Moises Asis cmacc 2009 apitherapy for mental disorders and chemical addictions
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Moises Asis cmacc 2009 apitherapy for mental disorders and chemical addictions

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  • “Apiterapia 101 para todos”, page 3
  • Stings / apipuncture –chiapi- / stipers / stipers + infrared heat
  • Honey oral / honey injections / honey or propolis massage / beeswax ear conning
  • Propolis tincture / candies
  • DEWNIS is only a suggestion by me (M.A.), never before this pre-protocol has been shared with other apitherapists and health professionals.
  • Detoxification, Energy, Wellness in General, Nutrition, Immune System Boost, Synergy with Other Procedures & Medications
  • Also, it is rich in sugars, natural acids, aminoacids, enzymes, and other substances incorporating to blood stream within 15 minutes. Antioxidants help alcoholics to repair demage from free radicals. * Int. J. of Food Sciences & Nutrición 2008 May 8.
  • * Evidence-based Complementary and Alternative Medicine 2009 Jan 12;
  • *Ostomy Wound Management 55(1):38-47, Apr 2009; **Experimental & Toxicologic Pathology 2008 Nov 4;
  • * J. Wound Ostomy Continence Nurs . 36(1):60-66, Jan-Feb 2009, J. of Advanced Nursing 65(3):565-575, Feb 2009; ** Irish Medical News 11/10/2008;*** Altern Med Rev 13(4):331-334, Dec 2008.
  • *Dr. Nicola Starkey, Univ.Waikato in New Zealand, The Mirror (UK) 4/7/2008, Adv. Gerontol . 21(2):252-257, 2008.
  • Alcoholics frequently have Vitamin B deficiency, essential to strengthening and rebuilding the nervous system, Alcoholics suffer from zinc deficiency, essential for alcohol detoxification: when Zn levels are low, liver cannot metabolize alcohol, toxicity increases, and risk of cirrhosis also increases. In alcoholics, 1-4 g pollen a day * Food Chem Toxicol 16 Dec 2008.
  • *Phytotherapy Research 23(1):41-48, Dec 2008.
  • Safe dosis is 5 mg/kg of body weight/day. In rats on experimental alcoholic hepatopathy: 10 mg/kg reduce concentrations of transaminases(GOT and GPT) and seric and hepatic triglycerides; 30 mg/kg prevent that concentrations of citochromes P-450 and NADPH-depending-C-reductase and lipidic peroxidation signficantly increae. *Analytica Chimica Acta 635(1):115-120, March 2009;
  • * Medicina (Kaunas) 44(12):977-983, 2008; ** Brazilian Dental J. 19(4):301-305, 2008; *** Phytotherapy Research 2009 Jan. 22; **** Experim. Anim . 57(5):453-460, Oct. 2008, Food & Chemical Toxicology 2009/Al-Sayeda et al.; ***** European J. of Pharmacology 591(1-3):73-79, Sept. 2008.
  • * Advances in Therapy 24(5):1136-1145, Sept. 2007; J. Molecular & Cellular Biochemistry 302(1-2):215-224, Aug. 2007; Integrative Zoology 3(4):311-321, 2008; Toxicology 246(2-3):148-157, Apr.2008; Genes & Nutrition 2(4) 2008; ** Int. J. Food Sci. Nutr . 10:1-5, Oct. 2008.
  • * Molecules 14(2):738-752, Feb. 2009; ** Arh. Hig. Rada Toksikol . 59(4):299-308, Dec. 2008; *** Phytotherapy Research 23(2):226-230, Feb. 2009; J. Food Science 2008 Oct. 21
  • *Phytotherapy Research 2008 Nov. 1; **Toxicological Sciences 104(1):100-106, 2008, Eur. Surg. Res. 41:231-237, 2008, Food & Chemical Toxicology 2008; ***Pancreatology 8(6):566-576, Sept. 2008, Phytotherapy Research 23(2):226-230, Feb. 2009; ****Pharmacology Biochemistry & Behavior 2008
  • Let’s remember the high incidence of HIV and other immunological diseases and sexually-transmitted diseases in drug addicts. 500 mg per day * Lupus 18(1):44-52, 2009; ** J. of Food Science 21 Oct 2008.
  • * Biomedical Research 28:295-299, 2007; ** Experimental & Toxicologic Pathology 2008; *** Altern Med Rev 13(4):331-334, Dec 2008.
  • Protein from larvae is 20% dry matter, rich in enzymes, vitamin A, minerals, glucosides (1-3%). Many drugs produce depression, amotivational syndrome, tiredness. Sexual weakness (asthenia) is the motivation for the use of cocaine and other stimulants.
  • *Anticancer Research 28(28A):833-842, Mar-Apr 2008.
  • * Exp. Mol. Med. 39(5):603-613, Oct. 2007; ** J. Biol Chem . 284(6):3804-3813, Feb. 2009; *** Experimental Parasitology 119(2):246-251, June 2008. [25% OF PRESENTATION TILL HERE]
  • Some 370 diagnostic codes in DSM-IV
  • *Tricyclic antidepressants (abbreviation TCAs ) are a class of antidepressant drugs first used in the 1950s. They are named after the drugs' molecular structure, which contains three rings of atoms (compare tetracyclic antidepressant). They are used in the treatment of major depression and, in lower doses, for insomnia and pain relief in some chronic pain syndromes. Side effects are mainly anticholinergic in nature, with dry mouth and sedation reported. They have been largely replaced in clinical use by newer antidepressants, although there is some evidence they are more effective in severe depression. **SSRIs: Selective serotonin reuptake inhibitors. *** Monoamine oxidase inhibitors ( MAOIs ) are a class of powerful antidepressant drugs prescribed for the treatment of depression.
  • * Antidepressants are also used in treatment of panic disorder. ** Antidepressants, especially SSRIs, are also used in the treatment of anxiety ***Antidepressants with stimulant properties, such as Norpramin and Wellburtrin, are also used in the treatment of ADHD.
  • [2 nd . Fourth of Presentation]
  • Addiction is a state in which an organism engages in a compulsive behavior, even when faced with negative consequences. This behavior is reinforcing, or rewarding, as you have just discussed. A major feature of addiction is the loss of control in limiting intake of the addictive substance. The most recent research indicates that the reward pathway may be even more important in the craving associated with addiction, compared to the reward itself. Scientists have learned a great deal about the biochemical, cellular and molecular bases of addiction; it is clear that addiction is a disease of the brain. State that you will provide 2 examples of the interaction between drugs that are addictive, their cellular targets in the brain, and the reward pathway.
  • [50% OF PRESENTATION TILL HERE]
  • Reward and addiction intervening mechanisms. Human beings and other organisms have rewarding behaviors: pleasant stimuli provide positive reinforcement, which lead to a repetition of behavior. There are natural rewards and artificial rewards (drugs).
  • Natural rewards Natural rewards such as food, water, sex and nurturing allow the organism to feel pleasure when eating, drinking, procreating and being nurtured. Such pleasurable feelings reinforce the behavior so that it will be repeated. Each of these behaviors is required for the survival of the species. Remind your audience that there is a pathway in the brain that is responsible for rewarding behaviors. This can be viewed in more detail in the next slide.
  • The brain is your body’s “Command Central.” Your brain controls more than the way you think. The brain controls our physical sensations and body movements. How we understand what we see, hear, smell, taste, and touch. Our sense of balance and coordination. Memory. Feelings of pleasure and reward. The ability to make judgments. When we catch a football, dance, jog, speak, sing, laugh, whistle, smile, cry—that’s our brain receiving, processing, and sending out messages to different parts of our body.   When we feel good for whatever reason—laughing with a friend or seeing a good movie or eating our favorite ice cream—the brain’s reward system is activated. As we said before, the reward system is the part of the brain that makes you feel good. The reward system is a collection of neurons that release dopamine, a neurotransmitter. When dopamine is released by these neurons, a person feels pleasure.   Scientists have linked dopamine to most drugs of abuse—including cocaine, marijuana, heroin, alcohol, and nicotine. These drugs all activate the reward system and cause neurons to release large amounts of dopamine. Over time, drugs damage this part of the brain. As a result of this damage, things that used to make you feel good—like eating ice cream, skateboarding, or getting a hug—no longer feel as good.   Photo courtesy of the NIDA Web site. From A Slide Teaching Packet: The Brain and the Actions of Cocaine, Opiates. and Marijuana.  
  • Definition of tolerance When drugs such as heroin are used repeatedly over time, tolerance may develop. Tolerance occurs when the person no longer responds to the drug in the way that person initially responded. Stated another way, it takes a higher dose of the drug to achieve the same level of response achieved initially. So for example, in the case of heroin or morphine, tolerance develops rapidly to the analgesic effects of the drug. [The development of tolerance is not addiction, although many drugs that produce tolerance also have addictive potential.] Tolerance to drugs can be produced by several different mechanisms, but in the case of morphine or heroin, tolerance develops at the level of the cellular targets. For example, when morphine binds to opiate receptors, it triggers the inhibition of an enzyme (adenylate cyclase) that orchestrates several chemicals in the cell to maintain the firing of impulses. After repeated activation of the opiate receptor by morphine, the enzyme adapts so that the morphine can no longer cause changes in cell firing. Thus, the effect of a given dose of morphine or heroin is diminished.
