Summary: <p>Medication-Assisted Therapies for Addiction<br> Presented by: Dr. Dawn-Elise Snipes, Ph.D, LMHC, LPC-MHSP<br> Executive Director of AllCEUs.com</p> <p>An on-demand course based on this product is available for CEUs at <a href="https://www.allceus.com/member/cart/index/product/id/16/c/">https://www.allceus.com/member/cart/index/product/id/16/c/</a></p> <p>Objectives<br> ~ Discuss the purpose of long-term pharmacotherapy<br> ~ Identify pharmacotherapies for<br> ~ Smoking<br> ~ Alcohol<br> ~ Opioids<br> ~ Methadone<br> ~ Buprenorphine<br> ~ Cases<br> Why Medication Assisted Therapy<br> ~ Early Recovery<br> ~ Reduces cravings<br> ~ Provides increased self-efficacy and a greater sense of control<br> ~ Anxiety Reduction due to:<br> ~ May alleviate some of the anxiety/fear about relapsing<br> ~ Pharmacological effects of certain MATs<br> ~ May improve depressive symptoms by<br> ~ Enhancing hope and an sense of empowerment<br> ~ Pharmacological effects of certain MATs</p> <p>What is our Goal in Early Recovery<br> ~ Reduce Co-Occurring issues<br> ~ Identify and address vulnerabilities<br> ~ Improve overall health<br> ~ Sleep<br> ~ Nutrition<br> ~ Energy (exercise)<br> ~ Maintain abstinence<br> ~ Increase time to relapse<br> ~ Reduce intensity of binge if relapse occurs</p> <p>Clinical Use of Pharmacotherapy<br> ~ Part of comprehensive plan that addresses the following issues or problems:<br> ~ Emotional<br> ~ Cognitive<br> ~ Physical<br> ~ Social<br> ~ Occupational<br> ~ Environmental<br> ~ Not a substitute for counseling<br> ~ Works best in combination with psychosocial support<br> Co-Occurring Model of Addiction<br> ~ Co-Occurring Disorders are the Expectation<br> ~ Mood issues must be addressed to prevent relapse<br> ~ Relapse begins when thoughts/urges or behaviors return to “addicted” mindset<br> ~ Addictive behaviors were “learned” as a way to stop distress.<br> ~ Learned behaviors cannot be unlearned.<br> ~ Alternate behaviors and their consequences must be more rewarding than addictive behaviors and the consequences. (LT vs. ST)</p> <p>Drugs or No Drugs<br> No pharmacotherapy for most abused drugs<br> ◦ Stimulants<br> ◦ Hallucinogens (LSD, PCP, Ketamine, Dextromethorphan, Benadryl, Dramamine)<br> ◦ Inhalants<br> ◦ Marijuana<br> What is the function of…<br> ◦ Stimulants<br> ◦ Hallucinogens<br> ◦ Psychedelics (5HT2A); “state of empathetic wellbeing”<br> ◦ Dissociatives (reduces glutamate); altered pain perception, depressant; Ketamine, Dextromethorphan<br> ◦ Deliriants (reduces acetylcholine) Benadryl, Dramamine<br> ◦ Inhalants (Depressants)<br> ◦ Marijuana (increases dopamine); generally “relaxing,” pain relieving</p> <p>Drugs or No Drugs<br> Factors to consider<br> ◦ Cost<br> ◦ Availability<br> ◦ Side effects<br> ◦ Barriers<br> Workplace drug testing<br> Other meds taken<br> Incarceration<br> ◦ Motivation</p> <p>Barriers<br> ~ Stimatization<br> ~ Science vs. dogma<br> ~ Evidence-based treatment vs. “drugs for drug addicts”<br> ~ 12-Step groups<br> ~ Becoming more progressive<br> ~ Methadone Anonymous is alternative<br> ~ Counselors<br> ~ Different experiences and biases<br> ~ Payors<br> ~ Most payors require medication assisted therapy be “considered when available.”<br> What is the endpoint?<br> ~ Duration of most pharmacotherapy is not indefinite<br> ~ Months to years<br> ~ Goal is stabilization<br> ~ Flexibility<br> ~ Individualized<br> ~ Allow for relapse<br> Smoking Cessation Pharmacotherapy<br> ~ Replacement<br> ~ nicotine patches<br> ~ nicotine gum<br> ~ nicotine lozenges<br> ~ nic</p>
