Source: National Institute on Alcohol Abuse and Alcoholism. Bethesda, Md: NIAAA; NIH Publication No

Size: px
Start display at page:

Download "Source: National Institute on Alcohol Abuse and Alcoholism. Bethesda, Md: NIAAA; 2004. NIH Publication No. 04-3769."

Transcription

1 Diagnosis and Treatment of Alcohol Dependence Lon R. Hays, MD, MBA Professor and Chairman an Department of Psychiatry University of Kentucky Medical Center

2 Defining the Standard Drink A standard drink = 14 g ethanol 12 oz of regular beer or cooler (5% alcohol) 5 oz of table wine (12% alcohol) 1.5 oz of hard liquor (40% alcohol, l 80 proof) The average person metabolizes about 1 standard drink per hour 12 oz 8-9 oz 5 oz 3-4 oz 2-3 oz 1.5 oz 1.5 oz beer or malt liquor table wine fortified wine cordial, brandy spirits cooler 8.5 oz shown in a (such as sherry liqueur, (a single jigger) 12 oz glass that, or port) or aperitif of 80 if full, would hold about 1.5 standard drinks of malt liquor 3.5 oz shown 2.5 oz shown (a single jigger of 80-proof gin, vodka, whiskey, etc.) shown straight and in a highball glass with ice to show level before adding mixer 12 oz 8.5 oz 5 oz 3.5 oz 2.5 oz 1.5 oz 1.5 oz Source: National Institute on Alcohol Abuse and Alcoholism. Bethesda, Md: NIAAA; NIH Publication No

3 Addiction has so many dimensions and disrupts so many aspects of an individual s life, treatment for this illness is never simple. Alan Leshner, MD

4 Why Should We Be Concerned?

5 Medical Complications of Alcohol Abuse/Dependence

6 Comorbidity Substance Use Disorders are particularly prevalent among individuals id with psychiatric i disorders

7 National Comorbidity Survey Half of female alcoholics have a history of major depression One-quarter of male alcoholics have a depression history

8 Medical Complications of CNS Alcohol Use Cardiovascular Gastrointestinal Endocrine

9 CNS Manifestations Withdrawal/DT s Alcoholic Dementia Hepatic Encephalopathy 40 Wernicke s 10 0 Encephalopathy Korsakoff s s Psychosis East 40 West st Qtr 2nd Qtr 3rd Qtr 4th Qtr North

10 Cardiovascular Cardiomyopathy Arrhythmias h h i Hypertension Myocardial y Depression

11 Effects of Chronic Alcohol Use on Body Systems Cognitive deficits psychosis Oral/esophageal cancer Cirrhosis Pancreatitis Cardiomyopathy arrhythmias hypertension stroke Stomach ulcers, gastritis Duodenal ulcers Sources: Schuckit MA. In: Harrison s Principles of Internal Medicine. New York: McGraw-Hill; 2001: American Psychiatric Association. DSM-IV-TR. American Psychiatric Association: Washington, DC; 2000.

12 Diseases Associated with Chronic Alcohol Use Primary Pi Diseases Secondary Diseases Alcohol poisoning Alcoholic heart disease (cardiomyopathy) Alcoholic gastritis Alcoholic li liver cirrhosis i Alcoholic nerve disease (polyneuropathy) Alcoholic psychoses Cancer (lip, mouth, pharynx, esophagus, larynx, liver, stomach) Diabetes Gastrointestinal disease Heart disease (hypertension, stroke) Liver disease Pancreatitis (acute, chronic) Pneumonia/influenza Tuberculosis Sources: Schuckit MA. In: Harrison s Principles of Internal Medicine. New York: McGraw-Hill; 2001: American Psychiatric Association. DSM-IV-TR. American Psychiatric Association: Washington, DC; 2000.

13 Gastrointestinal Fatty Liver Alcoholic h li Hepatitis Alcoholic Cirrhosis Pancreatitis Gastritis

14 Endocrine Hypogonadism Feminization

15 Assessment to Determine Level of Care Acute Intoxication and/or Withdrawal Potential Biomedical Conditions and Complications Emotional and Behavioral Conditions Treatment Acceptance or Resistance Relapse Rl Potential il Recovery Environment

16 Continuum of Care Medically Managed Inpatient Residential Treatment Partial Hospitalization Intensive Outpatient Treatment Psychotherapy/Counseling Alcoholic s Anonymous

17 Methods of Detoxification Benzodiazepines Barbiturates t Valproic Acid Carbamazepine p

18 Factors Associated With Alcohol Dependence Alcohol dependence is a complex disorder in which many factors act together to produce the illness Approximately 50% of the risk is attributed to genetics Genetic factors can act in combination with other biological or environmental factors May arise in individuals without any apparent family history of alcohol dependence as a result of environmental and/or interpersonal factors Source: American Psychiatric Association. DSM-IV-TR. American Psychiatric Association: Washington, DC; 2000.