  • Definition of dependence With repeated use of heroin, dependence also occurs. Dependence develops when the neurons adapt to the repeated drug exposure and only function normally in the presence of the drug. When the drug is withdrawn, several physiologic reactions occur. These can be mild (e.g. for caffeine) or even life threatening (e.g. for alcohol). This is known as the withdrawal syndrome. In the case of heroin, withdrawal can be very serious and the abuser will use the drug again to avoid the withdrawal syndrome.
  • The action of heroin (morphine) Heroin is an addictive drug, although not all users become addicted; other factors are important in producing addiction, such as the environment and the personality of the user. Heroin produces euphoria or pleasurable feelings and can be a positive reinforcer by interacting with the reward pathway in the brain. Indicate that you will explain how this happens.
  • HIV/AIDS, Hepatitis and Other Infectious Diseases Drug injectors who do not enter treatment are up to six times more likely to become infected with HIV than injectors who enter and remain in treatment. Drug users who enter and continue in treatment reduce activities that can spread disease, such as sharing injection equipment and engaging in unprotected sexual activity. Participation in treatment also presents opportunities for screening, counseling, and referral for additional services. The best drug abuse treatment programs provide HIV counseling and offer HIV testing to their patients.
  • Withdrawal peaks in 48 – 72 hours, ending in @ 1 week
  • Long-Term Ecstasy Use May Impair Memory It is not possible to look directly at damaged serotonin terminals in living humans. The best evidence for damage to serotonin neurons after long-term or repeated Ecstasy use in humans is the association between the neurochemical and behavioral changes. While many behavioral measures have been assessed in Ecstasy users (the list is extensive), the most consistent findings are that some chronic Ecstasy users have verbal and visual memory impairments. Research is ongoing to determine if thinking ability is disrupted as well. However, it is important to keep in mind that many users of Ecstasy may unknowingly be taking other drugs that are sold as Ecstasy, and/or they may intentionally use other drugs, such as marijuana, which may contribute to the observed deficits in memory. Additionally, most studies in people do not have measures of memory ability in Ecstasy users before they began taking drugs. Therefore, it is difficult to rule out pre-existing memory deficits in Ecstasy users compared to nonusers. Nevertheless, in some studies Ecstasy users who had memory impairments also had less serotonin metabolites or changes in other markers of serotonin function. In fact, several studies have shown that the degree of impairment or the changes in markers of serotonin function were related to the extent of Ecstasy use over the lifetime. On the slide, point to the brain areas that are involved in the memory impairment – the neocortex (yellow) and the hippocampus (blue). As an aside, you can tell students an interesting link between low serotonin and memory impairment: normal people who are fed a diet that causes them to synthesize less serotonin also have memory impairment.
  • Long-term Effects of Ecstasy: Neurotoxic? When people use Ecstasy repeatedly or long term, there may be changes in their brain chemistry that suggest that the serotonin neurons are damaged. One major clue is that serotonin itself and its metabolites (remind students that serotonin that is taken back up into the terminal is metabolized by enzymes) are diminished in the brains of animals treated with ecstasy. Moreover, the best evidence that we have so far is that even 7 years after a brief exposure to Ecstasy, serotonin levels in monkey brains have not fully returned to normal. This is described in the next slide.
  • Short-term (acute) Effects of Ecstasy Explain that when a person uses Ecstasy, the increase in serotonin in different brain regions (i.e. the areas where serotonin neurons traveling from the raphe nucleus terminate) causes psychological effects. These include, elevated mood and feelings of empathy. The Ecstasy is also reinforcing; this means that its pleasurable properties increase the likelihood that the person will take it again. Tell the students that drugs that are reinforcing are usually addictive. Students might ask you if Ecstasy is addictive. Scientists and health professionals don't have a definitive answer yet. For now there are several pieces of evidence that suggest that Ecstasy has the potential to be addictive. In one study of ecstasy users, 43% of respondents met criteria that are commonly used to determine dependence for other drugs of abuse. This included symptoms such as continuing to use the drug despite knowledge of physical or psychological harm, experiencing withdrawal effects, and tolerance (or diminished response) to repeated use of ecstasy. In a research setting, monkeys will administer Ecstasy to themselves (they actually press a lever to obtain an injection), just as they do for other addictive drugs. Monkeys will not self-administer drugs that are not addictive. In addition, there is emerging research to show that Ecstasy has actions in a specific pathway within the limbic system called the 'reward pathway'--which can explain it's reinforcing effects. In fact, all addictive drugs act in some way within the 'reward pathway'. For more information on this, see the NIDA Teaching Packet referenced at the end. Many of the psychological effects of Ecstasy are due to its actions within the limbic system (the amygdala, in red, and hippocampus, in blue, especially). The ability of Ecstasy to produce mild stimulation is due to its actions in another part of the limbic system -- the basal ganglia (in purple). It is here where Ecstasy's effects on the dopamine system may be important. The heightened perceptions involve the actions of ecstasy in the neocotex (in yellow). Ecstasy can also reduce the appetite, because it acts in the hypothalamus (in green), which controls feeding behavior.
  • Long-term Effects in Monkeys A very important experiment was performed in monkeys to determine if Ecstasy can actually damage neurons. Monkeys were given Ecstasy twice a day for 4 days (control monkeys were given saline). One group of monkeys’ brains were removed 2 weeks later for analysis and another group of monkeys lived for an additional 7 years before their brains were removed. Scientists examined the brains for the presence of serotonin. This slide shows the presence of serotonin in neurons of the neocortex from 3 typical monkeys. On the left, the monkey who did not receive any Ecstasy had a lot of serotonin (in pink) in the neocortex. Two weeks after a monkey received Ecstasy, most of the serotonin was gone (point to the middle panel), suggesting that the serotonin neuron terminals were destroyed (there was no destruction of the serotonin cell bodies arising back in the brainstem). Point to the right hand panel and show students that this damage appeared to be long-term because 7 years later there was some recovery, but it was not complete (in fact the pattern of regrowth of serotonin terminals was abnormal– point out one of the areas where the pink lines are running sideways). Scientists found similar changes in limbic areas of the brain such as the hippocampus and amygdala. The monkey experiments are an important reminder that humans may suffer the same fate, although this still remains to be demonstrated. Tell the students how difficult it is to do this same kind of experiment in humans because it requires removing pieces of the brain to look for the loss of the serotonin neurons. Image courtesy of Dr. GA Ricaurte, Johns Hopkins University School of Medicine
  • Snorting vs smoking cocaine: different addictive liabilities Historically cocaine abuse involved snorting the powdered form (the hydrochloride salt). When cocaine is processed to form the free base, it can be smoked. Heating the hydrochloride salt form of cocaine will destroy it; the free base can be volatilized at high temperature without any destruction of the compound. Smoking gets the drug to the brain more quickly than does snorting. Show the audience why this happens. Snorting requires that the cocaine travels from the blood vessels in the nose to the heart (blue arrow), where it gets pumped to the lungs (blue arrow) to be oxygenated. The oxygenated blood (red arrows) carrying the cocaine then travels back to the heart where it is pumped out to the organs of the body, including the brain. However, smoking bypasses much of this--the cocaine goes from the lungs directly to the heart and up to the brain. The faster a drug with addictive liability reaches the brain, the more likely it will be abused. Thus, the time between taking the drug and the positive reinforcing or rewarding effects that are produced can determine the likelihood of abuse.
  • Long-term effects of drug abuse. This PET scan shows us that once addicted to a drug like cocaine, the brain is affected for a long, long time. In other words, once addicted, the brain is literally changed. Let’s see how...   In this slide, the level of brain function is indicated in yellow. The top row shows a normal-functioning brain without drugs. You can see a lot of brain activity. In other words, there is a lot of yellow color.   The middle row shows a cocaine addict’s brain after 10 days without any cocaine use at all. What is happening here? [Pause for response.] Less yellow means less normal activity occurring in the brain—even after the cocaine abuser has abstained from the drug for 10 days.   The third row shows the same addict’s brain after 100 days without any cocaine. We can see a little more yellow, so there is some improvement— more brain activity—at this point. But the addict’s brain is still not back to a normal level of functioning. . . more than 3 months later. Scientists are concerned that there may be areas in the brain that never fully recover from drug abuse and addiction.   Photo courtesy of Nora Volkow, Ph.D. Volkow ND, Hitzemann R, Wang C-I, Fowler IS, Wolf AP, Dewey SL. Long-term frontal brain metabolic changes in cocaine abusers. Synapse 11:184-190, 1992; Volkow ND, Fowler JS, Wang G-J, Hitzemann R, Logan J, Schlyer D, Dewey 5, Wolf AP. Decreased dopamine D2 receptor availability is associated with reduced frontal metabolism in cocaine abusers. Synapse 14:169-177, 1993.
