OPIATES - Shore Behavioral Medicine: Manasquan, NJ:...
Transcript of OPIATES - Shore Behavioral Medicine: Manasquan, NJ:...
OPIATES
What Is The REAL Problem? Is There A Solution?
Russell Ferstandig, M.D. Medical Director and Founder
Monmouth Behavioral Medicine Center Manasquan, New Jersey
monmouthbehavioralmedicine.com [email protected]
732-477-4470
Why You Should Listen To Me ! Psychiatrist For 35 Years
! Addiction Specialist For 30 Years
! Board Certified In Addiction Medicine (American Board Of Addiction Medicine)
! Suboxone® Provider For 9 Years With 100’s of Successes
! Recovered Cocaine Addict So I Have Lived The Life Of Addiction
THIS PRESENTATION IS ABOUT HOPE BECAUSE THERE IS A GUARANTEED SOLUTION FOR ANYONE
ADDICTED TO OPIATES!!!!
THIS PRESENTATION IS ABOUT HOPE BECAUSE THERE IS A GUARANTEED SOLUTION FOR ANYONE
ADDICTED TO OPIATES!!!!
In Order To Find An Opiate Solution,
You Need To Understand The Opiate Problem
The Problem
The Problem The problem has two components:
The Problem The problem has two components:
Lifestyle – People feel the need to hide in unreality because reality is uncomfortable.
The Problem The problem has two components:
Lifestyle – People feel the need to hide in unreality because reality is uncomfortable.
Physiologic – Opiates Addict Everyone
The Problem Lifestyle Component
The Problem Lifestyle Component ! No simple solution
The Problem Lifestyle Component ! No simple solution ! Based on unrealistic goals and
expectations about life
The Problem Lifestyle Component ! No simple solution ! Based on unrealistic goals and
expectations about life ! Young people feel inadequate
The Problem Lifestyle Component ! No simple solution ! Based on unrealistic goals and
expectations about life ! Young people feel inadequate ! A search to feel better – NOW
The Basic Rule Of Human Behavior
People will resist change by maintaining their current behavior until:
! The perceived cost of maintaining the
behavior exceeds the perceived cost of changing the behavior
The Basic Rule Of Human Behavior
People will resist change by maintaining their current behavior until:
! The perceived cost of maintaining the
behavior exceeds the perceived cost of changing the behavior
! The perceived benefit from change greatly exceeds the trouble (real and imagined) generated by the change process.
The Basic Rule Of Human Behavior
Simplified
People will change when it hurts too
much not to change.
The Problem Opiate Physiology – No one is protected from opiate addiction.
The Problem Opiate Physiology – No one is protected from opiate addiction.
The Problem Opiate Physiology – No one is protected from opiate addiction.
The Problem The Brain Does Not Like
External Opiates Of Any Sort
The Problem The Brain Does Not Like
External Opiates Of Any Sort ! Heroin – especially NJ Heroin
The Problem The Brain Does Not Like
External Opiates Of Any Sort ! Heroin
! Opiates (Pills- prescribed and street sourced)
The Problem The Brain Does Not Like
External Opiates Of Any Sort ! Heroin
! Opiates (Pills) ! Opioids (Opiate-Like Substances)
The Problem The Brain Does Not Like
External Opiates Of Any Sort ! Heroin
! Opiates (Pills) ! Opioids (Opiate-Like Substances) ! Natural Opium
The Brain’s Natural Opiate System Is Disrupted By
External Opiates Of Any Type
The Brain’s Natural Opiate System Is Disrupted By
External Opiates Of Any Type ! Natural opiates (endorphins) are secreted by the brain
in very small amounts, probably less than 1/1000th% (0.001%) of external opiates, AND only for seconds or a minute or two
The Brain’s Natural Opiate System Is Disrupted By
External Opiates Of Any Type ! Natural opiates (endorphins) are secreted in very small
amounts, probably less than 1/1000th% (0.001%) of external opiates AND only for seconds or a minute or two
! External Opiates Are Present In Progressively Large Doses For Hours, Days, Months Or Years
The Brain’s Natural Opiate System Is Disrupted By
External Opiates Of Any Type ! Natural opiates (endorphins) are secreted in very small
amounts, probably less than 1/1000th% (0.001%) of external opiates AND only for seconds or a minute or two
! External opiates are present in progressively large doses for hours, days, months or years
! The Combination Of Excessive Opiates For Long Durations Forces The Brain To ADAPT To Keep The Individual Alive
The Stronger The Opiate, The Faster The Individual Becomes Addicted, Their
Brain Adapts To The External Opiate And Becomes
NJ Heroin Is One Of The Strongest Opiates Available
NJ Heroin Is One Of The Strongest Opiates Available
NJ Heroin Cut With Fentanyl (Bud Light)
