Download - Recovery Enhancing Meds-Press Ready
RECOVERY-ENHANCING MEDICATIONS IN ADDICTION TREATMENT CHRISTOPHER COOK, B.A., CADC, SAP Founder-Executive Director SperanzaHealth Clinical Partners Project Manager HOPE PROGRAM @ Cove Forge 724-614-6669 [email protected]
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INTRODUCTIONS INTRO’s Everyone Loves Introductions…
OBJECTIVES
! Addiction is a BIO-PSYCH-SOCIAL DISEASE
! To understand the medications, we must pay close attention to the BIOLOGY
! Medication-Assisted Therapy (Maintenance) vs. Recovery-Enhancing Medications: Is there a difference?
! Research and Practice…
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What’s all the fuss about Neuroscience?
! Neuroscience – definition from dictionary.com - the field ofstudy encompassing the various scientific disciplines dealingwith the structure, development, function, chemistry,pharmacology, and pathology of the nervous system thateffect the brain.
! Every thought, sensation, emotion, physical movement isaccounted for in terms of brain structures and chemistry.
! In other words… nothing happens in human behaviorexcept by the mechanisms of the brain.
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Is it really a Disease?
! Disease of the brain.! >33% of Public believes it is simply willpower…HOW
ABOUT CLINICIANS?
! Compared to:! Type 2 Diabetes, Chronic hypertensive disease, Asthma,
Obesity
! No one treatment episode will resolve illness…hence 12Steps, Other social supports
! Course of dependency is multiple episodes of treatment,recovery activities, relapse periods.
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Does this matter to what you do?
THERAPY…
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Application “The longer you’re in treatment…” ! Research has shown unequivocally that good outcomes
are contingent on adequate treatment length.
! Generally, for residential or outpatient treatment,participation for less than 90 days is of limitedeffectiveness, and treatment lasting significantly longeris recommended for maintaining positive outcomes.
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Therefore…
! Understanding how thebrain functions duringand after drug use,encourages practitionersto correlate appropriatestrategies to the stage ofrecovery andconsequently impact onprogram retention.
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Biology of Addiction Neurotransmitters and drugs of abuse
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Neurotransmitters
! Several Involved in Addiction ! Serotonin
! Dopamine
! Endorphins
! GABA1
! Glutamate (NMDA)
! Norepinephrine (Adrenaline)
! Cannabinoids
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Neurotransmitters…what do they do?
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The importance of dopamine…
Dopamine
! D2 receptor changes associated with addiction in people and animals
! Drugs of Abuse cause 5x to 10x increase…
! Chronic exposure to stimulants, opioids or alcohol leads to decreased dopamine activity ! Decreased sensitivity to everyday rewards
! How does this affect psychotherapy?
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The importance of Glutamate
! Memory Formation
! New pharmacological + psychological therapy?
! Glutamate + Dopamine Directly influence the formation of new memories… ! How does this affect the addict?
Biology of Addiction MICRO-VIEW
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The synapse up close…
The Action of Opioids (Morphine)
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Opioids…
The Action of Cocaine
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Ways Chemicals “Act” in the Brain
Drugs of Abuse act…
! Increasing Presence of Neurotransmitters by reducing uptake or forcing release (Cocaine, SSRI’s/SNRI’s, Amphetamines…)
! Mimicking Neurotransmitters (Opioids, Cannabinoids…)
Differences…
! Agonists (opioids)
! Antagonists (naltrexone, naloxone, flumazenil)
! Partial Agonists (Buprenorphine, Talwin)
! Efficacy
! Affinity
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Biology of Addiction MACRO-VIEW
Why do they act that way?
Phineus Gage*
Phineus Gage
! After the accident: Personality Change ! Rude
! Sexually inappropriate
! Poor impulse control
Neurotoxicity Methamphetamine
Neuroscience of Addiction Day 2
The Brain in “Recovery”
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724-651-6669 - Christopher Cook412-447-4677 - Clinicians
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