Day 3 :
- Workshop session on
Location: Prestwick
Chair
E Renea Snyder
Pennsylvania Department of Corrections, USA
Session Introduction
E Renea Snyder
Pennsylvania Department of Corrections, USA
Title: AOD recovery units in correctional institutions
Biography:
E Renea Snyder is a Drug and Alcohol Program Administrator, Pennsylvania Department of Corrections. She has done Bachelor’s in Psychology and English, a Master’s degree in Education with a Specialization in Curriculum Design and Development, and is currently enrolled as a PhD Psychology student, specializing in Addictions Psychology. She started her career in 2005 with the PA Department of Corrections as Food Service Instructor at SCI-Pine Grove. In 2007, she took a position with SCI-Somerset as a Corrections Counselor and Treatment Specialist. In 2012, she took a position with the Department of Public Welfare, where she had oversight of the Mental Health housing for the Office of Mental Health and Substance Abuse Services. In 2013, she was provided, the opportunity to return to the Department of Corrections, as the Drug and Alcohol Program Administrator. She has worked diligently to bring the AOD Department to current Evidence Based Practices and Programs, by making significant changes to the co-occurring disorders programs, outpatient, and therapeutic communities. She was the lead in making significant changes to the auditing process for the AOD Department and policy revisions. She developed the first Recovery Unit model which is currently being piloted at SCI-Graterford. The model includes progressive treatment modes for the AOD and Corrections field. She has developed training for AOD staff involving clinical supervision and the key components to being an effective AOD counselor.
Abstract:
The Bureau of Treatment Services, Alcohol and other Drug Division for the Pennsylvania Department of Corrections designed an AOD Recovery Unit Model for Correctional Institutions. The AOD Recovery Unit Model is currently being piloted at State Correctional Institution Graterford, in the Eastern Region of Pennsylvania. It is anticipated that the AOD Recovery Unit will decrease AOD relapse once an offender re-enters into the community, as well as the overall recidivism rates of AOD offenders. It is believed that once an offender completes the recommended AOD programming such as Inpatient, Outpatient, or Co-Occurring programs; that the offender will then voluntarily participate in the AOD Recovery Unit. The AOD Recovery Unit offers eighteen workshops and one gender specific workshop. There are eighty-two modules that are gender neutral and 24 modules that are gender specific. The workshops encompass evidence based programs such as SHIELD (Self Help in Eliminating Life Threatening Diseases), SAMHSA’s Intensive Outpatient Matrix, Living in Balance (Hazelden), Natural Meditation, Alcoholics Anonymous, Narcotics Anonymous, Al-Anon, Double Trouble in Recovery and Moving On. There are many self-recovery tools included in the workshops such as; Addictions Journaling, Addictions Art, Addictions Book Club, Beat the Streets Series, and Guided Group topics. The modules are facilitated by Drug and Alcohol Treatment Specialists and trained AOD Peer Assistants. The AOD Recovery Unit at SCI-Graterford is a 115 bed, Outside Secured Housing Unit. Offenders are recommended AOD programming based on the Texas Christian University screening tool. There are currently four levels of AOD treatment provided; Inpatient – Therapeutic Community (4 months), Outpatient (41 sessions), Dual Diagnosis Therapeutic Community (6 months), and Dual Diagnosis Outpatient (47 sessions). Once an offender has completed the recommended programming, they are provided the opportunity to participate in the AOD Recovery Unit. Of those willing to participate in the AOD Recovery Unit, offenders are randomly selected to participate in the AOD Recovery Unit. It is anticipated from this process that AOD Recovery Unit participants will be less likely to relapse upon release into the community. Although we do not have the current numbers available to validate our thesis, we believe this to be a valid Recovery Unit Model and will be able to provide data based on the research at the August conference. We are working closely with our research department and the field staff to ensure efficacy of the model and workshops.
- Special Session on
Location: Prestwick
Chair
Ms. Renee Brown
Next Level Recovery, LLC, USA
Session Introduction
Renee Brown
Next Level Recovery, LLC, USA
Title: Treatment with real life in mind… a model where behavioral science shakes hands with traditional recovery methodologies
Biography:
Renee Brown is President of Next Level Recovery, LLC; Sober Living Properties, LLC; and Smart Medical, LLC. Her past is rich with a diversified outlook on addiction, as she has served as a provider of recovery housing and treatment. She was the first to license a recovery house (Sober Living Properties) in the state of Utah, which is now one of the largest providers of recovery housing in Utah and has programs with behavioral science in the treatment center, Next Level Recovery. Her clients engage in healthy relationships, work or school, and are known to overcome some of their most difficult obstacles in early recovery, before they leave treatment and or recovery housing.
Abstract:
Objective: To introduce a recovery model based on matriculation back into society from the beginning of treatment. To illustrate some of the current draw backs in the traditional model of inpatient care for those who are struggling with substance abuse. To compare and contrast treatment models inside and outside of recovery that entertains the use of behavioral science. To outline some new hope in recovery that might offer more longevity and affordability. Methods: Focus was on executive brain function with an array of goals in recovery housing and treatment – feedback back and accountability in a peer environment and in a clinical environment. Observation and support was needed for immediate positive outcomes, in context to life skills, when a client is still in treatment or recovery housing. Peer accountability, Positive Psychology, CBT, Trauma based therapy, Art therapy, Recreational Therapy and Least restrictive environments are some of the important factors. Results: Connection, social skills, self-regulation, program retention, participation in work or school. Transition from treatment and or recovery housing, was as seamless as possible in context to life skills (family, social, work/school) and sobriety. Affordable resources were provided for continued support.
- Addictions and Addictives
Behavioral and Multimedia Addiction
Alcoholism and Substance Abuse
Location: Prestwick
Chair
Kathy Sexton-Radek
Elmhurst College, USA
Co-Chair
Jason Connor
The University of Queensland, Australia
Session Introduction
Adi Jaffe
Alternatives Behavioral Health LLC, USA
Title: Mindful drinking: A clinical case study of non-abstinence AUD treatment
Time : 11:55
Biography:
Adi Jaffe has received his PhD from the University of California, Los Angeles (UCLA) in 2010. Even before he graduated, his name had become known through his online and academic writing. His views on addiction and his research on the topic have been published in dozens of journals and online publications and he has appeared on several television shows and documentaries discussing current topics in addiction and the problem of addiction as a whole. He also teaches courses at UCLA that address addiction specifically or biological psychology and behavioral neuroscience more generally. His view is a holistic one, drawing from the best and most recent research to bring as complete a solution to addiction clients. At Alternatives, he serves as the Director of Research, education and innovation and is in charge of client monitoring, technology solutions and data collections and outcomes research.
Abstract:
The talk will address non-abstinence treatment options for alcohol use disorder (AUD) within an outpatient setting. General treatment modalities will be discussed along with monitoring and outcome measurement approaches. A clinical case presentation for a male patient (age=29) with severe AUD will be used in the presentation in order to provide examples of current application within an intensive-outpatient setting in Los Angeles, CA. Data obtained over the course of eight (8) months from daily mobile-breathalyzer readings and tailored mobile-assessments will be presented along with more extensive baseline and monthly assessment batteries. Baseline and monthly assessments were comprised of a range of psychological instruments such as the Beck Depression Inventory (BDI-Depression), Barratt Impulsiveness Scale-(BIS Impulsivity), PANAS-X (Affect) and Rumination Responses Scale (RRS-Rumination) with intervals of the Addiction Severity Index (ASI) given at month one (1), three (3) and six (6). All results and analysis were completed using SPSS 20. Our analysis indicated significant decreases in depression, anxiety and negative affect as well as increase in positive affect and general health that continued to significantly improve even after the reintroduction and moderate use of alcohol. Implications for the future of structured non-abstinence treatments for AUD will be discussed and explored.
Sevil Sonmez
University of Central Florida
Title: Bar crawls, foam parties, and clubbing networks: A Mediterranean vacation ritual
Time : 12:20
Biography:
Sevil Sonmez completed her PhD in Tourism Management from Penn State University. She is currently Professor in the Department of Tourism, Events, and Attractions, Rosen College of Hospitality Management, University of Central Florida, Orlando, Florida. Prior to UCF, she served on the faculties of the University of North Carolina Greensboro, Zayed University (UAE), European University of Cyprus, Emory University, and Arizona State University. Her research is interdisciplinary and applied and delves into the nexus of leisure, work, and health. Her work focuses on adverse health consequences of occupational and leisure mobility, occupational health of tourism and hospitality sector employees, and reduction of tourism’s adverse health effects and promotion of its health benefits. Her work has appeared in both tourism/hospitality and health journals and conferences. She is the coeditor of three books: Women as Producers and Consumers of Tourism in Developing Regions, Mediterranean Islands and Tourism Development, and Population Mobility and Infectious Disease.
Abstract:
Mediterranean nightlife destinations spanning across Spain, Italy, Greece, Cyprus, and Turkey draw millions of visitors annually with promises of sun, sea, sand, unrestricted drinking, and nonstop partying. Incidence and prevalence of health and safety risks for young adults of age 18-35, at these resorts has reached epidemic proportions. In these environments young adults engage primarily in binge drinking, recreational drug use, and casual sex. This study is designed to elucidate the physical space of clubbing settings where health and safety risks unfold; delineate the social organization of risk taking in order to identify stakeholders and primary players involved; ascertain risk exchanges and transactions among these populations; and explore potential multifaceted solutions for harm reduction. Ethnographic assessment of risk environments in Ayia Napa, Cyprus included participant and nonparticipant observation, socio-spatial mapping of risk settings, informal discussions, and secondary data collection. Results revealed an array of individual and public health, as well as safety risks exacerbated by characteristics of the spatial environment. Data analysis revealed that excessive drinking often leads to increased hospital visits due to blackouts, alcohol poisoning, substance overdoses, accidents, injuries, fatal falls, and various acts of violence. In addition incidents of unplanned pregnancies, sexual assault, and even death, were revealed during analysis. Recommendations are made for interventions and harm reduction in response to an urgent need to create healthier and safer recreational settings at tourist destinations. Additionally, the use of complexity science perspectives is recommended to better understand the dynamic and complex nature of international nightlife tourism and its health and safety risks.
Rocco de Filippis
Institute of Psychopathology, Italy
Title: Substance use and bipolar spectrum: A naturalistic study
Time : 12:45
Biography:
Rocco de Filippis completed his MD and PhD from Catholic University of the Sacred Heart in Rome. He holds a Master’s degree and he improved respectively in Bipolar Disorders and Addictive behavior in the years 2011/2012. He currently works at the Institute of Psychopathology - Rome as a Psychiatrist and Addictive Medicine, and up to now presented as Scientific Coordinator of CME and Master of Addictive Behaviors; he currently publishes on Bipolar Disorders with high specialization on rapid cycling; he is also an official candidate at the Psychoanalytic Italian Society of the First Italian Center of Rome, and member of IPSO (International Psychoanalytic Studies Organization). He delivered an oral speech at Translational Medicine 2014 in Las Vegas on QTc Prolungation and Psychotropic Drugs.
Abstract:
It a naturalistic study that refers to a highly real context in the clinical field (RealWorld) aimed to highlight some not well-defined aspects of psychiatric comorbidity in addicted patients. The medical literature gives prevalence to data on inpatients while this naturalistic study collects data on the first visit in services dedicated to the treatment of pathological addictions. The sample is made of 519 persons (410 males, 109 females) (79% males, 21% females). The data brings out a prevalence of bipolar spectrum disorders of medium severity in outpatients while in the literature data on inpatients with a high psychopathological severity prevail. The percentages of psychiatric diagnoses recorded are congruous with other published epidemiological works giving importance to an undoubtedly exploratory study made on a quite relevant sample compared with other studies made on quantitatively smaller samples. These people have been visited after their request to be helped with their addiction. Alcohol consumption stands out: It is significant and is present across-the-board as in subjects receiving agonist for opiate addiction. The prevailing input substances are THC and cocaine while in everyday use, alcohol, cocaine and THC are prevalent (without forgetting the poly-use). Other data give an account that is not only psychopathological and about the style of consumption of substances but also social, giving an idea of the social context of patients’ lives (family and society).
Cynthia Stuhlmiler
University of New England, Australia
Title: Fetal alcohol syndrome prevention strategies: Issues and challenges
Time : 14:00
Biography:
Cynthia Stuhlmiller is a Professor of Rural Nursing at the University of New England School of Health. She has been a clinical chair in mental health nursing since 1997 and has held academic appointments in the California, Norway, New Zealand, University of Technology Sydney, Flinders Adelaide, University of Hawaii, and University of Essex United Kingdom. Her clinical and research background includes work in areas of traumatic stress and trauma response, various aspects of mental health including co-morbidities, computer-aided CBT, action-based and PBL learning, clinical supervision, and health self-management. She is involved in a wide variety of local, national and international collaborative projects. She is currently leading a large grant aimed at expanding student clinical placements through a student-led clinic in a rural indigenous community in New South Wales.