Is The Strongest Opiate Available
NJ Heroin Is One Of The Strongest Opiates Available
NJ Heroin Cut With Fentanyl (Bud Light)
Is The Strongest Opiate Available
Bud Light Is The Most Addictive Opiate On The Planet
Opiates And Opiate Withdrawal
Opiates And Opiate Withdrawal ! One of the biggest causes of
opiate relapse is
that promotes and justifies repeat opiate use
Opiates And Opiate Withdrawal ! One of the biggest causes of
opiate relapse is distorted thinking that promotes and justifies repeat opiate use
! occurs while using opiates AND/OR when withdrawing from opiates
Opiates And Opiate Withdrawal
The only way to avoid “opiate logic” and opiate behaviors is:
Opiates And Opiate Withdrawal
The only way to avoid “opiate logic” and opiate behaviors is:
! 100% abstaining from opiate use
Opiates And Opiate Withdrawal
Therefore, the only way to avoid “opiate logic” and opiate behaviors is:
! 100% abstaining from opiate use
AND
Opiates And Opiate Withdrawal
Therefore, the only way to avoid “opiate logic” and opiate behaviors is:
! 100% abstaining from opiate use
AND ! 100% stop of withdrawal symptoms
24/7 till the brain is 100% healed
The Solution
The Solution There Are Four Necessary
Steps To Produce A Lasting Solution –
The Four Steps To Becoming Opiate Free
1. Individual must be truly ready to stop using opiates (“should stop without commitment” almost never works)
The Four Steps To Becoming Opiate Free
1. Individual must be truly ready to stop using opiates (“should stop without commitment” almost never works)
2. Withdrawal must be stopped 100% 24/7 until the brain has 100% healed (returned to the pre-opiate state. Said another way – the opiate altered state TOTALLY reversed)
The Four Steps To Becoming Opiate Free
3. Identify and correct all psychiatric problems that are likely triggers for relapse (anxiety, depression, ADD, etc.)
The Four Steps To Becoming Opiate Free
3. Identify and correct all psychiatric problems that are likely triggers for relapse (anxiety, depression, ADD, etc.)
4. Therapy to better identify triggers, modify opiate thinking distortions and learning new coping skills
The Four Steps To Becoming Opiate Free
The Four Steps To Becoming Opiate Free
All Four Steps Are Required For Lasting Success
1. Committed to stop
The Four Steps To Becoming Opiate Free
Summary
1. Committed to stop
2. 100% Removal of withdrawal symptoms and opiate logic till the brain is recovered
The Four Steps To Becoming Opiate Free
Summary
1. Committed to stop
2. 100% Removal of withdrawal symptoms and opiate logic till brain 100% recovered
3. Correct psychiatric triggers
The Four Steps To Becoming Opiate Free
Summary
1. Committed to stop
2. 100% Removal of withdrawal symptoms and opiate logic till brain 100% recovered
3. Correct psychiatric triggers
4. Therapy for better life coping skills
The Four Steps To Becoming Opiate Free
Summary
Four Necessary Steps Options
Four Necessary Steps Options
There Are Many Options To Treatment Design
Four Necessary Steps Options
There Are Many Options To Treatment Design
Choose The Design That Works Best For You
Four Necessary Steps Options
There Are Many Options To Treatment Design
Choose The Design That Works Best For You
Four Necessary Steps Options
There Are Many Options To Treatment Design
Choose The Design That Works Best For You
There Are No Shortcuts
There Are No Shortcuts Shortcuts Essentially Guarantee Relapse
There Are No Shortcuts Shortcuts Essentially Guarantee Relapse
Common Shortcuts That Produce Relapse
There Are No Shortcuts Shortcuts Essentially Guarantee Relapse
Common Shortcuts That Produce Relapse:
! Individual Not Ready To Stop Using Opiates
There Are No Shortcuts Shortcuts Essentially Guarantee Relapse
Common Shortcuts That Produce Relapse
! Individual Not Ready To Stop Using Opiates
! Withdrawal NOT Stopped 100% Until The Brain Has 100% Healed (Returned To The Pre-opiate State)
How To Feel Good And Be Productive During Recovery From Opiate Use And Abuse
How To Feel Good And Be Productive During Recovery From Opiate Use And Abuse ! It is impossible to feel good and be
productive during active use and/or opiate withdrawal
How To Feel Good And Be Productive During Recovery From Opiate Use And Abuse ! It is impossible to feel good and be
productive during active opiate use and/or withdrawal
The Only Solution Is 100% Elimination Of Withdrawal
The Only Solution Is 100% Elimination Of Withdrawal
Currently there are only two ways to eliminate withdrawal symptoms totally:
The Only Solution Is 100% Elimination Of Withdrawal
Currently there are only two ways to eliminate withdrawal symptoms totally:
! Suboxone® treatment using the required medication techniques AND proper doses during all phases of treatment, especially the taper phase
The Only Solution Is 100% Elimination Of Withdrawal
Currently there are only two ways to eliminate withdrawal symptoms totally:
! Suboxone® treatment using the required medication techniques AND proper doses during all phases of treatment, especially the taper phase
! Methadone maintenance, which controls the withdrawal symptoms, does not end use due to the ongoing need for methadone
Suboxone® Is The Only Option Currently Available To Stop Withdrawal AND
Eliminate Opiate Influence
Suboxone® Is The Only Option Currently Available To Stop Withdrawal AND
Eliminate Opiate Influence Methadone Has Problems Because:
Suboxone® Is The Only Option Currently Available To Stop Withdrawal AND
Eliminate Opiate Influence Methadone Has Problems Because: ! By virtue of its “maintenance” approach, methadone
maintains some degree of opiate influence 24/7
Suboxone® Is The Only Option Currently Available To Stop Withdrawal AND
Eliminate Opiate Influence Methadone Has Problems Because: ! By virtue of its “maintenance” approach, methadone
maintains some degree of opiate influence 24/7
! Methadone frequently does not have an exit strategy because of ongoing maintenance
Suboxone® Is The Only Option Currently Available To Stop Withdrawal AND
Eliminate Opiate Influence Methadone Has Problems Because: ! By virtue of its “maintenance” approach, methadone
maintains some degree of opiate influence 24/7
! Methadone frequently does not have an exit strategy because of ongoing maintenance
! When tapered, there is a very high relapse rate
Suboxone® Fools The Brain Into Acting Like The
Changes From Opiate Use Have Totally Healed
Suboxone® Fools The Brain Into Acting Like The
Changes From Opiate Use Have Totally Healed
! The patient functions as if they never used opiates
Suboxone® Fools The Brain Into Acting Like The
Changes From Opiate Use Have Totally Healed
! The patient functions as if they never used opiates
! Opiate induced brain changes are stimulated to heal and revert to the pre-opiate state
As The Brain Heals, Less Suboxone® Is Needed To
Insure Proper Function And No Withdrawal Symptoms
As The Brain Heals, Less Suboxone® Is Needed To
Insure Proper Function And No Withdrawal Symptoms
! It is the altered state of the brain that drives opiate withdrawal
As The Brain Heals, Less Suboxone® Is Needed To
Insure Proper Function And No Withdrawal Symptoms
! It is the altered state of the brain that drives opiate withdrawal
! When the brain has totally recovered from its opiate induced alterations, Suboxone® is no longer needed because the withdrawal is over
Dr. Russ’ Suboxone® Rule
Dr. Russ’ Suboxone® Rule The key to effective Suboxone® treatment
Dr. Russ’ Suboxone® Rule The key to effective Suboxone® treatment
! Insure that the Suboxone® blood level in the patient is always at the lowest level necessary to insure 100% elimination of withdrawal symptoms 24/7 until the opiate induced brain alterations have 100% healed
Dr. Russ’ Suboxone® Rule The key to effective Suboxone® treatment
! Insure that the Suboxone® blood level in the patient is always at the lowest level necessary to insure 100% elimination of withdrawal symptoms 24/7 until the opiate induced brain alterations have 100% healed
! This 100% guarantees proper functioning as long as the individual does not ACTIVELY CHOOSE to use opiates
Dr. Russ’ Suboxone® Rule Using more Suboxone® than the minimum needed causes problems:
Dr. Russ’ Suboxone® Rule Using more Suboxone® than the minimum needed causes problems:
! Generates a mild opiate response than can trigger relapse
Dr. Russ’ Suboxone® Rule Using more Suboxone® than the minimum needed causes problems:
! Generates a mild opiate response than can trigger relapse
! Takes energy to fuel the opiate response that could be used for healing
Dr. Russ’ Suboxone® Rule Using more Suboxone® than the minimum needed causes problems:
! Generates a mild opiate response than can trigger relapse
! Takes energy to fuel the opiate response that could be used for healing
! Inhibits healing because opiates appear to be present, suggesting the need for the brain alteration
Ideal Suboxone® Blood Level
Ideal Suboxone® Blood Level
Ideal Suboxone® Blood Level
Low Suboxone® Blood Level
There Is Life After Opiates!!
It Is Wonderful And
Available For Everyone
For More Information Please Go To
monmouthbehavioralmedicine.com Click “Resources” And Then “Addiction Medicine”
Email to [email protected]
Call 732-477-4470