Neurobiology and Treatment of Opioid Dependence. Nebraska MAT Training September 29, 2011
|
|
- Rosa Lindsey
- 5 years ago
- Views:
Transcription
1 Neurobiology and Treatment of Opioid Dependence Nebraska MAT Training September 29, 2011
2 Top 5 primary illegal drugs for persons age entering treatment, % Heroin or Prescription Opioids are the primary drug of abuse for more than 1 in 4 persons age seeking treatment COCAINE MARIJUANA HEROIN/OPIOIDS METHAMPHETAMINE 5 0 TEDS A
3 % of persons coming to treatment for heroin addiction by age year olds are the largest group represented among persons seeking treatment for heroin or opioid abuse, nearly 40%. 1: : : : : 50+ TEDS A
4 Prior treatment episodes for persons starting treatment for heroin dependence, None or more SAMHSA (2009) Treatment Episodes Data Set.
5 History of MAT for heroin dependence 1806 Scientists isolate morphine from opium 1820 Scientists isolate codeine from opium 1853 Introduction of the hypodermic syringe 1898 introduction of heroin Late 1800s marketing of opioid based patent medicines
6 History of MAT for heroin dependence 1919 The Harrison Act and its interpretation 1929 Congress establishes narcotics hospitals at Lexington and Fort Worth over 90% relapse rate 1964 Mary Nyswander and Vincent Dole experiment with methadone
7 Primary virtues of Methadone Long acting so that with a daily dose, a steady state of active opioids can be achieved Eliminates or severely reduces opioid craving At proper doses, it can create an opioid blockade through cross tolerance People with opioid addiction can focus on the rest of their lives
8 2002 Buprenorphine (Suboxone /Subutex ) Long acting so that with a daily dose, a steady state of active opioids can be achieved Eliminates or severely reduces opioid craving At proper doses, it can create an opioid blockade through antagonist effect A ceiling effect makes buprenorphine safer than methadone in preventing respiratory depression
9 Myth # 2: Methadone and Buprenorphine ( replacement medications ) just maintain a person s addiction Reality: Methadone and Buprenorphine stabilize a client and free up their cognitive and intentional resources so that they can begin to engage in treatment
10 Heroin Addiction INTOXICATION WITHDRAWAL
11 Buprenorphine or Methadone Maintenance INTOXICATION WITHDRAWAL
12 What s the difference between addiction and physical dependence?
13 Cycle of Addiction PANICKED DRUG SEEKING LYING, CHEATING, STEALING DRUG USE PHYSICAL RELIEF GUILT / SHAME RECALL OF CONSEQUENCES RECALL OF GOOD INTENTIONS FEELING OF HELPLESSNESS LOSS OF CONTROL WITHDRAWAL LOSS OF COGNITIVE CONTROL COMPROMISED VALUES COMPROMISED INTENTIONS AMNESIA RE: CONSEQUENCES RATIONALIZATION OF USE CRAVING DECREASING WELL BEING INCREASING STRESS MENTAL OBSESSION
14 Myth # 3: A person is not really in recovery if they re relying on medications Reality: A person is in recovery when they re doing what they have to do one day at a time to avoid relapsing to the destructive cycle of addiction
15 Effect of Stigma on Client Success I m I m succeeding failing MAKE Engage THIS with FEELING others in GO treatment AWAY USE Continue DRUGS/ working ALC the program Depression/Shame Confidence / CRAVINGS happiness I am defective Receiving maintenance tx
16 Methadone Maintenance reduces crime The Effectiveness of Methadone Maintenance Treatment (p. 182), by J. C. Ball and A. Ross, 1991, New York: Springer-Verlag.