Abstract:
Fetal Alcohol Syndrome (FAS) is the most common preventable cause of mental retardation. It affects around 40,000 infants each year and has lifelong implications (SAMS) with 60 million people worldwide living with its defects and disabilities. The costs in health and education services in the USA alone are estimated to be around $5.4 billion per year. FAS is caused by maternal ingestion of alcohol during pregnancy which results in irreversible damage to the developing embryo or fetus and leads to physical, mental, behavioural and/or learning disabilities. Some identifying characteristics of FAS such as low birth weight, prematurity, and microcephaly are present at birth while others, such as distinctive facial features, may become more obvious over time. Although signs of brain damage include delays in growth, development, learning and behavioural abnormalities, affected individuals exhibit a wide range of abilities and disabilities. Australia has among the highest alcohol consumption in the world and between 51%-60% of Australian women report alcohol use in pregnancy. Although indigenous Australian women are reported to be less likely to drink during pregnancy, those who do, drink at a high risk levels. Efforts to prevent FAS that focus on warning women of the danger of alcohol consumption during pregnancy have proven of little value. However approaches that include broader determinants of women’s and children’s health, including overall health, nutrition, experiences of violence and trauma, sexual and reproduction health services and prenatal care seem to have better outcomes. Community-driven policy may also be an effective strategy. In this session, the key issues and challenges regarding FAS prevention strategies will be discussed. The efforts being undertaken in a community project in Australia will be used as a case example.
Christina Santini
Kildehoej Private Hospital, Denmark
Title: Nutrition strategies in recovery
Time : 14:25
Biography:
Christina Santini is a certified Nutritionist from Copenhagen Metropol University in addition to a certified Yoga Therapist from Naam Yoga Healing & Research Center, Los Angeles. She integrates Eastern Medicine with Western nutrition science to balance body, mind+soul, bite by bite. With over 10 years+ experience working with neuroscience, anti-aging, cancer, eating disorders and addictions in private hospitals and anti-aging clinics in Europe and for one of the pioneers in brain health. She is passionate about translating time-tested Eastern holistic health strategies with Western nutrition science into treatment tools that work to balance each individual’s biochemical blueprint. She is co-founder of TANT®-Target Aimed Nutrition Therapy. She is currently developing health apps for target nutrition intervention in addition to private practice in Los Angeles centered on biochemical testing.
Abstract:
Addictions and eating disorders often overlap and based on the latest neuroscientific findings, this presentation will focus on nutrition therapy as it relates to addiction and recovery from a practicing nutritionist’s perspective. No size fits all and no one diet fits all. We are all wired biochemically unique and require a customized approach to feel great in the skin we are in. Addiction is an expression of a severe disconnection from body mind-soul that leads to a lack of nourishment which further makes the individual biochemical vulnerable for chronic addiction, depression, mental illness and general relapse. Christina Santini works specifically with nutrition as it relates to the imbalances associated with certain eating disorders and addictions in order to rebuild biochemical balance in recovery and prevent relapse and cross-addiction. This presentation help in understanding the link between addiction and certain eating disorders, addictive substances in foods that activate same reward circuit as drugs, an ayurvedic perspective on addiction and food energetic and nutrition strategies to rebuild biochemical balance in addiction.
Danielle Rossini-Dib
University of Sao Paulo, Brazil
Title: A naturalistic study of recovering gamblers: What gets better and when they get better
Time : 14:50
Biography:
Danielle Rossini Dib graduated in Psychology. She completed her Master in Sciences and researches mainly in the interface of neuropsychology and impulsivity. These studies were carried out at Institute and Department of Psychiatry, University of São Paulo, Brazil.
Abstract:
Gambling disorder is a behavioural addiction treated with a range from self-help support to more intensive therapy approaches. This is usualy associated to a clinical treatment envolving a better management of comorbidities and experiemental conditions to help control the gambling behaviour proprielly. In this way, gambling recovery has typically been focused in gambling behavior and its consequences. However, others features such as negative affectivity, gambling cognitive distortions, impulsivity and its neurocognitive aspects (cognitive flexibility, planning, inhibitory control, and decision-making) are usually evaluatedat a gamblers profile, but not during and after the treatment. In this study we investigate how gambling treatment affected these variables and if any are related to gambling recovery. One hundred and thirteen patients were assigned to psycho-education and psychiatric treatment; a subset of 48 patients was too assigned to cognitive behavioral therapy. From that 113 patients, 72 compleated treatment and was reassessed 6 months after the onset. For to determinate who was recovery or not after the treatement, was used a self-report scale (Gambling Follow-up Scale). Recovered and non-recovered gamblers did not differ in pre-treatment demographic, gambling, and psychiatric profiles. However, three outcome variables were strongly related with gambling recovery: Negative affectivity, cognitive distortions, and decision-making. Logistic regression identified reduction of gambling cognitive distortions and better performance on decision-making under ambiguos situation task as the best predictors of gambling recovery, regardless of the type of treatment received. Beyond the standard outcome measures for gambling treatment, increased sensitivity to loss and decreased positive expectancies towards gambling are key targets to promote recovery in gambling treatment.
Sarah C Herremans
Universitair Ziekenhuis Brussel, Belgium
Title: The predictive value of alcohol-related cues for relapse after accelerated HF-rTMS treatment in alcohol addiction
Time : 15:15
Biography:
Sarah C Herremans is a Psychiatrist at the University Hospital of Brussels, Belgium. She graduated as a medical doctor at the Free University of Brussels in 2006, after which she specialized in psychiatry. She started her PhD in 2011, which she plans to finish in 2015. Her field of research concerns the application of HF-rTMS in alcohol dependent patients.
Abstract:
Background: Alcohol addiction is a chronic relapsing disorder. The application of high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) could possibly serve as a new treatment option for alcohol addiction. To day, it is unknown which patients might benefit from this intervention. The underlying neurobiology of relapse is complex; previous research implicates the ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), ventral striatum (VS) and precuneus. Consequently, we explored if baseline differences in brain activity during an alcohol-related cue-exposure, between relapsers and abstainers, treated with accelerated HF-rTMS could possibly serve as a biomarker predicting future relapse. Methods: Before the start of the HF-rTMS treatment, which was administered as an intensive protocol (consisting of 15 active sessions spread over one week), patients were confronted with an alcohol-related cue-exposure. Because it is unclear whether a block or event-related paradigm is more suitable to identify imaging biomarkers, patients were confronted with both of them in a consequent manner. Relapse, defined as the consumption of any amount of alcohol, was assessed four weeks after the stimulation. We performed whole brain and subsequent regions of interest (ROI) analyses of vmPFC, ACC, VS and precuneus. Results: Fourteen against six patients had relapsed. Only the block paradigm could demonstrate brain activity differences between relapsers and abstainers at baseline. Whole brain analysis showed the implication of the reward system, while additional ROI analysis demonstrated ACC activity differences between relapsers and abstainers during the exposure to the alcohol cues. Conclusions: ACC activity at baseline could possibly serve as a biomarker to identify alcohol-dependent patients at risk for relapse after HF-rTMS treatment. Block paradigms are more sensitive than event paradigms in identifying imaging biomarkers for relapse.
Chun-Bae Kim
Yonsei University, Republic of Korea
Title: Does South Korea have hidden female smokers? Discrepancies in smoking rates between self-reports and urinary cotinine level
Time : 16:10
Biography:
Myung-Bae Park is a candidate of PhD from Yonsei University and major in health policy now. He has an experience in Korea Ministry of Health & Welfare. Then, he received the annual grand prize article at Korean Society for Health Education and Promotion on 2009. Now he is working as a Researcher at the Dept. of Preventive Medicine, Wonju College of Medicine, Yonsei University. Chun-Bae Kim completed his MD from Chung-Ang University and PhD from Yonsei University in Korea. He is working as a Professor at the Dept. of Preventive Medicine, Wonju College of Medicine, Yonsei University. Also, he is participating at the convergence research in the Institute for Poverty Alleviation and International Development, Yonsei University. Previously, he has studied at University of Minnesota School of Public Health and is a visiting Professor. He has received many honor and awards including MARQUIS Who’s Who in the World (29th Edition 2012).
Abstract:
Female smoking is perceived very negatively in East Asian countries such as South Korea, Japan, and China, as well as in Islamic countries. These countries’ self-reported surveys (SRs) tend to produce results that underestimate the number of smokers, owing to the social desirability response bias. The present study seeks to assess South Korea, Europe, and the Americas, by comparing data from SRs with those from urinary cotinine samples. Current smoking rates were calculated using the SRs and the urinary cotinine concentration (UCC) methods according to socioeconomic factors. In order to examine response accuracy regarding current smoking status in the SRs, participants who both completed the SRs and acquired UCC results were subject to analyses of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the difference ratio (DR) with respect to gender, age, region, economic level, household status, and the presence of chronic disease. Based on self-reports, the current smoking rate among women was 7.1% (official smoking rates), while that according to the UCC was 18.2%; the rates for men were 47.8% and 55.1%, respectively. The sensitivity of males was 0.8553, the specificity 0.9768, PPV 0.9783, NPV 0.8465, and the DR was 1.143. The sensitivity for females was 0.3670, the specificity 0.9956, PPV 0.9486, NPV 0.8761, and the DR was 2.600. These results exhibit a very low response alignment rate compared to males. This study shows that the actual female smoking rate is significantly higher than that reported officially, but also that the gap is decreasing steadily. Females exhibited a higher rate of false responses, which resulted in an underestimation of the female smoking rate.
Talakad N Sathyaprabha
National Institute of Mental Health and Neurosciences, India
Title: Structural correlates of dysregulated cardiac autonomic function in offspring exposed to alcohol during antenatal period
Time : 16:35
Biography:
T N Sathyaprabha is a Professor in the Department of Neurophysiology, NIMHANS Bangalore, India. She had published over 70 manuscripts in international journals and presented several lectures and research work in international scientific conferences. She is an eminent member of many professional bodies including Third World Organization for women, Indian Academy of Neurosciences, Association of Physiologist and Pharmacologists of India, Neurological Society of India, Indian Academy of Neurology.
Abstract:
Background: Several lines of investigations have shown the deleterious effect of an alcohol on the autonomic nervous system. Also, evidences have shown altered brain volume in children who were exposed to alcohol in utero. It remains unknown whether any brain structural alterations correlate with cardiac autonomic regulation. In this study we measured the cardiac autonomic functions and brain volumes in children who were exposed to alcohol in the antenatal period and compared them with non-exposed control children. Methods: Twenty eight children (age: 9±2 years) in the antenatal alcohol exposed group and age, gender matched 30non exposed healthy volunteers as a control (age: 10±2 years) were recruited. HRV parameters were recorded and analyzed in the time and frequency domains using customized software. Magnetic resonance imaging was acquired as per standard protocol. Data was analyzed using both manual and automated morphometric methods. Result: Low frequency power, normalized units (nu) and low frequency to high frequency ratio were significantly higher in the antenatal alcohol exposed children compared to the controls suggesting asympathetic predominance. Decrease in the gray matter volume was noted in right fusiform gyrusin prenatally alcohol exposed children when compared to controls. A positive correlation was noted with high frequency power and cingulate gyrus volume (p<0.001). The low frequency (nu) also showed a positive correlation with the amygdala volume p<0.001. Conclusion: In this study we provide evidence for the deleterious long lasting effect of antenatal exposure of alcohol on cardiac autonomic regulation. Neuroimaging data supports the notion that structural aberration in amygdala and cingulate gyrus might have role in the dysregulation of cardiac autonomic function. Further prospective studies are needed to confirm the causal relationship between antenatal alcohol exposure, brain volume changes and autonomic dysregulation.
Danielle Rossini-Dib
University of Sao Paulo, Brazil
Title: A naturalistic study of recovering gamblers: What gets better and when they get better
Biography:
Danielle Rossini Dib graduated in Psychology. She completed her Master in Sciences and researches mainly in the interface of neuropsychology and impulsivity. These studies were carried out at Institute and Department of Psychiatry, University of São Paulo, Brazil.
Abstract:
Gamling disorder is a behavioural addiction treated with a range from self-help support to more intensive therapy approaches. This is usualy associated to a clinical treatment envolving a better management of comorbidities and experiemental conditions to help control the gambling behaviour proprielly. In this way, gambling recovery has typically been focused in gambling behavior and its consequences. However, others features such as negative affectivity, gambling cognitive distortions, impulsivity and its neurocognitive aspects(cognitive flexibility, planning, inhibitory control, and decision-making) are usually evaluatedat a gamblers profile, but not during and after the treatment. In this study we investigate how gambling treatment affected these variables and if any are related to gambling recovery. One hundred and thirteen patients were assigned to psycho-education and psychiatric treatment; a subset of 48 patients was too assigned to cognitive behavioral therapy. From that 113 patients, 72 compleated treatment and was reassessed 6 months after the onset. For to determinate who was recovery or not after the treatement, was used a self-report scale (Gambling Follow-up Scale). Recovered and non-recovered gamblers did not differ in pre-treatment demographic, gambling, and psychiatric profiles. However, three outcome variables were strongly related with gambling recovery: negative affectivity, cognitive distortions, and decision-making. Logistic regression identified reduction of gambling cognitive distortions and better performance on decision-making under ambiguos situation task as the best predictors of gambling recovery, regardless of the type of treatment received. Beyond the standard outcome measures for gambling treatment, increased sensitivity to loss and decreased positive expectancies towards gambling are key targets to promote recovery in gambling treatment.
Dulciane Nunes Paiva
Graduate Stricto Sensu in Health Promotion,Brazil
Title: The influence of active and passive smoking on the cardiorespiratory fitness of adults
Biography:
Dulciane Nunes Paiva is a Graduate Stricto Sensu in Health Promotion,Brazil. His research interest include smoking, nicotine addiction.
