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RECOVERY-
ENHANCING
MEDICATIONS IN
ADDICTION
TREATMENT
CHRISTOPHER COOK, B.A., CADC, SAP
Founder-Executive Director
SperanzaHealth Clinical Partners
Project Manager
HOPE PROGRAM @ Cove Forge
724-614-6669
chris.cook@speranzahealth.org
SperanzaHealth Clinical Partners
INTRODUCTIONSINTRO’s
Everyone Loves Introductions…
OBJECTIVES
! Addiction is a BIO-PSYCH-SOCIAL DISEASE
! To understand the medications, we must pay close
attention to the BIOLOGY
! Medication-Assisted Therapy (Maintenance) vs.
Recovery-Enhancing Medications: Is there a
difference?
! Research and Practice…
SperanzaHealth Clinical Partners
What’s all the fuss about
Neuroscience?
!  Neuroscience – definition from dictionary.com - the field of
study encompassing the various scientific disciplines dealing
with the structure, development, function, chemistry,
pharmacology, and pathology of the nervous system that
effect the brain.
!   Every thought, sensation, emotion, physical movement is
accounted for in terms of brain structures and chemistry.
!   In other words… nothing happens in human behavior
except by the mechanisms of the brain.
SperanzaHealth Clinical Partners
Is it really a Disease?
!   Disease of the brain.
!   >33% of Public believes it is simply willpower…HOW
ABOUT CLINICIANS?
!   Compared to:
!   Type 2 Diabetes, Chronic hypertensive disease, Asthma,
Obesity
!   No one treatment episode will resolve illness…hence 12
Steps, Other social supports
!   Course of dependency is multiple episodes of treatment,
recovery activities, relapse periods.
SperanzaHealth Clinical Partners
Does this matter to what you do?
THERAPY…
SperanzaHealth Clinical Partners
Application
“The longer you’re in treatment…”
!   Research has shown unequivocally that good outcomes
are contingent on adequate treatment length.
!   Generally, for residential or outpatient treatment,
participation for less than 90 days is of limited
effectiveness, and treatment lasting significantly longer
is recommended for maintaining positive outcomes.
SperanzaHealth Clinical Partners
Therefore…
! Understanding how the
brain functions during
and after drug use,
encourages practitioners
to correlate appropriate
strategies to the stage of
recovery and
consequently impact on
program retention.
SperanzaHealth Clinical Partners
Biology of Addiction
Neurotransmitters and drugs of abuse
Speranza Training Associates
Neurotransmitters
!   Several Involved in Addiction
!   Serotonin
!   Dopamine
!   Endorphins
!   GABA1
!   Glutamate (NMDA)
!   Norepinephrine (Adrenaline)
!   Cannabinoids
Speranza Training Associates
Neurotransmitters…what do
they do?
Speranza Training Associates
The importance of
dopamine…
Dopamine
!   D2 receptor changes associated with addiction in
people and animals
!   Drugs of Abuse cause 5x to 10x increase…
!   Chronic exposure to stimulants, opioids or alcohol
leads to decreased dopamine activity
!   Decreased sensitivity to everyday rewards
!   How does this affect psychotherapy?
Speranza Training Associates
The importance of Glutamate
!   Memory Formation
!   New pharmacological + psychological therapy?
!   Glutamate + Dopamine Directly influence the
formation of new memories…
!   How does this affect the addict?
Biology of Addiction
MICRO-VIEW
Speranza Training Associates
The synapse up close…
The Action of Opioids
(Morphine)
Speranza Training Associates
Opioids…
The Action of Cocaine
Speranza Training Associates
Speranza Training Associates
Ways Chemicals “Act” in the
Brain
Drugs of Abuse act…
!   Increasing Presence of
Neurotransmitters by
reducing uptake or forcing
release
(Cocaine, SSRI’s/SNRI’s,
Amphetamines…)
!   Mimicking
Neurotransmitters
(Opioids,
Cannabinoids…)
Differences…
!   Agonists (opioids)
!   Antagonists (naltrexone,
naloxone, flumazenil)
!   Partial Agonists
(Buprenorphine, Talwin)
!   Efficacy
!   Affinity
Speranza Training Associates
Biology of Addiction
MACRO-VIEW
Why do they act that
way?
Phineus Gage*
Phineus Gage
!   After the accident: Personality Change
!   Rude
!   Sexually inappropriate
!   Poor impulse control
Neurotoxicity Methamphetamine
Neuroscience of Addiction Day 2
The Brain in “Recovery”
Like What You've Viewed?
Contact SperanzaHealth Clinical Partners and Ask For About Our Clinical Trainings!
Many completely free trainings throughout the year
Multiple trainers of differing backgrounds
We will come to you, or better yet, use SperanzaHealth Trainers as a marketing tool... call us
today for a completely free needs assessment or to just schedule a training!