19 Brain Reward Pathways The VTA-nucleus accumbens pathway is activated by all drugs of dependence including alcohol This pathway is important not only in drug dependence but also in essential Nucleus physiological behaviors accumbens such as eating, drinking, sleeping and sex Ventral tegmental t area (VTA) Source: Messing RO. In: Harrison s Principles of Internal Medicine. 2001:

20 Effects of Acute Alcohol on Reward Circuits Dopamine and Opioid Systems Indirectly increases dopamine levels in the mesocorticolimbic system Associated with positively reinforcing/rewarding effects of alcohol Indirect interaction with opioid receptors results in activation of opioid system Associated with reinforcing effects via µ-receptors cp Sources: Koob GF, et al. Neuron. 1998;21: Messing RO. In: Harrisions Principles of Internal Medicine, 15 th ed. 2001:

21 Effects of Acute Alcohol on Other Neural Circuits GABA and Glutamate Systems Increases the effects of GABA, the major inhibitory neurotransmitter in the brain Inhibits the effects of glutamate, the major excitatory neurotransmitter in the brain Contributes to decreased anxiety and increased sedation during acute alcohol intake GABA = gamma-aminobutyric acid. Source: Littleton J. Alcohol Health Res World. 1998;22:13-24.

22 Pharmacotherapy in the Treatment of Alcohol Dependence

23 Naltrexone Approved by the FDA in 1996 Blocks rewarding effects through its effect on endogenous opioid systems

24 Acamprosate (Calcium Acetyl Homotaurinate) Approved by the FDA in 2004 Chemically related to glutamate (brain s chief excitatory neurotransmitter)

25 Disulfiram (Antabuse Antabuse ) Prevents drinking by preventing liver from fully metabolizing alcohol Inhibits aldehyde dehydrogenase Reaction: nausea, flushing, high blood pressure, chest pain

26 Vivitrol Monthly Injection of Naltrexone 360 mg

27 Treatment of Comorbid Conditions Depression Panic i Disorder Generalized Anxiety Disorder Social Anxiety Disorder

Source: National Institute on Alcohol Abuse and Alcoholism. Bethesda, Md: NIAAA; 2004. NIH Publication No. 04-3769.

Source: National Institute on Alcohol Abuse and Alcoholism. Bethesda, Md: NIAAA; 2004. NIH Publication No. 04-3769. Diagnosis and Treatment of Alcohol Dependence Lon R. Hays, MD, MBA Professor and Chairman Department of Psychiatry University of Kentucky Medical Center Defining the Standard Drink A standard drink = 14

More information

Nalan Ward,MD Director MGH Outpatient Addiction Services

Nalan Ward,MD Director MGH Outpatient Addiction Services Nalan Ward,MD Director MGH Outpatient Addiction Services National Survey Results (2012) (52.1 percent) of Americans aged 12 or older reported being current drinkers of alcohol Nearly one quarter (23.0

More information

Update and Review of Medication Assisted Treatments

Update and Review of Medication Assisted Treatments Update and Review of Medication Assisted Treatments for Opiate and Alcohol Use Disorders Richard N. Whitney, MD Medical Director Addiction Services Shepherd Hill Newark, Ohio Medication Assisted Treatment

More information

Alcohol Overuse and Abuse

Alcohol Overuse and Abuse Alcohol Overuse and Abuse ACLI Medical Section CME Meeting February 23, 2015 Daniel Z. Lieberman, MD Professor and Vice Chair Department of Psychiatry George Washington University Alcohol OVERVIEW Definitions

More information

1. According to recent US national estimates, which of the following substances is associated

1. According to recent US national estimates, which of the following substances is associated 1 Chapter 36. Substance-Related, Self-Assessment Questions 1. According to recent US national estimates, which of the following substances is associated with the highest incidence of new drug initiates

More information

Systematic Review of Treatment for Alcohol Dependence

Systematic Review of Treatment for Alcohol Dependence Systematic Review of Treatment for Alcohol Dependence ALCOHOL ARCUATE NUCLEUS in Hypothalamus, pituitary Beta-endorphin Dynorphin Kappa receptor Nucleus Enkephalins accumbens Delta receptor (+) Mu receptor

More information

Alcohol Addiction. Introduction. Overview and Facts. Symptoms

Alcohol Addiction. Introduction. Overview and Facts. Symptoms Alcohol Addiction Alcohol Addiction Introduction Alcohol is a drug. It is classed as a depressant, meaning that it slows down vital functions -resulting in slurred speech, unsteady movement, disturbed

More information

The Results of a Pilot of Vivitrol: A Medication Assisted Treatment for Alcohol and Opioid Addiction

The Results of a Pilot of Vivitrol: A Medication Assisted Treatment for Alcohol and Opioid Addiction The Results of a Pilot of Vivitrol: A Medication Assisted Treatment for Alcohol and Opioid Addiction James H. Barger, MD SAPC Medical Director and Science Officer Desiree A. Crevecoeur-MacPhail, Ph.D.

More information

MAT: Medication Assisted Treatment for Alcohol Dependence

MAT: Medication Assisted Treatment for Alcohol Dependence MAT: Medication Assisted Treatment for Alcohol Dependence Maritza Lagos, MD, DABAM WMU Homer Stryker MD, School of Medicine - Psychiatry February 2015 Case 44 y.o. Divorced, Caucasian male with strong

More information

Naltrexone and Alcoholism Treatment Test

Naltrexone and Alcoholism Treatment Test Naltrexone and Alcoholism Treatment Test Following your reading of the course material found in TIP No. 28. Please read the following statements and indicate the correct answer on the answer sheet. A score

More information

Neurobiology and Treatment of Alcohol Dependence. Nebraska MAT Training September 29, 2011

Neurobiology and Treatment of Alcohol Dependence. Nebraska MAT Training September 29, 2011 Neurobiology and Treatment of Alcohol Dependence Nebraska MAT Training September 29, 2011 Prior treatment episodes for persons starting treatment for alcohol dependence, 2009 Percent 50 45 40 35 30 25

More information

Alcohol Awareness: An Orientation. Serving Durham, Wake, Cumberland and Johnston Counties