Abstract:
Background: Cardiorespiratory impairment increases morbidity and is an independent predictor of all-cause mortality, where it reduced by the inhalation of cigarette smoke. However, the effects of passive smoking on cardio respiratory fitness are rarely addressed. Objective: To analyze the influence of active and passive smoking on cardiorespiratory responses in asymptomatic adults during a sub-maximal-exertion incremental test. Methods: The participants (n=43) were divided into three different groups: Active smokers (n=14; aged 36.5±8 years), passive smokers (n=14; aged 34.6±11.9 years) and non-smokers (n=15; aged 30±8.1 years). They all answered the Test for Nicotine Dependence and underwent anthropometric evaluation, spirometry and ergospirometry according to the Bruce Treadmill Protocol. Results: Maximum consumption of oxygen (VO2 max) differ statistically among active and non-smokers groups (p=0.03), however, there was no difference between the passive and active smokers groups (p=0.88). Negative and significant correlations occurred between VO2max and age (r=-0.31, p=0.03), percentage of body fat (r=-0.44, p=0.01), and waist circumference (WC) (r=-0.46, p=0.01). Conclusion: VO2 max was significantly higher in non-smokers compared to active smokers and decreased with increasing age, percentage of body fat and WC.
Priya Mohan
Rajiv Gandhi University of Health Sciences, India
Title: Tobacco deaddiction – A missing link
Biography:
Dr. Priya M. has completed M.D.S.(Oral Medicine and Radiology) from Rajiv Gandhi University of Health Sciences, Bangalore. Has been practicing General Dentistry for the Past 12 years at self-owned ‘Mohan Dental Clinic’ and is a consulting oral diagnostician and radiologist. Also has 6 years of experience in teaching undergraduate and post graduate dental students. Has major interest in oral cancer and tobacco research also conducts tobacco deaddiction and prevention programs. Has been speaker and poster presenter at National, Asian and International conferences, authored scientific articles in national and International Journals. Is a member of the International advisory board of Indian Journal of Mednodent and Allied Sciences.
Abstract:
Tobacco, the major aetiological for most non communicable diseases is an established fact. In India it is the prime cause of oral cancer, the most common cancers, Pondicherry has one of the highest incidence of mouth cancer in the world among males -7.6 per 100,000. 34.6% adults use tobacco, unlike western countries apart from cigarette, indigenous smoking forms and use of smokeless tobacco with/without areca nut, psychoactive substance are used and continues to increase 2-3% every year. Also India has the 2nd highest prevalence of dual users, especially younger age group and develops higher degree of dependence. Unchecked availability of tobacco has led to initiation at as early as 5 years of age and addiction by 10-14 years. 46.6% of smokers and 45.2% of smokeless tobacco users planned to quit, however tobacco cessation - supportive system for deaddiction or prevention is lacking and also relapse is common among those who quit. Dentists form the premier group in identifying tobacco habit related oro-dental changes, but feasibility of tobacco prevention, cessation and deaddiction programs in real life dental setting are questionable. Though India played leadership role in tobacco control among developing countries, implementation of the legislation is ineffective and a major challenge too. Tobacco being easily accessible and affordable, the socio-economically disadvantaged groups are easily vulnerable, limited public healthcare services and unaffordable private healthcare corners them to disease burden further undermining their quality of life. This paper presents the current state of tobacco induced burden, ineffective tobacco cessation programs and importance of deaddiction support system as a strategy for tobacco control in India.
Kumar Gaurav Chhabra
Jodhpur Dental College General Hospital, India
Title: Exploring the predictors of quitting tobacco usage among patients attending a private dental institution- A survey from Jodhpur, India
Biography:
Kumar Gaurav Chhabra has completed Bachelor of Dental Surgery form SJM Dental College and Hospital, Chitrdurga, Karnataka, India in 2007 and Masters of Dental Surgery in Public Health Dentistry from SDM Dental College and Hospital, Dharwad, Karnataka, India. His interest on tobacco cessation made him to write his first manuscript in 2011 and subsequently in 2014 attended workshop on Tobacco Intervention Initiative organized by Indian Dental Association and was awarded a certificate of TII Specialist. He was guest speaker at the workshop organized by Jodhpur School of Public Health, Rajasthan, India on the topic “Ill effects of Tobaccoâ€. Till now 14 people has successfully quit the habit of tobacco because of his tobacco counseling and intervention.
Abstract:
Background: Burden of tobacco epidemic has swiftly moved to developing countries making the exploration of predictors of quitting tobacco usage extremely important. Aim: To assess the willingness to quit tobacco use and to ascertain the predictors of quitting tobacco as well as tobacco dependency by employing Fagerstrom scale. Methods: The study consisted of 252 subjects visiting the Public Health Dentistry department in a Dental institution JDCGH (Jodhpur Dental College General Hospital), Rajasthan, India. Data on demographic information, tobacco usage and quitting, information on reasons for quitting like; self-concepts, social concerns, legal issues, and health concern was collected by interview schedule method. Results: Overall 76% of the study participants were planning to quit. Demographic variables like age, marital status and religion were significant predictors of planning to quit tobacco usage (p≤0.05). Significant relationship was observed on Fagerstrom Scale with place of residence, type of tobacco use and frequency of tobacco use (p≤0.05). The most frequent cited reason for quitting tobacco usage was spitting and ash dropping which was embarrassing in-front of others (75.65%) and least reported reason was future health concerns (33.16%). Conclusions: Most of the respondents had favorable attitude towards quitting tobacco usage and social concern was the main predictor of quitting tobacco usage. Less reported reasons like legal issues and health concerns have to be explored in depth. The present study highlights the need for more researches exploring the predictors of quitting tobacco usage in India and further nationwide study.
T Nagamma
Manipal University, India
Title: Status of oxidative stress and antioxidant levels in smokers with breast cancer from western Nepal
Biography:
T Nagamma completed her MSc (Medical Biochemistry) from Manipal University and is pursuing PhD from LNM University, India. At present she is working as Senior Grade Lecturer in Department of Biochemistry, Melaka Manipal Medical College (Manipal campus), Manipal University, Karnataka, India. She has also worked as Medical Biochemistry teacher and Biochemistry Lab in charge for seven years in Manipal College of Medical Sciences, Pokhara, Nepal. She has been teaching biochemistry to undergraduate medical, dental and allied health sciences students for the past eleven years. Apart from teaching, she has published more than thirteen research articles in several national and international journals and has also published a book in MCQs in Biochemistry with explanatory answers.
Abstract:
This study was conducted in Manipal Teaching Hospital, Pokhara, Nepal. Breast cancer is the second most common cancer in Nepal. The major risk factors contributing to breast cancer are menarche at early age, having first pregnancy at late age, obesity, lifestyle changes and family history. Smoking is one of the major lifestyle risk factor. The tobacco leaf contains about 7000 toxic chemical species, 20 of which are established as mammary carcinogens. Smokers are more exposed to free radicals. These free radicals cause oxidative damage to lipids, proteins and DNA that can results in cancer. Study included a control group of 42 females (non-smoking healthy women) and test group was divided into two groups Group I consisting of 46 female breast cancer patients who were smokers and Group II consisting of 42 non-smoking breast cancer patients. Detailed history of the patients was collected with the help of pre-test proforma. Plasma levels of malondialdehyde (MDA), total antioxidant activity (TAA), which represents its total dietary antioxidants, vitamin C and α- tocopherol were estimated by standard methods. The plasma MDA, TAA, vitamin C and α- tocopherol were respectively. Vitamin C, α- tocopherol and TAA were significantly reduced whereas MDA was significantly raised in Group-I when compared to controls and Group-II. We observed a significant rise in oxidative stress and low levels of antioxidants in breast cancer patients with smoking habit. It is well known that free radicals facilitate the progression of breast cancer, possibly increases the risk of progression to the next stage. The key issues like how the smoke is affects the oxidative stress and it increasing the incidence of breast cancer in Nepali women will be discussed during presentation.
- Addiction Treatment and Rehabilitation
Yoga and Retreat Approaches
Advanced Research Techniques in Addiction Treatment
Location: Prestwick
Chair
Barry Tolchard
University of New England, Australia
Co-Chair
Adi Jaffe
Alternatives Behavioral Health, LLC, USA
Session Introduction
Jennifer Loftis
Oregon Health & Science University, USA
Title: An “immunomodulatory†approach for the treatment of methamphetamine addiction
Time : 9:50
Biography:
Jennifer Loftis earned a PhD in Behavioral Neuroscience from Oregon Health & Science University (OHSU) and completed a Postdoctoral fellowship in Molecular Microbiology and Immunology at OHSU. In 2008, she was awarded a career development award from the Veterans Health Administration (VHA) to study inflammatory mediators in depression and hepatitis C viral infection (HCV). As a VA career development award recipient she identified a novel role for cytokines in the etiology of depressive symptoms in adults with chronic HCV. This finding has guided the testing of hypotheses regarding how circulating inflammatory factors affect central nervous system functioning and how immunotherapeutic strategies may help to treat these conditions. She is currently a Research Scientist at the VA Portland Health Care System and an Associate Professor of Psychiatry at OHSU, with over 50 publications in the fields of psychiatry, neuroscience, and immunology. To support her translational research program and investigation of the psychoneuroimmunological mechanisms contributing to substance abuse and neuropsychiatric impairments, she has received grants from local and national organizations such as the Northwest Health Foundation, VHA, and the National Institutes of Health.
Abstract:
The role of the immune system in regulating psychiatric and cognitive function, including in the context of substance use disorders, has attracted increasing attention over recent years. Chronic use of methamphetamine (MA), a highly addictive central nervous system (CNS) psychostimulant, is associated with neuronal injury, neuroanatomical alterations, and serious psychiatric and cognitive impairments that make dependence on the substance particularly challenging to treat. Preclinical studies show that MA injures neurons through multiple mechanisms including interfering with dopamine metabolism, altering glutamate processing by astrocytes, worsening oxidative stress, and increasing expression of pro-inflammatory cytokines [e.g., tumor necrosis factor-alpha (TNF-ï¡) and interleukin 1-beta (IL-1ï¢)] secreted from activated glial cells, neurons, auto-reactive T-cells, infiltrating macrophages, or other peripheral immune cells. These findings converge with clinical studies demonstrating the relationship between both peripheral and central inflammatory systems and neuropsychiatric function in individuals addicted to MA. In line with current models of cytokine-induced depression and cognitive dysfunction, MA-associated immune dysregulation can influence neurotransmitter (e.g., dopaminergic, glutamatergic, serotonergic) and neuroendocrine (e.g. corticotropin releasing factor, hypothalamic-pituitary-adrenal axis) systems and contribute to cognitive dysfunction and mood disturbances (e.g., impulsivity, depression, anxiety, and irritability)—neuropsychiatric consequences of drug addiction that persist during remission and hinder recovery efforts. To date, pharmacotherapeutic development for substance use disorders has primarily focused on neurotransmitter systems and results from related clinical trials continue to be modest. Our preclinical data suggest that an immunotherapeutic approach using partial major histocompatibility complex (MHC)/neuroantigen peptide constructs (pMHCs), which have therapeutic effects on cognitive function and inflammation, has the potential to safely and effectively treat MA use disorders in adults. New approaches of this kind are expected to augment the efficacy of traditional substance dependence and mental health treatments.
Adi Jaffe
Alternatives Behavioral Health, LLC, USA
Title: Mobile breathalyzers in substance use disorder treatment: Utilization, validity, and utility in treatment provision
Biography:
Adi Jaffe received his PhD from the University of California, Los Angeles (UCLA) in 2010. Even before he graduated, his name had become known through his online and academic writing. His views on addiction and his research on the topic have been published in dozens of journals and online publications and he has appeared on several television shows and documentaries discussing current topics in addiction and the problem of addiction as a whole. He also teaches courses at UCLA and the California State University in Long Beach that address addiction specifically or biological psychology and behavioral neuroscience more generally. His view is a holistic one, drawing from the best and most recent research to bring as a complete solution to addiction clients. At Alternatives Behavioral Health, LLC, USA, he serves as the Director of Research, education, and innovation and is in charge of client monitoring, technology solutions, and data collections and outcomes research. His goal is to make Alternatives the best treatment program.
Abstract:
Aims: To describe the feasibility, implementation, validity and utilization of mobile momentary-assessment breathalyzers within the context of an intensive outpatient (IOP) treatment for Alcohol Use Disorder (AUD). Methods: Fifty-five participants in an IOP treatment program in Southern California were provided breathalyzers at the onset of treatment. Breathalyzer assessment schedules were set based on client’s self-report of sleep schedule and three to five assessments (M=4) per day were conducted remotely. Breathalyzer data was recorded for the duration of treatment, which lasted between two-to-six months (M=3.5 months). Participants were given a short survey to assess their satisfaction with the breathalyzer system. Data preparation and analysis was conducted using SPSS. Results: Analysis indicated substantial presence of missing data when looking at individual data points. Analysis of relative missing frequency, relative non-zero BAC readings as well as maximum BAC were conducted for the overall sample and based on initial treatment-goal selection. Conclusions: Our study reveals that the utilization of momentary substance detection methods, such as a breathalyzer, within an IOP treatment context is feasible. Furthermore, the study reveals specific analysis recommendations for providers engaged in such data collection. Finally the use of reporting adherence as a measure of treatment progress is suggested given the relationship between treatment success and breathalyzer reporting observance.
