S. Alex Stalcup, M.D. New Leaf Treatment Center

S. Alex Stalcup, M.D. New Leaf Treatment Center

S. Alex Stalcup, M.D. New Leaf Treatment Center 251 Lafayette Circle, Suite 150 Lafayette, CA 94549 Tel: 925-284-5200 Fax: 925-284-5204 [email protected] www.nltc.com A 33-Year Follow-Up of Narcotics Addicts . What is a Drug? A drug is a pleasure producing chemical. Drugs activate or imitate chemical pathways in the

brain associated with feelings of well-being, pleasure and euphoria. Neuroadaptation, Tolerance, and Withdrawal Neuroadaptation protects the brain from the over stimulation caused by drugs, but is the initiating step in the addiction disease process. Tolerance is the sign that neuroadaption is occurring: it is the process by which the reward and pleasure centers of the brain adapt to high concentrations of pleasure neurotransmitters. In direct response to overstimulation, the brain regions decrease in sensitivity and become unresponsive (deaf) to normal levels of stimulation. In addition to pleasure circuits each drug type affects other brain functions, including calming, alerting, and pain relief functions.. Other brain pathways overstimulated by drugs also neuroadapt and become underactive, directly leading to anxiety, depression, loss of energy, and pain. Once neuroadaptation develops (tolerance), there will always be Withdrawal symptoms that are the

mirror image of the drug effects. Cessation of drug use leads to inversion of the high; sobriety becomes pleasureless, anxious, sleepless, lacking energy, and painful. Under unstimulated conditions (without drugs) there is profound interference with the ability to experience normal pleasure. When sober, the user experiences Craving: anhedonia, anxiety, anger, frustration. The pleasure system remains impaired for months to years, interfering with sobriety, learning, and impulse inhibition. Definition of Addiction Compulsion: loss of control The user cant not do it s/he is compelled to use. Compulsion is not rational and is not planned. Continued use despite adverse consequences An addict is a person who uses even though s/he knows it is causing problems. Addiction is staged based on adverse consequences.

Craving: daily symptom of the disease The user experiences intense psychological preoccupation with getting and using the drug. Craving is dysphoric, agitating and it feels very bad. Denial/hypofrontality: distortion of cognition caused by craving Under the pressure of intense craving, the user is temporarily blinded to the risks and consequences of using. Causes of Craving in Addicts EW M S Environmental cues (Triggers) immediate, catastrophic, overwhelming craving stimulated by people,

places, things associated with prior drug-use experiences Drug Withdrawal inadequately treated or untreated Mental illness symptoms inadequately treated or untreated Stress equals craving Effects and Withdrawal

Opiates Effects Withdrawal

Analgesia Euphoria Anxiolytic - calming Sleep Inducing Constipation Dry mucous membranes Sensation of warmth Pupils constricted Pain

Dysphoria Anxiety Insomnia Diarrhea Rhinorrhea Chills Pupils dilated Kindling One Year Outcome of Opiate Treatment Kakko J, et.al. 1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden_ a randomised, placebo-controlled trial. 2003 The Lancet 361 (9358) 662-668

Overall, the dismal outcome for our controls reiterates the grave nature of heroin dependence, and shows the considerable health and social difficulties faced by our patients. Furthermore, the severity of problems in our patient sample is tragically emphasised by the 20% mortality in the controls over the course of a 1-year study.

Recently Viewed Presentations

  • מצגת של PowerPoint

    מצגת של PowerPoint

    (הַבְּשׂוֹרָה עַל־פִּי יוֹחָנָן פֶּרֶק א, 19-39) TIEPOLO, Giovanni Battista, John the Baptist Preaching, 1732-33, Fresco, Cappella Colleoni, Bergamo Workshop of Francesco Granacci, Saint John the Baptist Bearing Witness, ca. 1510 מתוך הידיעות המעטות על תורותיו של יוחנן ...
  • The Global Positioning System

    The Global Positioning System

    A Worldwide Information Utility NAVSAT 2002 Nice, France November 12, 2002 Jason Y. Kim Executive Secretariat Interagency GPS Executive Board Overview United States Policy Constellation Status & Performance Modernization Augmentations International Cooperation United States GPS Policy Consistent U.S. national policy...
  • Learning Session #3

    Learning Session #3

    Reminder: the DI theory of change has guided the creation of the entire readiness and capacity exploration process to date. The 3 phase LOCAL implementation planning process that follows (Snapshot, Prioritization, Action Planning, Requests for Support) is guided by this...
  • Modeling Infectious Disease Processes CAMRA August 10th, 2006

    Modeling Infectious Disease Processes CAMRA August 10th, 2006

    Early Modeling: William Farr develops a method to describe epidemic phenomena. He fits normal curves to epidemic data. History of Mathematical Epidemiology Germ theory leads to mass action model of transmission The rate of new cases is directly proportional to...
  • Technical Change, Competition and Vertical Integration

    Technical Change, Competition and Vertical Integration

    The paper analyzes the vertical integration strategy from a long-term profit-maximization perspective. RQ: Why certain investments in the long run would be more attractive to integrated firms than to independent suppliers? Vertical integration is less desirable in industries with more...
  • Integrated Memory Controllers with Parallel Coherence Streams Mainak

    Integrated Memory Controllers with Parallel Coherence Streams Mainak

    Parallel Coherence Streams Mainak Chaudhuri Mark Heinrich IIT Kanpur University of Central Florida Talk in One Slide Ever-increasing on-die integration Faster memory controllers and coherence processors Leads to new trade-offs in the domain of programmable coherence engines for scalable ...
  • Dorset & Wilts Rfu

    Dorset & Wilts Rfu

    DORSET & WILTS RFU. Volunteer Recognition . Roll of Honour. Welcome everyone to the first Dorset & Wilts CB Volunteer Awards. This evening is to recognise volunteers from across the two counties.
  • Dual Target Design for CLAS12 Omair Alam and

    Dual Target Design for CLAS12 Omair Alam and

    Made separate procedures for each target component to make replacement or modification of individual parts of the target easy. Established proper dependencies between all the target components to ensure that changes made to any substructure would reflect across the whole...