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Medication KindlinG

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Traditional Psychiatric Approach Excessive drinking is a deviant pattern of behavior which is secondary to an ... they will not be at risk for addictive ... – PowerPoint PPT presentation

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Title: Medication KindlinG


1
It doesnt take a lot of sense to stay sober.it
just takes all youve got!
Dr John Mooney 1910 -1983
2
Thank You
  • I would like to thank the staff of CAPTASA
    for allowing me the opportunity to present this
    information. I continue to believe that CAPTASA
    represents the finest gathering of committed
    addiction professional in existence today.
  • ( Sandy P. you know Burns cant help it !!)

3
Avoiding GoofBall pitfalls in Sobriety
  • Robert W. Mooney, MD

4
Thanks
  • I would like to thank District 32 of the Florida
    AA community for the willingness to request
    information on a subject that will become more
    important as newcomers become old-timers, then
    become really old-timers.

5
Financial Disclosure
  • I am employed at Vista Taos Renewal Center in
    Taos, New Mexico as Medical Director and
    Addiction Psychiatrist. They have supported my
    attendance at this presentation but have declined
    to present any information considered to be
    marketing materials. I will have contact
    information available for anyone having questions
    about information presented today.

6
Presentation Disclaimer
  • The information presented is considered by
    Alcoholics Anonymous to be an outside issue. AA
    encourages cooperation with medical and
    psychiatric professionals when needed. However,
    the number of medications that have the potential
    to threaten recovery has increased dramatically
    over the past several decades. This presentation
    is meant to be informative only. Please see your
    personal physician about any questions which may
    be raised concerning your medical condition.
  • Thank You

7
Bills Writing on Medications
Morphine, codeine, chloral hydrate, Luminal,
Seconal, Nebutal, amytal, these and kindred drugs
have killed many alcoholics. And I once nearly
killed myself with chloral hydrate. Nor is my own
observation and experience unique, for many an
old-time AA can speak with force and fervor on
the subject of goof balls. Language of
the Heart 1945
Bill Wilson 1895 - 1971
8
Bills Writing on Medications
Some of us, perfectly sober for months or years,
contract the habit of using sedatives to cure
insomnia or slight nervous irritability. I have
the impression that some of us get away with it,
year after year, just as we did when we first
began to drink alcohol. Yet experience shows, all
too often, than even the controlled pill taker
may get out of control. The same crazy
rationalizations that once characterized his
drinking begin to blight his existence. He thinks
that if pills can cure insomnia so may they cure
his worry.
Language of the Heart 1945
9
Bills Writing on Medications
  • Our friends the doctors are seldom directly to
    blame for the dire results we so often
    experience. It is much too easy for alcoholics to
    buy these dangerous drugs, and once possessed of
    them the drinker is often likely to use them
    without any judgment whatever.

  • Grapevine 1945

10
The Doctors Opinion
  • More often than not it is imperative that a
    mans brain be cleared before he is approached,
    as he has then a better chance of understanding
    and accepting what we have to offer.
  • William
    Silkworth, MD
  • Alcoholics Anonymous

11
Cooperation
  • Try to remember that though God has wrought
    miracles among us, we should never belittle a
    good doctor or psychiatrist. Their services are
    often indispensable in treating a newcomer and in
    following his case afterward.

  • The Family Afterward

  • Alcoholics Anonymous

12
What Do You Believe?
  • Traditional Psychiatric Approach
  • Excessive drinking is a deviant pattern of
    behavior which is secondary to an underlying
    emotional or mental disorder..

13
What Do You Believe?
  • Traditional Psychiatric Approach
  • if the underlying emotional or mental disorder
    is properly diagnosed and treated, then the
    deviant behavior pattern of drinking will resolve
    and normal drinking behavior will ensue.

14
What Do You Believe?
  • Traditional Psychiatric Approach
  • Excessive drinking is a deviant pattern of
    behavior which is secondary to an underlying
    emotional or mental disorder..
  • if the underlying emotional or mental disorder
    is properly diagnosed and treated, then the
    deviant behavior pattern of drinking will resolve
    and normal drinking behavior will ensue.

15
  • The idea that somehow, someday he will control
    and enjoy his drinking is the great obsession of
    every abnormal drinker.
  • Alcoholics Anonymous Chap 3 Page
    30

16
What Do You Believe?
  • An almost allergic like response in roughly 1 out
    of 10 individuals to chemicals which change brain
    activity and reward systems. This response can be
    immediate, such as cravings. Or, it can be more
    gradual where thinking and perceptions become
    altered such that motivation for sobriety
    decreases and they return to previous patterns of
    behavior linked to drug of choice.

17
What Do You Believe?
  • Because this type of response does not occur in
    the other 90 per cent of the population, they
    will not be at risk for addictive complications,
    they usually wont take what they are given
    anyway!
  • The previous 10 per cent is the focus of this
    presentation. What constitutes a hazardous
    substance for them?