17 SUBOXONE facilitates client engagement by reducing cravings and preventing withdrawal Percentage Participants completing 28 day treatment Participants who initiated naltrexone treatment 10 0 Buprenorphine Treatment Group Clonidine Marsch, L.A., et al. Comparison of pharmacological treatments for opioid dependent adolescents: A randomized controlled trial. Archives of General Psychiatry 62(10): , 200
18 SAMHSA Guidelines (TIP 40, 43) Treatment with Buprenorphine Phase 1: Induction (1 week) Phase 2: Stabilization (1 2 months) Phase 3: Maintenance (ongoing) Phase 4: Medically Supervised Withdrawal optional (3 days to several weeks) Phase 5: Continued care (ongoing)
19 Goal Induction Phase (short acting opioids) To find the minimum dose of methadone or buprenorphine at which the patient 1. discontinues or markedly diminishes use of other opioids 2. experiences no withdrawal symptoms, minimal or no side effects, and no uncontrollable cravings for drugs of abuse
20 Stabilization Phase (1 2 Months) Medical Treatment Weekly assessments Dosing adjustments as needed Goals Elimination of objective evidence of opioid use (negative drug screens) Reduced self reported cravings and illicit opioid use Self reported increase in opioid blockade such that self administered illicit opioids induce little or no euphoria
21 Maintenance Phase (indefinite) Some issues to address in treatment* Psychiatric comorbidity Somatic consequences of drug use Family and support issues Structuring of time in pro social activities Employment and financial issues Legal consequences of drug use Other drug and alcohol abuse *Detailed treatment goals and phases available in TIP 43
22 Medically Supervised Withdrawal optional (3 days to several weeks) Criteria for Medically Supervised Withdrawal Patient s desire to commence dose reduction Patient s commitment to becoming medication free Physician s confidence that tapering would be successful
23 Medically Supervised Withdrawal optional (3 days to several weeks) Factors that should generally precede Medically Supervised Withdrawal Extensive period of abstinence from illegal drugs and alcohol (1 2 years) Stable housing Stable source of income No untreated or unstable co occurring psychiatric disorders Engagement in productive activity (e.g. employment, school, volunteering) Adequate psychosocial support Absence of legal problems
24 Medically Supervised Withdrawal (3 days to several weeks) Rate of Dose Reduction Reduction should be done gradually at a predetermined period or at a rate negotiated by the patient and the physician together Rapid dose reduction should be performed only in the presence of a compelling urgency (e.g. impending incarceration, foreign travel, job requirement)
25 Continued Care (ongoing) After Medically Supervised Withdrawal Patients should be followed with psychosocial services Naltrexone/Vivitrol can be used as a key relapse prevention strategy Methadone or buprenorphine should be reintroduced if needed for continued progress
26 Naltrexone and Vivitrol 1950 s Abraham Wikler observes the phenomenon of conditioned withdrawal 1960 s Experiments with antagonist therapy cyclazocine 1971 President Nixon creates the Special Action Office for Drug Abuse Prevention 1972 Congress puts aside money to research nonaddictive anti craving medications 1984 FDA approves naltrexone for opioid dependence 2010 FDA approves 28 depot naltrexone (Vivitrol ) for opioid dependence
27 Medications of Opioid Addiction Methadone agonist Suboxone partial agonist Naltrexone antagonist Vivitrol 28 day injection of naltrexone
28 Methadone activates the opioid receptors to prevent withdrawal and prevents a person from getting high through cross tolerance
29 Suboxone activates the opiate receptors to prevent withdrawal and acts as an antagonist to other opioid agonists, blocking their effect
30 With both, the ADDICTION is curtailed through reduction in craving and compulsion, but physical dependence remains
31 Naltrexone and Vivitrol block opiate receptors to prevent an opiate high but do not activate the receptors
32 Naltrexone and Vivitrol prevent reinforcement of addictive drugs without causing physical dependence
33 VIVITROL reduces client cravings, prevents reactivation of addiction and leads to improved treatment retention (All participants received twice weekly relapse prevention therapy) Comer, Sandra D., et al. Injectable, sustained release naltrexone for the treatment of opioid dependence. Archives of General Psychiatry 63(2): , 2006.
34 % Opioid free weeks in 6 months
35 Limitations of Vivitrol No natural reward Compliance is based entirely on internal motivation Risk of overdose after medication is discontinued Client must be completely opioid free prior to naltrexone induction
36 Typical Suboxone taper 2 8 weeks No INCREASED self transportation No STRUCTURE cash available AND 24 hour ACCOUNTABILITY companionship 8mg (5 14 days) 6mg (5 14 days) 4mg (5 14 days) 2mg (5 14 days) Detox 4 days 1/16 1/8 1/4 1/2 Typical Naltrexone taper 3 7 days Full tablet (2 days) Vivitrol injection
37 Which is the best medication? As with any chronic disease or disorder, the correct medication depends on the characteristics of the patient as well as their stage of treatment
38 Ongoing Assessment 12 Motivation METHADONE Strongest drug reward Highest level of accountability SUBOXONE Moderate drug reward Moderate level of accountability VIVITROL No drug reward Moderate level of accountability Stability
39 Principles of Individualized MAT 1. Educate regarding options. 2. Assess motivation and stability. 3. Provide a clinical opinion 4. Support client in developing a treatment plan with concrete goals.