Alcohol Awareness: An Orientation. Serving Durham, Wake, Cumberland and Johnston Counties Alcohol Awareness: An Orientation Alcohol Facts The most commonly used addictive substance in the United States o 17.6 million people (1 in 12 adults) suffer from alcohol abuse or dependence o Millions

More information

Causes of Alcohol Abuse and Alcoholism: Biological/Biochemical Perspectives

Causes of Alcohol Abuse and Alcoholism: Biological/Biochemical Perspectives Causes of Alcohol Abuse and Alcoholism: Biological/Biochemical Perspectives Neurobehavioral Aspects of Alcohol Consumption Source: Eighth Special Report to the U.S. Congress on Alcohol and Health Secretary

More information

ARTICLE #1 PLEASE RETURN AT THE END OF THE HOUR

ARTICLE #1 PLEASE RETURN AT THE END OF THE HOUR ARTICLE #1 PLEASE RETURN AT THE END OF THE HOUR Alcoholism By Mayo Clinic staff Original Article: http://www.mayoclinic.com/health/alcoholism/ds00340 Definition Alcoholism is a chronic and often progressive

More information

Identification, treatment and support for individuals with Alcohol & Drug Addiction in the Community

Identification, treatment and support for individuals with Alcohol & Drug Addiction in the Community Identification, treatment and support for individuals with Alcohol & Drug Addiction in the Community Dr David Jackson Clinic Medical Officer The Hobart Clinic Association Drugs In tonight s context, drugs

More information

Medicines To Treat Alcohol Use Disorder A Review of the Research for Adults

Medicines To Treat Alcohol Use Disorder A Review of the Research for Adults Medicines To Treat Alcohol Use Disorder A Review of the Research for Adults Is This Information Right for Me? Yes, this information is right for you if: Your doctor* said you have alcohol use disorder

More information

Topics In Addictions and Mental Health: Concurrent disorders and Community resources. Laurence Bosley, MD, FRCPC

Topics In Addictions and Mental Health: Concurrent disorders and Community resources. Laurence Bosley, MD, FRCPC Topics In Addictions and Mental Health: Concurrent disorders and Community resources Laurence Bosley, MD, FRCPC Overview Understanding concurrent disorders. Developing approaches to treatment Definitions

More information

Alcohol Screening and Brief Intervention

Alcohol Screening and Brief Intervention Updatedì A POCKET GUIDE FOR Alcohol Screening and Brief Intervention Updated 2005 Edition This pocket guide is condensed from the 34-page NIAAA guide, Helping Patients Who Drink Too Much: A Clinician s

More information

Beyond SBIRT: Integrating Addiction Medicine into Primary Care

Beyond SBIRT: Integrating Addiction Medicine into Primary Care Beyond SBIRT: Integrating Addiction Medicine into Primary Care Community Clinic Association of Los Angeles County 14 th Annual Health Care Symposium March 6, 2015 Keith Heinzerling MD, Karen Lamp MD; Allison

More information

DrugFacts: Treatment Approaches for Drug Addiction

DrugFacts: Treatment Approaches for Drug Addiction DrugFacts: Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please

More information

Advanced Treatment for Opioid & Alcohol Dependence. John Larson, M.D. Corporate Medical Director Gateway Foundation

Advanced Treatment for Opioid & Alcohol Dependence. John Larson, M.D. Corporate Medical Director Gateway Foundation Advanced Treatment for Opioid & Alcohol Dependence John Larson, M.D. Corporate Medical Director Gateway Foundation Background 41 years practicing psychiatry Last 15 in addiction medicine I ve watched a

More information

Alcohol Screening and Brief Intervention

Alcohol Screening and Brief Intervention Updatedì A POCKET GUIDE FOR Alcohol Screening and Brief Intervention Updated 2005 Edition This pocket guide is condensed from the 34-page NIAAA guide, Helping Patients Who Drink Too Much: A Clinician s

More information

DSM-IV Alcohol Dependence. Alcohol and Drug Abuse. Screening for Alcohol Risk. DSM-IV Alcohol Abuse

DSM-IV Alcohol Dependence. Alcohol and Drug Abuse. Screening for Alcohol Risk. DSM-IV Alcohol Abuse DSM-IV Alcohol Dependence Alcohol and Drug Abuse David Gilder, MD Division of Mental Health Scripps Clinic Alcohol Research Center The Scripps Research Institute 1.5.11 Three or more criteria, same 12

More information

Your Care Clinics, LLC

Your Care Clinics, LLC Your Care Clinics, LLC 5985 49 th St. N., St. Petersburg, FL 33709 (727) 528-8997 1258 W. Bay Dr., Unit #F, Largo, FL 33770 (727) 588-7600 Alcoholism Introduction Alcoholism is characterized by a preoccupation

More information

Screening and Brief Intervention Steps: Quick Guide

Screening and Brief Intervention Steps: Quick Guide Screening and Brief Intervention Toolkit Screening and Brief Intervention Steps: Quick Guide Steps 1. Have student complete the AUDIT test. Procedures and Discussion 2. Introduce yourself and establish

More information

Alcohol Abuse and Addiction Management Protocol

Alcohol Abuse and Addiction Management Protocol Alcohol Abuse and Addiction Management Protocol All Team Members: Patient Self-Management Education and Support Alcohol is the most commonly abused drug in the United States. About 18 million people in

More information

The Addicted Brain. And what you can do

The Addicted Brain. And what you can do The Addicted Brain And what you can do How does addiction happen? Addiction can happen as soon as someone uses a substance The brain releases a neurotransmitter called Dopamine into the system that makes

