Day 2 :
- Addiction science
Session Introduction
Siobhan Morse
Georgia State University, USA
Title: Healthcare Utilization Savings Private Residential Treatment for Substance Abuse Mental Health Disorders
Biography:
Attending treatment to address substance abuse and mental health issues can play a significant role in reducing the use of expensive acute care such as ER visits as well as reduce the number of overnight stays in hospitals.
Abstract:
Health care costs associated with individuals who abuse drugs and alcohol are higher than those for the general populations. Of the $216 billion dollars paid by federal and state government for health care costs for persons abusing alcohol, drug and tobacco 98% represents medical consequences of substance abuse and only 2% represents direct spending for substance abuse treatment (National Center on Addiction and Substance Abuse at Columbia University, 2009). Chronic drug users utilize 30% more emergency healthcare services than the general population (McGeary & French 2000). Opiate users often receive care in emergency rooms, one of the most expensive points of entry to the healthcare system (Shanahan, Beers, Alford, Brigandi, & Samet, 2010). The risks of inpatient care and ER visits in bipolar patients are associated with key co-morbidities including substance abuse (Guo, Keck, Li, Jang and Kelton, 2008). Individuals who abuse drugs and alcohol have higher rates of mental and physical illnesses and use more expensive forms of acute care Clark.
Ni Fan
Guangzhou Brain Hospital, China
Title: Serum cytokines levels and their correlations with the psychotic symptoms in chronic ketamine abusers
Biography:
Dr. Ni Fan, M.D., Ph.D. got her ph.D. from Louisiana State University Health Science Center at 2009 and continued her postdoc training at Yale University School of Medicine from 2009 to 2012. Currently she is the vice director of the neuropsychiatric research institute of Guangzhou Brain Hospital, the Affiliated Brain Hospital of Guangzhou Medical University. Her research was funded by National Nature Science foundation of China.
Abstract:
Exposing to NMDAR receptor antagonists, ketamine, produces schizophrenia-like symptoms in humans and deteriorates symptoms in schizophrenia patients. Meanwhile, schizophrenia is associated with alterations of cytokines in the immune system. Serum cytokine levels in chronic human ketamine users were measured as compared to healthy subjects. The correlations between the serum cytokines levels with the demographic, ketamine use characteristics and psychiatric symptoms were assessed. Subjects who fulfilled the criteria of ketamine dependence and healthy control subjects were recruited. Serum cytokine levels were measured using an enzyme-linked immunosorbent assay (ELISA). The psychiatric symptoms of the ketamine abusers were assessed using the Positive and Negative Syndrome Scale (PANSS). Serum levels of cytokines were altered in chronic ketamine abusers which may play a role in schizophrenia-like symptoms in chronic ketamine abusers.
Pamela Wray
Executive Director and Founder of The Lighthouse for Recovery Ministries, USA
Title: An Addict in the Family: Family at Risk
Biography:
Pamela D. Wray is the Executive Director and Founder of The Lighthouse for Recovery in Birmingham, Al. The Lighthouse for Recovery Ministries has been recognized as a 2015 "Top Business" recipient by DiversityBusiness.com, winner of the Best Social Service Agency in Birmingham, Al for 2013 and winner of the “Top 500 Veteran Owned Businesses for 2014”. Pamela holds five bachelor degrees in business, computer and medical fields and one Master in Medical and Social Psychology. She holds eleven Military Occupational Specialties and is a former commanding officer in the U.S. Army Special Operation Command. She has eight certifications in business, publishing and editing, substance abuse counseling, finance, computer design and web design. She has been selected for numerous awards for her work with The Lighthouse for Recovery Ministries and other volunteering for sister agencies, including winner of the Presidents Citizen Medal 2013, Pont of Light Award in August 2014 , and “Outstanding Woman in the Community”, 2013, UAB Women’s Center.
Abstract:
The Lighthouse for Recovery Ministries provides programs, service and auxiliary programs as a transitional resettlement resource for the Homeless, Substance/Alcohol Abuse, Domestic Violence, At Risk Children and Youth, Animal Advocacy, Veterans and Prison Reentry, both state and federal. Our sacred mission is to open the door for recovery, restoration and hope to the Returning Citizen and its family members which will empower, enrich and promote positive change. We are dedicated to the individualized treatment plan and use of group therapeutic resources for each of our clients as well as integrating family and support units into the client’s treatment plans and future goals. The success of our individualized treatment plans based on the client’s input and definitive needs that we pursue for our clients has been phenomenal. The integration of the family and support units into our client’s future goals and dreams is what sets us apart from social service agencies and other recovery and rehabilitation programs. In this workshop, we will provide addicts, families, social service personnel and therapeutic communities with education on the disease of addiction which is designed to raise awareness and understanding of the dynamics and impact of addiction on the people whom we serve. It will cover the neurological basis of addiction; mental, behavioral, emotional and spiritual dimensions; stages of change; recovery; motivational techniques and resources.