  • Measuring Brain Activity in Response to Drug Use Position Emission Tomography (PET) measures emissions from radioactively-labeled chemicals that have been injected into the bloodstream and uses the data to produce images of the distribution of the chemicals in the body. In drug abuse research, PET is being used for a variety of reasons including: to identify the brain sites where drugs and naturally occurring neurotransmitters act; to show how quickly drugs reach and activate receptors; to determine how long drugs occupy these receptors; and to find out how long they take to leave the brain. PET is also being used to show brain changes following chronic drug abuse, during withdrawal from drug use, and during the experience of drug craving. In addition, PET can be used to assess the effects of pharmacological and behavioral therapies for drug addiction on the brain.
  • Positron Emission Tomography (PET) Scan of a Person Using Cocaine Cocaine has other actions in the brain in addition to activating the brain’s reward circuitry. Using brain imaging technologies, such as PET scans, scientists can see how cocaine actually affects brain function in people. PET allows scientists to see which areas of the brain are more or less active by measuring the amount of glucose that is used by different brain regions. Glucose is the main energy source for the brain. When brain regions are more active, they will use more glucose and when they are less active they will use less. The amount of glucose that is used by the brain can be measured with PET scans. The left scan is taken from a normal, awake person. The red color shows the highest level of glucose utilization (yellow represents less utilization and blue indicated the least). The right scan is taken from someone who is on cocaine. The loss of red areas in the right scan compared to the left (normal) scan indicates that the brain is using less glucose and therefore is less active. This reduction in activity results in disruption of many brain functions.
  • This is literally the brain on drugs.   When someone gets “high” on cocaine, where does the cocaine go in the brain? With the help of a radioactive tracer, this PET scan shows us a person’s brain on cocaine and the area of the brain, highlighted in yellow, where cocaine is “binding” or attaching itself. This PET scan shows us minute by minute, in a time-lapsed sequence, just how quickly cocaine begins affecting a particular area of the brain.   We start in the upper left hand corner. You can see that 1 minute after cocaine is administered to this subject nothing much happens. All areas of the brain seem to be functioning normally. But after 3 to 4 minutes [the next scan to the right, we see areas highlighted in yellow where cocaine is starting to bind to the striatum [stry-a-tum] of the brain and activate it.   At the 5- to 8-minute interval, we see that cocaine is affecting a large area of the brain. After that, the drug’s effects begin to wear off. At the 9- to 10-minute point, the high feeling is almost gone. Unless the abuser takes more cocaine, the experience is over in about 20 to 30 minutes.   Scientists are doing research to find out if the striatum produces the “high feeling” and controls our feelings of pleasure and motivation. One of the reasons scientists are curious about specific areas of the brain affected by drugs such as cocaine is to develop treatments for people who become addicted to these drugs. Scientists hope to find the most effective way to change an addicted brain back to normal functioning.   Photo courtesy of Nora Volkow, Ph.D. Mapping cocaine binding sites in human and baboon brain in vivo. Fowler JS, Volkow ND, Wolf AP, Dewey SL, Schlyer DJ, Macgregor RIR, Hitzemann R, Logan J, Bendreim B, Gatley ST. et al. Synapse 1989;4(4):371-377.
  • The memory of drugs. This slide demonstrates something really amazing—how just the mention of items associated with drug use may cause an addict to “crave” or desire drugs. This PET scan is part of a scientific study that compared recovering addicts, who had stopped using cocaine, with people who had no history of cocaine use. The study hoped to determine what parts of the brain are activated when drugs are craved.   For this study, brain scans were performed while subjects watched two videos. The first video, a nondrug presentation, showed nature images—mountains, rivers, animals, flowers, trees. The second video showed cocaine and drug paraphernalia, such as pipes, needles, matches, and other items familiar to addicts.   This is how the memory of drugs works: The yellow area on the upper part of the second image is the amygdala (a-mig-duh-luh), a part of the brain’s limbic system, which is critical for memory and responsible for evoking emotions. For an addict, when a drug craving occurs, the amygdala becomes active and a craving for cocaine is triggered.   So if it’s the middle of the night, raining, snowing, it doesn’t matter. This craving demands the drug immediately. Rational thoughts are dismissed by the uncontrollable desire for drugs. At this point, a basic change has occurred in the brain. The person is no longer in control. This changed brain makes it almost impossible for drug addicts to stay drug-free without professional help. Because addiction is a brain disease.   Photo courtesy of Anna Rose Childress, Ph.D.
  • Drugs have long-term consequences.   Here is another example of what science has shown us about the long-term effects of drugs. What this PET scan shows us is how just 10 days of drug use can produce very dramatic and long-term changes in the brain of a monkey. The drug in these images is amphetamine, or what some people call “speed.” Remember the previous slide showed us what the brain of a chronic cocaine abuser looks like. This slide shows us what using a drug like amphetamine can do in only 10 days to the brain of a monkey.   This slide also gives us a better idea of what methamphetamine, a drug similar in structure, can do to the brain. Methamphetamine use is becoming increasingly popular in certain areas of the country.   The top row shows us, in white and red, normal brain activity. The second row shows us that same brain 4 weeks after being given amphetamine for 10 days. There is a dramatic decrease in brain activity. This decreased brain activity continues for up to 1 year after amphetamine use. These continuous brain changes often trigger other changes in social and emotional behavior, too, including a possible increase in aggressiveness, feelings of isolation, and depression.   Photo courtesy of NIDA from research conducted by Melega WP, Raleigh MJ, Stout DB, Lacan C, Huang SC, Phelps ME. Recovery of striatal dopamine function after acute amphetamine- and methamphetamine induced neurotoxicity in the vervet monkey. Brain Res 1997 Aug 22;766(1-2);113-120.    
  • [75% OF PRESENTATION TILL HERE]
  • Components of Comprehensive Drug Addiction Treatment A variety of scientifically-based approaches to drug addiction treatment exist. Drug addiction treatment can include behavioral therapy (e.g., counseling, cognitive therapy, or psychotherapy), medications, or their combination. Case management and referral to other medical, psychological, and social services are crucial components of treatment for many people as well. The best programs provide a combination of therapies and other services to meet the needs of the individual patient, which are shaped by such issues as age, race, culture, sexual orientation, gender, pregnancy, parenting, housing, and employment, as well as physical and sexual abuse. Several of the key principles underlying this approach to treatment follow.
  • Matching Patients to Individual Needs No single treatment is appropriate for all individuals. Matching treatment setting, interventions, and services to each individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society. Effective treatment attends to multiple needs of the individual, not just his or her drug use. To be effective, treatment must address the individual’s drug use and any associated medical, psychological, social, vocational, and legal problems.  
  • Duration of Treatment Individuals progress through drug addiction treatment at various speeds, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate lengths of treatment. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited or no effectiveness, and treatments lasting significantly longer often are indicated. For methadone maintenance, 12 months of treatment is the minimum, and some opiate-addicted individuals will continue to benefit from methadone maintenance treatment over a period of years.
  • Medical Detoxification Medical detoxification safely manages the acute physical symptoms of withdrawal associated with stopping drug use. However, medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. While detoxification alone is rarely sufficient to help addicts achieve long-term abstinence, for some individuals it is a strongly indicated precursor to effective drug addiction treatment.
  • Counseling and Other Behavioral Therapies Counseling (individual and/or group) and other behavioral therapies are critical components of effective treatment for addiction. In therapy, patients address issues of motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding nondrug-using activities, and improve problem-solving abilities. Behavioral therapy also facilitates interpersonal relationships and the individual’s ability to function in the family and community.
  • Medications for Drug Addiction Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. Methadone and levo-alpha-acetylmethadol (LAAM) are very effective in helping individuals addicted to heroin or other opiates stabilize their lives and reduce their illicit drug use. Naltrexone is also an effective medication for some opiate addicts and some patients with co-occurring addiction to alcohol. For persons addicted to nicotine, a nicotine replacement product (such as patches or gum) or an oral medication (such as bupropion) can be an effective component of treatment. For patients with mental disorders, both behavioral treatments and medications can be critically important.  
  • Motivation to Enter/Sustain Treatment Treatment does not need to be voluntary to be effective . Strong motivation can facilitate the treatment process. Sanctions or enticements in the family, employment setting, or criminal justice system can increase significantly both treatment entry and retention rates and the success of drug treatment interventions. Individuals who enter treatment under legal pressure have outcomes as favorable as those who enter treatment voluntarily.  
