Day 2 :
- Addiction, Addiction - Case Report Studies, Addiction Therapy, CNS and Addictive Disorders, Approaches for Addiction Treatment, Addiction Psychiatry and Mental Health
Location: Webinar
Session Introduction
Gokcen Aydin
Hasan Kalyoncu University, Turkey
Title: Addiction Prevention Program Works For All: A Case Study in Turkey
Time : 09:00-09:30
Biography:
Gokcen Aydin has completed her PhD at the age of 29 years from Middle East Technical University. She is a faculty member at Hasan Kalyoncu University in Department of Psychological Counseling and Guidance. She is interested in Acceptance and Commitment Therapy, academic success and motivation, procrastination, addiction prevention. She also has presented several publications in several conferences and published articles.
Abstract:
The aim of the current study was to explore the perceptions of students, teachers, parents, school counselors and principals towards “Addiction Prevention Training Program of Turkey (APTP-Turkey)”. This program was developed by Green Crescent as an action plan against tobacco, alcohol, drug and technology addiction. APTP aimed to increase knowledge and awareness towards addiction among primary, secondary and high school students. This case study was conducted with students (n=55), teachers (n=18), parents (n=26), school counselors (n=3) and school principals (n=3) from primary, secondary and high school levels. The data were collected by semi-structured interviews: focused group interviews with students, teachers and parents; and individual interviews with school counselors and principals. Each interview was based on any improvement in students’ knowledge and attitude towards addiction. Students were asked directly while the other participants (teachers, parents, school counselors and principals) were asked about their observation about students’ knowledge and attitudes. Sample item from focused group interview of parents was “After APTP, how does your child react to relatives/friends who use tobacco?”. The results revealed that students’ knowledge and awareness increased as a result of the program. Parents and teachers stated that students learned the negative effects of tobacco, alcohol and drug addiction; and they also started using technology for academic purposes more than playing games. Students emphasized the necessity of teachers’ being a good model for them by not using tobacco. Finally, for drug addiction, all participants agreed that students learned the bad long-lasting effect of using drug even after the first trial.
Shahram Naderi Mazjin
School of Advanced Technologies in Medicine of Tehran University of Medical Science, Iran
Title: Evaluation of Nasal Oxytocin Spray Efficacy in Reducing Withdrawal Sighn and Craving and Relapse When Cutting Methadone in Opioids Addicted People that have Received Methadone
Time : 09:30-10:00
Biography:
Shahram Naderi Mazjin MD and student of addiction study PhD in School of Advanced Technologies in Medicine of Tehran University of Medical Science. This is my thesis title for PhD.
Abstract:
In our study, in addition to prescribing a high dose of oxytocin nasal, we were attempting to non-drug activities in group, for prevent of V1 vasopressin receptor cross reactivity at higher OT dosages.
This study was a double-blind clinical trial. That 60 men, all with methadone use, stopped their methadone and entered the 72-hour marathon group (or individually) on the second day, randomly receiving oxytocin or placebo.
We compared the subjects in four groups. - Prescribing nasal: 1 oxytocin as individually. 2. Placebo as individually. 3. placebo in Marathon group. 4. Oxytocin in marathon group. We measured the mean of each withdrawal sign on day 2, 3, and 4 after methadone discontinuation. We understood that those who took oxytocin sprays in the marathon group with group activities that enhance group empathy, withdrawal symptoms and craving after discontinuation of methadone would be less than other groups, and this was not related to the age of people and the amount of methadone that they consumed. These peoples participated more in the group therapy and continued that for a longer period.
Activity of Sensory and motor centers, (SMG, PCC, IPL, and SPL, all involved in the temptation and automatic addictive behaviors) reduced by oxytocin. Patients who discontinued methadone in this study and engaged in non-pharmacological activities, such as listening to music, group dance , etc., decreased their self-reflection following oxytocin use .because precuneus and pcc, ( which can induce self-reflection), decreased their activity due to oxytocin use.
Nader Charkhgard
Tehran University of Medical Sciences School of Advanced Technologies in Medicine, Iran
Title: Testosterone Ambiguities and Approaches to Treatment
Time : 10:00-10:30
Biography:
Nader Charkhgard, Medical Doctor and PhD Candidate of Addiction Studies in Tehran University of Medical Sciences School of Advanced Technologies in Medicine.
