات تانية كتير مصرية. أتكلموا على ان في 80 مريض وافقوا على الانضمام لدراسة الجهاز وكانوا 50 مريض بالسي و30 مريض بفيروس نقص المناعة المكتسب/أيدز. بعد الفيلم أتكلم العقيد تيسير عبدالعال (طبيب باطني ومناعة) عن ان الهيئة شديدة الحرص على سلامة المصريين وعلشان كده بتعمل الاختبارات الكتير دي. كان في كلام كتير عن المواصفات الفنية للجهاز واختباره للتأكد أنه لن يؤذي المرضى، ولأول مرة شرحوا طريقة عمل الجهاز العلاجي CCD بالرغم من قبل كده كان في تكتم شديد على الموضوع ده ومعتبرينه سر حربي. الجهاز بياخد الدم من المريض بيضخه في أنابيب لحجرة في وسط الجهاز ويرجعوا مره أخرى، الحجرة فيها مصدر للأشعة الفوق البنفسجية (UVA). تيسير شرح أنهم لم يصلوا لمرحلة اندثار الفيروس من الجسم لفترة مستمرة وطويلة، وأنهم بيحاولوا يوصلوا للنقطة دي. وأنهم تقدموا بتسجيل التجربة القادمة في موقع clinical-trials.go[...]

C-Fast Simulator

Fri, 27 Jun 2014 20:07:30 +0000

This is a very simple 2D simulator of the C-Fast device. Here I want to show that minor mouse movement are translated by the unstable hinge system into bigger movement. Thus try moving the antenna while looking at your hand, you will notice that it will be hardly moving.

This is an approximation of how the C-Fast virus detection device works. Also a chance for me to play with Processing :-)

For more information see previous posts on this blog.

Have fun!

محاكي (سيميولاتور) جهاز الكشف عن الفيروسات، حركات الماوس البسيطة بتترجم بالمفصلة الغير مستقرة لحركات كبيرة للإريل، حاول تحرك الأريل وتخليه يجري ورا القطة، لاحظ أيدك هاتلقيها تقريبا مش بتتحرك.

ده بالتقريب كده أزاي جهاز الكشف على الفيروسات بيشتغل.ال بيستخدم الجهاز ممكن ما يشعرش بالحركات البسيطة دي وإيده بتحرك الجهاز بحيث ان الاريل يتجه في المكان ال هو بيفكر فيه (التأثير الفكرحركي).

وعلشان كده لو غمض عنيه الجهاز مش هايشتغل لأنه بيعتمد على المستخدم أكتر ما هو بيعتمد على أي تكنولوجيا حقيقية جوا الجهاز.

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ATTENTION ALL JOURNALISTS: #KoftaGate Press Conference Tomorrow

