Successfully reported this slideshow.

Moises Asis cmacc 2009 apitherapy for mental disorders and chemical addictions

6

Share

Upcoming SlideShare
Bee venom therapy
Bee venom therapy
Loading in …3
×
1 of 107
1 of 107

More Related Content

Related Books

Free with a 14 day trial from Scribd

See all

Related Audiobooks

Free with a 14 day trial from Scribd

See all

Moises Asis cmacc 2009 apitherapy for mental disorders and chemical addictions

  1. 1. APITHERAPY FOR MENTAL DISORDERS AND SUBSTANCE ADDICTIONS Moisés Asís, MSW, JD, PhD. (CMACC 12/2009, New York)
  2. 2. APITHERAPY: Definition (2007) • “It is the Complementary and Alternative Medicine that promotes the use of bee products (honey and honeydew, propolis, beeswax, pollen and bee bread, apitoxin or bee venom, drone larvae, royal jelly, and whole bees) for nutrition, enhancement of health and life quality, prevention and treatment of diseases, and for cosmetics. Apitherapy comprises, among its many procedures, the apitoxitherapy or bee venom therapy, and the apipuncture or acupuncture by beestings or apitoxin microinjections.”
  3. 3. Some Apitherapy procedures
  4. 4. ...Some Apitherapy procedures
  5. 5. …Some Apitherapy procedures
  6. 6. …Some Apitherapy procedures
  7. 7. Mental Disorders and Addictions • Intrapsychic Factors • Social/Family • Biological & Genetic • Motivational • Emotional • Other Factors
  8. 8. ALL DISEASES ARE PSYCHOSOMATIC • … but some ones are more psychosomatic than others.
  9. 9. D.E.W.N.I.S.: Apitherapy Protocol for Mental Disorders & Addictions: 1. Detoxification 2. Energy 3. Wellness in General 4. Nutrition 5. Immune System Boost 6. Synergy with Other Procedures & Medications
  10. 10. Apitherapy will be used • For treatment of mental disorders and addictions. • For synergies of such treatments. • For treatment of medical conditions associated to such conditions and treatments.
  11. 11. 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 for withdrawal symptoms and for synergy with other treatments. 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 Apitherapy cosmetics. 7. Beekeeping is an activity requiring discipline, physical activity, contact with nature, and body clean from drug/alcohol odors.
  12. 12. Honey • Its fast assimilation prevents alcoholic fermentation. • Euphorizant. • Very valuable for fast detoxification of alcoholics. • For weakness (asthenia) and mental/physical exhaustion. • Depressive conditions. • Beneficial on body weight and blood lipids in type 2 diabetes.* • For dengue virus prevention.
  13. 13. …Honey • Antitoxic properties. • High energy value (3.3 cal/g) • Insomnia. • Antioxidant, nutritive, and energetic properties. • Antianemic. • Increases libido, has aphrodisiac properties. • Antitumor activitiy in lung carcinoma.*
  14. 14. …Honey • For stress and hyperactivity. • Helps heal radiotherapy-impaired wounds.* • Improves sleep. • Hepatoprotective effects. • Prevents liver damage. Facilitates the production of liver glycogen.**
  15. 15. …Honey • Laryngitis, rhinitis, sinusitis, coryza (head cold). • Excellent dressings for wound care. Heals faster than conventional wound dressing.* • Effective for MRSA (methicillin-resistant Staphylococcus aureus) infection, in 70% of cases.** • Antifungal. • Action against Pseudomonas aeruginosa.***
  16. 16. …Honey • Honey is promising in restorative sleep, memory and off-line processing, immune system enhancement, useful in poor memory, cognitive dysfunction, depression, Alzheimer’s type dementia. (Ronald Fessenden, 1st Int. Symp. On Honey & Human Health, Sacramento, Ca, Jan. 8, 2008). • Honey decreases anxiety and improves memory during ageing. Slows aging process.*
  17. 17. Pollen and Bee Bread • Contains almost all vitamins. • It is the best known source of protein in nature: it contains the 22 essential aminoacids. • Recommended for liver disorders. • Disintoxicant. • Antioxidant activity*.
  18. 18. …Pollen and Bee Bread • Strong free radical scavenger activity, antioxidant and antiinflammatory activities.* • Euphorizant. • strengthens the nervous system functioning. • Stimulant. • Recommended for depressive disorders, anxiety, anemia, sexual dysfunctions, infertility.