40 Myth # 5: Eventually I ll have to be strong enough to do it without medication! Reality: Often chronic illnesses such as addiction require chronic medication management to prevent relapse
41 The world without medication
42 The world with medication
43 Myth # 4: When individuals are detoxified and abstinent through incarceration, they don t need medical treatment upon release. Reality: Release from prison can be a death sentence for persons with untreated addiction
44 REASONING REWARD PROCESSING STRESS RESPONSE EMOTION MEMORY
45 Mortality after release from prison RR=12 RR=Relative Risk RR=4 RR=3.2 Binswanger IA et al. N Engl J Med 2007;356:
46 Myth # 6: Addiction can best be treated with an intensive treatment episode followed by mutual support participation Reality: The episodic model of addiction treatment does not do justice to the chronic nature of the illness
47 Lifelong Diabetes Relapse Prevention Long term Regular doctor s recovery visits requires ongoing Monitor Relapse blood Prevention glucose strategies levels Plan meals carefully Exercise / sleep regularly Monitor red flag symptoms (deterioration of vision, circulation) Treat related physical problems Take prescribed medication
48 Lifelong Addiction Relapse Prevention Regular support groups Monitor emotional well being Avoid high risk situations Exercise / sleep regularly Monitor red flag symptoms (cognitive distortions, isolation) Treat related psychological problems Take prescribed medication
49 Take Home Message An individualized chronic care model for the treatment of addiction, including a full range of available medications and client options is the key to improving treatment outcomes This is the same model of care that is used for every other chronic illness
Medication Assisted Treatment. Ned Presnall, MSW, LCSW May 17, 2014
Medication Assisted Treatment Ned Presnall, MSW, LCSW May 17, 2014 FRONTAL LOBE Consciousness Reasoning Planning Goals Values Sense of Self I NEED TO USE!!!!!!!!!!! FRONTAL LOBE Consciousness Reasoning
How To Treat Anorexic Addiction With Medication Assisted Treatment
Medication Assisted Treatment for Opioid Addiction Tanya Hiser, MS, LPC Premier Care of Wisconsin, LLC October 21, 2015 How Did We Get Here? Civil War veterans and women 19th Century physicians cautious
Considerations in Medication Assisted Treatment of Opiate Dependence. Stephen A. Wyatt, D.O. Dept. of Psychiatry Middlesex Hospital Middletown, CT
Considerations in Medication Assisted Treatment of Opiate Dependence Stephen A. Wyatt, D.O. Dept. of Psychiatry Middlesex Hospital Middletown, CT Disclosures Speaker Panels- None Grant recipient - SAMHSA
Medication-Assisted Treatment for Opioid Addiction
Medication-Assisted Treatment for Opioid Addiction This document contains a general discussion of medications approved by the U.S. Food and Drug Administration (FDA) for use in the treatment of opioid
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
Treatment of opioid use disorders
Treatment of opioid use disorders Gerardo Gonzalez, MD Associate Professor of Psychiatry Director, Division of Addiction Psychiatry Disclosures I have no financial conflicts to disclose I will review evidence
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
Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery
Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery Marvin D. Seppala, MD Chief Medical Officer Hazelden Betty Ford Foundation This product is supported by
Care Management Council submission date: August 2013. Contact Information
Clinical Practice Approval Form Clinical Practice Title: Acute use of Buprenorphine for the Treatment of Opioid Dependence and Detoxification Type of Review: New Clinical Practice Revisions of Existing
Using Drugs to Treat Drug Addiction How it works and why it makes sense
Using Drugs to Treat Drug Addiction How it works and why it makes sense Jeff Baxter, MD University of Massachusetts Medical School May 17, 2011 Objectives Biological basis of addiction Is addiction a chronic
Joel Millard, DSW, LCSW Dave Felt, LCSW
Joel Millard, DSW, LCSW Dave Felt, LCSW 1. Provide an overview of the effectiveness of medication assisted treatment, to include a discussion of the different types of medications and how they are used