- Drug Abuse and Neurotoxicology
Biography:
Abstract:
Biography:
Norman S. Miller, MD, JD, PLLC, is the Medical Director, Detoxification and Residential Pro-grams, Bear River Health at Walloon Lake; and the President, Health Advocates PLLC. Umer Farooq, MD, is a Clinical Assistant Professor, Michigan State University College of Human Medi¬cine; and the Director, Dual Diagnosis Program, Pine Rest Christian Mental Health Services.
Abstract:
Why are opioid medications prescribed in large quantities and high frequency when there is little or no proven efficacy for their therapeutic value? Why are opioids the most commonly prescribed medication in the United States for the past decades when the adverse consequences continue to grow? Why does the medical profession continue to prescribe opioid medications that result in increased pain and increased disability? This article summarizes the inherent addictive pharmacologic properties that are the impetus and basis for America’s current opioid epidemic.
Thersilla Oberbarnscheidt
Central Michigan University, USA
Title: Mechanisms of Pain and Opioid Pharmacology
Biography:
Thersilla Oberbarnscheidt is a resident psychiatrist at Central Michigan University, Department of Psychiatry, College of Medicine, MI, USA. Thersilla got her medical degree from the Christian-Albrechts-University in Kiel, Germany and did her 4th Year medical training at Yale University, School of Medicine in New Haven, CT, USA. She received her PhD in Neuroscience from the Christian Albrechts- University in Kiel, Germany. Her thesis was on Phenazone in the treatment of the acute migraine attack.
Abstract:
Opioid-induced hyperalgesia (OIH) is a very common consequence of pain management with opioids. Characteristics of OIH are worsening pain over time despite an increased dose of the opioid. It is often recognized neither by the physician nor the patient, and it results in increasing doses of opioid medications and continued unsatisfying pain levels experienced by the patient. The increased use of narcotics has a negative impact on patient outcome, as patients suffer from increased pain levels and often develop depression. Patients with OIH require frequent assessment for aberrant behaviors as an indicator of addictive use. Opioid-seeking behavior may complicate the clinical picture of failed opioid therapy. The treatment of OIH is to discontinue the opioid medication and to treat the patient’s withdrawal symptoms, if necessary, in an inpatient setting with medical monitoring.
- Addiction Treatment and Rehabilitation
Session Introduction
Young Lee
Manchester University, U.S.A
Title: A mathematical modeling approach to the dynamics of gambling
Biography:
Young Lee completed multiple advanced degrees including her Doctorate of Philosophy in mathematics at University of Wisconsin – Madison. Her research interests are mathematical biology, scientific computation and computer system performance. She has published papers on infectious diseases and socioeconomic dynamics such as Ebola, H. pylori, juvenile crimes, and gambling using epidemiological models and stability analysis, also on numerical analysis of finite difference schemes, perturbations and fixed point theory in differential equations. Her models are often discussed both analytically and numerically. She has also worked on queuing network modeling and simulation and global memory systems in a network of workstations. She has taught mathematics and computer science at Manchester University since 1998.
Abstract:
We take a mathematical modeling approach to the gambling epidemiology. Two deterministic models with ordinary differential equations are created to study the dynamics of gambling: one is for older adults aged 65-80 with four compartments; the other population is youth ages 16-24 composed of three classes. The models seek to examine dynamics of the system through stability analysis and a basic reproductive number. A sociological term for a basic reproductive number is a tipping point because it provides a point at which a stable system turns to an unstable one or vise versa, which is a threshold condition. All parameters are approximated, and numerical simulations are also explored. Analyses indicate that problem gambling is present in an endemic state among both older adults and young adults. One of the main goals for the young adult model is to see how prevalence rates of at-risk gambling and problem gambling change as adolescents enter into young adulthood. The parameters to which the system is most sensitive are identified and are translated to primary prevention for both models. Prevention and control strategies are discussed: school education on gambling addiction should be offered for young adults; a self-exclusion program for older adults, which is used to intervene problem gamblers or pathological gamblers by allowing them to voluntarily exclude from gambling establishments, should be extended to those who are identified as potential excessive gamblers. Although research has been active on gambling, this is the first mathematical modeling approach to study the dynamics of gambling.