Barry Tolchard
University of New England, Australia
Title: Outcome of treatment seeking rural gamblers attending a state-wide cognitive-behaviour therapy service
Biography:
Barry Tolchard has been a clinician and gambling researchers for the past 20 years. He has published work on the outcomes of Cognitive-behavior Therapy for problem gamblers and examined the concomitant health factors associated with gambling. He was one among the team to create a new gambling screening tool (The Victorian gambling Screen) based on public health principles of harm. He is also the co-author of the New England 4G Framework for Guided Self-Health. This framework offers clinicians a model for working with people experiencing a range of mental and physical problems to find solutions to help themselves. He is currently the Deputy Head of School (Health) for research at the University of New England in Australia.
Abstract:
Background: Problem gambling affects many people in Australia and especially rural areas. However, little is reported regarding the differences between the experiences of urban and rural gamblers especially with treatment outcome. The prevalence of problem gambling while stable remains an ongoing issue. There are health and social disparities reported in rural communities related to accessibility, availability, and acceptability of treatments including for problem gamblers. The relationship with problem gambling and co-morbid presentations, in particular anxiety and depression, is well known, 22 although there is little has been reported differentiating between rural and urban gamblers. There is growing evidence to support cognitive-behaviour therapy as the main evidence based treatment for problem gamblers, but until now little research has identified differences between the outcomes of rural verses urban gamblers. Method: A naturalistic examination of the differences between rural and urban gamblers will be presented. All participants were treated in a state-wide Cognitive-Behavioral Therapy (CBT) gambling treatment service in South Australia. A standardised clinical assessment and treatment was provided to all participants. As part of routine clinical outcome measurement a series of validated questionnaires were given to all participants at assessment, discharge and 1-, 3-month follow-up. This is a provisional analysis and as such the number of rural participants was low, therefore a series of descriptive and non-parametric analyses were performed to identify similarities and differences in presentation and outcome of rural gamblers. Results: This study is one of the first investigations to tease out similarities and differences between rural and urban problem gamblers and provides useful guidance on alternative ways of offering treatment. Differences emerged between urban and rural gamblers. While overall treatment outcomes were much the same at three months post-treatment, rural gamblers appear to respond more rapidly and have sustained improvement over time. Female rural gamblers show higher levels of co-morbid anxiety while male rural gamblers experience higher levels of depression compared to urban gamblers. Conclusion: This naturalistic study suggests rural problem gamblers experience different level of co-morbid anxiety and depression from their urban counterparts, but once in treatment appear to respond quicker. CBT is effective in treating rural gamblers and outcomes are maintained. However, ensuring better access and availability of such treatment requires attention. Alternative approaches such as tele-health, internet based therapy and guided self-help may increase the take up of treatments. While also the case with urban gamblers, therapists needs to be aware of the impact specific co-morbidity poses and modifies their interventions accordingly. Limitations: This was a non-randomized study and the number of rural gamblers was small. Therefore further research is required with a larger sample to ensure these outcomes are replicable.
Deanna Mulvihill
Registered Nurse- Multi-State Privilege,USA
Title: The application of rebonding of the body to a substance abuse program
Time : 11:50
Biography:
Deanna is a senior nurse therapist and researcher who have developed a technique called Rebonding of the Body which helps people recover from trauma, learn self-help techniques and lead more productive lives. Her intersubjective ethnographic study has been published in a text called, Women, Trauma and Alcohol Dependency, Connection and Disconnections in Alcohol Treatment for Women. She has published a number of articles in child and family psychiatry including an extensive literature review called “The Health Impact of Childhood Trauma.†Presently Deanna has a small private practice and she works as a consultant for Cogenz and Thought Leadership and Innovation Foundation. Deanna graduated from the University of Western Ontario with Doctor of Philosophy in Nursing in 2009. Her dissertation was “Seeking and Obtaining Help for Alcohol Dependence by Women who have Posttraumatic Stress Disorder and a History of Intimate Partner Violence.
Abstract:
People who have experienced trauma are at a greater risk of physical and mental health problems including PTSD and alcohol and substance abuse. Women with trauma who seek treatment have difficulty benefiting from present programs. Alcohol and other substance used to cope with the symptoms of PTSD and both produce neurohormonal changes in the body. During a 4 month intersubjective ethnographic study in a treatment, it was documented that all women had a history of trauma including the staff, the trauma was documented and discussed during admission meeting but was not considered as part of the treatment plan. Many of the interventions that were part of the program triggered PTSD. Rebonding of the body, a trauma specific multimodality trauma specific program was introduced to a 24 day program to address the underlying trauma issues and provided skills to address triggers.
Ehab Sayed Ramadan
Tanta University, Egypt
Title: Detoxification methods of benzodiazepines mono-dependence: Application and comparison
Time : 13:25
Biography:
Ehab Sayed Ramadan completed MD and PhD from Faculty of Medicine Tanta University, Egypt. He is currently working as a Professor in Psychiatry and Psychology Faculty of Medicine, Tanta University, Egypt. He has sixteen publications in scientific journals. He worked as Director of Neuroscience University Center- Tanta, Egypt, from 9-2008 till 31-6-2010 and Consultant and Head of Neuropsychiatry Department Saudi German Hospital, KSA (from 2000 – 2006). He has experiences in clinical, educational and research work in the fields of psychiatry & psychology at faculties of Medicine, Nursing, and Arts.
Abstract:
Benzodiazepines are among the most common drugs of abuse in Egypt. The severe suffering during withdrawal of benzodiazepines following long term use; magnifies the need to develop treatment strategies for discontinuing these medications. The study aimed to evaluate different detoxification procedures that have been followed to manage benzodiazepines dependence and to assess their efficiency in controlling withdrawal symptoms and relapse rates. This study had been conducted in the center of Psychiatry, Neurology and Neurosurgery, Faculty of Medicine, Tanta University, Egypt. It lasted for 45 days and was divided into three phases; pretreatment phase (7 days), detoxification phase (8 days) and follow-up phase (30 days). Three different methods of detoxification of benzodiazepines dependence were applied during the detoxification phase and included 1) Slow flumazenil infusion (1 mg/500ml saline twice daily) as the main line of treatment with low doses of oxazepam given orally during the first three nights of detoxification phase 2) using oxazepam gradual tapering and 3) abrupt discontinuation of benzodiazepines with symptomatic treatment. Withdrawal symptoms were assessed by psychometric scales BWSQ, HAM-A, HAM-D scores and craving was assessed by VAS scores emerged in the three studied groups during the detoxification phase. The study revealed that flumazenil infusion with low doses of oxazepam was associated with the least intensity of withdrawal symptoms and craving. Also, relapse rates decreased in patients treated with flumazenil than those treated by oxazepam tapering or abrupt discontinuation with symptomatic treatment. It can be concluded that slow flumazenil infusion with low doses of oxazepam appeared to be more effective in controlling withdrawal symptoms, reducing craving and relapse rate after benzodiazepine discontinuation than oxazepam tapering or abrupt discontinuation with symptomatic treatment.
Biography:
Arash Ghodousi, MD is a Forensic medicine specialist, licensed for treatment of addiction from Ministry of Health of IR of Iran. He is working as an Assistant Professor in Islamic Azad University, Isfahan branch, and is the Head of Hashbehesht Private Clinic in Isfahan. He is also a renowned Addiction Therapist.
Abstract:
Today, in Iran, there are various treatments for addicted persons. There are official private and public clinics alongside self-help groups. There also exist compulsory treatment camps under the supervision of police enforcement and judiciary system. Additionally, there are various forms of elicit treatments such as unknown medicine prescription by non medical staff persons. There are some specialized clinics such as alcohol addiction treatment clinics. Different organizations supervise the treatment and rehabilitation such as ministry of health, (State welfare organization of Iran) and (Iran drug control headquarters). Various treatments are done in the supervised clinics such as maintenance therapies with methadone, buprenorphine, opium tincture, psychotherapy and psychiatric therapy, inpatient treatments, rehabilitation and numerous other treatments. Different specialties engage in addiction treatments such as psychiatrists, psychologists, GPs, nurses, and social workers. However state funded medical centers have treatment protocols that need to be followed by each of their medical staffs. In this article, we will review the common addiction treatments practiced in Iran.
Biography:
Prem Kumar Shanmugam is the Chief Executive Driector and Co-Founder of Solace Sabah. He is one of the founding members and Regional Director of the Asia Pacific Certification Board (APCB). He also acts as the President of the Psychotherapy and Counselling Association of Singapore while being one of the founding members as well. He is an independent researcher, trainer working with people with issues from all walks of life exposed to multicultural settings. He specializes in developing and evaluating treatment programmes. He is a certified practitioner in the Management of Family Violence Counselling (Ministry of Community Development Youth and Sports Singapore), a Certified Masters Addictions Therapist (APCB Singapore), a Certified Masters Psychotherapist (APACS Singapore) and an Accredited Clinical Supervisor (Australian Counselling Association and Association of Psychotherapists and Counsellors Singapore). He reviews and writes articles and presents results of substance abuse treatment studies around the region. He has co-authored two handbooks for Masters Students on a counselling course and is an active lecturer.
Abstract:
The etiology of addiction is multifactorial and complex. We know that not everyone becomes dependent instantly as the disease takes time to manifest itself. Furthermore there are multifactorial components that lead to and condition this disease mainly, biological, psychological, social and spiritual. All these various components play a specific role in addictions while some serve a bigger purpose as compared to others. Treating this biopsychosociospiritual disease in a residential setting requires a comprehensive approach, which not only addresses these models influencing it but be holistic at the same time. Treatment also needs to meet clients at their level of motivation and extend even upon discharge addressing the situations in society and the environment the person returns to. This paper presents such a programme, Solace Prime, a residential treatment programme for addictions. It is developed based on scientific and evidence-based approaches with all addictions in mind. The programme is built around Prochaska’s Transtheoretical model of change with the spiritual concepts of the 12-step programme at each stage and driven by theories such as Cognitive Behavioural Therapy (CBT) and Rational Emotive Behavioural Theray (REBT) coupled with alternative therapies such as meditation, nutrition and fitness training. This provides the holistic approach needed to treat a biopsychosociospiritual disease. Over the years treating addictions has taken many approaches but not many have looked into the 28-day residential treatment programme. This paper presents Solace Prime, a holistic, scientific and integrated treatment approach, which has the capability to extend treatment even after discharge from residential treatment.
Emily Stevens
Institute for Restoration and Renewal, USA
Title: Integrating Neurotherapy in the Treatment of Addiction
Biography:
Emily Stevens has over 22 years of clinical experience with diverse populations. Her unique background and approach with emerging brain-based research and interventions such as EEG/QEEG, neurofeedback, alpha-stim/CES, BAUD and AVS has provided her with a unique approach to working with clients with a variety of disorders and dual diagnosis. She began working with addiction clients in 1994 with the Peniston Protocol and began developing specialized protocols for individuals with multiple treatment experiences to better address their dual diagnosis needs in treatment. In 1995, she provided the first of several regional brain-based dual-diagnosis trainings for the Council for Alcohol and Drug Abuse and became an active proponent for the need for more dual diagnosis based treatment. She has been an invited speaker at numerous conferences around the country and has presented over 500 seminars in mental health and addiction nationwide. Her research and publications have focused on innovative clinical and brain-based approaches to improve treatment outcomes with depression, anxiety, ADHD and addiction. Emily recently published a chapter on the use of technology in treatment in Clinical Neurotherapy: Application of Techniques for Treatment.
Abstract:
Technology is expanding the ways that we can improve symptoms to treat disorders. By taking the research and information that we have learned from neuroscience and our understanding of disorders, we can apply different technology to improve client functioning. Clients can learn to manage stress, anxiety and blood pressure with a simple biofeedback program that can be provided in treatment and then transferred to home. Specialized brain based non-invasive stimulation technology can be used with clients with anxiety, OCD, depression and addiction to assist with managing their symptoms within 5 minutes or less. This technology is especially helpful and essential for anyone that works with first responders in treatment. Explore specialized software to improve attention and working memory that may be damaged after years of substance use and abuse. These tools can transform a client’s ability to maintain sobriety and improve functioning in their daily lives. Explore which tool has a 77% abstinence rate according to the literature post one year of treatment if applied with the right clinical protocols. As treatment programs continue to expand the services they provide these tools can fit nicely into treatment. This session will explore proper clinical protocol that will provide the long-term changes and success in treatment that clients are looking for.
Biography:
Ken Seeley is an internationally acclaimed interventionist known to millions of people worldwide from the A&E reality TV show, Intervention. Certified as a Board Registered Interventionist, he has worked full-time in the business of recovery and intervention since 1989. He is a regular contributor to CNN, MSNBC, NBC, CBS, Fox, and ABC on the topics of addiction and intervention, and is also the author of Face It and Fix It, a popular book about overcoming the denial that leads to common addictions while bringing guidance to those struggling with addiction.
Abstract:
Treatment alone often fails people. Evidence based statistics prove this over and over again. The 5 year plan breaks down all key components to a success recovery. The five year plan was created after working with judges from drug court programs. This presentation goes in depth to explain how we build a seamless continuum of care morning past a 28 day model.