More information

Karen Drexler, M.D. ALCOHOLISM AND DEPRESSION

Karen Drexler, M.D. ALCOHOLISM AND DEPRESSION Karen Drexler, M.D. for the DUMC Alcohol Awareness Task Force ALCOHOLISM AND DEPRESSION Overview What is major depression? What is alcohol dependence? Does depression lead to alcohol dependence? Does alcohol

More information

Strategies for Addressing Alcohol Dependence

Strategies for Addressing Alcohol Dependence Strategies for Addressing Alcohol Dependence Jennifer McNeely, MD, MS Assistant Professor NYU School of Medicine Disclosures No relevant financial relationships to disclose Current research grant support:

More information

Alcohol Withdrawal. Introduction. Blood Alcohol Concentration. DSM-IV Criteria/Alcohol Abuse. Pharmacologic Effects of Alcohol

Alcohol Withdrawal. Introduction. Blood Alcohol Concentration. DSM-IV Criteria/Alcohol Abuse. Pharmacologic Effects of Alcohol Pharmacologic Effects of Alcohol Alcohol Withdrawal Kristi Theobald, Pharm.D., BCPS Therapeutics III Fall 2003 Inhibits glutamate receptor function (NMDA receptor) Inhibits excitatory neurotransmission

More information

The Impact of Alcohol

The Impact of Alcohol Alcohol and Tobacco Smoking cigarettes and drinking alcohol are behaviors that often begin in adolescence. Although tobacco companies are prohibited from advertising, promoting, or marketing their products

More information

This brochure explains how alcohol:

This brochure explains how alcohol: When you are HIV positive, you have to work hard to stay healthy. Drinking less alcohol or not drinking at all can help you fight HIV disease and improve your health. Quitting drinking or cutting down

More information

Brain Damage & Recovery: The Resilience of the Brain, Addiction Impact & Therapeutic Repair. Michael Fishman, MD Director of Young Adult Program

Brain Damage & Recovery: The Resilience of the Brain, Addiction Impact & Therapeutic Repair. Michael Fishman, MD Director of Young Adult Program Brain Damage & Recovery: The Resilience of the Brain, Addiction Impact & Therapeutic Repair Michael Fishman, MD Director of Young Adult Program How Addiction Takes Hold Large & rapid upsurges in dopamine

More information

Alcoholism. Alcoholism is a type of drug addiction. There is both physical and mental dependence on alcohol.

Alcoholism. Alcoholism is a type of drug addiction. There is both physical and mental dependence on alcohol. Alcoholism Alcoholism Alcohol dependence; Alcohol abuse Definition Alcoholism is drinking alcoholic beverages at a level that interferes with physical health, mental health, and social, family, or job

More information

Facts About Alcohol. Addiction Prevention & Treatment Services

Facts About Alcohol. Addiction Prevention & Treatment Services Facts About Alcohol Addiction Prevention & Treatment Services Table of Contents Facts about alcohol: What is harmful involvement with alcohol?... 2 What is alcohol dependence?... 3 What Is BAC?... 4 What

More information

Reintegration. Recovery. Medication-Assisted Treatment for Alcohol Dependence. Reintegration. Resilience

Reintegration. Recovery. Medication-Assisted Treatment for Alcohol Dependence. Reintegration. Resilience Reintegration Recovery Medication-Assisted Treatment for Alcohol Dependence Reintegration Resilience 02 How do you free yourself from the stress and risks of alcohol dependence? Most people cannot do it

More information

Addiction Neurobiology

Addiction Neurobiology Addiction Neurobiology Stephen Jurd University of Sydney Australia Richard W is sick Apology The site of pathology IF Addiction has a neurobiological basis THEN we should be able to: Define addiction AND

More information

http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx

http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx Alcohol Abuse By Neva K.Gulsby, PA-C, and Bonnie A. Dadig, EdD, PA-C Posted on: April 18, 2013 Excessive

More information

Alcoholism In The Office SCOTT PAIST, III, M. D.

Alcoholism In The Office SCOTT PAIST, III, M. D. Alcoholism In The Office SCOTT PAIST, III, M. D. The Dopaminergic Mesolimbic System PFC= Prefrontal Cortex NA=Nucleus Accumbens VTA= Ventral Tegemntal Area A = Amygdala C = Caudate Nucleus The Limbic System

More information

ALCOHOLISM, ALCOHOL DEPENDENCE AND THE EFFECTS ON YOUR HEALTH.

ALCOHOLISM, ALCOHOL DEPENDENCE AND THE EFFECTS ON YOUR HEALTH. ALCOHOLISM, ALCOHOL DEPENDENCE AND THE EFFECTS ON YOUR HEALTH. Alcoholism also known as alcohol dependence is a disabling ADDICTIVE DISORDER. It is characterized by compulsive and uncontrolled consumption

More information

Alcohol Awareness Month October 2013. Chad Asplund, MD, FACSM Medical Director, Student Health Georgia Regents University

Alcohol Awareness Month October 2013. Chad Asplund, MD, FACSM Medical Director, Student Health Georgia Regents University Alcohol Awareness Month October 2013 Chad Asplund, MD, FACSM Medical Director, Student Health Georgia Regents University Alcohol Statistics According to the Office of Juvenile Justice and Delinquency

More information

Treatment Approaches for Drug Addiction

Treatment Approaches for Drug Addiction Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call the

More information

Opiate Abuse and Mental Illness

Opiate Abuse and Mental Illness visited on Page 1 of 5 LEARN MORE (HTTP://WWW.NAMI.ORG/LEARN-MORE) FIND SUPPORT (HTTP://WWW.NAMI.ORG/FIND-SUPPORT) GET INVOLVED (HTTP://WWW.NAMI.ORG/GET-INVOLVED) DONATE (HTTPS://NAMI360.NAMI.ORG/EWEB/DYNAMICPAGE.ASPX?