Marianne stallvik
Trondheim University Hospital, Norway
Title: Assessing patients to Optimal Level of Care with the ASAM Criteria Software
Biography:
Marianne Stallvik completed her Ph.D. at NTNU, Trondheim, Norway and has over ten years’ experience working with research and research strategies in the field of substances and addiction. Dr. Stallvik has led several research projects in her region involving a wide range of clinics and topics, and has also led multi-cite studies involving clinics from both the public and private organisations. She is a researcher at St.Olavs Hospital, Trondheim University Hospital, R&D department, Clinic for substance and addiction medicine, and research advisor at the University Hospital Ahus in Oslo. Dr.Stallvik has also been elected representative for Network Health Care Research, SERAF and The Regional Research Committee for Health authorities. She is a specialist on the software placement tool ASAM (Continuum ASAM decision engine) and has led a validation study in cooperation with USA. The results validated the software decision basis and are now being implemented in several clinics in Norway.
Abstract:
ASAM Criteria software was studied for predictive and convergent validity by assessing patients with a substance use disorder to optimal level of care (LOC). ASAM criteria is a computer-assisted structured interview and clinical decision support programme that implements validated tools including the Addiction Severity Index, CIWA and CINA abstinence scores and measures biopsychosocial conditions to match patients to an optimal LOC. The talk will cover results from a pilot and a validation study including 261 patients. At post-test three months after treatment initiation, patients who had received matched treatment based on the ASAM recommendation reported less use of alcohol and cannabis versus undermatched patients. Overmatched patients had no better outcomes than matched patients; in some cases no change occurred or a more intensive LOC was recommended at post-test. Consistent with prior studies, the ASAM Criteria Software Norwegian version demonstrates elements of predictive validity for determining intensity of LOC placement using all three prospectively planned measures. We also studied the ability of the ASAM Criteria to clinically distinguish between the different LOC, and results lend support for the software’s convergent validity. This ability to distinguish by severity was taken further in a third paper which also examined the programme’s Dual Diagnosis taxonomy, incorporated in the second revised version to assess patients’ need for more specialised programmes for co-occurring psychiatric disorders. We aimed to study the prevalence of co-occurring disorders programme recommendations and ASAM Criteria convergent validity in terms of locating patients with co-occurring disorders and discriminating between severities among those who received more intense recommendations. The results are in line with previous research with the use of these criteria, and the different recommendations show differences in characteristics, severity and outcomes. The successful translation and software testing in Norway should encourage larger studies – preferably across nations and treatment system.
Francisco José Montero-Bancalero
Professor at Osuna University, Spain
Title: New technologies focused on prevention and intervention of addiction problems
Biography:
Francisco José Montero Bancalero, from Spain, studied psychology at Seville University and obtained his doctorate at Huelva University. He is currently a professor at Osuna University. His professional career started in the field of addictions working as a therapist in an outpatient treatment center, and then he began to participate in different investigation projects. Always interested in the link between researchi and applied practice, he reached the point of leading a pioneering tool in Aula de Alcoholism (Alcoholism Classroom). He has since been interested in new technologies and how to use them to improve the prevention of, and intervention in, substance use problems. He has become a member of the National Hispanic Science Network on Drug Abuse and has presented his projects at different international conferences.
Abstract:
Society is changing faster than ever before. New Technologies of Information and Communication (NTICs) play an important role in people’s life and have changed the way in which people interact forever. In this context, NTICs are a key tool that professionals must understand and make use of, while remembering that NTICs change quickly themselves. Since NTICs are a part of people’s life, they cannot be excluded from the field of health, and addictions are no exception. This tool allows professionals to reach a lot of people in a fast, easy and economical way for everyone. Websites, blogs, social networks, mobile apps, personal computers and tablets are important resources for contacting drug abusers or risk groups, for disseminating prevention campaigns to the general population, for accessing new advances in the research field or simply for sharing information about events or news related to addictions. Bloggers and community managers are new roles that feature a lot of professionals.
- Advanced Therapeutic Aspects for Addiction Recovery
Session Introduction
Lemarie Linda
University of Neuchatel, Switzerland
Title: Gambling advertising and the development of gambling addiction
Biography:
Linda LEMARIE obtained her MD from Paris-Dauphine University in France and her Ph.D. from HEC Montréal Canada. She started her research on gambling addiction during her Ph.D. in partnership with the National Public Health Institute of Quebec and continued as a professor at the EHESP School of Public Health-France. She is now an assistant professor in Switzerland at the University of Neuchatel. She is involved in several research programs aiming to analyze how media influence unhealthy and risky behaviors and also to develop strategies to minimize this influence. Her work has been published in journals such as Journal of Business Research or Recherche et Applications en Marketing (RAM) and presented in premier conferences such as ICAP (International Congress of Applied Psychology), AMA Marketing and Public Policy or AMS World Marketing Congress.
