Day 2 :
- 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.