Abstract:
Several factors contribute to the tendency, consumption, and recurrence of the substance. A wide range of factors, such as environmental factors, family, cognitive factors, comorbidity, stress, genetics, etc., are effective. In the meantime, the important role of hormones has largely been neglected. Testosterone is one of the most important hormones involved in addiction, There is a great deal of uncertainty about the role of this hormone in drug abuse, especially in the opioids, But together with the available evidence, there is a special role for testosterone in predicting the onset of substance use and the treatment of addictive disorders. In this panel, we plan to examine the role of Testosterone in the removal of substances and share the latest achievements in this area. We will also discuss the potential impact of opioids on testosterone and its possible role in evolution.
Rahul Hajare
Indian Council of Medical Research, India
Title: Balance Work-Life: Let Your Spouse Take Control
Time : 10:30-11:00
Biography:
Rahul Hajare was fortunate enough to be recognized for hard work with scholarships from India Council of Medical Research Ministry of Health Research New Delhi scholarship including a centenary post doc National AIDS Research Institute Pune that is presented by Respected Dr. R.S.Paranjape, Immunologist and World Renowned Scientist., Retired Director & Scientist ‘G’ National AIDS Research Institute Pune. His initial journey was a quest to heal with a different kind of highly education and did a sponsorship at the Ana Laboratory in Mumbai. After completing his training, he was privileged to practice in KLE College of Pharmacy Bangalore as a board certified Secretary KLE society Belgavi, he was work to formerly reputed Pune University and services to be recognized by special Investigation team (SIT) for work in education.
Abstract:
Busting the conventional notion, a recent study has found why 9 to 5 is not the only shift that can work for busy families. The study from the University of Pune focused on two-parent families in which one parent works a nonstandard shift, hours that are common in health care, law enforcement and the service sector. The study found that the impacts of parent work schedules on children vary by age and gender, and often reflect which shift a parent works. Rotating shifts a schedule that varies day by day or week by week can be most problematic for children. Workers often struggle to carve out the work/life balance they want for themselves, and in dual-earner families, balancing partners' schedules remains an issue for many families. Parents are facing these decisions of balancing work and caring for their children. Nonstandard schedules, especially for single parent and lower income families, are associated with behaviour problems among children, according to past research. To add to that research, researcher examined data on two parent households in which one parent worked a nonstandard shift. On this, she was inspired in part by her own family: A sibling, who is a nurse, another fire fighter, both with children.
Behnam Shakerian
Sina Hospital, Iran
Title: Thromboembolic Stroke Due to Left Ventricle Clot in the Setting of Methamphetamine Use
Time : 11:00-11:30
Biography:
Behnam Shakerian is Associate professor and work as a Heart Surgeon at Sina Hospital, Iran.
Abstract:
Introduction: Methamphetamine (MA) use is a significant public health problem, with an estimated 35 million stimulant users worldwide, predominantly of methamphetamine. Stroke too is a major public health problem, with high morbidity and mortality rate.
Methods: We discuss about stroke due to left ventricular thrombus secondary to myocardial infarction in a few patients with MA use.
Discussion: The prevalence of illicit drug use is highest among younger people. Clinical use of amphetamines dates back to 1920 for treatment of asthma and later used to increase alertness in military troops in World War two and also as a weight loss medication. The exact mechanism of cardiovascular effects of central nervous system stimulant drugs is not completely clear. MA abuse was associated with increase in heart rate and blood pressure, catecholamine-induced platelet aggregation which subsequently increases risk of thrombus formation, increased circulating catecholamine resulting in vasospasm and myocardial infarction, hyperplasia of coronary artery intima. MA may also increase the risk of stoke through the highly increased risk of cardiomyopathy, and with that an increased risk of arrhythmia and thrombosis, leading to thromboembolic strokes. It is well known that among young people strokes.
Elahe Hafezi
University of Tehran, Iran
Title: Comparison of the Anxiety, Worry and Intolerance of Uncertainty among Individuals with Obsessive-Compulsive and Substance Use Disorders
Time : 11:30-12:00
Biography:
Elahe Hafezi is M.A in Clinical Psychology, Department of Psychology and Education, University of Tehran, Iran.