Minimum Insurance Benefits for Patients with Opioid Use Disorder The Opioid Use Disorder Epidemic: The Evidence for Opioid Treatment:
Minimum Insurance Benefits for Patients with Opioid Use Disorder By David Kan, MD and Tauheed Zaman, MD Adopted by the California Society of Addiction Medicine Committee on Opioids and the California Society
Buprenorphine Therapy in Addiction Treatment
Buprenorphine Therapy in Addiction Treatment Ken Roy, MD, FASAM Addiction Recovery Resources, Inc. River Oaks Hospital Tulane Department of Psychiatry www.arrno.org Like Minded Doc What is MAT? Definition
Medication-Assisted Addiction Treatment
Medication-Assisted Addiction Treatment Molly Carney, Ph.D., M.B.A. Executive Director Evergreen Treatment Services Seattle, WA What is MAT? MAT is the use of medications, in combination with counseling
ARCHIVED BULLETIN. Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E
BULLETIN INTELLIGENCE Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E NDIC Within the past 2 years buprenorphine a Schedule III drug has been made available for use
Integrating Medication- Assisted Treatment (MAT) for Opioid Use Disorders into Behavioral and Physical Healthcare Settings
Integrating Medication- Assisted Treatment (MAT) for Opioid Use Disorders into Behavioral and Physical Healthcare Settings All-Ohio Conference 3/27/2015 Christina M. Delos Reyes, MD Medical Consultant,
Opioid Agonist Therapy: The Duration Dilemma Edwin A. Salsitz, MD, FASAM Mount Sinai Beth Israel, New York, NY March 10, 2015
Q: I have read 40 mg of methadone stops withdrawal, so why don t we start at 30mg and maybe later in the day add 10mg? A: Federal Regulations stipulate that 30mg is the maximum first dose in an Opioid
The ABCs of Medication Assisted Treatment
The ABCs of Medication Assisted Treatment J E F F R E Y Q U A M M E, E X E C U T I V E D I R E C T O R C O N N E C T I C U T C E R T I F I C A T I O N B O A R D The ABCs of Medication Assisted Treatment
Heroin Overdose Trends and Treatment Options. Neil A. Capretto, D.O., F.A.S.A.M. Medical Director
Heroin Overdose Trends and Treatment Options Neil A. Capretto, D.O., F.A.S.A.M. Medical Director Type date here www.gatewayrehab.org Drug Overdose Deaths Increasing in Allegheny County Roberta Lojak holds
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
Developing Medications to Treat Addiction: Implications for Policy and Practice. Nora D. Volkow, M.D. Director National Institute on Drug Abuse
Developing Medications to Treat Addiction: Implications for Policy and Practice Nora D. Volkow, M.D. Director National Institute on Drug Abuse Medications Currently Available For Nicotine Addiction Nicotine
Buprenorphine/Naloxone Maintenance Treatment for Opioid Dependence
Buprenorphine/Naloxone Maintenance Treatment for Opioid Dependence Information for Family Members Family members of patients who have been prescribed buprenorphine/naloxone for treatment of opioid 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
Medication-Assisted Treatment for Opiate Addiction and the Public Financing of that Treatment
Medication-Assisted Treatment for Opiate Addiction and the Public Financing of that Treatment Introduction March 3, 2008 By: Suzanne Gelber, MSW, Ph.D., Managing Partner, The Avisa Group Defining Characteristics
Substitution Therapy for Opioid Dependence The Role of Suboxone. Mandy Manak, MD, ABAM, CCSAM Methadone 101-Hospitalist Workshop, October 3, 2015
Substitution Therapy for Opioid Dependence The Role of Suboxone Mandy Manak, MD, ABAM, CCSAM Methadone 101-Hospitalist Workshop, October 3, 2015 Objectives Recognize the options available in treating opioid
Information for Pharmacists
Page 43 by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. Information for Pharmacists SUBOXONE (buprenorphine HCl/naloxone HCl
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 1-800-662-HELP(4357)
Suboxone Programs: Treating Opioid Dependence in CHCs Andrew Putney, MD Medical Director SSTAR ATS and CHC, Fall River, Massachusetts
Suboxone Programs: Treating Opioid Dependence in CHCs Andrew Putney, MD Medical Director SSTAR ATS and CHC, Fall River, Massachusetts Educational Objectives: Review epidemiology of opioid addiction in
TENNESSEE BOARD OF MEDICAL EXAMINERS POLICY STATEMENT OFFICE-BASED TREATMENT OF OPIOID ADDICTION