  19. 19. Propolis • Contains gammaglobulins. • Antitoxic properties. • Can be either immunostimulant or immunodepressant. • Extraordinary antioxidant properties. • Stimulates collagen synthesis of vascular walls. • Stimulates wound healing.* • Very valuable in cases of rhinitis, inflammation of nasal mucosa, septal erosion, and other disorders of respiratory pathways.
  20. 20. …Propolis • Has activity against microbial activity of Escherichia coli, Staphylococcus aureus, Enterococcus faecalis, Klebsiella pneumoniae, 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 of aluminium chloride.**** • Pinocembrin, the most abundant flavonoid in propolis, has neuroprotective, antioxidant, antibacterial, and antiinflammatory properties.*****
  21. 21. …Propolis • Hepatoprotective. Its minerals (copper, iron, manganese, zinc), flavonoids (mainly pinocembrin, caffeic acid phenethyl ester (CAPE), ), and phenolic compounds have hepatoprotective effects, prevent liver damage, cancer.* • Artepillin C, CAPE, galangin, kaempferol, quercetin, etc., are antioxidant and antiangiogenic. • Activity against leukemia.**
  22. 22. …Propolis • Protects collagen against free radicals. • Caffeic acid methyl caffeate, phenylethyl caffeate, and phenylethyl dimethyl caffeate have antitumor properties. • Propolis ethanolic extract enhances apoptosis-inducing potential in cancer cells.* • Quercetin, caffeic acid, and crysin kill leukemia cells**. • CAPE (caffeic acid phenylester etyl) suppresses the growth of neurofibromatosis tumor.*** • Flavonoids have antitumor, antioxidant, antimicrobial, antiinflammatory, antiviral action****
  23. 23. …Propolis • Action against breast and prostate cancers.* • CAPE protects against liver cancer at doses of 200-400 mg/kg.** • CAPE induces apoptosis of human pancreatic cancer cells and suppresses the growth of neurofibromatosis tumor.*** • Propolis is effective against depression and fatigue. • Water-soluble components of propolis may mitigate amnesia at doses of 100 mg/kg, and have potential for preventing Alzheimer’s disease.****
  24. 24. Royal Jelly • Immunostimulant. • Stimulant, invigorating, and euphorizant. • Improves physical, sexual, and intellectual performance. • Significant delay in the onset of lupus.* • Antidepressant. • Regulates arterial pressure. • Antibacterial, antiinflammatory, vasodilative, hypotensive, disinfectant, antioxidant, antihypercholesterolemic, antitumor, antibrowning.** • Antitoxic.
  25. 25. …Royal Jelly • Increases content of haemoglobin, leukocites, glucose, and blood red cells. • Effective for mood disorders. • Enhances strength and metabolism. • Adenosine monophosphate N1-oxide may help heal brain injuries.* • Protective effect on liver tissue.** • Action against Pseudomonas aeruginosa.***
  26. 26. Drone Larvae • Exhaustion and weakness (asthenia) • Sexual weakness (asthenia) • Anorexia • Insomnia • Depression • Anxiety • Hepatitis
  27. 27. …Drone Larvae • Pharyngitis, laryngitis, rhinitis due to cocaine • Improves digestive functions. • Tonic, stimulant • Premature aging.
  28. 28. Beeswax • For inflammations of nasal mucosa. • In avitaminosis A: 4,100 IU of vitamin A/100 g • Antioxidant properties. • Removes teeth tartar and nicotine stain, activates salivation and and gastric fluid, strengthens gums.
  29. 29. Apitoxin or Venom • Immunostimulant. • Effective for arthritis, multiple sclerosis, lupus, chronic fatigue syndome. • Normalization of arterial hypertension. • Improves brain activity and metabolism of central and peripheric nervous systems. • Increases peristaltic movements. • Increases metabolism. • Improves liver functioning. • Induces cancer cell death (apoptosis) in many cancer cell lines.*
  30. 30. …Apitoxin or Venom • Helps to repigmentation in vitiligo skin.* • Melittin promotes apoptosis of human hepatocellular carcinoma by activating Ca2+/calmodulin- dependent protein kinase.** • Active against trypanosomiasis.***