Abstract:
Recently, clinical studies consider a different picture of obsessive-compulsive disorder. An image that similar to addictive behaviors in people with substance use disorder. The aim of the present study was to compare the anxiety, worry and intolerance of uncertainty among people with obsessive-compulsive disorder and substance use with normal people. It is a case control study. For this purpose, 120 people with obsessive compulsive disorder and 120 substance use disorder were selected through target sampling. Also, for comparison with two clinical sampling groups 120 people were selected from the normal population. Beck Anxiety Inventory (BAI), Pennsylvania Worry Questionary (PSWQ) and Intolerance of Uncertainly Scale (IUS) were divided between three groups. The results showed that there was a significant difference between the scores of clinical groups and normal people in anxiety, worry and intolerance of uncertainly variables. However, there was no significant difference between obsessive-compulsive and substance use disorders. In general, according to the findings of this study and the similarity of people with obsessive-compulsive and substance use disorders, it is necessary to study the meta-diagnostic components in both of these disorders in order to prevent them.
Ariadna Jorda Gifre
Universitat de Barcelona, Spain
Title: Life Stories of Heroine Consumers Treated with Metadona
Time : 12:00-12:30
Biography:
Ariadna Jorda Gifre has completed her medicine degree at the age of 23 years from Universitat de Barcelona, Family doctor specialty at the age of 31 years from Unitat Docent de Girona and post degree master in drugs from Universitat de Barcelona at the age of 31 years. She has been working as a prison doctor during 10 years, now she is working as a family doctor in Bàscara, in a rural primary care center. She is a member of East Girona research group.
Abstract:
Objective: Know life stories from the point of view of consumers or former consumers of heroin who came to collect methadone in a Primary Care Center (Girona).
Design: Qualitative study with phenomenological approach. Opinion sampling as it required criteria such as accessibility and convenience. The biographical story technique was used or life stories (4 in total). Thematic content analysis: coding and creation of categories.
Results:
1) Influences of childhood / adolescence and the relationship with the neighborhood to start / maintenance of consumption. They attribute the fact of have been living in the neighborhood the cause of drug use.
2) Influence of the family environment on the start, maintenance and relapses of consumption.
Some of them came from families where the mother had disappeared, either by death or because she decided to leave. Others where family structure was maintained, the relationship between both parents has a mother's submission, being hidden under father’s authoritarianism. There is a relationship with abuse of the father towards the mother and / or children.
3) Perception of being / have been a consumer, beliefs about heroine contradictory feelings, good memories in relation to the consumption partners and the need to find good and bad in relation to physical problems, overdose, deaths and the need to cheat or steal to maintain consumption.
Conclusions: A difficult socioeconomic and family situation and child abuse seem to be basic elements to develop a consumption problem. At political level, it was interesting that the neighborhood / ghetto was a point of sale and drug use, this affected vulnerable people to end up using drugs.
E. Renea Snyder
Migliore Institute of Behavioral Sciences, USA
Title: Three Levels of Quality Addictions Treatment through Telehealth Model
Time : 12:30-13:00
Biography:
E. Renea Snyder, MS, ICAADC, CCTP, CCFAS, CCFC, is a National Trainer for Seeking Safety, Trauma Informed Systems of Care, and SMART Recovery. Renea leads a National Consulting Team with experts in Criminal Justice, Addiction, Trauma, Policy Reform, and Medication Assisted Treatment. Renea leads the addiction field in Pennsylvania with her progressive treatment practices and commitment for patient advocacy. Renea developed the first recovery model for correctional settings and received international recognition in 2015. Renea still conducts forensic evaluations, case consultations, and trauma/addiction therapy upon special request.
Abstract:
Opioid prescriptions and addiction have made headlines across the world for almost a decade. As policy makers, hospitals, physicians, prisons, pharmaceuticals, etc. dedicate efforts to reduce the death tolls, conduct opioid education, and create new medications to treat pain, there are still many barriers to accessing quality addictions treatment. One of the leading barriers to treatment is transportation and access to quality care. With the increase in telehealth and telemedicine models of care, it was pertinent that addiction medicine joins telehealth on the proper evidence-based platform. With the patent pending telehealth evidence-based addictions model; the platform offers three levels of care (Outpatient, Intensive Outpatient, and Partial Hospitalization), individual, group, and recovery sessions, in-home services, 24/7 treatment access, and medication assisted treatment.