TENNESSEE BOARD OF MEDICAL EXAMINERS POLICY STATEMENT OFFICE-BASED TREATMENT OF OPIOID ADDICTION The Tennessee Board of Medical Examiners has reviewed the Model Policy Guidelines for Opioid Addiction Treatment
MEDICALLY SUPERVISED OPIATE WITHDRAWAL FOR THE DEPENDENT PATIENT. An Outpatient Model
MEDICALLY SUPERVISED OPIATE WITHDRAWAL FOR THE DEPENDENT PATIENT An Outpatient Model OBJECTIVE TO PRESENT A PROTOCOL FOR THE EVALUATION AND TREATMENT OF PATIENTS WHO ARE CHEMICALLY DEPENDENT ON OR SEVERLY
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
Opioid Treatment Services, Office-Based Opioid Treatment
Optum 1 By United Behavioral Health U.S. Behavioral Health Plan, California Doing Business as OptumHealth Behavioral Solutions of California ( OHBS-CA ) 2015 Level of Care Guidelines Opioid Treatment Services,
MEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION
MEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION Sidarth Wakhlu,M.D. Addiction Team Leader North Texas VA Health Care System Addiction Psychiatry Fellowship Director Associate Professor Of Psychiatry
EPIDEMIOLOGY OF OPIATE USE
Opiate Dependence EPIDEMIOLOGY OF OPIATE USE Difficult to estimate true extent of opiate dependence Based on National Survey of Health and Mental Well Being: 1.2% sample used opiates in last 12 months
Opioid overdose can occur when a patient misunderstands the directions
Facts About Opioid Overdose How Does an Overdose Occur? Opioid overdose can occur when a patient misunderstands the directions for use, accidentally takes an extra dose, or deliberately misuses a prescription
Opioid/Opiate Dependent Pregnant Women
Opioid/Opiate Dependent Pregnant Women The epidemic, safety, stigma, and how to help. Presented by Lisa Ramirez MA,LCDC & Kerby Stewart MD The prescription painkiller epidemic is killing more women than
5317 Cherry Lawn Rd, Huntington, WV 25705 Phone: (304) 302-2078 Fax: (304) 302-0279. Welcome
5317 Cherry Lawn Rd, Huntington, WV 25705 Phone: (304) 302-2078 Fax: (304) 302-0279 Welcome Welcome to Starlight Behavioral Health Opiate Dependence program. At Starlight, we believe that addiction is
Ohio Legislative Service Commission
Ohio Legislative Service Commission Bill Analysis Brian D. Malachowsky H.B. 378 130th General Assembly () Reps. Smith and Sprague BILL SUMMARY Prohibits a physician from prescribing or personally furnishing
Update on Buprenorphine: Induction and Ongoing Care
Update on Buprenorphine: Induction and Ongoing Care Elizabeth F. Howell, M.D., DFAPA, FASAM Department of Psychiatry, University of Utah School of Medicine North Carolina Addiction Medicine Conference
Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction. Frequently Asked Questions
Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction Frequently Asked Questions What is Naltrexone? Naltrexone is a prescription drug that effectively blocks the effects of heroin, alcohol,
Medications for Alcohol and Drug Dependence Treatment
Medications for Alcohol and Drug Dependence Treatment Robert P. Schwartz, M.D. Medical Director Rschwartz@friendsresearch.org Friends Research Institute Medications for Alcohol Dependence Treatment Disulfiram
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
Non medical use of prescription medicines existing WHO advice
Non medical use of prescription medicines existing WHO advice Nicolas Clark Management of Substance Abuse Team WHO, Geneva Vienna, June 2010 clarkn@who.int Medical and Pharmaceutical role Recommendations
Use of Buprenorphine in the Treatment of Opioid Addiction
Use of Buprenorphine in the Treatment of Opioid Addiction Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Executive Summary Which of the following is an
Frequently asked questions
Naltrexone Pellet Treatment for Opiate, Heroin, and Alcohol Addiction Frequently asked questions What is Naltrexone? Naltrexone is a prescription drug that completely blocks the effects of all opioid drugs
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
One example: Chapman and Huygens, 1988, British Journal of Addiction
This is a fact in the treatment of alcohol and drug abuse: Patients who do well in treatment do well in any treatment and patients who do badly in treatment do badly in any treatment. One example: Chapman
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
Applicant Webinar for BJA s Drug Court Discretionary Grant Solicitation