  • Effectiveness of Treatment According to several studies, drug treatment reduces drug use by 40 to 60 percent and significantly decreases criminal activity during and after treatment. For example, a study of therapeutic community treatment for drug offenders demonstrated that arrests for violent and nonviolent criminal acts were reduced by 40 percent or more. Methadone treatment has been shown to decrease criminal behavior by as much as 50 percent. Research shows that drug addiction treatment reduces the risk of HIV infection and that interventions to prevent HIV are much less costly than treating HIV-related illnesses. Treatment can improve the prospects for employment, with gains of up to 40 percent after treatment. (Note: Although these effectiveness rates hold in general, individual treatment outcomes depend on the extent and nature of the patient’s presenting problems, the appropriateness of the treatment components and related services used to address those problems, and the degree of active engagement of the patient in the treatment process.)
  • Self-Help and Drug Addiction Treatment Self-help groups can complement and extend the effects of professional drug addiction treatment. The most prominent self-help groups are those affiliated with Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA), all of which are based on the 12-step model and Smart Recovery. Most drug addiction treatment programs encourage patients to participate in a self-help group during and after formal treatment.
  • Cost Effectiveness of Drug Treatment Drug addiction treatment is cost-effective in reducing drug use and its associated health and social costs. Treatment is less expensive than alternatives, such as not treating addicts or simply incarcerating addicts. For example, the average cost for 1 full year of methadone maintenance treatment is approximately $4,700 per patient, whereas 1 full year of imprisonment costs approximately $18,400 per person. According to several conservative estimates, every $1 invested in addiction treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft alone. When savings related to health care are included, total savings can exceed costs by a ration of 12 to 1. Major savings to the individual and society also come from significant drops in interpersonal conflicts, improvements in workplace productivity, and reductions in drug-related accidents.
  • 5,000 IU of vitamin A, 75 mg of each component of vitamin B complex, 1,500 mg of vitamin C, 800 mg of vitamin E, 3,000 mg of glutathione, 1,000 mg de coline, 250 mg of L-carnitine, 500 mg of N-acetylcysteine, 400 mg of selenium, 50 mg of zinc, 4 mg of copper, 200 mg of chromium, flavonoids, and other antioxidants.
  • milk thistle ( Silybum marianum ), ginger ( Zingiber officinale ), burdock ( Arctium lappa ), dandelion ( Taraxacum officinale ) and liquorice ( Glycyrrhiza glabra ). In the case of opioids, treatment can be complemented with passion flower ( Pasiflora incarnata ) infusion or tincture.
  • [END OF PRESENTATION HERE]

Moises Asis cmacc 2009 apitherapy for mental disorders and chemical addictions Moises Asis cmacc 2009 apitherapy for mental disorders and chemical addictions Presentation Transcript

  • APITHERAPY FOR MENTALDISORDERSAND SUBSTANCE ADDICTIONSMoisés Asís, MSW, JD, PhD. (CMACC 12/2009, New York)
  • APITHERAPY: Definition (2007)• “It is the Complementary andAlternative Medicine thatpromotes the use of beeproducts (honey andhoneydew, propolis,beeswax, pollen and beebread, apitoxin or bee venom,drone larvae, royal jelly, andwhole bees) for nutrition,enhancement of health and lifequality, prevention andtreatment of diseases, and forcosmetics. Apitherapycomprises, among its manyprocedures, the apitoxitherapyor bee venom therapy, and theapipuncture or acupuncture bybeestings or apitoxinmicroinjections.”
  • Some Apitherapy procedures
  • ...Some Apitherapy procedures
  • …Some Apitherapy procedures
  • …Some Apitherapy procedures
  • Mental Disorders andAddictions• IntrapsychicFactors• Social/Family• Biological &Genetic• Motivational• Emotional• Other Factors
  • ALL DISEASES AREPSYCHOSOMATIC• … but some onesare morepsychosomaticthan others.
  • D.E.W.N.I.S.: Apitherapy Protocolfor Mental Disorders &Addictions:1. Detoxification2. Energy3. Wellness in General4. Nutrition5. Immune System Boost6. Synergy with Other Procedures& Medications
  • Apitherapy will be used• For treatment of mental disordersand addictions.• For synergies of such treatments.• For treatment of medical conditionsassociated to such conditions andtreatments.
  • Some D.E.W.N.I.S. Tips:1. Clear drugs from body, and manage withdrawal,purification of organism: ad libitum tea with honey,propolis, other bee products.2. Diet on high doses of honey, propolis, pollen forwithdrawal symptoms and for synergy with othertreatments.3. Bee products for drug-related medical problems.4. Psychotherapy, counseling, social work.5. Involve, educate patients, families, community.6. Improving self-image is important: Use Apitherapycosmetics.7. Beekeeping is an activity requiring discipline,physical activity, contact with nature, and bodyclean from drug/alcohol odors.
  • Honey• Its fast assimilation preventsalcoholic fermentation.• Euphorizant.• Very valuable for fastdetoxification of alcoholics.• For weakness (asthenia)and mental/physicalexhaustion.• Depressive conditions.• Beneficial on body weightand blood lipids in type 2diabetes.*• For dengue virus prevention.
  • …Honey• Antitoxic properties.• High energy value (3.3 cal/g)• Insomnia.• Antioxidant, nutritive, andenergetic properties.• Antianemic.• Increases libido, hasaphrodisiac properties.• Antitumor activitiy in lungcarcinoma.*
  • …Honey• For stress andhyperactivity.• Helps healradiotherapy-impairedwounds.*• Improves sleep.• Hepatoprotectiveeffects.• Prevents liver damage.Facilitates theproduction of liverglycogen.**
  • …Honey• Laryngitis, rhinitis,sinusitis, coryza (headcold).• Excellent dressings forwound care. Heals fasterthan conventional wounddressing.*• Effective for MRSA(methicillin-resistantStaphylococcus aureus)infection, in 70% ofcases.**• Antifungal.• Action againstPseudomonasaeruginosa.***
  • …Honey• Honey is promising inrestorative sleep, memoryand off-line processing,immune systemenhancement, useful inpoor memory, cognitivedysfunction, depression,Alzheimer’s type dementia.(Ronald Fessenden, 1stInt.Symp. On Honey & HumanHealth, Sacramento, Ca,Jan. 8, 2008).• Honey decreases anxietyand improves memoryduring ageing. Slowsaging process.*
  • Pollen and Bee Bread• Contains almost allvitamins.• It is the best knownsource of protein innature: it contains the22 essentialaminoacids.• Recommended for liverdisorders.• Disintoxicant.• Antioxidant activity*.
  • …Pollen and Bee Bread• Strong free radicalscavenger activity,antioxidant andantiinflammatory activities.*• Euphorizant.• strengthens the nervoussystem functioning.• Stimulant.• Recommended fordepressive disorders,anxiety, anemia, sexualdysfunctions, infertility.
  • Propolis• Contains gammaglobulins.• Antitoxic properties.• Can be eitherimmunostimulant orimmunodepressant.• Extraordinary antioxidantproperties.• Stimulates collagensynthesis of vascular walls.• Stimulates wound healing.*• Very valuable in cases ofrhinitis, inflammation of nasalmucosa, septal erosion, andother disorders of respiratorypathways.
  • …Propolis• Has activity against microbial activity of Escherichia coli,Staphylococcus aureus, Enterococcus faecalis, Klebsiellapneumoniae, Pseudomonas aeruginosa, Proteus mirabilis,Bacillus subtilis, Bacillus cereus, and fungus Candida albicans.Also parasites (example: Leishmania tropica).*• Effective against microbial dental infections and gum disease.**• Caffeic acid, crysin, and naringin have radioprotective effect.***• Protects against pesticide toxicity, alleviates toxicity ofaluminium chloride.****• Pinocembrin, the most abundant flavonoid in propolis, hasneuroprotective, antioxidant, antibacterial, and antiinflammatoryproperties.*****
  • …Propolis• Hepatoprotective. Itsminerals (copper, iron,manganese, zinc),flavonoids (mainlypinocembrin, caffeic acidphenethyl ester (CAPE), ),and phenolic compoundshave hepatoprotectiveeffects, prevent liverdamage, cancer.*• Artepillin C, CAPE, galangin,kaempferol, quercetin, etc.,are antioxidant andantiangiogenic.• Activity against leukemia.**
  • …Propolis• Protects collagen against freeradicals.• Caffeic acid methyl caffeate,phenylethyl caffeate, andphenylethyl dimethyl caffeatehave antitumor properties.• Propolis ethanolic extractenhances apoptosis-inducingpotential in cancer cells.*• Quercetin, caffeic acid, andcrysin kill leukemia cells**.• CAPE (caffeic acidphenylester etyl) suppressesthe growth ofneurofibromatosis tumor.***• Flavonoids have antitumor,antioxidant, antimicrobial,antiinflammatory, antiviralaction****
  • …Propolis• Action against breast andprostate cancers.*• CAPE protects against livercancer at doses of 200-400mg/kg.**• CAPE induces apoptosis ofhuman pancreatic cancercells and suppresses thegrowth of neurofibromatosistumor.***• Propolis is effective againstdepression and fatigue.• Water-soluble components ofpropolis may mitigateamnesia at doses of 100mg/kg, and have potential forpreventing Alzheimer’sdisease.****
  • Royal Jelly• Immunostimulant.• Stimulant, invigorating, andeuphorizant.• Improves physical, sexual,and intellectual performance.• Significant delay in the onsetof lupus.*• Antidepressant.• Regulates arterial pressure.• Antibacterial,antiinflammatory,vasodilative, hypotensive,disinfectant, antioxidant,antihypercholesterolemic,antitumor, antibrowning.**• Antitoxic.
