Scientific Program

Conference Series Ltd invites all the participants across the globe to attend International Conference and Exhibition on Dual Diagnosis Chicago, Illinois, USA.

Day 1 :

Keynote Forum

John. T. McDevitt

New York University College of Dentistry, USA

Keynote: Programmable Bio-Nano-Chips for Quantitation of Drugs of Abuse in Oral Fluids

Time : 09:00-09:40

Conference Series Dual Diagnosis 2016 International Conference Keynote Speaker John. T. McDevitt photo
Biography:

Dr. John T. McDevitt will serve as the new Chairman for the Department of Biomaterials and Biomimetics within New York University College of Dentistry (NYUCD). McDevitt is a pioneer in the development of tools for affordable and accessible healthcare. He also serves as the Scientific Founder for and Chief Scientific Officer for SensoDx, LLC. His innovations have been awarded Best of What's New in the Medical Device Category in 2008 by Popular Science, Best Scientific Advance of the Year for 1998 by the Science Coalition and Nokia Sensing X Prize Finalist in 2013 and 2014.

Abstract:

Use of illicit drugs and abuse of licit counterparts are associated with multiple physical health, emotional, and interpersonal problems. Cardiovascular disease, stroke, cancer, HIV/AIDS, anxiety, depression, and sleep problems, financial difficulties and legal complications, work, and family problems can all result from or be exacerbated by drug abuse. In 2013, 21.6 million Americans were dependent on drugs or were drug abusers, representing 8.2% of our population aged 12 and over. In the U.S. each year drug abuse and drug addiction cost employers over $122 billion in lost productivity time and another $15 billion in health insurance costs. Routine screening for substance use disorders could alter this statistic and get more people the help they need. Indeed, since the inception of medication-assisted treatment (MAT) for opioid addiction, drug testing has provided both an objective measure of treatment efficacy and a tool to monitor patient progress.

Keynote Forum

Norman S Miller

Michigan State University, USA

Keynote: Marijuana and violence

Time : 09:40-10.20

Conference Series Dual Diagnosis 2016 International Conference Keynote Speaker Norman S Miller photo
Biography:

Norman S Miller, MD, JD, PLLC, is the Medical Director, Detoxifi cation and Residential Programs, Bear River Health at Walloon Lake, and the President, Health
Advocates PLLC. He is a Psychiatrist in East Lansing, Michigan and is affi liated with multiple hospitals in the area, including Covenant Medical Center and DMC
Detroit Receiving Hospital. He received his medical degree from Howard University College of Medicine and has been in practice for 41 years. He is one of 6
doctors at Covenant Medical Center and one of 26 at DMC Detroit Receiving Hospital who specialize in Psychiatry..

Abstract:

As a Psychiatrist, Addiction Psychiatrist, Forensic Psychiatrist and Attorney, I gained a comprehensive perspective of the
problems associated with opioid prescription medications. As the editor and author of the issue, I attempted to provide
clinical and research experience and a comprehensive review of the available medical and scientifi c literature to the questions
regarding effi cacy for prescribing opioid medications for chronic pain. And why is the current policy to prescribe these
medications on demand fueled by patients? Th is issue of Psychiatric Annals on prescription opioid medications answers the
following questions: Why are opioid medications prescribed in large quantities and high frequency when there is little or
no proven effi cacy for their therapeutic value? Why are opioids the most commonly prescribed medication in the United
States when their adverse consequences continue to grow and mount? Why does the medical profession continue to prescribe
opioid medications that result in increased pain, psychiatric and medical disability, and even death? When the evidence
is reviewed, there is minimal support for long-term prescribing of opioid medications. An extensive review of over 2,000
publications did not fi nd evidence to justify opioid medication for chronic pain. In addition, there were few articles that
researched addiction despite opioid medications’ highly addicting pharmacologic properties. In fact, opioid addiction explains
why doctors prescribe and patients consume opioids continuously with substantial risks of psychiatric and medical adverse
consequences—and without benefi t. Th e Diagnostic and Statistical Manual of Mental Disorders, fi ft h edition (DSM-5) provides
for a diagnostic scheme for the frequent occurrence of substance or opioid-induced psychiatric disorders titled “Substance/
Medication-Induced Depressive Disorder and Substance/Med-ication-Induced Anxiety Disorder.” In DSM-5 the exclusionary
criteria require accounting for psychiatric eff ects of opioid medications, such as depression and anxiety and withdrawal, before
making diagnoses of depressive and anxiety disorders. Th e effi cacy for prescribing opioid medications for chronic pain is not
only limited by their highly addicting nature, but also by a paradoxical response—opioid-induced hyperalgesia. Surprisingly,
opioids induce pain through increased pain sensitivity locally at the site of the lesions or diff usively at non-pathologic sites.
Th us, effi cacy is severely limited by mounting subjective pain induced by opioids. Th e engine that drives continued opioid use
is, according to DSM-5, “Addictive and Opioid Use Disorders.” Opioid medications are scheduled medications defi ned by the
Controlled Substance Laws as highly dangerous and addicting. Th e commonly prescribed opioid medications are schedule II,
which Dr. Th omas Frieden, Director of the Centers for Disease Control and Prevention, recommends prescribing for no longer
than 3 days except in extreme, justifi ed cases due to their highly addicting nature.