Renee Brown
Next Level Recovery, LLC, USA
Title: Treatment with real life in mind… a model where behavioral science shakes hands with traditional recovery methodologies
Biography:
Renee Brown is President of Next Level Recovery, LLC; Sober Living Properties, LLC; and Smart Medical, LLC. Her past is rich with a diversified outlook on addiction, as she has served as a provider of recovery housing and treatment. She was the first to license a recovery house (Sober Living Properties) in the state of Utah, which is now one of the largest providers of recovery housing in Utah and has programs with behavioral science in the treatment center, Next Level Recovery. Her clients engage in healthy relationships, work or school, and are known to overcome some of their most difficult obstacles in early recovery, before they leave treatment and or recovery housing.
Abstract:
Objective: To introduce a recovery model based on matriculation back into society from the beginning of treatment. To illustrate some of the current draw backs in the traditional model of inpatient care for those who are struggling with substance abuse. To compare and contrast treatment models inside and outside of recovery that entertains the use of behavioral science. To outline some new hope in recovery that might offer more longevity and affordability. Methods: Focus was on executive brain function with an array of goals in recovery housing and treatment – feedback back and accountability in a peer environment and in a clinical environment. Observation and support was needed for immediate positive outcomes, in context to life skills, when a client is still in treatment or recovery housing. Peer accountability, Positive Psychology, CBT, Trauma based therapy, Art therapy, Recreational Therapy and Least restrictive environments are some of the important factors. Results: Connection, social skills, self-regulation, program retention, participation in work or school. Transition from treatment and or recovery housing, was as seamless as possible in context to life skills (family, social, work/school) and sobriety. Affordable resources were provided for continued support.
E Renea Snyder
Pennsylvania Department of Corrections, USA
Title: AOD recovery units in correctional institutions
Biography:
E Renea Snyder, Med is a Drug and Alcohol Program Administrator, Pennsylvania Department of Corrections. She has done Bachelors in Psychology and English, a Master in Education with a Specialization in Curriculum Design and Development, and is currently enrolled as a PhD Psychology student, specializing in Addictions Psychology. She started her career in 2005 with the PA Department of Corrections as Food Service Instructor at SCI-Pine Grove. In 2007, she took a position with SCI-Somerset as a Corrections Counselor and Treatment Specialist. In 2012, she took a position with the Department of Public Welfare, where she had oversight of the Mental Health housing for the Office of Mental Health and Substance Abuse Services. In 2013, she was provided, the opportunity to return to the Department of Corrections, as the Drug and Alcohol Program Administrator. She has worked diligently to bring the AOD Department to current Evidence Based Practices and Programs, by making significant changes to the Co-Occurring Disorders programs, Outpatient, and Therapeutic Communities. She was the lead in making significant changes to the auditing process for the AOD Department and policy revisions. She developed the first Recovery Unit model which is currently being piloted at SCI-Graterford. The model includes progressive treatment modes for the AOD and Corrections field. She has developed training for AOD staff involving clinical supervision and the key components to being an effective AOD counselor.
Abstract:
The Bureau of Treatment Services, Alcohol and other Drug Division for the Pennsylvania Department of Corrections designed an AOD Recovery Unit Model for Correctional Institutions. The AOD Recovery Unit Model is currently being piloted at State Correctional Institution Graterford, in the Eastern Region of Pennsylvania. It is anticipated that the AOD Recovery Unit will decrease AOD relapse once an offender re-enters into the community, as well as the overall recidivism rates of AOD offenders. It is believed that once an offender completes the recommended AOD programming such as Inpatient, Outpatient, or Co-Occurring programs; that the offender will then voluntarily participate in the AOD Recovery Unit. The AOD Recovery Unit offers eighteen workshops and one gender specific workshop. There are eighty-two modules that are gender neutral and 24 modules that are gender specific. The workshops encompass evidence based programs such as SHIELD (Self Help in Eliminating Life Threatening Diseases), SAMHSA’s Intensive Outpatient Matrix, Living in Balance (Hazelden), Natural Meditation, Alcoholics Anonymous, Narcotics Anonymous, Al-Anon, Double Trouble in Recovery and Moving On. There are many self-recovery tools included in the workshops such as; Addictions Journaling, Addictions Art, Addictions Book Club, Beat the Streets Series, and Guided Group topics. The modules are facilitated by Drug and Alcohol Treatment Specialists and trained AOD Peer Assistants. The AOD Recovery Unit at SCI-Graterford is a 115 bed, Outside Secured Housing Unit. Offenders are recommended AOD programming based on the Texas Christian University screening tool. There are currently four levels of AOD treatment provided; Inpatient – Therapeutic Community (4 months), Outpatient (41 sessions), Dual Diagnosis Therapeutic Community (6 months), and Dual Diagnosis Outpatient (47 sessions). Once an offender has completed the recommended programming, they are provided the opportunity to participate in the AOD Recovery Unit. Of those willing to participate in the AOD Recovery Unit, offenders are randomly selected to participate in the AOD Recovery Unit. It is anticipated from this process that AOD Recovery Unit participants will be less likely to relapse upon release into the community. Although we do not have the current numbers available to validate our thesis, we believe this to be a valid Recovery Unit Model and will be able to provide data based on the research at the August conference. We are working closely with our research department and the field staff to ensure efficacy of the model and workshops.
Adriana de Oliveira Christoff
Centro Universitário Autônomo do Brasil: Unibrasil
Title: Reducing substance involvement in college students: A three arm parallel group randomized controlled trial of a computer based intervention
Biography:
Adriana de Oliveira Christoff is a Professor at Centro Universitário Autônomo do Brasil: Unibrasil
Abstract:
The prevalence of alcohol and other drug use is high among college students. Reducing their consumption will likely be beneficial for society as a whole. Computer and web-based interventions are promising for providing behaviorally based information. The present study compared the efficacy of three interventions (computerized screening and motivational intervention [ASSIST/MBIc], non-computerized screening and motivational intervention [ASSIST/MBIi] and screening only (control)) in college students in Curitiba, Brazil. A convenience sample of 458 students scored moderate and high risk on the ASSIST. They were then randomized into the three arms of the randomized controlled trial (ASSIST/MBIc, ASSIST/MBIi (interview) and assessment-only (control)) and assessed at baseline and 3 months later. The ASSIST involvement scores decreased at follow-up compared with baseline in the three groups suggesting that any intervention is better than no intervention. For alcohol, the specific involvement scores decreased to a low level of risk in the three groups and the MBIc group showed a positive outcome compared with control and the scores for each question were reduced in the two intervention groups compared to baseline. For tobacco, involvement scores decreased in the three groups but they maintained moderate risk. For marijuana, a small positive effect was observed in the ASSIST/MBIi and control groups. The ASSIST/MBIc may be a good alternative to interview interventions because it is easy to administer, students frequently use such computer-based technologies and individually tailored content can be delivered in the absence of a counselor.
Dalal Akoury
The AWAREmed Health and Wellness Resource Center, USA
Title: Clinical competencies: Topics, gaps and learning objectives and key clinical applications
Biography:
Dr. Dalal Akoury is founder and Medical Director of The AWAREmed Health and Wellness Resource Center, where she directs a team of coaches, nutritionists and nurses who utilize a comprehensive approach to health. She practices, Cellular, Anti-Aging, Functional, Regenerative, Sexual, Cellular and Metabolic Medicine. Her practice Concentrates on Women Health and Rejuvenation, Integrative Addictive treatment, Integrative Cancer treatment, Healthy Aging, Age Management and lifestyle medicine, focusing on customized Facial rejuvenation, nutrition and fitness programs. She is a Fellowship trained and certified in Integrative Cancer Therapy, Anti-Aging, Regenerative, Metabolic and Functional Medicine, and has more than twenty years of accumulated experience in emergency medicine, pediatrics, and a master’s degree in public health. She has also served fellowships in pediatric hematology/oncology and has performed research in leukemia and the effects of smoking at Emory in collaboration with the CDC. Over the past 3 years, she has focused strictly on stress and its effect on aging, sexuality, cancer, and addiction. She has designed the addiction training series offered by the A4M, furthermore she is the founder of the Integrative Addiction Conference and the Integrative Addiction Institute, she has written numerous articles on the topic of addiction and is a well-known advocate and speaker. She Akoury is a Seasoned Media and Community Public Speaker. She is knowledgeable on obesity, fitness, and nutrition, and Sexual Medicine. She is not only a living proof of the benefits of Stress relief, diet and exercise but she is also a medical expert who can guide audiences in understanding the fundamentals behind proper stress relief, nutrition and living well. Her mission is to help change lives.
Abstract:
Learning objectives 1. Emphasize a wholistic approach to understanding the Biologic stress and addiction networks and sub-networks including the Limbic, HPA, HPT, HPG, Serotonergic and Dopaminergic system. 2. Focus on the non-linear interactions between the various components and pathways of stress and addiction to determine the major players in the pathophysiology of cancer and suggested targets of therapy. 3. A “paradigm shift†of molecular biology from a reductionist approach to a more wholistic approach will be highlighted. 4. We will allude to the complex genomics, transcriptomics, epigenomics, and proteomics involved in the neuroendocrine system creating an exceptional self-healing brain circuitry including sub-networks. 5. We will discuss the effect of hypothalamic pituitary adrenal (HPA) axis is deregulation in addiction and cancer. Reflecting on the effect of these HPA imbalances on all the Limbic and HPT circuits and emphasizing the restoration of these circuits as a first step in addiction recovery and cancer treatment. Stress, pain, addiction and the cancer cycle The links between stress, addiction and cancer are multifaceted, spanning from the low incidence of cancer in relaxed happy individuals to altered cancer cell metabolism resulting from unchecked stresses and addictive behaviors. The effect of any form of addictive behavior on cancer development is too obvious to be ignored anymore. Cancer prevention and cure cannot be attained unless stress, addiction, and pain are properly addressed. Cancer is a complex collection of distinct stress induced epigenetic dis-eases united by common hallmarks. In the quest to survive, every living organism is equipped with the armor to withstand the impacts of stress. Every person is equipped to naturally deal with enormous amounts of stress, but when stress exceeds the allostatic body capability to handle it, sizeable imbalances and discomfort result. Contemporary lifestyle is exceptionally infamous for creating continuous stress. This demanding stressful lifestyle creates an environment that cultivates dis-eases progressing from indigestion to insomnia to depression pain, addiction and ultimately cancer. Besides the Physiologic qualitative approach to coping with stress, the nervous system is almost exclusively recognized for the task to maintain homeostasis. The nervous system is a complex networking structure where chemical, electric and energetic reactions occur between billions of individual neurons facilitating large number of behaviors. Stress and Emotion are complex phenomena that play significant roles in the quality of human life and can predispose individuals to a variety of disorders including pain, addiction, and cancer. Many drugs that affect the mind—ranging from sugar, food, addictive street drugs to therapeutic agents—do so by acting on specific neural circuits concerned with emotional states and feelings. The complex System Biology: Limbic, HPA, HPT, HPG, Serotonergic and Dopaminergic system conduct the Symphony of life Survivorship vs environment. The hallmarks of cancer comprise biological capabilities acquired during the multistep development of human tumors. These hallmarks constitute an organizing principle for rationalizing the complexities of neoplastic disease. They include sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, and activating invasion and metastasis. Underlying these hallmarks is genomic instability, which is generated by an epigenetic chaos in most cases stemming from stresses and addictive behaviors. This epigenetic turmoil created by allostatic imbalances; from stress, pain and addictive destructive behaviors generate a cancer prone genetic diversity that accelerates the acquisition and activation of inflammatory cascades that fuel cancer genesis. In addition to cancer epigenetics, cancers exhibit another dimension of complexity: they contain a repertoire of recruited, seemingly normal cells that contribute to the acquisition of trademark traits by creating the “tumor microenvironment.†Recognition of the widespread applicability of these concepts will increasingly affect the development of new means to treat human cancer. This presentation describes a conceptual framework of how addictions contribute to the hallmarks of cancer and how it can be exploited through stress reduction and addictive behaviors reprogramming to restore allostatic balance and energy metabolism evading immune destruction and subsequently selectively kill cancer cells. Finally, we discuss the path ahead to therapeutic discovery and provide theoretical considerations for combining right-angled cancer therapies by addressing stresses and addictive behaviors.
Larry D Reid
Rensselaer Polytechnic Institute, USA
Title: Focusing on cognitive rehabilitation and evidence-based practices will improve treatments for alcoholism
Biography:
Larry D Reid has been a Professor at major universities and centers for more than 47 years. During most of that time, he maintained a small, but continuously funded, laboratory. Among the laboratory’s topics was the behavioral neuroscience of alcoholism, including basic research on opioidergic effects on alcohol intake. A recent interest has been alcoholism among females. The findings from the research on females led to writing a book for smart young women and the people who love them, titled Slowly, Softly Killing Us. Passages of the book are harsh criticisms of the alcohol beverage industries marketing practices.
