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  1. 1. 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 chris.cook@speranzahealth.org SperanzaHealth Clinical Partners
  2. 2. INTRODUCTIONSINTROs Everyone Loves Introductions
  3. 3. 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 SperanzaHealth Clinical Partners
  4. 4. Whats all the fuss about Neuroscience? ! Neuroscience definition from dictionary.com - the field of study encompassing the various scientific disciplines dealing with the structure, development, function, chemistry, pharmacology, and pathology of the nervous system that effect the brain. ! Every thought, sensation, emotion, physical movement is accounted for in terms of brain structures and chemistry. ! In other words nothing happens in human behavior except by the mechanisms of the brain. SperanzaHealth Clinical Partners
  5. 5. Is it really a Disease? ! Disease of the brain. ! >33% of Public believes it is simply willpowerHOW ABOUT CLINICIANS? ! Compared to: ! Type 2 Diabetes, Chronic hypertensive disease, Asthma, Obesity ! No one treatment episode will resolve illnesshence 12 Steps, Other social supports ! Course of dependency is multiple episodes of treatment, recovery activities, relapse periods. SperanzaHealth Clinical Partners
  6. 6. Does this matter to what you do? THERAPY SperanzaHealth Clinical Partners
  7. 7. Application The longer youre 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 limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes. SperanzaHealth Clinical Partners
  8. 8. Therefore ! Understanding how the brain functions during and after drug use, encourages practitioners to correlate appropriate strategies to the stage of recovery and consequently impact on program retention. SperanzaHealth Clinical Partners
  9. 9. Biology of Addiction Neurotransmitters and drugs of abuse Speranza Training Associates
  10. 10. Neurotransmitters ! Several Involved in Addiction ! Serotonin ! Dopamine ! Endorphins ! GABA1 ! Glutamate (NMDA) ! Norepinephrine (Adrenaline) ! Cannabinoids Speranza Training Associates
  11. 11. Neurotransmitterswhat do they do? Speranza Training Associates
  12. 12. The importance of dopamine
  13. 13. 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? Speranza Training Associates
  14. 14. 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?
  15. 15. Biology of Addiction MICRO-VIEW Speranza Training Associates
  16. 16. The synapse up close
  17. 17. The Action of Opioids (Morphine) Speranza Training Associates
  18. 18. Opioids
  19. 19. The Action of Cocaine Speranza Training Associates
  20. 20. Speranza Training Associates
  21. 21. Ways Chemicals Act in the Brain Drugs of Abuse act ! Increasing Presence of Neurotransmitters by reducing uptake or forcing release (Cocaine, SSRIs/SNRIs, Amphetamines) ! Mimicking Neurotransmitters (Opioids, Cannabinoids) Differences ! Agonists (opioids) ! Antagonists (naltrexone, naloxone, flumazenil) ! Partial Agonists (Buprenorphine, Talwin) ! Efficacy ! Affinity Speranza Training Associates
  22. 22. Biology of Addiction MACRO-VIEW
  23. 23. Why do they act that way?
  24. 24. Phineus Gage*
  25. 25. Phineus Gage ! After the accident: Personality Change ! Rude ! Sexually inappropriate ! Poor impulse control
  26. 26. Neurotoxicity Methamphetamine Neuroscience of Addiction Day 2
  27. 27. The Brain in Recovery
  28. 28. Like What You've Viewed? Contact SperanzaHealth Clinical Partners and Ask For About Our Clinical Trainings! Many completely free trainings throughout the year Multiple trainers of differing backgrounds We will come to you, or better yet, use SperanzaHealth Trainers as a marketing tool... call us today for a completely free needs assessment or to just schedule a training! 724-651-6669 - Christopher Cook 412-447-4677 - Clinicians SperanzaHealth Clinical Partners is a specialist behavioral health firm. We are a group of independent, private contractors specializing in: 1. Sub-Contracted Assessment and Referral 2. NEW Sub-contracted Utilization Review RN's 3. Clinical and Corporate Training 4. Business Consultants specializing in MentalHealth and Substance Abuse Tretment Agencies