  31. 31. Mental Disorders: DSM-IV The Diagnostic and Statistical Manual of Mental Disorders is a reference work consulted by psychiatrists, psychologists, physicians in clinical practice, social workers, medical and nursing students, pastoral counselors, and other professionals in health care and social service fields. The book's title is often shortened to DSM, or an abbreviation that also indicates edition, such as DSM- IV-TR, which indicates fourth edition, text revision of the manual, published in 2000, and contains some 370 diagnostic entries.
  32. 32. Some DSM Disorders • Mood Disorders: Mood Episodes, Major Depressive Episode, Manic Episode, Mixed Episode, Hypomanic Episode, Depressive Disorders, Major Depressive Disorder, Dysthymic Disorder, Bipolar Disorders, Cyclothymic Disorder. • Anxiety Disorders: Panic Attack, Agoraphobia, Panic Disorder, Social Phobia, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, 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 Sexual Desire 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.
  33. 33. Commonly Prescribed Psychotropic Medications • Antipsychotics (used in the treatment of schizophrenia 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).
  34. 34. …Commonly Prescribed Psychotropic 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).
  35. 35. …Commonly Prescribed Psychotropic 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).
  36. 36. PSYCHOTROPIC MEDICATIONS: SIDE EFFECTS The dramatic increase in the use of psychotropic medications is evident. A Health and Safety Alert, Excessive Psychotropic Medication and Psychotropic Medication Side Effects (2002), describes the following serious side effects common to most psychotropic drugs: • Allergic reaction (difficulty breathing, swelling of lips/face/tongue, rash or fever). • 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 upon standing. • Abnormal posture, movement, or gait. • Yellowing of eyes or skin. • Unusual bruising or bleeding.
  37. 37. Concerns on Side-Effects of Psychotropic Medication • http://www.medicationsense.com/articles/oct_dec_03/suicides_homicides. html : Suicides and Homicides in Patients Taking Paxil, Prozac, and Zoloft: Why They Keep Happening -- And Why They Will Continue – • http://organicconsumers.org/school/antidepressants060413. : Experts Say Antidepressant Drugs Cause Suicides Instead of Preventing Them - • http://www.antidepressantsfacts.com/2000-05-16-School-Shootings-Psychotropic-D : School Shootings Linked to Psychotropic Drugs Such as Prozac, Ritalin, Luvox, and Paxil -
  38. 38. www.free_republic.com Brandeis University via sciencedaily.com ^ | 2006-01-04 • Psychotropic drug prescriptions for teenagers skyrocketed 250 percent between 1994 and 2001, rising particularly sharply after 1999, when the federal government allowed direct- to-consumer advertising and looser promotion of off-label use of prescription drugs, according to a new Brandeis University study in the journal Psychiatric Services.
  39. 39. APITHERAPY OF MENTAL DISORDERS Apitherapy of Nervous Exhaustion • Honey + pollen + soy lecithin, oral. Apitherapy of Insomnia Honey diluted in water, oral. • Honey from linden (Justicia pectoralis), oral. • Honey from acacia (Acacia sp.) or other fluid honey, massage. • Pollen from linden (Justicia pectoralis), oral.
  40. 40. Apitherapy of Stress and Anxiety Disorders (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 in enfleurage over 48 hours; one spoonful (or more) half an hour before breakfast. Honey (500 g) + pollen (20 g) + royal jelly (2 g); mix pollen and royal jelly with honey, store in hermetic amber bottles in a dry and fresh place; teaspoons 2 - 3 times a day before meals, for 1 – 1.5 month and, if necessary, to repeat treatment after a 2 -3 weeks break. Crystallized honey is preferred. • Complement: Passion flower (pasiflora, pasionaria, or maracuyá, Pasiflora incarnata) infusion or tincture.