Abstract:
If we define alcoholism as: “A chronically relapsing disease†we are, in effect, admitting that our treatment programs are inadequate. No one expects 100% of persons treated for alcoholism to emerge transformed from a usually troubled habitual drinker of toxic amounts of ethanol into a happy, flourishing person who does not drink. However, if we attended to what has scientifically been discovered, treatments can be transformed, hence allowing for transformation of our clients. We can continue to hope for some magical, spiritual transformation to finally bring enlightenment to those beset by the disease of alcoholism. Or, we can hope for eventually discovering a medicine fixing the inherent problem of the alcoholic. Or, for the better, we can incorporate recently derived knowledge and step by step design treatments that will make relapse to drinking toxic amounts of ethanol uncommon rather than a definition of a problem needing resolution. I will show that prescribing naltrexone is merely a setting condition for correcting the toxic effects of ethanol on brain that, in turn, has reduced the cognitive ability to make the needed changes in life-styles to support continuing abstinence. Although we used to think that a brain once damaged was not repairable, I will show that he can provide computer-assisted game-like programs that will undue the cognitive decline caused by chronic intoxication thereby enhancing the ability to resist temptations, be less impulsive and develop new life-styles. New knowledge directs us to focus on cognitive rehabilitation for improving treatment outcomes.
Natacha Rodrigues
Middlesex University, UK
Title: Therapeutic treatments from an existential approach and transpersonal psychology theories and practices
Biography:
Natacha Rodrigues Counsellor Psychologist (Hons) BSc, MSc and an Integrative/Humanistic Psychotherapist who also works in an Existential way. Accreditor Mediator and Lecturer for Diplomas in Psychotherapeutic Counselling. Currently she is doing her MSc / Doctorate in Counselling Psychology and Existential Psychotherapy Studies at the Middlesex University. She was born and raised in Lisbon, Portugal. She has lived in South of England – Bournemouth for the last fourteen years where she began her training as an Ericksonian Hypnotherapist, NLP and Life Coaching Practitioner. After completing her training she decided to train as a Humanistic/ Integrative Psychotherapist while working as Counsellor with people in addiction and in bereavement. Meanwhile she trained as a Psychologist at Bournemouth University. During that time she also worked as a Psychologist research assistant - ADHD and Eating Disorders Projects.
Abstract:
My particular interest lies in working with the dilemmas presented by Being-in-the-World-with-Others. How can we negotiate living authentically as individuals alongside other people who are attempting the same task from their own perspective? This question encompasses an issue of identity, addictions and individual’s spiritual connection/disconnection. The workshop will start by giving an overview on existential approach that is first and foremost philosophical. It is concerned with the understanding of people’s position in the world and with the clarification of what it means to them to be alive. This means facing up to ultimate concerns, such as death, guilt, freedom, isolation, meaninglessness, etc. At the time of crises in addictions old patterns need to be revised in order to initiate changes for better. This theme will be discussed from an Existential approach and transpersonal psychology theories; theories that focus on the spiritual dimension and legitimate the development of higher states of consciousness as being part of addiction experiences and as being exceptionally healthy or as representing the epitome of human potential as a tool when in recovery. The approaches are especially suitable for people who feel alienated from the expectations of society or for those seeking to clarify their personal ideology. I will outline the goals of existential therapy and Transpersonal Psychology; Major therapeutic strategies and techniques; The change process in therapy; The task of the Existential therapist/ Transpersonal Psychologist; Themes to explore; Limitations of the approaches. The workshop will end with a brief evaluation of our disconnected culture from a spiritual dimension in treatments.
Biography:
Artemis Igoumenou completed her MD, MSc and PhD from National and Kapodistrian University of Athens in Greece. She completed her psychiatric training in Oxford, UK obtaining a CCT in General Adult Psychiatry and Psychiatry of Addictions. Whilst in Oxford she participated in a number of research projects and collaborated with highly esteemed academics. She became a Clinical Lecturer in Forensic Psychiatry in 2013 at Barts School of Medicine, Queen Mary University London. She is completing her training as Forensic Psychiatrist. She is involved in research and teaching and has strong national and international collaborations. Her main research interest is the relationship between mental disorders and offending. She is currently analyzing neuropsychological data of a large cohort of prisoners in UK and Wales.
Abstract:
In conjunction with publication records, more and more weight is put on citations in determining research productivity by individuals, universities and even nations. This topic is widely discussed and debated within psychiatry but without much empirical evidence to draw on. We felt it was important to examine this issue by analyzing publication output and citations in a range of psychiatry journals. We investigated research productivity and citation practices at both country and university level. We found large differences between and within countries in terms of their research productivity in psychiatry. In addition, the ranking of countries and institutions differed widely by whether productivity was assessed by total research records published, overall citations these received, or citations per paper. We found that most publications came from the USA, with Germany being second and UK third in productivity. USA articles received most citations and the highest citation rate with an average 11.5 citations per article. The UK received the second highest absolute number of citations, but came fourth by citation rate (9.7 citations/article), following the Netherlands (11.4 citations/article) and Canada (9.8 citations/article). Within the USA, Harvard University published most articles and these articles were the most cited, on average 20.0 citations per paper. In Europe, UK institutions published and were cited most often. The Institute of Psychiatry/Kings College London was the leading institution in terms of number of published records and overall citations, while Oxford University had the highest citation rate (18.5 citations/record). The choice of measures of scientific output could be important in determining how research output translates into decisions about resource allocation.
- Symposium session on "Continuum of care for drug addiction"
Location: Prestwick
Chair
Prapapun Chucharoen
Mahidol University
Session Introduction
Prapapun Chucharoen
Mahidol University, Thailand
Title: Continuum of care for drug addiction
Biography:
Prapapun Chucharoen has completed PhD in Neuroscience from Mahidol University. She received National Excellent Award in academic for addiction in 2015. She is the Director of Master of Arts program in Addiction Studies, ASEAN Institute for Health Development, Mahidol University, Thailand, the only Master Program in addiction studies in Southeast Asia. She has published more than 25 papers in journals and serving as an Editorial Board Member of Journal of Public Health and Development Thailand.
Abstract:
Continuum of care is a continuing care which provides quality of care services. The management must concern from first day visit until aftercare program. Therefore all of practitioners are convinced and holistic approaches are used. Addictions are chronic and complicate illness and individualize. We try put energy and resources into rebuilding the comprehensiveness and continuity that represent high-quality care. At Outpatient Department we encourage all clients and his family via step of treatment engagement stage. It is not tailor-made for all. The Clinical indications that support the client\'s transition from the treatment engagement stage to the early recovery stage. For Inpatient Department, We design continuing care services which supports maintain abstinence during institution program. The aftercare programs are used after discharge e.g. occupational program, family based, and community based. The activities provide client’s recovery and status. Clients need continuing care varies for each individual who remain abstinent or relapses prevention.
Bang-on Thepthien
Mahidol University, Thailand
Title: Chronic care model and social protection in addition
Biography:
Bang-on Thepthien is a researcher working at Department of Addiction Studies, ASEAN Institute for Health Development , Mahidol University Thailand
Abstract:
Substance dependence is a chronic disease for which many affected adults receive no intervention or detoxification without subsequent treatment. Like other chronic diseases (e.g., diabetes, congestive heart failure), substance dependence has no cure and is characterized by relapses requiring longitudinal care. In Thailand, the current system of substance dependence care is fragmented, not coordinated, and does not always include proven efficacious treatments. Patient motivation and coexisting health and social problems are barriers to receipt of effective treatment. Integrated and coordinated care, which simultaneously addresses patient motivation and needs, across health domains, provides efficacious addiction treatments and facilitates effective access to other treatment. This integrated care may increase the likelihood that care is received and that addiction-related and other clinical outcomes improve. Social protection has been defined as “all public and private initiatives that provide income or consumption transfers to the poor, protect the vulnerable against livelihood risks, and enhance the social status and rights of the marginalized; with the overall objective of reducing the economic and social vulnerability of poor, vulnerable and marginalized groups.†Social protection can help reduce disadvantages and inequalities that make drug abuse, help overcome barriers to access treatment, and mitigate the impact of drug user on household poverty and social exclusion.
Chanchai Thongphanit
Thanyarak Khonkaen Hospital, Thailand
Title: Aftercare program in continuum of care
Biography:
Chanchai Thongphanit completed Doctor of Medicine Program from Faculty of Medicine, Srinakarinviroj University, Thailand since 1999. He then continued Diploma of the Thai Board of Preventive Medicine (Community Mental Health) from the Medical Council of Thailand on 2010. He is the Deputy Director of Thanyarak Khonkaen Hospital, Department of Medical Services, Ministry of Public Health. His experiences are Director of Medical Affair Center (Area number 12) from 2008-2014, The working group on the revised treatment model for problematic alcohol user in health system (revised-i-MAP Health Program), The working group of the research project: Development of Screening and Brief Invention System for Substance Users in Primary Care Units, Southern Substance Abuse Academic Network, Prince of Songkhla University, Lecturer in Master of Arts program in Addiction Studies, Mahidol University, and Quality Consultant of Healthcare Accreditation Institute, Thailand from 2010-2014.
Abstract:
Addiction is a chronic disease. It is often relapses that causes compulsive seeking and use drug. Beside that the effective treatment of addiction as a chronic disease is important address in continuity of care that involves monitoring the patient’s transition from outpatient services to inpatient services before they are discharged and also aftercare program.Thanyarak Khonkaen Hospital is a specialized drug treatment hospital of Department of Medical Services, Ministry of Public Health, Thailand. It is a tertiary care unit in The National Health Security System for drug patients referred from a primary or secondary health care unit. There are 200 beds capacity. The aftercare program is done by multidisciplinary team which composes of Physician, Nurse, and Clinical psychologist. All clients who get admitted in aftercare program must stop drug use over 90 days. The follow up appointment were used. Those were 7 times within 6 month. Therefore, we have social workers for home visit. The result revealed that aftercare program maintains long-term recovery and sobriety. Most of the clients develop spiritual and life skill.
Lacha Rueangkit
Mahidol University, Thailand
Title: Effect of social support on continuum of care for methamphetamine addicts
Biography:
Lacha Rueangkit completed BPolSc in 2013. She is a Master’s student of Addiction Studies Program, ASEAN Institute for Health Development, Mahidol University. Her research field is in the area of alternative treatment in addiction. She is interested in research on drug and alcohol addiction.
Abstract:
Human resource is an important asset of country development. If we can cure the addict clients they ought to return human resource of society and country. Addiction is typically a chronic disease. All the clients need continuum services to maintain abstinence. This focuses, on moving the clients along continuing care services both of Outpatient department and Inpatient Department. This research work aimed to study the effect of social support on continuum of care for Methamphetamine addicts. The study population was 400 Methamphetamine dependent outpatients and inpatients admitted of Tanyarak drug dependence treatment. The patients were interviewed using a questionnaire. The result revealed that most of the outpatient clinic received emotional support, information support and tangible support, respectively. Inpatients received emotional support, tangible support and information supports, respectively. Emotional supports were significantly higher in family than practitioner. On the other hand information supports were significantly higher in practitioner than family. On finding, suggested that social supports especially emotional supports are important in helping the clients maintain abstinent. The social supports are direct effect on recovery of Methamphetamine addicts.
- Drug Addiction and Neurotoxicology
Addiction Medicine
Addiction Psychiatry and Mental Health
Psychology and Group Therapies
Location: Prestwick
Chair
Igor Elman
Harvard Medical School, USA
Co-Chair
Monika Heidemarie Seltenhammer
Medical University of Vienna, Austria
Session Introduction
Elizabeth Halpern
Federal University of Rio de Janeiro, Brazil
Title: The dual commitment of a naval outpatient clinic specialized in chemical dependency of the Brazilian Navy: The patients and the institution
Time : 11:40
Biography:
Elizabeth Halpern is a Psychologist and a Frigate-Commander of the Brazilian Navy, a specialist in Medical Psychology, a Master in Collective Health, and a PhD in Mental Health. She dedicated 28 years in the Brazilian Navy hospitals and outpatient clinics, working as a chief and therapist, from prevention to rehabilitation, giving lectures and courses to military personnel, assisting families, couples, adolescents, and children, in groups and individually. As the Chief of the Center for Chemical Dependency during the last decade, she dedicated her practice towards addiction, and published 14 articles related to drinking practices in the workplace. Presently, she is the Chief of the Health Department of the Central Navy Hospital in Rio de Janeiro, Brazil.
Abstract:
An inaugural study conducted at the Center for Chemical Dependency (CEDEQ) of the Brazilian Navy through an ethnographic study, with participant observation, from 2005 to 2009, investigated the influence of the naval organization in the construction of these patients’ alcoholism. One of the main results of the major study revealed the existence of a double commitment of this Outpatient Clinic, both with the patients and the institution. The results encompassed topics such as the functioning of this Center, the therapeutic contract, anonymity, confidentiality, discharge, relapses, readmission, withdrawal, secondary gains, \"scams\", sanctions, and ambiguous perceptions about the role of the CEDEQ. In addition, the research demonstrated that the CEDEQ seems to be divided into two orders, therapeutic and military ones. In practice, the staff and patients are committed to the naval system, since the CEDEQ is part of the military structure. The patients feel that it is an extension of their working space, a place where they can share the same codes, rules, and language, mainly because they are connected by common experiences. Immersed in the naval culture, the CEDEQ somehow incorporates the values and codes of the Brazilian Navy, reproducing the institutional view that blames individuals for their deviant acts linked to alcohol addiction. Although the therapeutic approach focuses on the rehabilitation of the patients based on the principles of the Twelve Steps of Alcoholics Anonymous and behavioral techniques, this Clinic must keep the administration informed about their diagnosis, prognosis, and status regarding their recovery. To summarize, the conclusions related to the dual commitment of the CEDEQ with the Brazilian Navy and the patients\' treatment help to understand the peculiarities of the organization that contribute to the emergence of these patients’ alcoholism.