724-651-6669 - Christopher Cook
412-447-4677 - Clinicians
SperanzaHealth Clinical Partners is a specialist behavioral health firm. We are a group of
independent, private contractors specializing in:
1. Sub-Contracted Assessment and Referral
2. NEW Sub-contracted Utilization Review RN's
3. Clinical and Corporate Training
4. Business Consultants specializing in MentalHealth and Substance Abuse Tretment Agencies

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Recovery Enhancing Meds-Press Ready

  • 1. RECOVERY- ENHANCING MEDICATIONS IN ADDICTION TREATMENT CHRISTOPHER COOK, B.A., CADC, SAP Founder-Executive Director SperanzaHealth Clinical Partners Project Manager HOPE PROGRAM @ Cove Forge 724-614-6669 chris.cook@speranzahealth.org SperanzaHealth Clinical Partners
  • 3. OBJECTIVES ! Addiction is a BIO-PSYCH-SOCIAL DISEASE ! To understand the medications, we must pay close attention to the BIOLOGY ! Medication-Assisted Therapy (Maintenance) vs. Recovery-Enhancing Medications: Is there a difference? ! Research and Practice… SperanzaHealth Clinical Partners
  • 4. What’s all the fuss about Neuroscience? !  Neuroscience – definition from dictionary.com - the field of study encompassing the various scientific disciplines dealing with the structure, development, function, chemistry, pharmacology, and pathology of the nervous system that effect the brain. !   Every thought, sensation, emotion, physical movement is accounted for in terms of brain structures and chemistry. !   In other words… nothing happens in human behavior except by the mechanisms of the brain. SperanzaHealth Clinical Partners
  • 5. Is it really a Disease? !   Disease of the brain. !   >33% of Public believes it is simply willpower…HOW ABOUT CLINICIANS? !   Compared to: !   Type 2 Diabetes, Chronic hypertensive disease, Asthma, Obesity !   No one treatment episode will resolve illness…hence 12 Steps, Other social supports !   Course of dependency is multiple episodes of treatment, recovery activities, relapse periods. SperanzaHealth Clinical Partners
  • 6. Does this matter to what you do? THERAPY… SperanzaHealth Clinical Partners
  • 7. Application “The longer you’re in treatment…” !   Research has shown unequivocally that good outcomes are contingent on adequate treatment length. !   Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes. SperanzaHealth Clinical Partners
  • 8. Therefore… ! Understanding how the brain functions during and after drug use, encourages practitioners to correlate appropriate strategies to the stage of recovery and consequently impact on program retention. SperanzaHealth Clinical Partners
  • 9. Biology of Addiction Neurotransmitters and drugs of abuse Speranza Training Associates
  • 10. Neurotransmitters !   Several Involved in Addiction !   Serotonin !   Dopamine !   Endorphins !   GABA1 !   Glutamate (NMDA) !   Norepinephrine (Adrenaline) !   Cannabinoids Speranza Training Associates
  • 13. Dopamine !   D2 receptor changes associated with addiction in people and animals !   Drugs of Abuse cause 5x to 10x increase… !   Chronic exposure to stimulants, opioids or alcohol leads to decreased dopamine activity !   Decreased sensitivity to everyday rewards !   How does this affect psychotherapy? Speranza Training Associates
  • 14. The importance of Glutamate !   Memory Formation !   New pharmacological + psychological therapy? !   Glutamate + Dopamine Directly influence the formation of new memories… !   How does this affect the addict?
  • 16.
  • 17. The synapse up close…
  • 18. The Action of Opioids (Morphine) Speranza Training Associates
  • 20. The Action of Cocaine Speranza Training Associates
  • 22. Ways Chemicals “Act” in the Brain Drugs of Abuse act… !   Increasing Presence of Neurotransmitters by reducing uptake or forcing release (Cocaine, SSRI’s/SNRI’s, Amphetamines…) !   Mimicking Neurotransmitters (Opioids, Cannabinoids…) Differences… !   Agonists (opioids) !   Antagonists (naltrexone, naloxone, flumazenil) !   Partial Agonists (Buprenorphine, Talwin) !   Efficacy !   Affinity Speranza Training Associates
  • 24. Why do they act that way?
  • 25.
  • 27. Phineus Gage !   After the accident: Personality Change !   Rude !   Sexually inappropriate !   Poor impulse control
  • 29. The Brain in “Recovery”
  • 30. Like What You've Viewed? Contact SperanzaHealth Clinical Partners and Ask For About Our Clinical Trainings! Many completely free trainings throughout the year Multiple trainers of differing backgrounds We will come to you, or better yet, use SperanzaHealth Trainers as a marketing tool... call us today for a completely free needs assessment or to just schedule a training! 724-651-6669 - Christopher Cook 412-447-4677 - Clinicians SperanzaHealth Clinical Partners is a specialist behavioral health firm. We are a group of independent, private contractors specializing in: 1. Sub-Contracted Assessment and Referral 2. NEW Sub-contracted Utilization Review RN's 3. Clinical and Corporate Training 4. Business Consultants specializing in MentalHealth and Substance Abuse Tretment Agencies