  41. 41. Apitherapy of Mood Disorders (depressive disorders and dysthymic disorder; bipolar disorders and cyclothymic disorder) • Honey + propolis (powder), 2 capsules a day for 2 - 3 months. • Honey (500 g) + pollen (20 g) + royal jelly (2 g); mix pollen and royal jelly with honey: store in hermetic amber bottles and in a dry and fresh place; teaspoons 2 - 3 times a day before meals, for 1 – 1.5 month and, if necessary, to repeat treatment after a 2 – 3 weeks break.
  42. 42. Apitherapy of Dissociative Disorders (dissociative amnesia, fugue, identity disorders [MPD], depersonalization disorder) • Drone larvae (lyophilized or freeze-dried) + propolis (powder), 2 capsules a day for 2 – 3 months. • Honey (500 g) + pollen (20 g) + royal jelly (2 g); mix pollen and royal jelly with honey: store in hermetic amber bottles and in a dry and fresh place; teaspoons 2 - 3 times a day before meals, for 1 – 1.5 month and, if necessary, to repeat treatment after a 2 – 3 weeks break.
  43. 43. Apitherapy of Somatoform Disorders (somatization disorder, conversion disorder, hypochondriasis) • Drone larvae (lyophilized or freeze-dried) + propolis (powder), 2 capsules a day, for 2 - 3 months. • Honey (500 g) + pollen (20 g) + royal jelly (2 g); mix pollen and royal jelly with honey: store in hermetic amber bottles and in a dry and fresh place; teaspoons are taken 2 - 3 times a day before meals, for 1 – 1.5 month and, if necessary, to repeat treatment after a 2 - 3 weeks break.
  44. 44. Apitherapy of Sexual Dysfunctions (hypoactive sexual desire disorder, erectile dysfunction or impotence, sexual arousal disorder, hypoactive sexual desire disorder) • Drone larvae (lyophilized or freeze-dried), 2 capsules a day for 2 – 3 months. • Propolis supositories ( 2,5 %), 5 g each night before sleep, 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 of penis bulbous branch.
  45. 45. …Apitherapy of Sexual Dysfunctions (hypoactive sexual desire disorder, erectile dysfunction…) • Honey oral. • Pollen, 2 teaspoons a day, 2-3 months. • Also, diet supplemented with honeycomb, bee bread and royal jelly. • In addition, 30 g de ginseng (Panax quinquefolium, P. repens, P. schinseng) + red pitahaya (Acanthocereus pitajaya), 3 times a day.
  46. 46. …Apitherapy of Sexual Dysfunctions (hypoactive sexual desire disorder, erectile dysfunction…) In addition, 1 teaspoon of juice or infusion of any of the following plants: • ashwagandha (Withania somnifera), • black pepper (Piper nigrum), • coriander (Coriandrum sativum), • English lavender (Lavandula stoechas), • thyme (Thymus sp.), • celery (Apium graveolens dulce), • basil (Ocimum basilicum), • orégano (Origanum vulgare), • damiana (Turnera aphrodisiaca), • muira puanua (Ptychopetalum olacoides), • cinnamon (Cinnamum zeylanicum), • bay laurel (Laurus nobilis), • catuaba (Erythroxylum vacciniifolium).
  47. 47. Addictions. What can we do when the person suffers instead of or moreover an addiction? • Most definitions refer to addiction as the compulsive need to use a habit-forming substance, or an irresistible urge to engage in a behavior. Two other important defining features of addiction are tolerance, the increasing need for more of the substance to obtain the same effect, and withdrawal, the unpleasant symptoms that arise when an addict is prevented from using the chosen substance.
  48. 48. Addictions include • Alcohol • Amphetamines • Caffeine • Cannabis (marijuana, hashish, Cannabis sativa) • Cocaine • Hallucinogens (LSD, psilocybin, mescaline) • Inhalants (glues, cleaners, paints, solvents, inks, nail polish, brake fluid, etc.) • Nicotine (tobacco) • Opioids (heroin, morphine) • Phencyclidine • Sedatives, hypnotics, or anxiolytics, painkillers, other prescription medicines • Dissociative drugs (ketamine, dextromethorphan, PCP) • Steroids • Ecstasy • Polysubstance • Other substances • Other activities: addiction for gambling, some foods or eating, sex, shopping, etc., etc.
  49. 49. 185 Million People the World Over Abuse of Illegal Drugs (The Boston Globe, 2005). Abuse of Illegal, Legal, and Prescription Drugs Are a Challenge for Modern World