More information

Alcohol and Prescription opiate abuse: Responsibilities of Stakeholders to reduce the problem. Thomas Kosten MD

Alcohol and Prescription opiate abuse: Responsibilities of Stakeholders to reduce the problem. Thomas Kosten MD Alcohol and Prescription opiate abuse: Responsibilities of Stakeholders to reduce the problem Thomas Kosten MD Waggoner Chair & Professor of Psychiatry & Neuroscience Baylor College of Medicine Past-President,

More information

Healing the Addicted Brain Innovative Addiction Support and Treatment. Harold C. Urschel III MD, MMA Chief Medical Strategist - Enterhealth

Healing the Addicted Brain Innovative Addiction Support and Treatment. Harold C. Urschel III MD, MMA Chief Medical Strategist - Enterhealth Healing the Addicted Brain Innovative Addiction Support and Treatment Harold C. Urschel III MD, MMA Chief Medical Strategist - Enterhealth 1 Credentials Author of The New York Times best seller, Healing

More information

Disclosure INTRODUCTION TO SUBSTANCE USE DISORDERS. Substances of Abuse. Substances of Abuse. Primary Substance Use Disorders

Disclosure INTRODUCTION TO SUBSTANCE USE DISORDERS. Substances of Abuse. Substances of Abuse. Primary Substance Use Disorders INTRODUCTION TO SUBSTANCE USE DISORDERS Disclosure Some slides courtesy of Dr. D. Charney Co-owner 38DTX private treatment center Ronald Fraser, MD, CSQP, FRCPC Assistant Professor McGill University Dalhousie

More information

Alcohol: The good, the bad and

Alcohol: The good, the bad and Alcohol: The good, the bad and the Clare Wilhelm, Ph.D. Portland VA Medical Center Oregon Health & Science University Supported by VA Career Development Grant (BX001294) Overview Alcohol statistics the

More information

Alcohol Abuse and Dependence in Native Americans

Alcohol Abuse and Dependence in Native Americans Alcohol Abuse and Dependence in Native Americans Its link to suicide and medication treatment options Addiction Psychiatrist Objectives Will discuss alcohol s role in suicide with the limited data we have.

More information

The Science of Addiction:

The Science of Addiction: The Science of Addiction: Why it s a bad idea to turn to drugs in times of stress Regina M. Carelli, PhD Stephen B. Baxter Distinguished Professor Department of Psychology & Neuroscience The University

More information

Medications Used in the Treatment of Addiction Developed by Randall Webber, MPH. Alcohol Withdrawal

Medications Used in the Treatment of Addiction Developed by Randall Webber, MPH. Alcohol Withdrawal Medications Used in the Treatment of Addiction Developed by Randall Webber, MPH Alcohol Withdrawal MEDICATION Long/intermediateacting benzodiazepines (e.g., chlordiazepoxide/ Librium, diazepam/valium)

More information

Terrence D. Walton, MSW, CSAC Director of Treatment Pretrial Services Agency for the District of Columbia

Terrence D. Walton, MSW, CSAC Director of Treatment Pretrial Services Agency for the District of Columbia Terrence D. Walton, MSW, CSAC Director of Treatment Pretrial Services Agency for the District of Columbia Terrencewalton@aol.com 1. Legal & Illicit it 1. Stimulants t 2. Street Drugs and Prescribed Drugs

More information

Cocaine. Like heroin, cocaine is a drug that is illegal in some areas of the world. Cocaine is a commonly abused drug.

Cocaine. Like heroin, cocaine is a drug that is illegal in some areas of the world. Cocaine is a commonly abused drug. Cocaine Introduction Cocaine is a powerful drug that stimulates the brain. People who use it can form a strong addiction. Addiction is when a drug user can t stop taking a drug, even when he or she wants

More information

Substance Addiction. A Chronic Brain Disease

Substance Addiction. A Chronic Brain Disease Substance Addiction A Chronic Brain Disease What you will Learn Addiction is a Brain Disease Understand the Structure and Pathways Associated with changes in the brain. Addiction is a Chronic Condition

More information

Downers/Depressants (pages 40-50)

Downers/Depressants (pages 40-50) Downers/Depressants (pages 40-50) Read pages 49-54, 59-60, and 78-79 of the booklet, Street Drugs. Pages 40-50 of the text. Narcotics: Prescription Origin: Southeast Asia, Southwest Asia, and in the Western

More information

What Can Science Contribute to the Treatment of Alcoholism?