Keynote Forum

Ronald Bradley

Central Michigan University, USA

Keynote: Psychiatric medical home model; Medical, substance use disorders and mental health cost savings

Time : 10.20-11.00

Conference Series Dual Diagnosis 2016 International Conference Keynote Speaker Ronald Bradley photo
Biography:

Ronald Howard Bradley, DO, PhD, FACN, works at Central Michigan University College of Medicine in Saginaw, Michigan. Board certified in pain medicine, addiction management, and forensic psychiatry, Dr. Bradley handles many types of psychiatric cases. He is Chief of Psychiatry for the University, and author of over 60 articles and book chapter contributor. In 1986, the American Osteopathic College of Neurology and Psychiatry awarded Dr. Bradley with a Sidney Kanef Memorial Award.

Abstract:

People with severe mental illness (SMI) die from the same chronic medical conditions as those in the general population (e.g., heart disease, diabetes, stroke, and pulmonary disease). However, these diseases are more common in people with SMI leading to death 25 years earlier than the general population. The modifiable health risk factors that contribute to these diseases smoking, obesity, hypertension, metabolic disorder, substance use, low physical activity, poor fitness and diet are also more common and have an earlier onset in people with SMI. Side effects of psychiatric medications, which may include weight gain and metabolic disorders, add to these health risks. The risk to African Americans with SMI is even greater due to existing racial health disparities.

Keynote Forum

Gregory Rudolf

American Board of Addiction Medicine, USA

Keynote: Non-opioid protocol for opioid detoxifi cation and/or transition to antagonist treatment
Biography:

Gregory Rudolf has been board-certifi ed by the American Board of Addiction Medicine since 2004, by the American Board of Family Medicine since 2003 and by
the American Academy of Medical Acupuncture since 2010. He divides his clinical time between inpatient addiction medicine at Cascade Behavioral Hospital in
Seattle, where he is the Medical Director of addiction recovery services and Swedish Pain Services, where he practices outpatient pain management, addiction
medicine and medical acupuncture. His research has been inspired by his breadth of clinical experience. He has developed a novel protocol for opioid withdrawal
management which has a range of clinical applications among the available treatment options for opioid use disorders and which has been the subject of research
presented at this and other conferences.

Abstract:

Introduction: Th e clinical eff ectiveness of a novel non-opioid and benzodiazepine-free protocol was compared to a
buprenorphine/naltrexone taper for opioid detoxifi cation and transition to subsequent relapse prevention strategies, including
initiation of extended release (ER) naltrexone treatment.
Methods: Retrospective chart review of DSM IV diagnosed opioid-dependent patients admitted for inpatient detoxifi cation
examined diff erences between 84 non-opioid protocol (treated with scheduled 4-day tizanidine, hydroxyzine and gabapentin)
and 40 bup/nx protocol (treated with scheduled 4-day bup/nx taper) subjects. Both groups received ancillary medications and
routine counseling. Primary outcomes measured completion of detoxifi cation and facilitation to further chemical dependency
treatment. Secondary outcomes included length of stay (LOS), adverse eff ects, Clinical Opiate Withdrawal Scale (COWS)
scores, ancillary medication use and initiation of injectable ER naltrexone treatment.
Results: Non-opioid protocol subjects had greater completion of detoxifi cation (94% vs. 80%; p=0.029) and facilitation to
further chemical dependency treatment (85% vs. 63%; p=0.004). Th e non-opioid protocol was superior to the bup/nx protocol
in lower incidence of bradycardia (44% vs. 65%; p=0.040) and lower mean COWS scores on day 1 (3.3 vs. 4.8; p<0.001).
No signifi cant diff erence was found in mean COWS scores on day 2 (3.4 vs. 3.2), day 3 (2.8 vs. 2.1) and day 4 (2.4 vs.1.9);
asymptomatic (26% vs. 35%) and symptomatic (8/3% vs. 10%) hypotension; LOS (3.6 vs. 3.4) and ancillary medication use
(11.6 vs. 11.8 doses). A total of 27 (32%) of patients in the non-opioid protocol arm pursued transition to ER naltrexone and
24 (89%) of them received the injection prior to hospital discharge.
Conclusion: Th is retrospective, non-randomized, case review study demonstrates a novel, eff ective non-opioid detoxifi cation
protocol using scheduled tizanidine, hydroxyzine and gabapentin for management of opioid withdrawal during the phase
between cessation of opioids and initiation of relapse prevention strategies, including transition to injectable ER naltrexone