  50. 50. Journal of the American Medical Association 293(3):298, 2005: • 17,000 deaths related to illegal drugs in the U.S. • 20,308 deaths related to homocide. • 20,308 deaths related to suicide. • 26,347 deaths related to car accidents • 85,000 deaths related to alcohol consumption. • 435,000 deaths related to tobbaco comsumption.
  51. 51. 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
  52. 52. 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).
  53. 53. Natural Rewards • Food • Water • Sex • Nurturing
  54. 54. 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
  55. 55. Dependence: Definition • With repeated use of heroin or any other drug, 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.
  56. 56. 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.
  57. 57. Narcotics: Heroin, Opium, Morphine, Meperidine, Phentanyl, Oxycodone, Hydrocodone, Codeine, Darvon, etc. “Designer Drugs”: Analogs of Phetanyls, Meperidines, Amphetamines (MDMA, Ecstasy), and PCPs (PCP, PCE) • Euphoria, pupilar constriction, breath depression, nausea reflex, bradicardia, hypotension, constipation. • Hepatitis B, VIH/AIDS, subacute bacterial endocarditis, cerebral abscesses … (more)
  58. 58. Heroin-Related Disorders • Malnutrition • Dehydration • Weight loss • Fatigue • Constipation • Collapsed veins • Abscesses • Inflammation under the skin • Kidney failure • HIV (shared needles) • Pneumonia & other pulmonary complications • Infection of the heart lining and valves • Clogged blood vessels that lead to the lungs, heart, liver, brain, and kidneys. • Spontaneous abortions, premature births and stillbirths
  59. 59. 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.
  60. 60. Heroin Withdrawal Symptoms • Drug craving • Restlessness • Insomnia • Cold flashes with goosebumps (“cold turkey”) • Diarrhea and vomiting • Uncontrollable kicking movements (“kicking the habit”)
  61. 61. Heroin Traditional Treatment • Detoxification (clearing drug from patient’s body and managing withdrawal). • Life in a drug-free environment. • Outpatient drug-free programs (counseling)…
  62. 62. …Heroin Traditional Treatment. Drug therapies: • Methadone (synthetic opiate that blocks the effect of heroin for 24 hours). • LAAM (ORLAAM) [levo-alpha-acetyl-methadol], synthetic opiate that blocks the effects of heroin for up 72 hours. • Naltrexone, blocks for @ 1 year. • Suboxone and Subutex (brand names of buprenorphine). • Naloxone, treatment of cases of overdoses. Blocks the effects of morphine, heroin, and other opiates.
  63. 63. Ecstasy
  64. 64. 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.
  65. 65. Stimulants: Cocaine, Crack, Amphetamines, Metamphetamine, Metylphenidate, Diet Pills 1. Joy, euphoria, restlessness, irritability, insomnia, pupilar dilatation, tachycardia, arrhythmia, chest pain, hypertension, anorexia, hyperpyrexia, hyperreflexia. 2. Inflammation of nasal mucosa, septal erosion or nasal perforation; confusion, sensory hallucinations, paranoia, depression. 3. Sudden cardiac arrest, hypertensive crisis, seizures. 4. Withdrawal syndrome: severe depression with suicida/homocidal ideation,tiredness, prolonged sleep, voracious appetite.
  66. 66. Long-term effects of drug abuse (PET Scan) Normal Cocaine Abuse (10 d.a.) Cocaine Abuse (100 d.a.)
  67. 67. easuring Brain Activity in Response to Dru Use Position Emission Tomography (PET)(PET)
  68. 68. ControlControl On CocaineOn Cocaine www.drugabuse.gov
  69. 69. The brain on drugsThe brain on drugs 1-2 Min 3-4 5-6 6-7 7-8 8-9 9-10 10-20 20-30
  70. 70. PET Scan: The “memory” of drugsPET Scan: The “memory” of drugs NaturalNatural CocaineCocaine Brain FrontBrain Front Brain BackBrain Back Non-activatedNon-activated AmygdalaAmygdala ActivatedActivated AmygdalaAmygdala
  71. 71. Drugs have long- term consequences
  72. 72. Tobacco-Related Disorders (22.3% of deaths in the United States) • Acute Risks: Shortness of breath, exacerbation of asthma, harm to pregnancy, sexual impotence, infertility, and increased serum carbon monoxide. • Long-Term Risks: Heart attacks and strokes, lung and other cancers (larynx, oral cavity, pharynx, esophagus, colon, pancreas, bladder, cervix, some leukemia), C.O.P.D. (chronic obstructive pulmonary diseases: chronic bronchitis and emphysema), long-term disability, and need for extended care.