18
Hazardous Drugs
  • Hazardous Drugs are those substances which in our
    experience have contributed to relapse. Our 50
    years of experience have shown this to include
    most if not all CNS active substances.

19
Sources
  • Recreational/Street Drugs
  • Prescription/Pharmaceutical Drugs
  • Over The Counter/Dietary Supplements

20
Hazardous Medical Procedures
  • Dental Procedures Nitrous Oxide, local
    anesthetic with epinephrine, Rx
  • Diagnostic Procedures Versed, propofol,
    Fentanyl
  • Surgery Adverse brain effects last for about 3
    months following general anesthesia.
  • Pregnancy OBs like their patients calm.

21
In addicts, doses of drugs that are too low to
produce any conscious recognition that they
received drugs are still capable of inducing
changes in the brain and influencing
behavior
Mark S. Gold, MD
Dept of Psychiatry University
of Florida
22
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27
Willingway Tranquilizer Rule
There are two types of tranquilizers
habit-forming and non habit-forming. The
habit-forming ones are the old ones and the non
habit-forming ones are the new ones. When the new
ones become old, they become habit-forming and
are replaced by new non habit-forming ones.
28
Approved Medications
  • Antabuse
  • Methadone
  • Buprenorphine (Suboxone/Subutex)
  • Naltrexone (Revia/Vivitrol)
  • Acamprasate (Campral)

29
Medications Used in Addiction Medicine
  • Prozac
  • Effexor
  • Paxil
  • Cymbalta
  • Zoloft
  • Trazodone
  • Depakote
  • Neurontin
  • Klonopin
  • Xanax
  • Ultram
  • Soma
  • Adderal
  • Concerta
  • Lithium
  • Seroquel
  • Abilify
  • Geodon
  • Zofran

30
Psychiatric Training
  • Increase Meds
  • Change Meds
  • Add Meds

31
  • Once you have committed to a chemical
    solution, it is almost impossible to revert to a
    spiritual solution.

32
Problem Child of History
  • Alcoholics and more recently drug addicts have
    been resistant to cures since earliest
    recordings of history. The Bible records cases of
    alcoholism but no cure. Early medical attempts
    included Typhoid treatment, VD cures, ice baths,
    insane asylums, lobotomy and electro-convulsive
    therapy. Then something occurred in 1941 which
    has changed everything

33
Prior to 1941 alcoholism relied primarily on
psychiatrists and mental institutions for
treatment which was mostly ineffective.
34
Where Are We Heading?
  • There is rush to develop strategies and
    pharmaceutical agents to treat alcohol/drug
    addiction at the expense of 12 step programs. The
    expectation of changes in delivery of healthcare
    will increase the pressure from pharmaceutical
    and insurance companies as a result of the
    billions of dollars which are at stake. The
    belief that 12 Step recovery is ineffective will
    push healthcare providers to encourage
    alternative approaches, which may in fact
    increase risks of failure in continued sobriety.

35
Research Intent
  • ADial is developing compounds that affect the
    reward center of the brain, thereby decreasing
    the craving for alcohol and reducing alcohol
    consumption. Our medications appear to be
    effective based on a combination of an ability to
    leverage propriety targeted genetic efforts with
    synergistic treatment mechanisms targeting
    multiple neurological pathways in the brain,
    thereby enhancing efficacy while reducing side
    effects. In addition, our compounds can be given
    to patients currently drinking, no abstinence
    prior to treatment required. This significant
    improvement not only increases access to
    treatment it increases the likelihood of
    success, which can now be measured as a reduction
    in alcohol consumption and control over ones
    drinking.
  • Adial Pharmaceuticals
  • Bankole Johnson, MD

36
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38
Stuart Gitlow, MD
  • There are risks in leading the patient to
    believe that a pill or injection can save them
    from an illness where that patient mistakenly has
    believed that problems can be cured by taking
    something.

39
  • It doesnt take a lot of sense to stay sober
    It just takes all youve got !!!
  • Dr. John
    Mooney
  • Founder
    Willingway Hospital

40
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41
I would like to thank my parents, Dot and Dr.
John Mooney who believed in what they saw and
gave me an opportunity to be part of an amazing
experience that one day may no longer exist.
I hope we never forget.
42
Resources
  • Anatomy of an Epidemic Magic Bullets,
    Psychiatric Drugs, and the Astonishing Rise of
    Mental Illness in America by Robert Whitaker
  • Mad in America by Robert Whitaker
  • A Voice from the Wilderness by Andrew D. Bennett
    (Article in March/April issue of Addiction
    Professional)

43
You can read, study and learn everything about
alcoholism but if you cant laughyoure screwed!
44
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45
Vista Taos Renewal Center
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