  • Addiction psychiatry
Location: Double Tree by Hilton Chicago - North Shore
Speaker

Chair

John. T. McDevitt

New York University College of Dentistry, USA

Co-Chair

Mickael Naassila

University of Picardie, USA

Session Introduction

Michael Groat

The Menninger Clinic-Baylor College of Medicine, USA

Title: Transforming vicious cycles into virtuous ones: Psychodynamic perspectives on treatment of the addicted patient
Biography:

Michael Groat is the Director of the Division of Adult Services at the Menninger Clinic and is an Associate Professor of Psychiatry & Behavioral Sciences at the
Baylor College of Medicine. He received his Master’s degree at Miami University, Ohio and his Doctorate in Psychology from the State University of New York,
Albany. He completed a four-year clinical psychology fellowship in psychodynamic psychotherapy and dynamic family work at the Austen Riggs Center. He is a past
fellow of the American Psychoanalytic Association and Anna Freud/Yale Child Study Center research fellowship. He is currently a candidate in adult psychoanalysis
at the Houston Center for Psychoanalytic Studies.

Abstract:

Individuals troubled by addictive illness present clinicians with serious challenges regarding the experience, understanding
and management of dual diagnosis disorders. Among them, the diffi cult-to-reach patient features prominently. Such
individuals can pull clinicians into intense and endless cycles of relapses, impasses and stalemates and thwarted progress. Not
only are clinicians and families left exhausted and frustrated, patients oft en earn the distinction of being deemed “treatment
resistant.” Outside the extremes, there are many subtle but no less powerful risks for the patient and professional engaged
in psychotherapy—where enactments around addiction (dishonesty/hiding, enabling, etc.) can wind their way throughout
a treatment and create havoc of their own. Using clinical examples and research fi ndings from work with diffi cult-to-treat
patients, this presentation will discuss multiple issues involving the vagaries of working with such patients within the framework
of psychodynamic treatment. Th e presenter will lead a discussion with the audience encouraging dialogue from everyone’s
clinical experience.

Thersilla Oberbarnscheidt

Central Michigan University, USA

Title: Cannabis- is it really a Medicine?
Speaker
Biography:

Cannabis has been used in medicine for thousands of years for various medical conditions. Over the last decade it is increasingly
getting used in the treatment of chronic pain. Cannabis has been shown to have some positive effi cacy in the reduction of pain as
an adjunct in therapy combined with opioids. Clinical studies published are mostly small in number and solely for neuropathic pain.
Most studies that showed a clinical benefi t were short in duration. Longer-term studies for more than 4 weeks have reported psychosis
in the patients with percentages ranging from 36.3% to even 80%. Most patients report a long list of side eff ects associated with the use
of cannabis. Symptoms reported are memory problems, problems with motor coordination and impaired judgment and more serious
medical problems like cancer or cardiac ischemia. Cannabis consists of more than 60 pharmacologically active cannabinoids. Th e
primary cannabinoids in marijuana are delta9-tetrahydrocannabinol (THC) and cannabidiol. Not all cannabinoids are yet identifi ed
or understood. Th e dosing of cannabis and its metabolism are problematic in the treatment as well. Cannabis is liposoluble and
tends to accumulate in adipose tissue together with its derivates. Th erefore the substance gets released into the body long aft er last
ingestion, resulting in even more potent eff ects and adverse eff ects in the users. Cannabis is a Schedule I substance and the attempt to
discontinue does create a set of symptoms called “marijuana abstinence syndrome”. Symptoms of marijuana withdrawal are consistent
of: anxiety, depression, decreased appetite, headaches, insomnia, irritability, muscle tension, nausea, nightmares and unpleasant vivid
dreams. Lastly, patients develop tolerance to cannabis as well, similar to alcohol, meaning over time are larger doses required to
achieve the same clinical response.