  • …Royal Jelly• Increases content ofhaemoglobin, leukocites,glucose, and blood redcells.• Effective for mooddisorders.• Enhances strength andmetabolism.• Adenosinemonophosphate N1-oxidemay help heal braininjuries.*• Protective effect on livertissue.**• Action againstPseudomonasaeruginosa.***
  • Drone Larvae• Exhaustion andweakness (asthenia)• Sexual weakness(asthenia)• Anorexia• Insomnia• Depression• Anxiety• Hepatitis
  • …Drone Larvae• Pharyngitis,laryngitis, rhinitisdue to cocaine• Improves digestivefunctions.• Tonic, stimulant• Premature aging.
  • Beeswax• For inflammations ofnasal mucosa.• In avitaminosis A: 4,100IU of vitamin A/100 g• Antioxidant properties.• Removes teeth tartarand nicotine stain,activates salivation andand gastric fluid,strengthens gums.
  • Apitoxin or Venom• Immunostimulant.• Effective for arthritis, multiplesclerosis, lupus, chronicfatigue syndome.• Normalization of arterialhypertension.• Improves brain activity andmetabolism of central andperipheric nervous systems.• Increases peristalticmovements.• Increases metabolism.• Improves liver functioning.• Induces cancer cell death(apoptosis) in many cancercell lines.*
  • …Apitoxin or Venom• Helps to repigmentationin vitiligo skin.*• Melittin promotesapoptosis of humanhepatocellularcarcinoma by activatingCa2+/calmodulin-dependent proteinkinase.**• Active againsttrypanosomiasis.***
  • Mental Disorders: DSM-IVThe Diagnostic and Statistical Manual of MentalDisorders is a reference work consulted bypsychiatrists, psychologists, physicians in clinicalpractice, social workers, medical and nursingstudents, pastoral counselors, and otherprofessionals in health care and social service fields.The books title is often shortened to DSM, or anabbreviation that also indicates edition, such as DSM-IV-TR, which indicates fourth edition, text revision ofthe manual, published in 2000, and contains some370 diagnostic entries.
  • Some DSM Disorders• Mood Disorders: Mood Episodes, Major Depressive Episode, ManicEpisode, Mixed Episode, Hypomanic Episode, Depressive Disorders,Major Depressive Disorder, Dysthymic Disorder, Bipolar Disorders,Cyclothymic Disorder.• Anxiety Disorders: Panic Attack, Agoraphobia, Panic Disorder, SocialPhobia, Obsessive-Compulsive Disorder, Posttraumatic StressDisorder, Acute Stress Disorder, Generalized Anxiety Disorder.• Somatoform Disorders: Somatization Disorder, Conversion Disorder,Pain Disorder, Hypochondriasis, Body Dysmorphic Disorder.• Dissociative Disorders: Dissociative Amnesia, Dissociative Fugue,Dissociative Identity Disorder (frmly. Multiple Personality Disorder),Depersonalization Disorder.• Sexual Dysfunctions, Sexual Desire Disorders, Hypoactive SexualDesire Disorder, Sexual Aversion Disorder, Sexual Arousal Disorders,Male Erectile Disorder, Orgasmic Disorders, Dyspareunia, Vaginismus.• Eating Disorders: Anorexia Nervosa, Bulimia Nervosa.• Sleep Disorders, Dyssomnias, Insomnia, Hypersomnia, etc.• Delirium, Dementia, Amnestic & Other Cognitive Disorders.
  • Commonly PrescribedPsychotropic Medications• Antipsychotics (used in the treatment ofschizophrenia and mania). Typical Antipsychotics: Haldol(haloperidol), Loxitane (loxapine), Mellaril (thioridazine), Moban(molindone), Navane (thiothixene), Prolixin (fluphenazine),Serentil (mesoridazine), Stelazine (trifluoperazine), Thorazine(chlorpromazine), Trilafon (perphenazine).• Atypical Antipsychotics: Abilify (aripiprazole), Clozaril(clozapine), Geodon (ziprasidone), Risperdal (risperidone),Seroquel (quetiapine), Zyprexa (olanzapine).• Mood Stabilizers (used in the treatment of bipolar disorder):Depakene (valproic acid), Depakote, Eskalith, Lithobid (lithium),Lithonate, Lithotabs, Lamictal (lamotrigine), Neurontin(gabapentin), Tegretol (carbamazepine), Topamax (topiramate).
  • …Commonly PrescribedPsychotropic Medications• Anti-depressants. Tricyclics*: Anafranil(clomipramine), Asendin (amoxapine), Elavil(amitriptyline), Norpramin (desipramine), Pamelor(nortriptyline), Sinequan (doxepin), Surmontil(trimipramine), Tofranil (imipramine), Vivactil(protiptyline).• Anti-depressants. SSRIs**: Celexa (citalopram),Lexapro (escitalopram), Luvox (fluvoxamine), Paxil(paroxetine), Prozac (fluoxetine), Zoloft (sertraline).• Anti-depressants. MAOIs***: Nardil (phenelzine),Parnate (tranylcypromine).• Anti-depressants. Others: Desyrel (trazadone),Effexor (venlafaxine), Remeron (mirtazapine),Serzone (nefazodone), Wellbutrin (bupropion).
  • …Commonly PrescribedPsychotropic Medications• Anti-panic Agents*: Klonopin (clonazepam), Paxil (paroxetine),Xanax (alprazolam), Zoloft (sertraline).• Anti-obsessive Agents: Anafranil (clomipramine), Luvox(fluvoxamine), Paxil (paroxetine), Prozac (fluoxetine), Zoloft(sertraline).• Antianxiety Agents: Ativan (lorazepam), BuSpar (buspirone),Centrax (prazepam)**, Inderal (propranolol)**, Klonopin(clonazepam), Lexapro (escitalopram), Librium(chlordiazepoxide), Serax (oxazepam)**, Tenormin (atenolol),Tranxene (clorazepate), Valium (diazepam), Xanax(alprazolam).• Stimulants (used in the treatment of ADHD)***: Adderall(amphetamine and dextroamphetamine), Cylert (pemoline),Dexedrine (dextroamphetamine), Ritalin (methylphenidate).
  • PSYCHOTROPIC MEDICATIONS:SIDE EFFECTSThe dramatic increase in the use of psychotropic medications is evident. A Healthand Safety Alert, Excessive Psychotropic Medication and PsychotropicMedication Side Effects (2002), describes the following serious side effectscommon to most psychotropic drugs:• Allergic reaction (difficulty breathing, swelling of lips/face/tongue, rash orfever).• Change in level of alertness (excess sleepiness, insomnia or confusion).• Eating problems (nausea, vomiting, weight gain or loss).• Change in stool pattern (constipation, diarrhea).• Change in heartbeat (slow, fast, irregular) or blood pressure (high or low).• Fainting or dizziness, especially with change in position such as uponstanding.• Abnormal posture, movement, or gait.• Yellowing of eyes or skin.• Unusual bruising or bleeding.
  • Concerns on Side-Effects ofPsychotropic Medication• http://www.medicationsense.com/articles/oct_dec_03/suicides_homicides. html: Suicides and Homicides in Patients TakingPaxil, Prozac, and Zoloft: Why They KeepHappening -- And Why They Will Continue –• http://organicconsumers.org/school/antidepressants060413.: Experts Say Antidepressant Drugs CauseSuicides Instead of Preventing Them -• http://www.antidepressantsfacts.com/2000-05-16-School-Shootings-Psychotropic-D: School Shootings Linked to Psychotropic DrugsSuch as Prozac, Ritalin, Luvox, and Paxil -
  • www.free_republic.comBrandeis University via sciencedaily.com ^| 2006-01-04• Psychotropic drug prescriptions for teenagersskyrocketed 250 percent between 1994 and2001, rising particularly sharply after 1999,when the federal government allowed direct-to-consumer advertising and looserpromotion of off-label use of prescriptiondrugs, according to a new Brandeis Universitystudy in the journal Psychiatric Services.
  • APITHERAPY OFMENTAL DISORDERSApitherapy of Nervous Exhaustion• Honey + pollen + soy lecithin, oral.Apitherapy of InsomniaHoney diluted in water, oral.• Honey from linden (Justicia pectoralis), oral.• Honey from acacia (Acacia sp.) or other fluidhoney, massage.• Pollen from linden (Justicia pectoralis), oral.