What Can Science Contribute to the Treatment of Alcoholism? What Can Science Contribute to the Treatment of Alcoholism? George F. Koob, Ph.D. Director National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Flow of Talk 1. Conceptual Framework

More information

Gabapentin Treatment for Alcohol Dependence: A Randomized Clinical Trial

Gabapentin Treatment for Alcohol Dependence: A Randomized Clinical Trial Gabapentin Treatment for Alcohol Dependence: A Randomized Clinical Trial Barbara J. Mason, Ph.D. Professor, Committee on the Neurobiology of Addictive Disorders Director, Laboratory of Clinical Psychopharmacology

More information

Getting Older ]Wiser: safer drinking. as you age. Massachusetts Department of Public Health Office of Healthy Aging

Getting Older ]Wiser: safer drinking. as you age. Massachusetts Department of Public Health Office of Healthy Aging Massachusetts Department of Public Health Office of Healthy Aging Getting Older ]Wiser: safer drinking as you age Do you drink alcohol even just one drink now and then? Are you over 50? Do you ever take

More information

SUBSTANCE ABUSE SCREENING

SUBSTANCE ABUSE SCREENING OVERVIEW Substance abuse in the elderly is a common problem that is frequently under- diagnosed by primary care doctors and families. Alcohol abuse is present in 10% to 15% of elderly individuals who seek

More information

a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes einforcement

a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes einforcement Drug Abuse (chapter 18) 1. Definitions iti a. positive vs. negative reinforcement b. tolerance vs. sensitization c. drug classes 2. Neural Mechanisms of Re einforcement a. mesolimbic dopamine system b.

More information

What You Don t Know Can Harm You

What You Don t Know Can Harm You A L C OHOL What You Don t Know Can Harm You National Institute on Alcohol Abuse and Alcoholism National Institutes of Health U.S. Department of Health and Human Services If you are like many Americans,

More information

Opiate Addiction, Pharmacological Treatment Approaches CO-OCCURRING MENTAL HEALTH DISORDERS JOSEPH A. BEBO MA, CAGS, LADC1

Opiate Addiction, Pharmacological Treatment Approaches CO-OCCURRING MENTAL HEALTH DISORDERS JOSEPH A. BEBO MA, CAGS, LADC1 Opiate Addiction, Pharmacological Treatment Approaches CO-OCCURRING MENTAL HEALTH DISORDERS JOSEPH A. BEBO MA, CAGS, LADC1 Disclosure Statement Prevalence of Opioid Addiction 100 Individuals Die Every

More information

SC 215 FIGHTING DRUG ADDICTION WITH DRUGS. John Bush April 15, 2013

SC 215 FIGHTING DRUG ADDICTION WITH DRUGS. John Bush April 15, 2013 SC 215 FIGHTING DRUG ADDICTION WITH DRUGS John Bush April 15, 2013 ADDICTION A persistent, compulsive dependence on a behavior or substance Behavioral Compulsive shopping --Compulsive eating Compulsive

More information

Alcohol. Problems with drinking alcohol

Alcohol. Problems with drinking alcohol Alcohol Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol. If you are alcohol- dependent then

More information

Alcohol & Chemical Dependence. Chisoo Choi, M.D. Internal Medicine Consultant Brookhaven Hospital Tulsa, Oklahoma

Alcohol & Chemical Dependence. Chisoo Choi, M.D. Internal Medicine Consultant Brookhaven Hospital Tulsa, Oklahoma Alcohol & Chemical Dependence Chisoo Choi, M.D. Internal Medicine Consultant Brookhaven Hospital Tulsa, Oklahoma Objectives Increased awareness of alcohol and chemical dependence problems Hallmarks of

More information

EPIDEMIC 4.6 % OF INDIVIDUALS 18 25 USED PAIN RELIEVERS FOR NON-MEDICAL REASONS. 1.5 MILLION YOUNG ADULTS USED PAIN RELIEVERS IN THE PAST MONTH.

EPIDEMIC 4.6 % OF INDIVIDUALS 18 25 USED PAIN RELIEVERS FOR NON-MEDICAL REASONS. 1.5 MILLION YOUNG ADULTS USED PAIN RELIEVERS IN THE PAST MONTH. Drug Court EPIDEMIC In the 10 years (1997 2007) the per capita retail purchases of Methadone, Hydrocodone and Oxycodone in the United States increased 13-fold, 4-fold and 9-fold, respectively. 4.6 % OF

More information

The Brain, Behavior, and Addiction. Objectives. Advances in science have revolutionized our fundamental views of drug abuse and addiction.

The Brain, Behavior, and Addiction. Objectives. Advances in science have revolutionized our fundamental views of drug abuse and addiction. The Brain, Behavior, and Addiction Flo Hilliard University of Wisconsin-Madison Division of Continuing Studies Objectives Progress of science in addiction studies Why it is a brain disease Changing our

More information

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380

opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380 opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 ed #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380 effects of alcohol in the brain 100 Top 30 698 heroin addiction 100

More information

ASAM 101: How to complete the ASAM Placement Form

ASAM 101: How to complete the ASAM Placement Form ASAM 101: How to complete the ASAM Placement Form What is the ASAM? The ASAM Placement Form is a document required by contract The ASAM Form is an ASSESSMENT tool as well as a PLACEMENT tool It seeks to

More information

Produced and Published by The Cabin Chiang Mai, Alcohol and Drug Rehab Centre. Copyright 2013. and How is it Treated?

Produced and Published by The Cabin Chiang Mai, Alcohol and Drug Rehab Centre. Copyright 2013. and How is it Treated? and How is it Treated? 1 About this book This E-book has been produced as a guide to help explain some of the fundamental things you need to understand about addiction and its treatment, starting with

More information

Alcoholism and Problem Drinking

Alcoholism and Problem Drinking Page 1 of 5 Alcoholism and Problem Drinking Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol.

More information

Alcohol-use disorders: alcohol dependence. Costing report. Implementing NICE guidance

Alcohol-use disorders: alcohol dependence. Costing report. Implementing NICE guidance Alcohol-use disorders: alcohol dependence Costing report Implementing NICE guidance February 2011 (February 2011) 1 of 37 NICE clinical guideline 115 This costing report accompanies the clinical guideline:

More information

When alcohol is present in the brain for long periods as with long term heavy drinking the brain seeks to compensate for its effects.