Abstract:

Cannabis has been used in medicine for thousands of years for various medical conditions. Over the last decade it is increasingly getting used in the treatment of chronic pain. Cannabis has been shown to have some positive efficacy in the reduction of pain as an adjunct in therapy combined with opioids. Clinical studies published are mostly small in number and solely for neuropathic pain. Most studies that showed a clinical benefit were short in duration. Longer-term studies for more than 4 weeks have reported psychosis in the patients with percentages ranging from 36.3% to even 80%. Most patients report a long list of side effects associated with the use of cannabis. Symptoms reported are memory problems, problems with motor coordination and impaired judgment and more serious medical problems like cancer or cardiac ischemia.

Norman S Miller

Michigan State University, USA

Title: Psychiatric diagnoses and chronic opioid use
Speaker
Biography:

Norman S. Miller, MD, JD, PLLC, is the Medical Director, Detoxification and Residential Pro¬grams, Bear River Health at Walloon Lake; and the President, Health Advocates PLLC. Umer Farooq, MD, is a Clinical Assistant Professor, Michigan State University College of Human Medi¬cine; and the Director, Dual Diagnosis Program, Pine Rest Christian Mental Health Services.

Abstract:

The psychiatric symptoms, particularly depression and anxiety, associated with chronic use of opioid medications as a result of
overprescribing are common and debilitating. Opioid medications are classifi ed as depressants and induce serious depression and
anxiety, particularly with chronic and persistent use. Th e Diagnostic and Statistical Manual of Mental Disorders, fi ft h edition (DSM-
5) provides diagnoses for these opioid-induced conditions. Substance-induced disorders, particularly for depression and anxiety,
include intoxication and withdrawal, substance/medication-induced depressive disorder and substance/medication-induced anxiety
disorder. Importantly, DSM-5 criteria indicate that diagnoses for major depressive disorder and anxiety disorder cannot be made if
there is a substance, such as opioid medications, responsible for the condition. Oft en the way to distinguish between a substanceinduced
disorder and an independent major depressive or anxiety disorder is to discontinue the opioid medications. Given that
opioids are not effi cacious for long-term prescribing, discontinuation of the medication is the treatment of choice.

Biography:

Thersilla Oberbarnscheidt is a resident Psychiatrist from Central Michigan University. She received her medical degree from the University of Kiel Germany and
Yale University School of Medicine. Her PhD thesis in Neuroscience was on “Phenazone in the treatment of the acute migraine attack”. She is involved in research
regarding pain management and addiction.

Abstract:

Opioid-induced hyperalgesia (OIH) is a very common consequence of pain management with opioids. Characteristics of OIH
are worsening pain over time despite an increased dose of the opioid. It is oft en recognized neither by the physician nor the
patient, and it results in increasing doses of opioid medications and continued unsatisfying pain levels experienced by the patient. Th e
increased use of narcotics has a negative impact on patient outcome, as patients suff er from increased pain levels and oft en develop
depression. Patients with OIH require frequent assessment for aberrant behaviors as an indicator of addictive use. Opioid-seeking
behavior may complicate the clinical picture of failed opioid therapy. Th e treatment of OIH is to discontinue the opioid medication
and to treat the patient’s withdrawal symptoms, if necessary, in an inpatient setting with medical monitoring.