  • Apitherapy of Stress and AnxietyDisorders (panic disorder, phobias, obsessive-compulsive disorder, posttraumatic stress disorder,and generalized anxiety disorder)• Drone larvae (lyophilized or freeze-dried) + propolis(powder), 2 capsules a day, for 2 - 3 months.• Honey (1 kg) + pollen (100 g); mixed and left inenfleurage over 48 hours; one spoonful (or more) halfan hour before breakfast. Honey (500 g) + pollen (20g) + royal jelly (2 g); mix pollen and royal jelly withhoney, store in hermetic amber bottles in a dry andfresh place; teaspoons 2 - 3 times a day beforemeals, for 1 – 1.5 month and, if necessary, to repeattreatment after a 2 -3 weeks break. Crystallizedhoney is preferred.• Complement: Passion flower (pasiflora, pasionaria, ormaracuyá, Pasiflora incarnata) infusion or tincture.
  • Apitherapy of Mood Disorders(depressive disorders and dysthymicdisorder; bipolar disorders andcyclothymic disorder)• Honey + propolis (powder), 2 capsules a dayfor 2 - 3 months.• Honey (500 g) + pollen (20 g) + royal jelly (2g); mix pollen and royal jelly with honey:store in hermetic amber bottles and in a dryand fresh place; teaspoons 2 - 3 times a daybefore meals, for 1 – 1.5 month and, ifnecessary, to repeat treatment after a 2 – 3weeks break.
  • Apitherapy of DissociativeDisorders (dissociative amnesia,fugue, identity disorders [MPD],depersonalization disorder)• Drone larvae (lyophilized or freeze-dried) +propolis (powder), 2 capsules a day for 2 – 3months.• Honey (500 g) + pollen (20 g) + royal jelly (2g); mix pollen and royal jelly with honey:store in hermetic amber bottles and in a dryand fresh place; teaspoons 2 - 3 times a daybefore meals, for 1 – 1.5 month and, ifnecessary, to repeat treatment after a 2 – 3weeks break.
  • Apitherapy of SomatoformDisorders (somatization disorder,conversion disorder, hypochondriasis)• Drone larvae (lyophilized or freeze-dried) +propolis (powder), 2 capsules a day, for 2 - 3months.• Honey (500 g) + pollen (20 g) + royal jelly (2g); mix pollen and royal jelly with honey:store in hermetic amber bottles and in a dryand fresh place; teaspoons are taken 2 - 3times a day before meals, for 1 – 1.5 monthand, if necessary, to repeat treatment after a2 - 3 weeks break.
  • Apitherapy of SexualDysfunctions (hypoactive sexual desiredisorder, erectile dysfunction or impotence, sexualarousal disorder, hypoactive sexual desire disorder)• Drone larvae (lyophilized or freeze-dried), 2 capsulesa day for 2 – 3 months.• Propolis supositories ( 2,5 %), 5 g each night beforesleep, for 2 continuous weeks followed by another 2-week break.• Venom apipuncture for 7 days in points ST36, LR3,LI4, LI10, LI11, KI2, KI3, KI9, KI14, KI15, KI17, BL11,BL13, BL22, BL23, BL31, BL32, BL40, BL42, BL43,CV3, CV4, CV5, CV6, GV4, GV14.• Venom micro-stings on the base or pelvic inlet ofpenis bulbous branch.
  • …Apitherapy of SexualDysfunctions (hypoactive sexual desiredisorder, erectile dysfunction…)• Honey oral.• Pollen, 2 teaspoons aday, 2-3 months.• Also, diet supplementedwith honeycomb, beebread and royal jelly.• In addition, 30 g deginseng (Panaxquinquefolium, P.repens, P. schinseng) +red pitahaya(Acanthocereuspitajaya), 3 times a day.
  • …Apitherapy of SexualDysfunctions (hypoactive sexual desiredisorder, erectile dysfunction…)In addition, 1 teaspoon ofjuice or infusion of any ofthe following plants:• ashwagandha (Withaniasomnifera),• black pepper (Piper nigrum),• coriander (Coriandrumsativum),• English lavender (Lavandulastoechas),• thyme (Thymus sp.),• celery (Apium graveolensdulce),• basil (Ocimum basilicum),• orégano (Origanum vulgare),• damiana (Turneraaphrodisiaca),• muira puanua(Ptychopetalum olacoides),• cinnamon (Cinnamumzeylanicum),• bay laurel (Laurus nobilis),• catuaba (Erythroxylumvacciniifolium).
  • Addictions. What can we do when theperson suffers instead of or moreover an addiction?• Most definitions refer toaddiction as the compulsiveneed to use a habit-formingsubstance, or an irresistibleurge to engage in abehavior. Two otherimportant defining featuresof addiction are tolerance,the increasing need for moreof the substance to obtainthe same effect, andwithdrawal, the unpleasantsymptoms that arise whenan addict is prevented fromusing the chosen substance.
  • Addictions include• Alcohol• Amphetamines• Caffeine• Cannabis (marijuana,hashish, Cannabis sativa)• Cocaine• Hallucinogens (LSD,psilocybin, mescaline)• Inhalants (glues, cleaners,paints, solvents, inks, nailpolish, brake fluid, etc.)• Nicotine (tobacco)• Opioids (heroin, morphine)• Phencyclidine• Sedatives, hypnotics, oranxiolytics, painkillers,other prescriptionmedicines• Dissociative drugs(ketamine,dextromethorphan, PCP)• Steroids• Ecstasy• Polysubstance• Other substances• Other activities: addictionfor gambling, some foodsor eating, sex, shopping,etc., etc.
  • 185 Million People the World Over Abuse of IllegalDrugs (The Boston Globe, 2005). Abuse of Illegal,Legal, and Prescription Drugs Are a Challenge forModern World
  • Journal of the American MedicalAssociation 293(3):298, 2005:• 17,000 deaths related toillegal drugs in the U.S.• 20,308 deaths related tohomocide.• 20,308 deaths related tosuicide.• 26,347 deaths related to caraccidents• 85,000 deaths related toalcohol consumption.• 435,000 deaths related totobbaco comsumption.
  • Main Causes of Death in U.S.(pop. 300 million inhabitants):• Heart Diseases 710.760• Malignant Neoplasms (Cancer) 553.091• Tobacco, Alcohol, & Ill. Drugs 537.000• Cerebrovascular Disorders 167.661• Respiratory Disorders 122.009• Non Intentional Injuries 97.900• Diabetes mellitus 69.301• Influenza and Pneumonia 65.313• Alzheimer’s Dementia 49.558• Nephritis, Nephrotic Syndr., Nephrosis 37.251• Septicemia 31.224• Other Causes 499.283
  • Reward and Addiction. Interveningmechanisms• Human beings and other organismshave rewarding behaviors: pleasantstimuli provide positive reinforcement,which lead to a repetition of behavior.• There are natural rewards and artificialrewards (drugs).
  • Natural Rewards• Food• Water• Sex• Nurturing
  • Tolerance• When drugs such as heroin are used repeatedly over time,tolerance may develop.• Tolerance occurs when the person no longer responds to the drugin the way that person initially responded. Stated another way, ittakes a higher dose of the drug to achieve the same level ofresponse achieved initially. So for example, in the case of heroinor morphine, tolerance develops rapidly to the analgesic effects ofthe drug. [The development of tolerance is not addiction, althoughmany drugs that produce tolerance also have addictive potential.]• Tolerance to drugs can be produced by several differentmechanisms, but in the case of morphine or heroin, tolerancedevelops at the level of the cellular targets. For example, whenmorphine binds to opiate receptors, it triggers the inhibition of anenzyme (adenylate cyclase) that orchestrates several chemicals inthe cell to maintain the firing of impulses.• After repeated activation of the opiate receptor by morphine, theenzyme adapts so that the morphine can no longer cause changesin cell firing. Thus, the effect of a given dose of morphine orheroin is diminished
  • Dependence: Definition• With repeated use of heroin or any other drug,dependence also occurs.• Dependence develops when the neurons adapt to therepeated drug exposure and only function normally inthe presence of the drug.• When the drug is withdrawn, several physiologicreactions occur.• These can be mild (e.g. for caffeine) or even lifethreatening (e.g. for alcohol).• This is known as the withdrawal syndrome. In thecase of heroin, withdrawal can be very serious andthe abuser will use the drug again to avoid thewithdrawal syndrome.
  • The action of heroin(morphine)• Heroin is an addictive drug, although not allusers become addicted; other factors areimportant in producing addiction, such as theenvironment and the personality of the user.• Heroin produces euphoria or pleasurablefeelings and can be a positive reinforcer byinteracting with the reward pathway in thebrain.