Abstract:
For industry officials and gambling defenders, gambling is an effective way to create jobs and to raise revenue without raising taxes. However, these benefits come with a hefty social and economic price tag. The growing of legalized gambling brings an increase in the number of addicted gamblers with what it all means: higher indebtedness and bankruptcy rates as well as increased divorces, suicides, and gambling-related crimes. Pathological gambling is recognized as an impulse disorder since 1980 (DSM IV – American Psychiatric Association, 1994). The reasons why gamblers become addicted are complex. There is some research-based evidence that gamblers are influenced in part by their social and physical environment. However, non-profit organizations, public agencies, and researchers are focusing their attention on another possible cause of problem gambling development, which is gambling advertising. In response to these accusations, some gambling companies have developed their own program of prevention designed to educate people, especially gamblers, about the harmful effects of heavy gambling. The main goals of this presentation will be first to review the literature on pathological gambling and to expose the different categories of pathological gamblers, second to explain how messages sent by the gambling industry through gambling advertising and marketing impact on these different types of pathological gamblers and, third to open the discussion on anti-gambling programs developed by the gambling industry. Are they effective? Do they need to be encouraged or stopped? What kind of problem can emerge from these individual initiatives? The final discussion will enlarge the results to others types of behavioral addictions and especially food addiction.
Norman Miller
Central Michigan University, USA
Title: Do Current Policy and Practices for Prescribing Opioid Medications Solve Chronic Pain Problems
Biography:
Norman S. Miller, MD, JD, PLLC, is the Medical Director, Detoxification and Residential Pro¬grams, Bear River Health at Walloon Lake; and the President, Health Advocates PLLC. Umer Farooq, MD, is a Clinical Assistant Professor, Michigan State University College of Human Medi¬cine; and the Director, Dual Diagnosis Program, Pine Rest Christian Mental Health Services.
Abstract:
Despite the widespread prescribing of opioid medications for the treatment of chronic pain there is little or no evidence for its efficacy. In fact, the studies show that long-term prescribing of opioid medications leads to significant morbidity and mortality. The Controlled Substance Laws define prescription opioid medication as dangerous and addicting medications. Despite the classification and scheduling of opioid medication, their prescribing continues to be widespread and adverse. Of central importance is there are few studies of the addicting properties that drive the high rates of prescribing and adverse consequences. It is a myth that most people treated with opioids never become addicted and addiction does not develop if you are prescribing for pain.
Jonathan Chick
Edinburgh Napier University, UK
Title: Diagnostic definitions affect evaluations of alcohol problems treatment and their extrapolation to clinical practice
Biography:
Professor Chick is a practising psychiatrist and Medical Director at the internationally renowned addiction treatment Castle Craig Hospital. As Visiting Professor at Edinburgh Napier University, Edinburgh, his current research is into the effects of pricing legislation on alcohol harms. He has led numerous randomised controlled studies into treatments for alcohol problems- both psychological and pharmacological - for alcohol problems, and cautions regarding use of psychiatric medications in some populations of patients. He is Chief Editor of the international journal Alcohol and Alcoholism. He has been an advisor to the World Health Organization and government departments in UK, Australia, Canada, USA and Brazil. He has served as a Trustee for Alcoholics Anonymous (UK).
Abstract:
One objective of a diagnostic system is to provide precision of diagnosis for use when selecting appropriate treatments. Correspondingly precision in diagnosis is essential for devising clinical trials, whether these be medications or psychological therapies. The increasing associated use of other addictive substances along with alcohol plus co-existing mental health disorders such as depression, anxiety disorders and trauma-related illness add to the need for precision of diagnosis when potential treatments are being tested, and the results extrapolated to clinical practice. This presentation will examine current practice in diagnostic assessment in clinical trials on alcohol use disorders, and will explore how the different diagnostic entities in DSM 5 and draft ICD 11 might affect diagnostic precision and case selection in clinical trials. Negative trials of treatments previously found to be effective serve to illustrate this, and examples will be described.