This is the first documented telehealth model of addictions treatment. The telehealth model meets some of the most restrictive state regulations, confidentiality requirements, highly trained/qualified clinicians, and documentation for addictions treatment.
Kalia Nikolaou
Aristotle University of Thessaloniki, Greece
Title: The Role of Dynamic Inter-Family Characteristics in Drug Addiction
Time : 13:00-13:30
Biography:
Kalia Nikolaou is a second year-PhD student at the department of Clinical Psychology of University of Cyprus. She has completed the postgraduate program "Criminal Law and Addictions" in the Department of Law at the Aristotle University of Thessaloniki. In 2015, while she participated in the Erasmus+ Program, she completed her 6-month internship at the psychiatric hospital in Thessaloniki, the Drug Rehabilitation Centre. Afterward, she continued as a volunteer for two years in the rehabilitation center at the Psychiatric Hospital of Thessaloniki. At the moment, her clinical and research focus is in adolescents with internalizing and externalizing behavioral problems considering the family resilience perspective. She has contributed as an author and co-author in two articles published in foreign and Greek journal respectively.
Abstract:
In the context of this qualitative study, the relationship between heroin addicts and parents were investigated, taking into consideration the trajectory from adolescence to adulthood, including the active periods of substance abuse and rehabilitation clinical trial. The aim of this study was the identification of problematic communicational processes in the relationship between parents and heroin addicts which contribute to the initiation and maintenance of addiction. The study was carried out with the participation of addictive members of the Social Unit of Rehabilitation Center “Ianos” which pertains to the Psychiatric Hospital of Thessaloniki. In this qualitative study, fourteen semi-structured (one to one) interviews have been received by male heroin addicts aged 30 to 45 years old. The results of the qualitative research highlight a dysfunctional dyadic interaction between parents and heroin addicts which affects negatively the parental practices, the subsequent psychological and emotional development of the addict and his direction towards the addiction. This study found that the majority of these families show restricted communicational patterns with double bind dilemmas, triangulation traumas as well as features of rigidness and co-dependency. However, the addict due to chronic social and psycho-emotional deficits hesitates to separate from the family, escalating the communicational, social and economic difficulties in a vicious family circle. Considering the context of therapy, the results of the study recommend that family therapy looks promising as a substantial treatment for the addict and his family as a system. The whole family needs to participate in therapy, to be restructured and more flexible in order to support the rehabilitation process and prevent the relapse of the heroin addict.
Frank J Edwards
Arnot Ogden Medical Center, USA
Title: Treating Opioid Withdrawal with Buprenorphine in a Community Hospital ED: Rates of Continued Follow-up Engagement with Medication Assisted Treatment, Safety and Attending Physician Acceptance
Time : 13:30-14:00
Biography:
Frank Edwards, MD received a BA degree from the University of North Carolina at Chapel Hill and his MD from the University of Rochester. He has been board certified in Emergency Medicine since 1988. He served on the faculty of the University of Rochester and most recently started and was program director of a new Emergency Medicine residency in Elmira, New York. He has written two medical books and a number of articles in peer-reviewed journals.
Abstract:
Study objective: In collaboration with an outpatient substance abuse treatment center, our community hospital emergency department (ED) developed a program to treat patients in opioid withdrawal with buprenorphine/naloxone in the ED and arrange timely referral (< 3 days) for medication assisted treatment (MAT). We measured the continued engagement of subjects with MAT at 30 and 90 days, assessed for adverse medication effects in the form of precipitated withdrawal, and surveyed physician acceptance of the program at the end of its first year.
Methods: This is a prospective observational cohort study. Concomitant with a month-long media campaign to alert the public, we offered study enrollment to all patients presented to the ED in opioid withdrawal requesting treatment with buprenorphine and MAT follow-up from March 15, 2018 through March 15, 2019. There was no control group and patients who declined data tracking were still offered treatment.
Results: Of 80 potentially eligible subjects, 5 eloped before evaluation and were not enrolled, and 13 did not consent to data sharing. Fifty-four of the 62 patients enrolled in the study met inclusion criteria and were administered buprenorphine in the ED. Six of the 13 patients who did not agree to follow-up data sharing also met inclusion criteria and were given buprenorphine.
Conclusions: Such a program is feasible and safe in a community hospital ED and serves as an accelerated portal to addiction treatment for patients who might otherwise relapse into illicit opioid use with its attendant dangers.