Speaker
Biography:

Professor Mickael Naassila received his PhD in Neurosciences at the University of Rouen studying the mechanisms of action of acamprosate and the role of nitric oxide synthase in alcohol dependence in rats. During his postdoctoral training at the Pharmacology & toxicology dept of the Pharmacy school at the University of Kansas, he studied the transcriptional and post-transductional effects of alcohol on NMDA receptor subunits. Since coming at the University of Picardie Jules Verne in 2000, he has been working on the effect of early life ethanol exposure (in utero and/or adolescence) on the vulnerability to develop alcohol dependence. He was also involved in different clinical projects on the genetic vulnerability to develop a severe phenotype of alcohol dependence and alcohol liver disease He is the leader of a European project on the cognitive and emotional impact of binge drinking in young people and on the use of preclinical model to mimic this phenomenon in rodents to uncover neurobiological mechanisms underlying long term vulnerability to alcohol abuse. Currently he is the head of the Research Group on Alcohol & Pharmacodependences, one of the very rare laboratories in France seeking to elucidate neurobiological bases of alcohol dependence in pertinent animal models of the disease.

Abstract:

Schizophrenia is a mental disorder characterized by a series of positive, negative or cognitive symptoms but with also the particularity of exhibiting high rate of comorbid use of drugs of abuse. While more than 80%of schizophrenics are smokers, the second drug the most consumed is alcohol with dramatic consequences on frequency and intensity of psychotic episodes and on life expectancy. Here we investigated the impact of light alcohol intake during adolescence on the subsequent occurrence of alcohol addiction like behavior in neonatal ventral hippocampal lesion (NVHL) rats, a neurodevelopmental model of schizophrenia. Our findings demonstrated an increased liability to addictive behaviors in adult neonatal ventral hippocampal lesioned (NVHL) rats after voluntary alcohol intake during adolescence.

Speaker
Biography:

Women with alcohol dependence and PTSD with a history of IPV want help however the health and social services do not always recognize their calls for help or their symptoms of distress. Recommendations are made for treatment centers to become trauma-informed that would help this recognition.

Abstract:

Women who have experienced intimate partner violence (IPV) are at greater risk for physical and mental health problems including posttraumatic stress disorder (PTSD) and alcohol dependency. On their own IPV, PTSD and alcohol dependency result in significant personal, social and economic cost and the impact of all three may compound these costs. Researchers have reported that women with these experiences are more difficult to treat; many do not access treatment and those who do, frequently do not stay because of difficulty maintaining helping relationships. However, these women’s perspective have not been previously studied. The purpose of this study is to describe the experience of seeking help for alcohol dependency by women with PTSD and a history of IPV in the context in which it occurs.

Biography:

Amnon Jacob Suissa is a professor with the school of social work at Universite du Quebec à Montreal. He teaches courses on addictions as a social problem and the methodology of social intervention. With a constructivist approach to social problems, he is interested in the social determinants of addictions and their impact on intervention processes. He has a background in family therapy and sociology and is the author of several books and a hundred scientific articles on the phenomenon of medicalization of behaviors understood as pathologies or even diseases.

Abstract:

Contrary to the understanding of two separate conditions, addiction and mental health, the history of human behavior teaches us that we obtain more results by focusing on the persons and their social ties than on the problems. Applied to addictions and mental health, the psychosocial approach can help us better understand the phenomenon by including not only the individual with the addiction and mental conditions but also his social ties.

Biography:

He earned my Ph.D. in Graduate School of Pharmaceutical Sciences, Kyushu University, Japan,, and have been a postdoctoral research fellow in at the National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH). Also, I have been a Research Associate at University of Colorado at Boulder. I am currently a Visiting Scientist in the Division of Neurotoxicology, NCTR, FDA. I have published more than 30 papers in reputed journals and has been serving as an editorial board member of repute.

Abstract:

Sigma1 receptors are intracellular chaperones that translocate from their primary endoplasmic reticulum localization to different subcellular compartments upon agonist actions, and regulate ion channels and G-protein-coupled-receptor signaling. Reports have implicated 1Rs in various biological functions. On the other hand, the dopamine (DA) transporter (DAT) is known as a primary target underlying reinforcing effects of stimulants. However, past studies suggest that several atypical DAT inhibitors have low abuse potential, and are prospective leads for cocaine abuse treatments. However, it is unknown about a mechanism underlying the “atypical” property. I characterized the reinforcing effects of 1R agonists and investigated a potential interaction between DAT and 1R using a drug self-administration procedure in rats. Primary findings are as follows: (1) 1R agonists were not reinforcing in naïve rats; however, 1R agonists maintained self-administration responding above saline levels in rats with a reinforcement history of stimulants, but not of heroin or ketamine; (2) the induced reinforcing effects of 1R agonists were DA-independent; (3) several atypical DAT inhibitors functioned as a R antagonist; (4) a dual DAT/1R inhibition resulted in insurmountable antagonism of cocaine self-administration; however, self-administration of heroin or ketamine was insensitive to the dual inhibition. Thus, these results suggest that stimulants function as a specific inducer of DA-independent reinforcement mechanisms mediating 1Rs, which might shed light on understanding the mechanisms underlying the intractability of stimulant abuse to pharmacotherapy. Further, the results indicate a proof of concept that dual DAT/1R inhibition is a target for the discovery of medications specific for stimulant abuse.