Applicant Webinar for BJA s Drug Court Discretionary Grant Solicitation Cynthia Caporizzo, Senior Criminal Justice Advisor, Office of National Drug Control Policy (ONDCP) - Review of the administration
BUPRENORPHINE TREATMENT
BUPRENORPHINE TREATMENT Curriculum Infusion Package (CIP) Based on the Work of Dr. Thomas Freese of the Pacific Southwest ATTC Drug Addiction Treatment Act of 2000 (DATA 2000) Developed by Mountain West
Conceptualizing and Integrating Medication Assistant Treatment into your Court s Armamentarium
Conceptualizing and Integrating Medication Assistant Treatment into your Court s Armamentarium Ted Parran JR. M.D. FACP Carter and Isabel Wang Professor of Medical Education CWRU School of Medicine tvp@case.edu
Prescriber Behavior, Pain Treatment and Addiction Treatment
Prescriber Behavior, Pain Treatment and Addiction Treatment Mary Fleming, M.S. Director, Office of Policy, Planning, and Innovation Substance Abuse and Mental Health Services Administration NGA Policy
Frequently Asked Questions (FAQ s): Medication-Assisted Treatment for Opiate Addiction
Frequently Asked Questions (FAQ s): Medication-Assisted Treatment for Opiate Addiction March 3, 2008 By: David Rinaldo, Ph.D., Managing Partner, The Avisa Group In this FAQ What medications are currently
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
Office-based Treatment of Opioid Dependence with Buprenorphine
Office-based Treatment of Opioid Dependence with Buprenorphine David A. Fiellin, M.D Professor of Medicine, Investigative Medicine and Public Health Yale University School of Medicine Dr. Fiellin s Disclosures
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.
Allyse Adams PC, LICDC Oriana House, Inc.
Allyse Adams PC, LICDC Oriana House, Inc. 98 Heroin Overdose Deaths from 1/1/2015-7/26/2015 Last year enough narcotic pain medicines were prescribed to supply 67 pills to every man, woman and child In
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
Testimony Engrossed House Bill 1101 Department of Human Services Senate Human Services Committee Senator Judy Lee, Chairman February 19, 2013
Testimony Engrossed House Bill 1101 Department of Human Services Senate Human Services Committee Senator Judy Lee, Chairman February 19, 2013 Chairman Lee, members of the Senate Human Services Committee,
Treatment for Addiction in the Community Reduces Drug Use, Crime and Recidivism
Treatment for Addiction in the Community Reduces Drug Use, Crime and Recidivism Richard A. Rawson, Ph.D, Professor Semel Institute for Neuroscience and Human Behavior David Geffen School of Medicine University
Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio
Governor s Cabinet Opiate Action Team Promoting Wellness and Recovery John R. Kasich, Governor Tracy J. Plouck, Director Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio November 14,
MAT Counselor Education Course Exam Questions Packet Part 1
MAT Counselor Education Course Exam Questions Packet Part 1 Course No: Course Title: Course Objective: MA-1901P1 Medication-Assisted Treatment (MAT) Counselor Education Course Part 1 Includes primer on
A prisoners guide to buprenorphine
A prisoners guide to buprenorphine 2 The Opium poppy In the land of far, far away the opium poppy grows. The seed pods of this poppy are scratched until they drip with a sticky resin called opium. Raw
Using Buprenorphine in an Opioid Treatment Program
Using Buprenorphine in an Opioid Treatment Program Thomas E. Freese, PhD Director of Training, UCLA Integrated Substance Abuse Programs Director, Pacific Southwest Addiction Technology Transfer Center
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?
Use of Vivitrol for Alcohol and Opioid Addiction
Use of Vivitrol for Alcohol and Opioid Addiction Ken Bachrach, Ph.D. Clinical Director, Tarzana Treatment Centers, Inc. kbachrach@tarzanatc.org What is Vivitrol? An injectable from of naltrexone, which
IN THE GENERAL ASSEMBLY STATE OF. Ensuring Access to Medication Assisted Treatment Act
IN THE GENERAL ASSEMBLY STATE OF Ensuring Access to Medication Assisted Treatment Act 1 Be it enacted by the People of the State of Assembly:, represented in the General 1 1 1 1 Section 1. Title. This
Ever wish you could... Quit using heroin? Protect yourself from HIV infection? Get healthier?
