Dr Shalini Arunogiri

Overview

Shalini is an addiction psychiatrist and supports patients and families living with addiction and related mental health problems. At Turning Point, Shalini leads a team of over 50 multidisciplinary staff at the Richmond site, delivering face-to-face and telephone services.

Shalini is also a clinical researcher at Monash University and a specialist in treating addiction in women. As an educator, Shalini is passionate about promoting addiction psychiatry as a career to the medical students and junior doctors she trains.

Shalini holds a MBBS(Hons) PhD, FRANZCP (Cert Addiction Psychiatry) and a MPsychiatry MSc (Addiction Studies). She is also Chair of the Binational Faculty of Addiction Psychiatry at the RANZCP, the peak body for psychiatrists across Australia and New Zealand, where she leads policy and practice positions relating to addiction.

What made you want to work in the addiction sector?

I was the first trainee in Victoria to train in addiction psychiatry – it isn’t a very popular specialty! I trained in addiction because I wanted to make a difference. Alcohol and tobacco are some of the biggest contributors to the global burden of disease – yet, they are modifiable risk factors. If we help people recover from addiction, we can stop the development of related mental health and physical problems, many of which can be fatal.

But, so many patients I saw presented late in their illness; after their relationships, work, lives had been ravaged. I stayed in addiction because it was clear that the root cause of this delay in getting help was stigma. Now the focus of my work in addiction is contributing to changing that stigma. What are the misconceptions of addiction?

The biggest misconception, that still persists in Australian society, is that addiction is a moral failing. This myth means that we don’t think people deserve help; rather, that they deserve blame and judgement. This myth excuses a lack of compassion and allows people to look away, to not help. And it drives disparity in resourcing, funding and research meaning that addiction treatment cannot progress at the same rate as treatment for any other health disorder.

The other misconception is that stopping [quitting] is a cure for addiction. Every person in recovery and every clinician working in the field can tell you that isn’t true. I once heard Walter Ling, a Professor at UCLA and a legend in the addiction field; say, “Detox is like a destination wedding to a marriage.” He’s absolutely right, the hard work is in what comes after, it’s in trying to remain stopped.

What are the biggest challenges for someone with an addiction?

For someone with an addiction, one of the biggest challenges can be asking for help. To take that step takes tremendous courage because it means being vulnerable in the face of shame and discrimination, and also uncertainty.

We don’t talk about what happens in addiction treatment, and we don’t share stories of people getting better, so for many people (and their families) they don’t know what to expect and they don’t know recovery is possible.

Getting help also requires resourcefulness and persistence, because in this country, we don’t make it easy to ask for and get help. There are so many hurdles and barriers in the way. For people with co-occurring mental health problems and addiction, they are often told they need to get one problem ‘fixed’ first before they can even get treatment for the other. This is confusing and frustrating, meaning people sometimes decide it’s easier to keep on using than to get treatment.

What has been your experience of the documentary?

I was involved in the documentary from inception, so this has been over a year on this journey. I came to it with reservations because I’m naturally an introvert and wasn’t keen on the idea of being on national television. But I knew we had to do this as an organisation, because this could have the potential to change public opinion about addiction in a way nothing else could. For me, and for the clinical team I work with at Turning Point, the purpose of this documentary really aligns with why we do what we do. If this documentary means that Australians living with addiction, and their families, find it easier to ask for help, and to get help, then it will have been worth it.

What do you hope people will see when they watch the documentary?

My hope is that people watching the documentary will see the reality of what an ‘addict’ looks like – no different from you and me. I hope they will relate to, understand and empathise with the journey people living with an addiction go on. And, I hope that by watching the documentary people will understand the burden of fear, shame and stigma people with addiction face every day.

How can we as a society ‘Rethink Addiction’?

We can ‘Rethink Addiction’ by firstly, accepting and treating it like any other health disorder. If we can remove the blame and the judgement, we remove a tremendous amount of suffering. One way we can do this is by asking for addiction to be a national priority, because this will mean we commit to clear actions and outcomes that can change the landscape of addiction treatment.