  • Dual Diagnosis treatment & Addictive disorders
Location: Double Tree by Hilton Chicago - North Shore
Speaker

Chair

Norman S Miller

Michigan State University, USA

Speaker

Co-Chair

Lesch Otto-Michael

Austrian Society of Addiction Medicine

Session Introduction

Priyamvada Sharma

Centre for Addiction Medicine, NIMHANS, USA

Title: Qualitative and Quantitative determination of solvent abuse
Biography:

Priyamvada Sharma is currently working in National Institute of Mental Health and Neuro Science. Bengaluru, Karnataka, India Join institution. Her research includes Simultaneous Determination of Morphine, Codeine, Pentazocine and Propoxyphene in Urine Using HPTLC

Abstract:

During the late nineteenth century several countries around the world started reporting problem of solvent abuse among adults and teenagers. Inhalant abuse is the intentional gasp of volatile substances because of their fast and pleasurable sensory experience. (Flanagan and Fisher 2008) A nationwide survey conducted in Korea reported that more than 90% of male teenagers and over 60 % of female teenagers have at least sniffed glue once in their lifetime. These substances give an intoxicating high to the users and this euphoria is the cause for addiction.(Kwon et al. 2011) Most inhalant drugs are non-medically used ingredients in household or industrial chemical products and are not intended to be concentrated and inhaled. A small number of recreational inhalant drugs are pharmaceutical products that are used illicitly. Inhalants can be classified by their intended function

Biography:

Francis Acquah Born in West Africa, Francis qualified as a Mental Health Nurse in the United Kingdom and is a Credentialed Mental Health Nurse accredited by the Australian College of Mental Health Nurses. He has over 25 years of experience across youth, adult, public and private health care in Australia and the United Kingdom and has undertaken a range of roles, including clinical, managerial and educational. He has also served as a Specialist Pharmaceutical advisor for a leading pharmaceutical company.

Abstract:

The West African country of Ghana is situated just north of the equator bordering the Atlantic Ocean. Ghana’s tropical beaches and picturesque countryside are starkly contrasted by the destitute and inhumane living environments of people living with mental health conditions who often find themselves subjected to archaic treatment regimes as articulated in the report “Like a Death Sentence”, Human Rights Watch (2012). The MHFGH was formed as a direct result of this report and comprises mental health professionals and academics mainly based in the diaspora. It is a registered charity and contributes to government, community and private efforts to promote mental health and wellbeing, and reduce stigmatisation of mental illness in Ghana.

Biography:

Ms. Jacqueline Heron has completed her Master degree in Counselling Psychology from the University of Toronto and a Master degree in Education from Central Michigan University. She works at Toronto Western Hospital as a Addiction Clinician and she also has a Psychotherapy practice in Toronto.

Abstract:

Women who are seeking addiction treatment often present with complex spectrum of issues, a history of trauma is often most specific to these presenting issues. Unfortunately, due to the stigma that is attached to women and addiction, trauma symptoms are often not detected and explored when women present for addiction treatment. Failing to address trauma symptoms can have devastating implications on the effectiveness of addiction treatment, which may result poor therapeutic rapport and disengagement in treatment.

Gregory Rudolf

American Board of Addiction Medicine, USA

Title: Buprenorphine in the treatment of opioid-induced hyperalgesia
Biography:

Gregory Rudolf is providing his services as a staff Physician in Swedish pain center and he is a medical Director, from Addiction Recovery Center, Cascade
Behavioral Hospital. His goal for every patient is to help devise and carry out a treatment plan which emphasizes safe, effective, and sustainable approaches
toward minimizing unwanted symptoms, and enhancing overall wellness proactively and preventatively. I often recommend integrating acupuncture and other
complementary/alternative treatment strategies into the management plan. I fi nd that patients with a willingness to put time and energy into their own care, and who
are open to making signifi cant changes to their management plan when it is not working, can very often achieve excellent results over time. His clinical interests is
on acupuncture, addictions, adolescent medicine, alcoholism, chemical dependency, cross-cultural medicine and pain management.