Fri, 27 Jun 2014 11:41:55 +0000

Egyptian Army Engineering Authority (EA) is organising a press conference tomorrow at the Qubba Military Hospital at 10:00am. According to Youm7 and Watan they will announce new information about 'their successes in the treatment of HIV/AIDS and Hepatitis C' using their newly invented devices. It is important to remember that there are two devices in the whole #koftagate story: A: The diagnostic devices: (Fast series) Including C-Fast that allegedly diagnoses Hepatitis C. This is the device with an antenna sticking out of it. According to their claim it can detect the virus from a distance up to 500 meters, works with static electricity and has not electronics inside it. Only one paper was published in a low quality peer-reviewed journal. Few days ago the journal was the subject of a sting operation by Egypt Independent and it accepted a plagiarised article that made no sense in less than 24 hours, this is a sign that this journal does no peer review. The device is made of a plastic handle and an antenna sticking out of a hinge. This hinge is unstable and can move in any which way if, while holding it, you move your hands. This device is GUARANTEED TO FAIL to work if the user closes his eyes. This is because the antenna move using a psychological trick where the user's thoughts affect his hand movement. Minor hand movements move the device very slightly and imperceptibly these movement are translated by the unstable hinge system. This is called the Ideomotor effect and is the same way Ouija boards work. Basically this is a CHEAP MAGIC TRICK. The device is very similar to the ineffective bomb detector used in Iraq ADE651 that turned out to be a huge scandal. The business man who sold this device to Iraq (James McCormick) is now serving jail time for fraud in the UK. Whilst Prime Minister Nouri el-Malaki insists that some bomb detectors work he admits that the device is less effective than trained dogs. The Egyptian medical and scientific community didn't denounce this device strongly because of the aforementioned paper. This is dangerous because several of members of the engineering authority and the HEALTH MINISTER mentioned it can be used in separating infected blood from viable blood in blood banks. B: The treatment device looks like a dialysis machine. The claim is that blood goes in then comes out free of viruses. The EA claims that it kills the virus by using electromagnetic signals. The lead inventor of this machine Maj. General Ibrahim Abdel-Atti is an interesting personality. He claims to have invented a new domain of medicine called Cosmic Medicine and that he is 20 years ahead of the rest of the world. He is an honorary army general and used to sell herbal medicine in the gulf and received a degree in biochemistry from Sri Lanka. Abdel-Atti gave the kofta name to this scandal by his comments about taking the virus into the machine and returning it kofta for the patient to nourish him. The most important point is that no controlled trials where published to test this machine. They refuse to do so claiming that it this device is a national secret. If this device enters into use, the EA will be exposing patients with serious conditions to untested and unproved treatment that didn't pass proper scientific procedures that clear treatments for wider use and may potentially harm them. C: According to several news sources few months ago Sisi asked a scientific committee to review the devices. This committee doesn't seem to be entirely independent but is nevertheless a good step. No report was made public until this point.[6] The Engineering Authority claimed several weeks ago that it will demonstrate the device to international and local scientists and doctors by mid-June. Nothing happened. Watch videos by Islam Hussein Videos are incredibly detailed and thorough in debunking EA claims Video 1Video 2 Islam is a highly published[...]

Time Is Running out: 30 Days till #koftagate — Update

Sun, 01 Jun 2014 21:02:23 +0000

El-Youm El-Sabe3 published an update on the Egyptian military devices that detect and treat Hepatitis C and HIV. Based on a military source the newspaper conveys the following points: 70,000 applied for treatment by email The device treated 1000 patients till now. Including judges, deputy ministers and doctors Treatment started in Abbasseya hospital (not clear which one) and Almaza military hospital. 100% of cases of HIV were cured. 97% of Hepatitis C. Foreign patients will be received in special hospitals until a tourist resort is dedicated to foreigners with HIV Every day 30 doctors are trained on using the devices. By June 30 a trained doctor will operate each device. Another source said the device treated 50 Hepatitis C cases and 30 HIV. Yesterday, el-Wattan newspaper published that the Engineering Authority will present the devices in an international conference. And will answer questions by both local and foreign scientists. Last month, the Engineering Authority presented the virus detection device in a medical equipment exhibition. The device is similar to the fake bomb detector sold in Iraq. I went to see the device, proved that it's a hoax and was kicked out. I wrote about this here. Earlier the Engineering Authority promised that it cured HIV and Hepatitis C and will make the miracle cure available by June 30. The interim president scientific advisor Essam Heggy said that both devices have no scientific merit. MIT virologist Islam Hussein published detailed videos in Arabic questioning both devices. Major General Abdel Atty is an obvious charlatan who claims to have invented a new medical discipline called cosmic medicine. He used to peddle herbal cures in the gulf. Then out of no where became an honorary general and made these extraordinary claims. June 30 is approaching and these devices offer nothing but false hope to thousands of patients. Despite this being an obvious and dangerous hoax there is little response from the Egyptian medical and scientific community. I want you to help change that. If you are a scientist or doctor please say something publicly and if you know a scientist or a doctor please ask them to raise their voice. Time is running out. You can also read the following links and follow the hashtag #koftagate on twitter. The Army’s Miracle Cure: Today’s Joke, Tomorrow’s Tragedy Why The Miracle Cure Offered To Egyptians With Hepatitis C Isn’t Funny Lysenko's time Even if we can cure AIDS, do we really want to? CC for complete cure Africa has cured AIDS many times before #KoftaGate : Let’s Burn those heretics at the Stake !! “Chapter3” #KoftaGate : Dr. StrangeLove or how We Cured AIDS and HCV “Chapter-1” Scientists are not divided over device that 'remotely detects hepatitis C' Hepatitis C detector promises hope and nothing more Update on #KoftaGate – Egyptian Miracle Detectors and Cures for Hepatitis C and AIDS Dubious Egyptian Hepatitis C Detector Pops up Again Englishkoftagateegypthivhcvmedicine[...]