Jennifer Kuvin
Renowned speaker in trauma, USA
Title: Embracing the Paradigm Shift: From Victim to Visionary
Biography:
Rabbi Jenny Skylark Kuvin, is a world renowned sacred teacher, healer and advisor, specializing in trauma, addiction, and self-esteem issues. Prior to attending seminary, an attorney, she has been an active member of the Florida Bar since 1996. She teaches on Spirituality for the American Bar Association and Tennessee Lawyers Assistance Program. Her first book, The Terrible and Wonderful, Ugly and Beautiful Story of My Life So Far, has helped many sufferers from trauma and addiction all over the world. Rabbi Jenny has traveled the world studying with the best spiritual and energy healers and teachers of indigenous cultures and remains passionate and centered in her mission to help others heal from the past and realize their divinity. She attended Seminary at the Rabbinical Seminary International and studied under 4th generational Hungarian Kabbalist and mystical Rebbe Joseph Gelberman. Rabbi Jenny has worked in the field of addiction for many years and currently works as a Spiritual Therapist at Dream Recovery in Boca Raton, Florida. She offers seminars in Spirituality and has recently created AHAVATAR Therapy Certification program for teaching all healing professionals to add Spirituality to their programs. Rabbi Jenny is currently Executive Director of Epiphany Resources Treatment Center implementing her spiritualing and empowerment model.
Abstract:
Rabbi Jenny will provide a clear definition of spirituality and explain it’s central role in the effective treatment of addiction. She will explain the similarities between the victim mindset and that of addiction and how reframing this will clear many blocks to successful recovery. In this comprehensive and ground breaking presentation Rabbi Jenny provides healing solutions for those who treat addiction to assist those suffering in reconnecting to the world, the self, and the divine. Participants will learn various tools, such as meditation, prayer, and creative exercises utilizing mythology, archetypal language, nature, and traditional religious reference, to use in conjunction with those modalities already in practice, including traditional medical and psychotherapeutic methods.
Edward Korzus
University of California Riverside, USA
Title: Abnormal interactions of neurodevelopment with drugs of abuse trigger permanent deficit in the endocannabinoid system-dependent brain natural ability to alter and protect itself
Biography:
Dr. Korzus is an Assistant Professor in Neuroscience and Psychology at University of California Riverside. He completed his Ph.D. in Molecular Biology and Biochemistry at the University of Georgia-Athens. Dr. Korzus completed a postdoctoral fellowship at Howard Hughes Medical Institute at University of California San Diego and is the recipient of numerous Medical Research Awards. Currently, he is a P.I. of the National Mental Health Institute’s research program “Prefrontal circuit and function in memory accuracy” and the holder of NARSAD Award.
Abstract:
Cannabis abuse is considered to be the serious, if not the greatest known environmental risk for neuropsychiatric disorders. Individuals who are exposed to cannabis experience variety of psychoactive effects such as general alteration of conscious perception, euphoria, problems with social interactions, memory and learning, and occasionally anxiety and paranoia. Our research indicates that abnormal interactions of neurodevelopment with the environment triggered by drugs of abuse during neonatal or adolescent periods may permanently impair brain function including the brain natural ability to alter and protect itself, i.e. endocannabinoid system (eCB)-dependent inherent neuroprotection of circuit integrity and neuroplasticity. The eCB system represents a major activity-dependent regulatory system in the central nervous system and has been implicated in multiple brain functions, including synaptic plasticity and the homeostatic regulation of network activity patterns. Noteworthy, deficiency in eCB signaling found in developmental model for psychosis is associated with abnormalities in prefrontal cortex-dependent fear discrimination learning. We also show that mouse model of adolescent cannabis abuse shows deficits in an endocannabinoid -mediated signaling and neuroplasticity in adult prefrontal cortex, a brain region encompassing neural circuit for decision-making. Blockade of the primary gene product responsible for degrading the endogenous endocannabinoid, with the specific drug ameliorates these deficits. The observed deficit in endocannabinoid-dependent signaling in the brain may represent a neural maladaptation underlying cortical network instability and abnormal cognitive functioning triggered by overactive CB1 receptor during adolescence. The validity of these observations to human conditions relies on their criteria and translating data obtained in mouse to human behavior and physiology. These results suggest that transiently overactive CB1 receptor in the brain during adolescence leads to permanent alterations in the endocannabinoid system dependent signaling and neuroplasticity. Cannabis abuse during adolescence increases the risk of schizophrenia, which involves developmental maladaptations in neural circuitry that result in impaired brain functioning. In addition, the endocannabinoid system is altered in the brains of people with schizophrenia. These findings provide additional insights into the pathological processes related to increased risk for neuropsychiatric disorders and point towards developing new treatment strategies.
Adeela saba,
Global welfare organization, Pakistan
Title: Rational Emotive Behavior Therapy (REBT) with Emotional Freedom Technique (EFT) for dealing substance craving among substance abusers
Biography:
Abstract:
David McCauley,
Oak valley Foundation, USA