  73. 73. …Tobacco-Related Disorders • Environmental Risks: Increased risk of lung cancer and heart disease in spouses; higher rates of smoking in children of tobacco users; increased risk of low birth weight, S.I.D.S. (Sudden Infant Death Syndrome), asthma, middle ear disease, and respiratory infections in children of smokers. • The risk of stomach ulcers increases. • The senses of smell and taste are dulled. • Smokers are more likely to develop cataracts and other eye problems. • Teeth turn yellow. • Premature wrinkling.
  74. 74. Cannabis-Related Disorders : Marijuana, THC Capsules, Hashish, Hashish Oil (0.03%) • Euphoria, sensory stimulation, pupilar constriction, conjuntival injection, photofobia, nystagmus, diplopia, • Increases appetite, autonomic system dysfunction (tachycardia, hypertension, orthostatic hypotension), temporary bronchodilatation • Gynecomastia (abnormal breast augmentation). • Reactive disease of respiratory pathways • Decreased sperm counts • Panic, delirium, psychosis, flashbacks
  75. 75. …Marijuana-Related Disorders • Depression • Fatigue • Weight increase, lethargy, amotivational syndrome • Effects on fetus: Low birth weight, developmental difficulties, excessive trembling and irritability. • HOWEVER, 11 States have decriminalized possession of small amounts of marijuana, it is used legally. • Marijuana is prescribed for stimulating appetite in cancer and AIDS patients. • Marijuana reduces nauseas of chemotherapy, and in general.
  76. 76. Alcohol: Beer, Wine, Distillated Liquors (5.55%) • ↓ level of consciousness, poor coordination, ataxia, nystagmus, conjuntival injection, slurred speech, stupor, large intestine bleeding, orthostatic hypotension. • Respiratory depression, pancreatitis, cirrhosis, coma, death. • Belligerant, excited, combative, psychotic state.
  77. 77. Depressors: Benzodiapines (Valium, “V´s”, Librium, Serax, Klonopin, Tranxene, Xanax, Halcion, Rohypnol, “Ruffies”), Barbiturates (Nembutal, Seconal, Amytal, Tuinal), Metaqualone (0.03%) • Sedation of CNS, pupilar constriction, disorientation, slurred speech, incoordinated walk • Respiratory depression, hypothermia, coma, death • Paradoxic disinhibition, hyperexcitability • Withdrawal syndrome from anxiety, agitation, and headaches to convulsions, delirium, hallucinations, hyperpyrexia, and death . …(more)
  78. 78. …Depressors: Benzodiapines (Valium, “V´s”, Librium, Serax, Klonopin, Tranxene, etc. • Acute overdosis can produce respiratory arrest and death • Withdrawal syndrome: restlessness, tearing, yawning, pupilar dilatation, rhinorrea, nasal pathways discomfort, sneezing, sweating, rubor, tachycardia, hypertension, muscle tremors, dizziness, vomiting, diarrheas.
  79. 79. Hallucinogens: Fencyclidine (PCP), Lysergic Acid Diethylamide (LSD), Mescaline, Peyote, Psilocybin • Perceptual distortion and hallucinations (visual, auditory), nystagmus, depersonalization syndrome, dizziness, tremors, tachycardia, hypertension, hyperflexia. • Flashbacks • Panic, paranoia, psychosis
  80. 80. 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: sudden hypoxemia, hypotension • Damage to peripheral nerves, CNS, liver, kidneys. • Arrhythmia and cardiac arrest.
  81. 81. Food-Addiction Related Diseases • Anorexia, Bulimia, Pica • Obesity • High Blood Pressure • Blood-Clot Disorders (DVT, stroke, embolism, other cerebrovascular accidents) • Sleep Apnea • Type 2 Diabetes • Increase Risk of Some Cancers • Heart Disease • Respiratory Problems
  82. 82. Components of Comprehensive Drug Addiction Treatment
  83. 83. 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.
  84. 84. Duration of Treatment • Individuals progress through drug addiction treatment at various speeds, so there is no predetermined length of treatment. • 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.
  85. 85. 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.