  • Narcotics: Heroin, Opium, Morphine, Meperidine, Phentanyl,Oxycodone, Hydrocodone, Codeine, Darvon, etc. “DesignerDrugs”: Analogs of Phetanyls, Meperidines, Amphetamines(MDMA, Ecstasy), and PCPs (PCP, PCE)• Euphoria, pupilarconstriction, breathdepression, nauseareflex, bradicardia,hypotension,constipation.• Hepatitis B, VIH/AIDS,subacute bacterialendocarditis, cerebralabscesses …(more)
  • Heroin-Related Disorders• Malnutrition• Dehydration• Weight loss• Fatigue• Constipation• Collapsed veins• Abscesses• Inflammation under theskin• Kidney failure• HIV (shared needles)• Pneumonia & otherpulmonarycomplications• Infection of the heartlining and valves• Clogged blood vesselsthat lead to the lungs,heart, liver, brain, andkidneys.• Spontaneous abortions,premature births andstillbirths
  • HIV/AIDS, Hepatitis andOther Infectious Diseases• Drug injectors who do not enter treatment are up tosix times more likely to become infected with HIVthan injectors who enter and remain in treatment.• Drug users who enter and continue in treatmentreduce activities that can spread disease, such assharing injection equipment and engaging inunprotected sexual activity.• Participation in treatment also presents opportunitiesfor screening, counseling, and referral for additionalservices.• The best drug abuse treatment programs provideHIV counseling and offer HIV testing to their patients.
  • Heroin WithdrawalSymptoms• Drug craving• Restlessness• Insomnia• Cold flashes with goosebumps (“coldturkey”)• Diarrhea and vomiting• Uncontrollable kicking movements(“kicking the habit”)
  • Heroin TraditionalTreatment• Detoxification (clearing drug frompatient’s body and managingwithdrawal).• Life in a drug-free environment.• Outpatient drug-free programs(counseling)…
  • …Heroin TraditionalTreatment. Drug therapies:• Methadone (synthetic opiate that blocks the effect ofheroin for 24 hours).• LAAM (ORLAAM) [levo-alpha-acetyl-methadol],synthetic opiate that blocks the effects of heroin forup 72 hours.• Naltrexone, blocks for @ 1 year.• Suboxone and Subutex (brand names ofbuprenorphine).• Naloxone, treatment of cases of overdoses. Blocksthe effects of morphine, heroin, and other opiates.
  • Ecstasy
  • Long-term Effects ofEcstasy:Neurotoxic?• When people use Ecstasy repeatedly or long term,there may be changes in their brain chemistry thatsuggest that the serotonin neurons are damaged.• One major clue is that serotonin itself and itsmetabolites (remind students that serotonin that istaken back up into the terminal is metabolized byenzymes) are diminished in the brains of animalstreated with ecstasy.• Moreover, the best evidence that we have so far isthat even 7 years after a brief exposure to Ecstasy,serotonin levels in monkey brains have not fullyreturned to normal.
  • Stimulants: Cocaine, Crack, Amphetamines,Metamphetamine, Metylphenidate, Diet Pills1. Joy, euphoria, restlessness,irritability, insomnia, pupilardilatation, tachycardia,arrhythmia, chest pain,hypertension, anorexia,hyperpyrexia, hyperreflexia.2. Inflammation of nasalmucosa, septal erosion ornasal perforation; confusion,sensory hallucinations,paranoia, depression.3. Sudden cardiac arrest,hypertensive crisis, seizures.4. Withdrawal syndrome: severedepression withsuicida/homocidalideation,tiredness, prolongedsleep, voracious appetite.
  • Long-term effects of drug abuse(PET Scan)NormalCocaine Abuse (10d.a.)Cocaine Abuse (100 d.a.)
  • easuring Brain Activity in Response to DruUse Position Emission Tomography (PET)(PET)
  • ControlControl On CocaineOn Cocainewww.drugabuse.gov
  • The brain on drugsThe brain on drugs1-2 Min 3-4 5-66-7 7-8 8-99-10 10-20 20-30
  • PET Scan: The “memory” of drugsPET Scan: The “memory” of drugsNaturalNatural CocaineCocaineBrain FrontBrain FrontBrain BackBrain BackNon-activatedNon-activatedAmygdalaAmygdalaActivatedActivatedAmygdalaAmygdala
  • Drugs have long-termconsequences
  • Tobacco-Related Disorders (22.3% ofdeaths in the United States)• Acute Risks: Shortness ofbreath, exacerbation ofasthma, harm to pregnancy,sexual impotence, infertility,and increased serum carbonmonoxide.• Long-Term Risks: Heartattacks and strokes, lung andother cancers (larynx, oralcavity, pharynx, esophagus,colon, pancreas, bladder,cervix, some leukemia),C.O.P.D. (chronic obstructivepulmonary diseases: chronicbronchitis and emphysema),long-term disability, and needfor extended care.
  • …Tobacco-RelatedDisorders• Environmental Risks: Increasedrisk of lung cancer and heartdisease in spouses; higher rates ofsmoking in children of tobaccousers; increased risk of low birthweight, S.I.D.S. (Sudden InfantDeath Syndrome), asthma, middleear disease, and respiratoryinfections in children of smokers.• The risk of stomach ulcersincreases.• The senses of smell and taste aredulled.• Smokers are more likely todevelop cataracts and other eyeproblems.• Teeth turn yellow.• Premature wrinkling.
  • Cannabis-Related Disorders :Marijuana, THC Capsules,Hashish, Hashish Oil (0.03%)• Euphoria, sensory stimulation,pupilar constriction, conjuntivalinjection, photofobia,nystagmus, diplopia,• Increases appetite, autonomicsystem dysfunction(tachycardia, hypertension,orthostatic hypotension),temporary bronchodilatation• Gynecomastia (abnormal breastaugmentation).• Reactive disease of respiratorypathways• Decreased sperm counts• Panic, delirium, psychosis,flashbacks
  • …Marijuana-Related Disorders• Depression• Fatigue• Weight increase, lethargy,amotivational syndrome• Effects on fetus: Low birthweight, developmentaldifficulties, excessive tremblingand irritability.• HOWEVER, 11 States havedecriminalized possession ofsmall amounts of marijuana, it isused legally.• Marijuana is prescribed forstimulating appetite in cancerand AIDS patients.• Marijuana reduces nauseas ofchemotherapy, and in general.
  • Alcohol: Beer, Wine,Distillated Liquors (5.55%)• ↓ level of consciousness,poor coordination, ataxia,nystagmus, conjuntivalinjection, slurred speech,stupor, large intestinebleeding, orthostatichypotension.• Respiratory depression,pancreatitis, cirrhosis,coma, death.• Belligerant, excited,combative, psychoticstate.
  • Depressors: Benzodiapines (Valium, “V´s”,Librium, Serax, Klonopin, Tranxene, Xanax, Halcion,Rohypnol, “Ruffies”), Barbiturates (Nembutal,Seconal, Amytal, Tuinal), Metaqualone (0.03%)• Sedation of CNS, pupilarconstriction, disorientation,slurred speech,incoordinated walk• Respiratory depression,hypothermia, coma, death• Paradoxic disinhibition,hyperexcitability• Withdrawal syndrome fromanxiety, agitation, andheadaches to convulsions,delirium, hallucinations,hyperpyrexia, and death .…(more)
  • …Depressors: Benzodiapines (Valium, “V´s”,Librium, Serax, Klonopin, Tranxene, etc.• Acute overdosis canproduce respiratory arrestand death• Withdrawal syndrome:restlessness, tearing,yawning, pupilar dilatation,rhinorrea, nasal pathwaysdiscomfort, sneezing,sweating, rubor, tachycardia,hypertension, muscletremors, dizziness, vomiting,diarrheas.
  • Hallucinogens: Fencyclidine (PCP),Lysergic Acid Diethylamide (LSD),Mescaline, Peyote, Psilocybin• Perceptual distortionand hallucinations(visual, auditory),nystagmus,depersonalizationsyndrome, dizziness,tremors, tachycardia,hypertension,hyperflexia.• Flashbacks• Panic, paranoia,psychosis
  • Inhalants: Nitrous Oxyde, Amyl Nitrite, Butyl Nitrate,Chlorhydrocarburates (Spray Cans), Hydrocarbures(Gasoline, Glues, Solvents, White-out)• Euphoria,disorientation, sedation,conjuntival injection,acute toxicity for CNS,liver, and kidneys.• Nitrates: suddenhypoxemia,hypotension• Damage to peripheralnerves, CNS, liver,kidneys.• Arrhythmia and cardiacarrest.
  • Food-Addiction Related Diseases• Anorexia, Bulimia, Pica• Obesity• High Blood Pressure• Blood-Clot Disorders (DVT,stroke, embolism, othercerebrovascular accidents)• Sleep Apnea• Type 2 Diabetes• Increase Risk of SomeCancers• Heart Disease• Respiratory Problems
  • Components of Comprehensive DrugAddiction Treatment
  • Matching Patients toIndividual Needs• No single treatment is appropriate for all individuals.• Matching treatment setting, interventions, and services to eachindividual’s particular problems and needs is critical to his orher ultimate success in returning to productive functioning inthe family, workplace, and society.• Effective treatment attends to multiple needs of the individual,not just his or her drug use.• To be effective, treatment must address the individual’s druguse and any associated medical, psychological, social,vocational, and legal problems.