Ever wish you could... Quit using heroin? Protect yourself from HIV infection? Get healthier? Good News: Medical treatments called opioid (oh-pee-oyd) maintenance can help you! Injecting heroin puts you
Tufts Health Care Institute Program on Opioid Risk Management Pharmacotherapy for Prescription Opioid Addiction: Implications for Pain Management
Tufts Health Care Institute Program on Opioid Risk Management Pharmacotherapy for Prescription Opioid Addiction: Implications for Pain Management June 10 and 11, 2011 Executive Summary Introduction Opioid
Use of Pharmacotherapies by Substance Abuse Treatment Facilities
Use of Pharmacotherapies by Substance Abuse Treatment Facilities Cathie E. Alderks, PhD Substance Abuse and Mental Health Services Administration Department of Health and Human Services November 2007 1
Medication treatments for opioid use disorders
Medication treatments for opioid use disorders Summary for counties JUDITH MARTIN, Medical Director of Substance Use Services, San Francisco Department of Public Health Brief history of Methadone and Buprenorphine
The Need for Medication-Assisted Treatment (MAT)
Presenters Erin Hall MSOT Hon. Kyle B. Haskins Closed Doors or Welcome Mat? Opening the Way for Medication-Assisted Treatment in Family Drug Courts Oklahoma Specialty Court Conference Thursday September
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
Prior Authorization Guideline
Prior Authorization Guideline Guideline: CSD - Suboxone Therapeutic Class: Central Nervous System Agents Therapeutic Sub-Class: Analgesics and Antipyretics (Opiate Partial Agonists) Client: County of San
MEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION
MEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION Mark Fisher Program Administrator State Opioid Treatment Adminstrator Kentucky Division of Behavioral Health OBJECTIVES Learn about types of opioids and
OPIOIDS. Petros Levounis, MD, MA Chair Department of Psychiatry Rutgers New Jersey Medical School
OPIOIDS Petros Levounis, MD, MA Chair Department of Psychiatry Rutgers New Jersey Medical School Rutgers New Jersey Medical School Fundamentals of Addiction Medicine Summer Series Newark, NJ July 24, 2013
Medication is not a part of treatment.
Medication is not a part of treatment. Medication can be an effective part of treatment. Medication is used in the treatment of many diseases, including addiction. Medical decisions must be made by trained
Treatment and Interventions for Opioid Addictions: Challenges From the Medical Director s Perspective
Treatment and Interventions for Opioid Addictions: Challenges From the Medical Director s Perspective Dale K. Adair, MD Medical Director/Chief Psychiatric Officer OMHSAS 1 Treatment and Interventions for
Opioid Addiction and Methadone: Myths and Misconceptions. Nicole Nakatsu WRHA Practice Development Pharmacist
Opioid Addiction and Methadone: Myths and Misconceptions Nicole Nakatsu WRHA Practice Development Pharmacist Learning Objectives By the end of this presentation you should be able to: Understand how opioids
Putting Addiction Treatment Medications to Use: Lessons Learned
Putting Addiction Treatment Medications to Use: Lessons Learned George E. Woody, M.D. Laura McNicholas, M.D., Ph.D. Department of Psychiatry, University of Pennsylvania School of Medicine and Philadelphia
The Science of Addiction and Its Effective Treatment
The Science of Addiction and Its Effective Treatment Anne Arundel County Opioid Misuse and Overdose Symposium April 15, 2015 D. Andrew Tompkins, M.D. M.H.S. Agenda 1. Terminology a. Addiction versus Substance
DEVELOPING MANUFACTURING SUPPLYING. Naltrexone Implants. Manufactured by NalPharm Ltd WWW.NALPHARM.COM
DEVELOPING MANUFACTURING SUPPLYING Naltrexone Implants Background to Nalpharm NalPharm is a specialist pharmaceutical company supplying proprietary branded medications and generic drugs in the area of
Medication Assisted Treatment
Medication Assisted Treatment Tanya Hiser, MS, LPC State Opioid Treatment Authority Bureau Of Prevention, Treatment, & Recovery State of Wisconsin Elizabeth Collier, MSW, CSAC, ICS, LCSW TANF Best Practice