  86. 86. Counseling and Other Behavioral Therapies Build skills to resist drug use Replace drug-using activities Motivation Improve problem-solving abilities Facilitate interpersonal relationships, family, community www.drugabuse.gov
  87. 87. 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. www.drugabuse.gov
  88. 88. 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.
  89. 89. …For example, Smoking cessation programs face some barriers: • Withdrawal symptoms. • Fear of failure. • Weight gain. • Lack of support. • Depression. • Enjoyment of tobacco. • Of the 2.4 million deaths that occur each year in the US, cigarette smoking is a root cause of 400,000 of them (20% of all deaths), but nicotine is much more addictive than any other drug.
  90. 90. 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. • 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.
  91. 91. 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.
  92. 92. 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.
  93. 93. Apitherapy of Addictions • Apitherapy Can Be an Non- Expensive, Affordable Part of the Solution
  94. 94. Apitherapy of Substance Addictions (cocaine, cannabis, metamphetamines, opioids, and others) • Beeswax, to chew and eat honeycomb pieces. • Royal jelly, 1 teaspoon a day. • Drone larvae oral. • Honey, 6 teaspoons every 20 minutes, 3 continued cycles. • Honey, oral, ad libitum, disolved in tea (Camellia sinensis). • Bee bread, ad libitum, disolved in tea.
  95. 95. Substance addictions (…) • Pollen, ad libitum, disolved in tea. • Propolis 500 mg capsules, 1 capsule 1 hour before each meal. • Propolis ointment, massage with pressure in acupuncture points LI4, LI10, LI11, LI20, • and in chiapi points (both sides of nasal septum, between nasal bone and nasal cartilage).
  96. 96. Substance addictions (…) • For their role as hepatoprotectors, reconstituyents, immunoregulators, and biostimulants, bee products are an excellent supplement for guaranteeing that patients are receiving a daily total of: • 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.
  97. 97. Substance addictions (…) As desintoxicants and hepatoprotectors, these medicinal 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 be complemented with passion flower (Pasiflora incarnata) infusion or tincture.
  98. 98. Apitherapy of Alcohol and Nicotine Addictions• Beeswax, to chew and eat honeycomb pieces. • Beeswax chewing for withdrawal anxiety. • Royal jelly, 1 teaspoon a day. • Drone larvae oral. • Honey, 6 teaspoons every 20 minutes, 3 continued cycles. • Honey, oral, ad libitum, disolved in tea (Camellia sinensis). • Bee bread, ad libitum, disolved in tea.
  99. 99. …Apitherapy of Alcohol and Nicotine Addictions• Propolis tinture in water, half an hour before meals reduce appetite. • Propolis 500 mg capsules, 1 capsule 1 hour before each meal. • Propolis ointment, massage with pressure in acupuncture points LI4, LI10, LI11, LI20, • and in chiapi points (both sides of nasal septum, between nasal bone and nasal cartilage).
  100. 100. …Apitherapy of Alcohol and Nicotine Addictions• In treating alcohol addiction, it is also recommended an infusion of 10 – 20 g of powdered root of pueraria (Pueraria lobata, P. thomsonii). • Thanks to their role as hepatoprotectors, reconstituyents, immunoregulators, and biostimulants, bee products are an excellent supplent for guaranteeing that patients are receiving a daily total of 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-acetylcisteine, 400 mg of selenium, 50 mg of zinc, 4 mg of copper, 200 mg of chromium, flavonoids, and other antioxidants.
  101. 101. …Apitherapy of Alcohol and Nicotine Addictions As desintoxicants and hepatoprotectors these medicinal plants can also be used: • milk thistle (Silybum marianum), • ginger (Zingiber officinale), • burdock (Arctium lappa), • dandelion (Taraxacum officinale) and • liquorice (Glycyrrhiza glabra).
  102. 102. + Questions?: apitherapy101@gmail.com . THANKS!!!

Editor's Notes

  • “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]
  • ×