Monika Heidemarie Seltenhammer
Medical University of Vienna, Austria
Title: Characterization of Accumulated ~35-37kD Isoforms of ΔFosB Detected in Postmortem Human Brain Tissue Samples of Chronic Drug Addicts
Time : 12:05
Biography:
Monika H. Seltenhammer completed her VMD. and Ph.D. from VMU in Austria and postdoctoral studies from Veterinary University of Vienna, Max Perutz Laboratories and Medical University of Vienna in Austria, where her core area of scientific work mainly consisted in cancer research (melanoma) and pathology, but also immunology, neurology and virology. Dr. Monika H. Seltenhammer has received several honor and awards. She is a leading member of the scientific staff of Dr. Daniele Ugo Risser at the Department of Forensic Medicine of the Medical University Vienna, where she specializes in neurobiology and addiction behavior.
Abstract:
As already extensively proofed with reams of animal experiments, but also recently shown in humans, the ~33kD transcription factor ΔFosB, a member of the Fos family proteins and belonging to the IEGs (Immediate Early Genes), is initiated by varying effects such as drugs of abuse or other psychoactive substances, and psychotherapeutic agents, in the acute phase. Chronic exposure to these interactions leads to the displacement of the unstable ~33kD to highly robust ~35-37kD isoforms. This in turn maintains to a consistent accumulation of these highly stable ΔFosB derivates in the nucleus accumbens (NAc), the reward center of the brain, insistently persisting there for months and beyond following cessation of the chronic stimulus - a major fact that seems to be responsible for the development of sustained neuronal plasticity. In case of long-term drug abuse, it ultimately leads to addictive behavior. Focused on this, we demonstrate the presence of accumulated ~35-37kD ΔFosB isoforms in the NAc of chronic drug-sick deceased people with pronounced long-term opioid abuse anamnesis via immunoblotting. Similar results we can present by immunohistochemistry. Further, this protein was characterized by means of Mass Spectrometry to elucidate potential additional phosphorylation sites, seeming to accelerate the factors stability. Our current results emphasize the remarkable high resistance of this phosphorylated transcription factor. The data confirm the strong impact of ΔFosB and its downstream transcriptional targets with regard to long-term biological consequences for and potentially fatal adaptations of the brain leading to addictive behavior and high relapse rates in response to chronic drug abuse. As a consequence, when thinking about establishment and interpretation of sensitive biomarkers on the one hand, and development of novel therapeutic strategies in terms of psychological disorders in general and especially in (drug) addiction on the other hand, this strong impact of ΔFosB should be in our mind.
Sushil Sharma
Saint James School of Medicine, The Netherlands
Title: Charnoly body as a novel biomarker in drug addiction
Time : 12:30
Biography:
Sushil Sharma is Professor (Course Director) Pharmacology, Saint James School of Medicine, Bonaire. He completed PhD in Neuropharmacology from AIIMS, Delhi and Radiopharmaceutical Training at BARC Bombay, GE, Siemens, Agilent Technologies, Cardinal Health (USA). He was a Research Officer at AIIMS from 1979-88, Royal Society Fellowship UK, 1988-89; MHRC Post-doctoral Fellowship, Canada: 1989-91. He was also a Research Officer at University of Montreal from 1993-94. He was a Research Associate, McGill University, 1994-95, Deputy Director (Scientist-E) at Defense Research Institute, Delhi, 1993-97, Senior Scientific Officer, Clinical Research Institute of Montreal, 1995-97, Scientist, University of Manitoba, 1997-99, Assistant Professor 2000-04, Associate Professor & Director, UND School of Medicine, Grand Forks, 2004-08, Associate Professor & Director, Methodist Hospital and Scientist at University Texas Medical Center, 2008-11. He organized and chaired world conferences and was awarded 5 gold medals.
Abstract:
Charnoly body (CB) is a pre-apoptotic biomarker of compromised mitochondrial bioenergetics, which is formed in the most vulnerable cell in response to nutritional stress, environmental toxins, or drug of abuse due to free radical overproduction and mitochondrial genome down-regulation. It is detected as a pleomorphic multi-lamellar, electron-dense, membrane stack of degenerated mitochondrial membranes in the hippocampal CA-3 and dentate gyrus neurons, hypothalamic neurons, and cerebellar Purkinje neurons in animal models of fetal alcohol syndrome, Parkinson’s disease, Alzheimer’s disease, vascular dementia, and chronic drug addiction. Accumulation of CB at the junction of axon hillock impairs axoplasmic flow in the synaptic terminals to cause cognitive impairments, early morbidity, and mortality in chronic drug addiction. Initially ΔΨ collapse, down-regulation of mitochondrial -NADH-oxidoreductase, and 8-OH-2dG can be detected as CB rudiments to evaluate early symptoms of acute drug addiction as epigenetic modulators of DNA methylation and histone acetylation. During chronic phase, CB formation can be detected at the ultrastructure level. Antioxidants such as Metallothioneins, inhibit CB formation as free radical scavengers by regulating zinc-mediated transcriptional activation of genes involved in growth, proliferation, and differentiation as established in gene-manipulated human dopaminergic (SK-N-SH and SHY5Y) cells and in mouse models of multiple drug abuse. Hence novel drugs may be developed to prevent CB formation or induce charnolophagy as an efficient molecular mechanism of intracellular detoxification during acute phaseand novel CB antagonists to avert chronic drug addiction by employing CB as an early, sensitive and specific biomarker to detect, prevent and effectively treat drug addiction.
Alaaeldin A. Elkoussi
Assiut University, Egypt
Title: Toxicological and Social Hazards of Solvent inhalant Abuse.
Time : 13:45
Biography:
Elkoussi is a professor of Pharmacology and Toxicology in Assiut College of Medicine since 1984. He was the Department Chairman in the years 1996-1999 and 2005-2007. He completed his PhD in 1972. In 1982 & 1984 he was granted postdoctoral fellowships in the University Of Florida College Of Pharmacy. From 1990 to 1994 he worked as a Senior Research Scientist in the Center for Drug Design and Delivery and Center for Drug Discovery, University of Florida and he also worked as pharmacologist in some pharmaceutical research companies in USA and pharmaceutical industrial companies in Egypt as a regulatory affairs manager. In 2002 he got a Hubert Humphrey Fellowship at Johns Hopkins University. He had published over 50 manuscripts in international journals and presented several lectures and research work in more than 60 international scientific conferences. He also supervised several Masters and PhD theses on different topics in experimental and clinical pharmacology and toxicology. For the last 2 decades he had conducted and supervised several research studies and projects on the topic of solvent inhalant abuse, causes patterns and significance in different countries.
Abstract:
Solvent inhalant is a term applied to a diverse group of volatile, psychoactive substances found in a number of common commercial products. Solvent inhalant abuse refers to the intentional inhalation of vapors from these products to achieve intoxication. Abusers self-administer inhalants to maintain a preferred level of intoxication. Solvent inhalants are easily available, inexpensive and not illegal; which collectively contribute to their abuse by individuals of lower socioeconomic status who cannot easily get other drugs of abuse. Yet, rates of inhalant abuse are currently increasing in other socioeconomic groups indicating an abuse epidemic. Today, inhalation of volatile substances is practiced worldwide, with a marked variability in the type and pattern of substances abused. Hence, inhalant abuse has become a particularly serious health and socioeconomic worldwide problem. in Egypt, a local glue “Kolla†is widely abused; especially among street children. In a previous study in our labs; we identified the physicochemical, neueropharmacological and some of the toxicological properties of this glue in rats. In the present study we explored more behavioral, biochemical, neuropharmacological and toxic effects of “Kolla†inhalation. Effects of inhalation on brain neurotransmitters (GABA, serotonin and dopamine) levels were studied in rats, in a trial to find out the possible mechanisms underlying these effects. In addition, we evaluated the influence of glue sniffing on liver and kidney functions and the pathological changes occurring in the brain of rats following glue inhalation. This presentation we will focus on the numerous hazards of “solvent inhalant†abuse and toxicity.
Huixiao Hong
National Center for Toxicological Research- FDA, USA
Title: Three dimensional structure of human nicotinic acetylcholine receptor α7 constructed through homology modelling and molecular dynamics simulation
Time : 14:10
Biography:
Huixiao Hong received Ph.D. in computational chemistry at Nanjing University, China in 1990 and completed postdoctoral fellowship at the Maxwell Institute at Leeds University in UK in 1992. He is a Sr. Scientist at the US FDA. He has published more than 130 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
Addiction to nicotine, and possibly other tobacco constituents, is a major factor that contributes to the difficulties smokers face when attempting to quit smoking. Amongst the various subtypes of nicotinic acetylcholine receptors (nAChRs), the α7 subtype plays an important role in mediating the addiction process. The human nAChR α7 is prevalent in the central nervous system, particularly in the hippocampus area of the brain, and is deemed as a promising target for smoking cessation therapies, treatment of neuropsychiatric and inflammatory disorders, amongst others. To date, a human structure of the nAChR α7 has not been elucidated. A homodimeric homology model of the extracellular ligand-binding domain of human nAChR α7 was constructed based on the crystal structure of the epibatidine-bound human nAChR α7 and Lymnaea stagnalis acetylcholine binding protein (AChBP) chimera protein (PDB ID 3SQ6), which share 71% similarity with the native human nAChR α7. With the cognate ligand preserved in the binding pocket, a 100ns molecular dynamics (MD) simulation was conducted to refine the homology model. The RMSD plot from the resultant trajectory shows that the protein achieved a steady state after ~20ns simulation with a stable fluctuation of approximately 3Å while the ligand after ~35ns with a stable fluctuation of <0.5Å. The refined structure could assist in identifying tobacco constituents that may have human α7 nAChR binding activity.
Ana Lúcia Brunialti Godard
Federal University of Minas Gerais, Brazil
Title: Analysis of the transcriptome in an animal model of alcohol addiction - Evidence for a new pathway for the control and maintenance of the phenotype
Biography:
Ana Lúcia Brunialti Godard graduated in Biological Sciences from the Catholic University of Campinas (1988), Master in Human Genetics, Université Pierre et Marie Curie (1993) and PhD in Human Genetics, Université Pierre et Marie Curie (1997). She is an Associate Professor of the Federal University of Minas Gerais. She is currently a Doc consultant to various funding agencies and the National Council for Animal Experiments Control - CONCEA - MCT, Coordinator of the Program of MBA in Genetics, Federal University of Minas Gerais. She has experience in human genetics, with emphasis in animal models of human disease, acting on the following topics: Functional genomics, genetic of the alcoholism, molecular mechanisms of addiction and compulsion.
Abstract:
The recreational and controlled use of alcohol is distinct from its scaled and uncontrolled use. The progression of controlled use for addition is influenced by many factors, including the drug itself, user behavior (psychological factors), environmental influences and genetic and epigenetic factors. In order to try to elucidate the genetic factors predisposing to addictive behavior to alcohol, we have studied the transcriptome of an animal model that has free choice for ethanol consumption. We used non-inbred, Swiss mice exposed to a three-bottle free-choice model (water, 5% v/v ethanol, and 10% v/v ethanol) that consisted of four phases: Acquisition (AC), withdrawal (W), re-exposure (RE), and quinine-adulteration (AD). Based on individual ethanol intake, the mice were classified into three groups: “addict†(A group; preference for ethanol and high levels of consumption during all phases), “heavy†(H group; preference for ethanol and high levels of consumption during the AC phase and a reduction in intake in the AD phase), and “light†(L group; preference for water during all phases). In order to highlight new avenues of gene regulation that may be involved with the addict phenotype, we evaluated the transcriptome of three brain areas (hippocampus, striatum and prefrontal cortex) of animals of all developed experimental groups. Through this analysis, we demonstrated that the striatum of these animals has transcriptional differences in several genes that constitute a pathway related to the flow and recycling of synaptic vesicles, called LRRK2. This pathway contributes to the maintenance of the dopaminergic tone in striatal neurons and possibly their dysfunction works for characteristic dopaminergic deficit of additions. Our hypothesis is that the change in gene regulation of this pathway is involved in the establishment and maintenance of the addict phenotype, providing evidences of potential new targets for prevention and treatment of the addiction.
Arash Ghodousi
Islamic Azad University, Iran
Title: Causes of non compliance in opioid dependency treatment protocol by agonist therapy in addiction patient referred to addiction treatment centers in Isfahan
Time : 15:30
Biography:
Arash Ghodousi, MD is a Forensic medicine specialist, licensed for treatment of addiction from Ministry of Health of IR of Iran. He is working as an Assistant Professor in Islamic Azad University, Isfahan branch, and is the Head of Hashbehesht Private Clinic in Isfahan. He is also a renowned Addiction Therapist.