John R. Kasich, Governor Orman Hall, Director
John R. Kasich, Governor Orman Hall, Director 2 3 Epidemics of unintentional drug overdoses in Ohio, 1979-2011 1,2,3 1800 1600 1400 1200 1000 800 Prescription drugs are causing a larger overdose epidemic
2015 OPSC Annual Convention. syllabus. February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California
2015 OPSC Annual Convention syllabus February 4-8, 2015 Hyatt Regency Mission Bay San Diego, California FRIDAY, FEBRUARY 6, 2015: 9:30am - 10:30am Opioid Addiction and Buprenorphine Use * Presented by
Program Assistance Letter
Program Assistance Letter DOCUMENT NUMBER: 2004-01 DATE: December 5, 2003 DOCUMENT TITLE: Use of Buprenorphine in Health Center Substance Abuse Treatment Programs TO: All Bureau of Primary Health Care
Effective Treatment Strategies for Adolescent Heroin and Opiate Use. Chris Gleason, MA, CAADC, MAATP Director Rosecrance McHenry County
Effective Treatment Strategies for Adolescent Heroin and Opiate Use Chris Gleason, MA, CAADC, MAATP Director Rosecrance McHenry County Learning Objectives The unique challenges related to clinical work
The Federation of State Medical Boards 2013 Model Guidelines for Opioid Addiction Treatment in the Medical Office
The Federation of State Medical Boards 2013 Model Guidelines for Opioid Addiction Treatment in the Medical Office Adopted April 2013 for Consideration by State Medical Boards 2002 FSMB Model Guidelines
the facts about NALTREXONE
the facts about NALTREXONE for Treatment of Opioid Addiction It s not like I woke up one day when I was young and told myself, I wanna be a drug addict. I wanna ruin my life and ruin the lives of those
A G U I D E F O R U S E R S N a l t r e x o n e U
A GUIDE FOR USERS UNaltrexone abstinence not using a particular drug; being drug-free. opioid antagonist a drug which blocks the effects of opioid drugs. dependence the drug has become central to a person
PATHWAYS TO RECOVERY
PATHWAYS TO RECOVERY PATHWAYS TO RECOVERY When Faces & Voices of Recovery was launched in 2001, our founding goal was to celebrate and honor recovery in all of its diversity. We believe that everyone has
Pain, Addiction & Methadone
Pain, Addiction & Methadone A CHALLENGING INTERFACE METHADONE AND SUBOXONE OPIOID SUBSTITUTION CONFERENCE Objectives 2 Explore the interface between concurrent pain and addiction. Appreciate the challenges
From the street to the NICU. Richard Christensen, PA, CAS
From the street to the NICU Richard Christensen, PA, CAS Treatment works Truths Disconnect with pregnant women seeking treatment Disconnect between community and science Medication is not a stand-alone
FRN Research Report January 2012: Treatment Outcomes for Opiate Addiction at La Paloma
FRN Research Report January 2012: Treatment Outcomes for Opiate Addiction at La Paloma Background A growing opiate abuse epidemic has highlighted the need for effective treatment options. This study documents
The Use of Non-Opioid Pharmacotherapies. for the Treatment of Alcohol Dependence
M00K02 Alcohol and Drug Abuse Administration Department of Health and Mental Hygiene The Use of Non-Opioid Pharmacotherapies for the Treatment of Alcohol Dependence Introduction The 2011 Joint Chairmen
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.
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
Patients are still addicted Buprenorphine is simply a substitute for heroin or
BUPRENORPHINE TREATMENT: A Training For Multidisciplinary Addiction Professionals Module VI: Myths About the Use of Medication in Recovery Patients are still addicted Buprenorphine is simply a substitute
Opioid Replacement Therapy (ORT): Yes or No?
Opioid Replacement Therapy (ORT): Yes or No? Carl Christensen, MD, PhD, FASAM Associate Professor, Dept OB Gyn, WSU (retd) Medical Director, Addiction Medicine Services, DMC Past Chair, Michigan Health
Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office
Model Policy on DATA 2000 and Treatment of Opioid Addiction in the Medical Office April 2013 The recommendations contained herein were adopted as policy by the House of Delegates of the Federation of State