  • Duration of Treatment• Individuals progress through drug addiction treatment at variousspeeds, so there is no predetermined length of treatment.• Good outcomes are contingent on adequate lengths oftreatment.• Generally, for residential or outpatient treatment, participationfor less than 90 days is of limited or no effectiveness, andtreatments lasting significantly longer often are indicated.• For methadone maintenance, 12 months of treatment is theminimum, and some opiate-addicted individuals will continue tobenefit from methadone maintenance treatment over a period ofyears.
  • Medical Detoxification• Medical detoxification safely manages the acutephysical symptoms of withdrawal associated withstopping drug use.• However, medical detoxification is only the firststage of addiction treatment and by itself does littleto change long-term drug use.• While detoxification alone is rarely sufficient to helpaddicts achieve long-term abstinence, for someindividuals it is a strongly indicated precursor toeffective drug addiction treatment.
  • Counseling and Other BehavioralTherapiesBuild skillsto resistdrug useReplacedrug-usingactivitiesMotivationImproveproblem-solvingabilitiesFacilitateinterpersonalrelationships,family,communitywww.drugabuse.gov
  • Medications for DrugAddiction• Medications are an important element of treatment for manypatients, especially when combined with counseling and otherbehavioral therapies.• Methadone and levo-alpha-acetylmethadol (LAAM) are veryeffective in helping individuals addicted to heroin or otheropiates stabilize their lives and reduce their illicit drug use.• Naltrexone is also an effective medication for some opiateaddicts and some patients with co-occurring addiction toalcohol.• For persons addicted to nicotine, a nicotine-replacementproduct (such as patches or gum) or an oral medication (suchas bupropion) can be an effective component of treatment.• For patients with mental disorders, both behavioral treatmentsand medications can be critically important.www.drugabuse.gov
  • Motivation toEnter/Sustain Treatment• Treatment does not need to be voluntary to be effective.• Strong motivation can facilitate the treatment process.• Sanctions or enticements in the family, employmentsetting, or criminal justice system can increasesignificantly both treatment entry and retention rates andthe success of drug treatment interventions.• Individuals who enter treatment under legal pressure haveoutcomes as favorable as those who enter treatmentvoluntarily.
  • …For example, Smokingcessation programs face somebarriers:• Withdrawal symptoms.• Fear of failure.• Weight gain.• Lack of support.• Depression.• Enjoyment of tobacco.• Of the 2.4 milliondeaths that occur eachyear in the US, cigarettesmoking is a root causeof 400,000 of them(20% of all deaths), butnicotine is much moreaddictive than anyother drug.
  • Effectiveness ofTreatment• According to several studies, drug treatment reduces drug use by40 to 60 percent and significantly decreases criminal activity duringand after treatment.• For example, a study of therapeutic community treatment for drugoffenders demonstrated that arrests for violent and nonviolentcriminal acts were reduced by 40 percent or more.• Methadone treatment has been shown to decrease criminalbehavior by as much as 50 percent.• Research shows that drug addiction treatment reduces the risk ofHIV infection and that interventions to prevent HIV are much lesscostly than treating HIV-related illnesses.• Treatment can improve the prospects for employment, with gains ofup to 40 percent after treatment.• Although these effectiveness rates hold in general, individualtreatment outcomes depend on the extent and nature of thepatient’s presenting problems, the appropriateness of the treatmentcomponents and related services used to address those problems,and the degree of active engagement of the patient in the treatmentprocess.
  • Self-Help and DrugAddiction Treatment• Self-help groups can complement and extend the effects ofprofessional drug addiction treatment.• The most prominent self-help groups are those affiliated withAlcoholics Anonymous (AA), Narcotics Anonymous (NA), andCocaine Anonymous (CA), all of which are based on the 12-step model and Smart Recovery.• Most drug addiction treatment programs encourage patientsto participate in a self-help group during and after formaltreatment.
  • Cost-Effectiveness ofDrug Treatment• Drug addiction treatment is cost-effective in reducing drug use andits associated health and social costs.• Treatment is less expensive than alternatives, such as not treatingaddicts or simply incarcerating addicts. For example, the averagecost for 1 full year of methadone maintenance treatment isapproximately $4,700 per patient, whereas 1 full year ofimprisonment costs approximately $18,400 per person.• According to several conservative estimates, every $1 invested inaddiction treatment programs yields a return of between $4 and $7in reduced drug-related crime, criminal justice costs, and theftalone. When savings related to health care are included, totalsavings can exceed costs by a ration of 12 to 1.• Major savings to the individual and society also come fromsignificant drops in interpersonal conflicts, improvements inworkplace productivity, and reductions in drug-related accidents.
  • Apitherapy of Addictions• Apitherapy Can Be an Non-Expensive, Affordable Part of theSolution
  • Apitherapy of SubstanceAddictions (cocaine, cannabis,metamphetamines, opioids, and others)• Beeswax, to chew and eathoneycomb pieces.• Royal jelly, 1 teaspoon aday.• Drone larvae oral.• Honey, 6 teaspoons every20 minutes, 3 continuedcycles.• Honey, oral, ad libitum,disolved in tea (Camelliasinensis).• Bee bread, ad libitum,disolved in tea.
  • Substance addictions(…)• Pollen, ad libitum,disolved in tea.• Propolis 500 mgcapsules, 1 capsule 1hour before each meal.• Propolis ointment,massage with pressurein acupuncture pointsLI4, LI10, LI11, LI20,• and in chiapi points(both sides of nasalseptum, between nasalbone and nasalcartilage).
  • Substance addictions(…)• For their role as hepatoprotectors, reconstituyents,immunoregulators, and biostimulants, bee productsare an excellent supplement for guaranteeing thatpatients are receiving a daily total of:• 5,000 IU of vitamin A, 75 mg of each component ofvitamin B complex, 1,500 mg of vitamin C, 800 mg ofvitamin E, 3,000 mg of glutathione, 1,000 mg decoline, 250 mg of L-carnitine, 500 mg of N-acetylcysteine, 400 mg of selenium, 50 mg of zinc, 4mg of copper, 200 mg of chromium, flavonoids, andother antioxidants.
  • Substance addictions(…)As desintoxicants and hepatoprotectors, thesemedicinal plants can also be used:• milk thistle (Silybum marianum),• ginger (Zingiber officinale),• burdock (Arctium lappa),• dandelion (Taraxacum officinale) and• liquorice (Glycyrrhiza glabra).In the case of opioids, treatment can becomplemented with passion flower (Pasifloraincarnata) infusion or tincture.
  • Apitherapy of Alcoholand NicotineAddictions• Beeswax, to chew and eathoneycomb pieces.• Beeswax chewing forwithdrawal anxiety.• Royal jelly, 1 teaspoon aday.• Drone larvae oral.• Honey, 6 teaspoons every20 minutes, 3 continuedcycles.• Honey, oral, ad libitum,disolved in tea (Camelliasinensis).• Bee bread, ad libitum,disolved in tea.
  • …Apitherapy of Alcoholand NicotineAddictions• Propolis tinture in water, halfan hour before meals reduceappetite.• Propolis 500 mg capsules,1 capsule 1 hour beforeeach meal.• Propolis ointment, massagewith pressure in acupuncturepoints LI4, LI10, LI11, LI20,• and in chiapi points (bothsides of nasal septum,between nasal bone andnasal cartilage).
  • …Apitherapy of Alcoholand NicotineAddictions• In treating alcohol addiction, it is also recommendedan infusion of 10 – 20 g of powdered root of pueraria(Pueraria lobata, P. thomsonii).• Thanks to their role as hepatoprotectors,reconstituyents, immunoregulators, andbiostimulants, bee products are an excellent supplentfor guaranteeing that patients are receiving a dailytotal of 5,000 IU of vitamin A, 75 mg of eachcomponent of vitamin B complex, 1,500 mg of vitaminC, 800 mg of vitamin E, 3,000 mg of glutathione,1,000 mg de coline, 250 mg of L-carnitine, 500 mg ofN-acetylcisteine, 400 mg of selenium, 50 mg of zinc,4 mg of copper, 200 mg of chromium, flavonoids, andother antioxidants.
  • …Apitherapy of Alcoholand NicotineAddictionsAs desintoxicants andhepatoprotectors thesemedicinal plants can also beused:• milk thistle (Silybummarianum),• ginger (Zingiber officinale),• burdock (Arctium lappa),• dandelion (Taraxacumofficinale) and• liquorice (Glycyrrhizaglabra).
  • + Questions?: apitherapy101@gmail.com .THANKS!!!