Abstract:
Aims: This study aims to investigate the reasons for patient non-compliance against \"Iranian agonist therapy protocol\" among those admitted to addiction treatment centers of Isfahan, Iran. Material & Methods: In this descriptive analytic study, a validity and reliability approved researcher- designed questioner were used. 400 patients were selected randomly between the 204 private and governmental addiction treatment centers. Finally, 254 patient questionnaires were completed and the data was analyzed in three areas: Personal factors, social factors, and factors related to the protocol limitations. The data was analyzed using statistical tests. Ethical code was also established by the central committee. Results: All respondents were male with low education. Based on analytical study, the mean of results in all questions related to the personal and social factors (except two questions) is smaller than the hypothetical average (3) (α≤0.05) but the results in factors related to the limitations of the protocol are greater than the hypothetical average (3). Moreover, the results of t test for personal and social factors and factors related to the protocol limitations are greater than the critical value (1.95). Conclusion: This study showed that personal and social factors are not effective factors on non-compliance based on \"agonist therapy protocol\" (p=0.001). Among the examined factors, the protocol limitation including the difficulty of paying medical costs, mandatory frequent visits, and forgetting to do different parts of the program have more of an effect on non-compliance with agonist therapy protocol among patients admitted to addiction treatment centers. Other studies have shown that education along with family support helps lower non-compliance but if the program is complicated, non-compliance increases.
Eden Tadesse T/tsadik
Universal University College, Ethiopia
Title: The effect of acute exposure to crude khat (Catha edulis F.) on mice using multiple T- maze test
Time : 15:55
Biography:
Eden Tadesse Ttsadik has completed her BPharm from Universal University College. She is a senior pharmacist. She is also a part time instructor at Universal University College. She writes drug related tips in local medical Magazines. She has published one research and sent three research papers for publication with her colleagues.
Abstract:
Schizophrenia is a psychological disorder which is characterized by the inability to separate reality from non reality. Symptoms may include delusions, hallucinations or disorganized thinking. Cognitive dysfunction is considered a core deficit of schizophrenia. Khat (Catha edulis F.) is an evergreen tree that belongs to Celestraceae family. It is claimed to have schizophrenic like effect. The aim of this study was to investigate the potential schizophrenic inducing effect of acute administration of crude khat extract in mice. Crude khat extract obtained using a mixture of chloroform and diethyl ether (1:3) was administered orally in doses of 100, 200, 300 mg/kg, the negative and positive control groups were administered with Tween 80 2% v/v in water and ketamine 10 mg/kg respectively. Multiple T-maze test was used to evaluate the cognitive function and the latency to reach the goal box was determined. The results collectively indicate acute administration of khat extract at the doses used did not have a significant cognitive effect in MTM test.
Biography:
Prapapun Chucharoen has completed Ph.D. in Neuroscience at the age of 38 years from Mahidol University. She is the director of Master of Arts program in Addiction Studies, ASEAN Institute for Health Development, Mahidol University, Thailand. This is the only Master Program in addiction studies in Southeast Asia. This program aimed to Create social leader/ practitioner in the field of addiction studies. Those who graduate from the program will be capable of practicing as well as conducting research in this discipline in order to support the social environment of a country with respect to the prevention and alleviation of narcotics and others addiction problems. The therapy and rehabilitation of addicts is also included in the curriculum. She has published more than 25 papers in journals and serving as an editorial board member of Journal of Public Health and Development Thailand.
Abstract:
When we talk about chronicity of addiction, we focus on life-long recovery, but this recovery cannot result by enrolling a client in one treatment model. It should be based on a continuum of care, where the treatment system in which clients enter at a particular level needs to correlate with the client’s needs and then step up to an intensive treatment or may lower to less intense treatment as needed. This would also result in client satisfaction and be helpful for those in less restricted environment. Continuum of care is the most comprehensive treatment for drug addicts, especially young clients. The aim of continuum of care is to reduce susceptibility and damage in young clients. This is a great prospect for future prevention as the ones in recovery would advocate others to stay drug free. The continuum of care provides an ongoing psychological and social support to prevent lapse or relapse and get hold of required routine treatment. The prime motive of a continuum of care can be a system where clients can get access and re-access based on their needs at any time. This would also help in catering co-occurring disorders that sometimes go unnoticed and becomes predominant cause of relapse. This symposium would shed a light on the importance of continuum of care which is an evidence based intervention model.
Maša Valkanou
Lorijen Hospital, Serbia
Title: Where is “I†in addiction? A link between personality disorders and drug addiction
Biography:
Maša Valkanou is a clinical psychologist working at Centre for Psychotherapy conducting psychotherapy, counselling, assessment and group psychotherapy for patients of different psychological disorders, especially addictions. She gained rich clinical experience working at Psychiatric clinic for addiction „Lorijen hospital“ and Institute of Mental Health in Belgrade. She is a certified Systemic Family psychotherapist, master psychologist of University of Belgrade and MSc in Psychology and Counselling, University of Sheffield. She is enrolled in Child and Adolescent Psychoanalytic Psychotherapy and has education in Transactional Analysis and Rorschach method. Additionally she is a part of the project Centre for Talented Youth "Nikola Tesla". She is also a Presidency member of Mensa Serbia.Maša Valkanou is currently working at Lorijen Hospital, Serbia
Abstract:
Is there something called “addictive personalityâ€, what is shared for most drug addicts and is there a space for individuality when addiction is in question? The main objective of this study was to discover the personality characteristic that are accountable for predicting addictive behaviour. The aim was to find a personality profile that is most vulnerable towards drug abuse. Additionally, factors such as emotional involvedness and professional ability were examined. The sample of this research contained 91 participants, 53 addicts and 48 individuals in a control group. Millon Multiaxial Clinical Inventory III (MCMI III) and specially constructed data sheet were used. Canonical discriminant analysis presented the best model which generates distinct personality features that strongly predict drug abuse and to explore differences in the presence of psychopathological features between groups, whilst a Chi-squared analysis examined the additional factors. Significant differences were found between general population and substance abuse group in the presence of personality disorders and level of presented pathology. In conclusion individuals who developed Antisocial, Borderline, Depressive and Dependant personal style are most prone to use substances, whilst individuals who belong to Histrionic or Compulsive Personality style are most unlikely to develop addiction (p<0.001). The addiction is firmly attached to the Depression major presence, PTSD and Dysthymia. Also, addiction group shows significantly higher level of pathology (p<0.001). Individuals who developed any kind of addiction are proven as professionally significantly less capable in comparison to the control group.
- Young Researchers Forum
Location: Prestwick
Session Introduction
Arjun Krishnamurthy
People’s Education Society Institute of Technology, India
Title: Modulation of cardiac autonomic regulation with yoga therapy in alcoholic patients: A pilot study using non-linear measures of heart rate variability
Biography:
Arjun Krishnamurthy is currently pursuing his final year MTech (Intelligent Systems) degree at PES Institute of Technology, Bangalore. He is a Computer Science and Engineering Graduate from BNM IT. He has achieved number of awards & prizes; to name a few received the prestigious Kishore Vaigyanik ProtsahanYojana Fellowship Award 2009, 1 out of 7 in India, ‘Student Innovation Award 2010’ at ABCS, National Conference at International Institute of Information Technology, Pune. Currently his project was selected for VGST Technology Related Innovative Project funding 2014-15.
Abstract:
Introduction: Heart Rate Variability (HRV) is a non-invasive method to estimate cardiovascular autonomic regulation. Several authors have reported abnormal HRV measures in alcoholics. Yoga therapy is known to modulate autonomic function in health and disease. It remains unknown if the yoga therapy improves HRV in alcoholics. Non-linear measures of HRV are more robust to capture alterations in the physiological signal. Particularly entropy measures provide information about the complexity and regularity of non-stationary signals. We investigated the influence of yoga therapy on non-linear measures of HRV in alcoholics. Methods: 15 minutes resting Lead II ECG of 19 alcoholic patients admitted for de-addiction were collected before and after yoga therapy. Non-linear measures of HRV were computed using Kubios software. In particular, Shannon entropy, approximate entropy, sample entropy, correlation dimension and detrended fluctuation analysis were estimated as per the standard algorithm. Results: There was significant improvement in the approximate entropy with yoga therapy [pre- 1.01±0.3 to post 1.14±0.15 (Mean±SD); p=0.023]. Similar observation was noted in the sample entropy [pre- 1.26±0.5 to post 1.47±0.4 (Mean±SD); p=0.045]. However, none of the other measures showed statistically significant change. Conclusion: Yoga therapy increases the complexity of HRV signal as suggested by the entropy measures & it also improves the disrupted autonomic function in alcoholic patients. Further, large scale randomized control studies are required to confirm the beneficial effects of add on yoga therapy in de-addiction treatment.
Eltoum Etdal Abdelrahman
King Faisal Specialist Hospital &Research Centre, Saudi Arabia
Title: Monitoring benzodiazepine use in mental health psychiatry outpatient clinics: A project from KSA
Biography:
Eltoum Etdal Abdelrahman is currently working as a psychiatry nurse coordinator in mental health department of King Faisal Specialist Hospital &Research Centre, Saudi Arabia. She has worked in various medical clinics and attends special courses in mental health department.
Abstract:
Background: Benzodiazepines (BZD) are recognized as one of the most widely prescribed medications in the world, the delicate balance between using & misusing are always a concern for the physicians. Objective: To minimize the risk of Benzodiazepine misuse in the psychiatry outpatient clinics of single tertiary care center in Riyadh, Saudi Arabia. Methods: This prospective project was conducted in the outpatient setting of mental health department at King Faial Specialist Hospital & Research Centre, Riyadh; targeting 49 patients who are following in one clinic out of five modules & taking benzodiazepine medications as shown in their records. The subjects were followed & their pattern of benzodiazepine use is surveilled from January to March 2015. All data were collected from patient visit and medication refill visit, unscheduled visit and emergency visit, and violent behavior at work place. In addition to basic demographic information and, duration, frequency of prescription of benzodiazepine use, as well as the reason it was noted. For those who are using benzodiazepine regularly as instructed by their physician with no suspicion of misuse they were given follow up appointments as usual, but for those whom suspected to misuse as seen in their previous records, a strict & well monitored schedule was assigned for them to minimize the risk of abuse. Results: Out of 49 patients involved in the project (32 male and 17 female), 24 patients are using the benzodiazepine regularly as instructed by physician while 25 patients are likely abusers as found by their frequent refill & ER visits The most common abused medication was clonazepam, duration of abuse range from 1 to 30 years. Conclusion: Overall, this project proves to mental health department, the possibility to monitor the controlled medications in effective way, assuring the safety for the patients & reduce the load of unscheduled patients who come for narcotics refill. The project will be adopted to include all psychiatric outpatient clinics in the hospital in the next phase.
Adeela Saba
Global welfare organization, Pakistan
Title: Effectiveness of rational emotive behavior therapy in disputing irrational beliefs of persons with substance used disorders
Biography:
Adeela Saba has completed advance Diploma in Clinical Psychology from University of Sargodha, Pakistan. She is working as Psychologist at Global Welfare Organization, Pakistan.
Abstract:
The present study explored the Effectiveness of rational emotive behavior therapy in disputing irrational beliefs of persons with substance used disorders. It was hypothesized that there is likely to be a decrease in irrational beliefs of persons with substance used disorders after the treatment (REBT). Repeated measure design was used. Sample consisted of (N=12) persons with substance use disorder. It was carried out on in door patients of Drug Addiction at Punjab Institute of Mental Health (PIMH), Fountain House Lahore. Demographic information sheet and MSE was used to rule out others psychiatric illness. The Shortened General Attitude and Belief Scale was used to assess pre and post assessment of irrational beliefs. Wilcoxon signed rank test indicated that there were significantly lower scores in irrationality post test compare to pre test. The present study contributes to resolve patient’s emotional turmoil that may put an individual at risk of psychological illness caused by irrational beliefs.
Pham Bich Diep
Hanoi Medical University, Vietnam
Title: The link between alcohol expectancies and alcohol outcomes is mediated by drinking motives among students in Vietnam
Biography:
Pham Bich Diep is a Lecturer at Department of Health Education-Institute for Preventive Medicine and Public Health, Hanoi Medical University, Vietnam. She obtained her Bachelor of Economics in Vietnam and then graduated Master of Public Health in Australia. She is now pursuing PhD in Health Promotion Department, Maastricht University, Netherlands. Her interested areas are in health education and promotion, health behavior. She participated as investigator in many researches in alcohol and tobacco control study. She has published some papers in international journals in the research field of alcohol.
Abstract:
To investigate whether, also in Vietnam, the links between alcohol expectancies (tension reduction; global positive change; improved cognitive and motor abilities and change in social behavior) and alcohol outcomes (drinking volume, 6+ drinking, alcohol problems and alcohol dependence) are mediated by drinking motives (social, enhancement, conformity and coping). The Vietnamese drinking culture differs from that in more developed Western countries, in particular due to large gender differences in alcohol use. A multi-stage (city, university/faculty, academic year) sampling strategy was used in four Vietnamese provinces resulting in a final sample of 4,756 students (43.2% females) with mean age 20.6 (SD 1.8) years. Structural equation models including indirect effects were estimated for women and men separately. Overall, expectancies were almost always mediated by motives but with major gender differences. Among female students the links between three expectancy factors (tension reduction; global positive change; change in social behavior) and all alcohol outcomes were fully mediated, most often by coping motives, rarely by enhancement and not at all by the other motives. Among male students these links were fully mediated by all four drinking motives. By confirming that, also in Vietnam, motives mediate the link between expectancies and drinking behavior, this study supports the cultural robustness of a key assumption of the motivational model (i.e., that drinking motives are more closely associated with alcohol use than expectancies). Drinking motives seem a more promising factor to be included in intervention efforts than expectancies.