When alcohol is present in the brain for long periods as with long term heavy drinking the brain seeks to compensate for its effects. U.S. Department of Health & Human Services National Institutes of Health National Institute on Alcohol Abuse and Alcoholism Num ber 77 Ap ril 2 00 9 NEUROSCIENCE: PATHWAYS TO ALCOHOL DEPENDENCE Why does

More information

Drugs, The Brain, and Behavior

Drugs, The Brain, and Behavior Drugs, The Brain, and Behavior John Nyby Department of Biological Sciences Lehigh University What is a drug? Difficult to define Know it when you see it Neuroactive vs Non-Neuroactive drugs Two major categories

More information

Substance Use Learning Event Nov 3, 2015 Bill Bullock MD, CCFP

Substance Use Learning Event Nov 3, 2015 Bill Bullock MD, CCFP Substance Use Learning Event Nov 3, 2015 Bill Bullock MD, CCFP Medical assessment of patient with Alcohol Use Disorder Identification patients suitable for home detox Process for referral to inpatient

More information

CLINICAL POLICY Department: Medical Management Document Name: Vivitrol Reference Number: NH.PHAR.96 Effective Date: 03/12

CLINICAL POLICY Department: Medical Management Document Name: Vivitrol Reference Number: NH.PHAR.96 Effective Date: 03/12 Page: 1 of 7 IMPORTANT REMINDER This Clinical Policy has been developed by appropriately experienced and licensed health care professionals based on a thorough review and consideration of generally accepted

More information

LESSON 5.7 WORKBOOK Is addiction a chronic disease?

LESSON 5.7 WORKBOOK Is addiction a chronic disease? DEFINITIONS OF TERMS Addiction is a disease idea that states drug addiction is no different from other chronic diseases, like diabetes and heart disease, and thus needs to be treated as a distinct medical

More information

PRESCRIPTION DRUG ABUSE prevention

PRESCRIPTION DRUG ABUSE prevention PRESCRIPTION DRUG ABUSE prevention Understanding Drug Addiction Many people do not understand how someone could abuse drugs even when their life seems to be falling apart. It is often assumed that those

More information

Treatment of Opioid Dependence with Buprenorphine/Naloxone (Suboxone )

Treatment of Opioid Dependence with Buprenorphine/Naloxone (Suboxone ) Treatment of Opioid Dependence with Buprenorphine/Naloxone (Suboxone ) Elinore F. McCance-Katz, M.D., Ph.D. Professor and Chair, Addiction Psychiatry Virginia Commonwealth University Neurobiology of Opiate

More information

Title: How to manage risky drinkers in Primary Health Care. Authors: Acknowledgements:

Title: How to manage risky drinkers in Primary Health Care. Authors: Acknowledgements: Title: How to manage risky drinkers in Primary Health Care Authors: Acknowledgements: This guide has been writen in accordance with the criteria of the PHEPA Training Programme on identification and brief

More information

Slide 1: Introduction Introduce the purpose of your presentation. Indicate that you will explain how the brain basically works and how and where

Slide 1: Introduction Introduce the purpose of your presentation. Indicate that you will explain how the brain basically works and how and where Slide 1: Introduction Introduce the purpose of your presentation. Indicate that you will explain how the brain basically works and how and where drugs such as heroin and cocaine work in the brain. Tell

More information

Treatment of Alcoholism

Treatment of Alcoholism Treatment of Alcoholism Why is it important Prevents further to body by getting people off alcohol. Can prevent death. Helps keep health insurance down. Provides assistance so alcoholics don t t have to

More information

SUBSTANCE USE DISORDER SOCIAL DETOXIFICATION SERVICES [ASAM LEVEL III.2-D]

SUBSTANCE USE DISORDER SOCIAL DETOXIFICATION SERVICES [ASAM LEVEL III.2-D] SUBSTANCE USE DISORDER SOCIAL DETOXIFICATION SERVICES [ASAM LEVEL III.2-D] I. Definitions: Detoxification is the process of interrupting the momentum of compulsive drug and/or alcohol use in an individual

More information

C. Chapman Sledge, MD, FASAM Chief Medical Officer. Nashville, TN

C. Chapman Sledge, MD, FASAM Chief Medical Officer. Nashville, TN ANATOMY OF RELAPSE C. Chapman Sledge, MD, FASAM Chief Medical Officer Cumberland Heights Nashville, TN chapman_sledge@cumberlandheights.org 250 200 150 100 50 0 We're addicted to rehab. It doesn't even

More information

GUIDELINES FOR COMMUNITY ALCOHOL DETOXIFICATION IN SHARED CARE

GUIDELINES FOR COMMUNITY ALCOHOL DETOXIFICATION IN SHARED CARE GUIDELINES FOR COMMUNITY ALCOHOL DETOXIFICATION IN SHARED CARE Dr Millicent Chikoore MBBS MRCPsych Dr O Lagundoye MBBS MRCPsych Community based alcohol detoxification is a safe and effective option for

More information

FAQ' s on Alcohol Abuse and Alcoholism

FAQ' s on Alcohol Abuse and Alcoholism FAQ' s on Alcohol Abuse and Alcoholism It is important to understand that these answers are not meant to provide specific medical advice, but to provide information to better understand the health consequences

More information

Pharmacological Management of Alcohol Dependence Syndrome

Pharmacological Management of Alcohol Dependence Syndrome Pharmacological Management of Alcohol Dependence Syndrome Cite as : Doyle, L. Keogh, B. & Lynch, A., Pharmacological Management of Alcohol Dependence Syndrome, Mental Health Practice, 14, (1), 2010, p14-19

More information

Like cocaine, heroin is a drug that is illegal in some areas of the world. Heroin is highly addictive.

Like cocaine, heroin is a drug that is illegal in some areas of the world. Heroin is highly addictive. Heroin Introduction Heroin is a powerful drug that affects the brain. People who use it can form a strong addiction. Addiction is when a drug user can t stop taking a drug, even when he or she wants to.

More information

ALCOHOLISM. getting the facts

ALCOHOLISM. getting the facts ALCOHOLISM getting the facts U.S. Department of Health and Human Services National Institutes of Health National Institute on Alcohol Abuse and Alcoholism ALCOHOLISM getting the facts For many people,

More information

Alcoholism and Problem Drinking

Alcoholism and Problem Drinking Page 1 of 5 Alcoholism and Problem Drinking Alcoholism is a word which many people use to mean 'alcohol dependence' (alcohol addiction). Some people are 'problem drinkers' without being dependent on alcohol.

More information

UNDERSTANDING CO-OCCURRING DISORDERS. Frances A. Campbell MSN, PMH CNS-BC, CARN Michael Beatty, LCSW, NCGC-1 Bridge To Hope November 18, 2015

UNDERSTANDING CO-OCCURRING DISORDERS. Frances A. Campbell MSN, PMH CNS-BC, CARN Michael Beatty, LCSW, NCGC-1 Bridge To Hope November 18, 2015 UNDERSTANDING CO-OCCURRING DISORDERS Frances A. Campbell MSN, PMH CNS-BC, CARN Michael Beatty, LCSW, NCGC-1 Bridge To Hope November 18, 2015 CO-OCCURRING DISORDERS What does it really mean CO-OCCURRING

More information

Dependence and Addiction. Marek C. Chawarski, Ph.D. Yale University David Metzger, Ph.D. University of Pennsylvania

Dependence and Addiction. Marek C. Chawarski, Ph.D. Yale University David Metzger, Ph.D. University of Pennsylvania Dependence and Addiction Marek C. Chawarski, Ph.D. Yale University David Metzger, Ph.D. University of Pennsylvania Overview Heroin and other opiates The disease of heroin addiction or dependence Effective

More information

Addiction: Disease or Choice?

Addiction: Disease or Choice? Addiction: Disease or Choice? Presented by Michael Coughlin RN October 18, 2012 Introduced by Melanie Willows B.Sc. M.D. C.C.F.P. C.A.S.A.M. C.C.S.A.M. Assistant Professor University Of Ottawa Clinical

More information

Understanding Addiction: The Intersection of Biology and Psychology

Understanding Addiction: The Intersection of Biology and Psychology Understanding Addiction: The Intersection of Biology and Psychology Robert Heimer, Ph.D. Yale University School of Public Health Center for Interdisciplinary Research on AIDS New Haven, CT, USA November

More information

Alcohol Use Disorder and Rrelated Comorbidities

Alcohol Use Disorder and Rrelated Comorbidities Main Conference Day 2 Panel l Date: 23 May 2013, Thursday Time: 0930hrs 1000hrs Alcohol Use Disorder and Rrelated Comorbidities Treatment in China Dr. Guo Song, MBBS, PhD Consultant Psychiatrist Head Research

More information

Emergencies Related to ETHANOL (ETOH) Alcohol

Emergencies Related to ETHANOL (ETOH) Alcohol University of Wisconsin Hospital and Clinics Emergency Education Center Emergencies Related to ETHANOL (ETOH) Alcohol Alcoholics are in all socio-economical levels of society ~ETOH is one of the most commonly

More information

Prior Authorization Guideline

Prior Authorization Guideline Prior Authorization Guideline Guideline: PDP IBT Inj - Vivitrol Therapeutic Class: Central Nervous System Agents Therapeutic Sub-Class: Opiate Antagonist Client: 2007 PDP IBT Inj Approval Date: 2/20/2007

More information

OVERVIEW OF MEDICATION ASSISTED TREATMENT

OVERVIEW OF MEDICATION ASSISTED TREATMENT Sarah Akerman MD Assistant Professor of Psychiatry Director of Addiction Services Geisel School of Medicine/Dartmouth-Hitchcock Medical Center OVERVIEW OF MEDICATION ASSISTED TREATMENT Conflicts of Interest

More information

THE BASICS. Community Based Medically Assisted Alcohol Withdrawal. World Health Organisation 2011. The Issues 5/18/2011. RCGP Conference May 2011

THE BASICS. Community Based Medically Assisted Alcohol Withdrawal. World Health Organisation 2011. The Issues 5/18/2011. RCGP Conference May 2011 RCGP Conference May 2011 Community Based Medically Assisted Alcohol Withdrawal THE BASICS An option for consideration World Health Organisation 2011 Alcohol is the world s third largest risk factor for

More information

Alcohol withdrawal A challenge in caring for patients after heart surgery

Alcohol withdrawal A challenge in caring for patients after heart surgery Abteilung Praxisentwicklung Pflege Alcohol withdrawal A challenge in caring for patients after heart surgery Wolfgang Hasemann, RN, PhD Deborah Leuenberger, MScN.cand. June 2015 Content Alcohol consumption

More information