Abstract:

Background: Th e clinical eff ectiveness of a novel non-opioid and benzodiazepine-free protocol was compared to a standardized
buprenorphine/naloxone (bup/nx) taper protocol for opioid medically supervised withdrawal and transition to subsequent relapse
prevention strategies.
Methods: A retrospective chart review of DSM-IV diagnosed opioid-dependent patients admitted for inpatient medically supervised
withdrawal examined diff erences between 84 non-opioid protocol subjects (treated with scheduled 4-day tizanidine, hydroxyzine and
gabapentin) and 40 bup/nx protocol subjects (treated with 4-day scheduled bup/nx taper). Both groups received ancillary medications
and routine counseling. Primary outcomes were completion of medically supervised withdrawal and facilitation to further chemical
dependency treatment. Secondary outcomes included length of hospital stay, Clinical Opiate Withdrawal Scale (COWS) scores,
ancillary medication use, adverse eff ects and initiation of injectable extended release (ER) naltrexone treatment.
Results: Non-opioid protocol subjects were more likely to complete medically supervised withdrawal (94% vs. 80%, p=0.026) and
engage in further chemical dependency treatment (85% vs. 63%, p=0.006). Th e non-opioid protocol subjects had a lower incidence
of bradycardia (44% vs. 65%, p=0.035) and lower mean COWS scores on day 1 (3.3 vs. 4.8; p<0.001). A total of 27 (32%) subjects in
the non-opioid protocol group pursued transition to ER naltrexone and 24 of the 27 (89%) received the injection prior to hospital
discharge.
Conclusion: Th is retrospective chart review suggests potential effi cacy of a novel protocol, containing no opioids or controlled
substances, for medically supervised opioid withdrawal and transition to relapse prevention strategies, including injectable ER
naltrexone.

Nachum Dafny

University of Texas Health Science Center at Houston, USA

Title: Behavioural and electrophysiological study of nucleus accumbens
Biography:

Nachum Dafny has received his MS and PhD degrees from Hadassah Medical School in Jerusalem in 1965 and 1969, respectively followed by Post-docs at

Abstract:

Methylphenidate (MPD) considered as the gold standard in the treatment of attention defi cit hyperactivity disorder (ADHD),
one of the most common childhood disorders. MPD is also fi nding their way into the hands of healthy adolescent as brain
augmentation to improve cognitive performance and for recreation. Th e possible long term eff ects of MPD exposure in adolescence
are considered controversial. Th e objective of this study is to investigate the acute and chronic dose response characteristics of MPD
on animal behavior concomitant with nucleus accumbens (NAc) neuronal activity recorded in freely behaving adolescent rats. Th e
experiment lasted for 10-16 consecutive days aft er the recovery from implanting 4 permanent semi microelectrodes in the NAc or its
destruction. Four groups of intact animals and eight groups with electrical or chemical NAc lesion were used: saline (control), 0.6,
2.5 and 10 mg/kg MPD groups. Acute MPD was found to elicit a dose response increase in animals' locomotor activity. Re-challenge
with MPD at experimental day 10 (ED10) compared to the eff ect of MPD at ED1 showed no signifi cant diff erences. When the
animals were divided into groups based on their individual responses to chronic MPD exposure, some animals expressed behavioral
tolerance and some expressed behavioral sensitization. NAc destruction prevents the chronic eff ect of MPD to elicit behavioral
sensitization or tolerance. Behavioral sensitization and tolerance is an experimental indicator suggesting that a drug has the potential
to elicit dependent. Electro-physiologically, a dose response characteristic for acute and chronic MPD exposure was observed. With
increasing MPD doses, more NAc units responded by changing their fi ring rate. Moreover, the neuronal responses to chronic MPD
recorded from animals expressing behavioral tolerance were signifi cantly diff erent compared to the neuronal population responses
recorded from animals expressing behavioral sensitization. Th e majority of the NAc units recorded from animals expressing behavioral
tolerance responded to MPD predominately by decreasing their fi ring rates, whereas NAc units recorded from the behaviorally
sensitized animals mainly showed an increase in their fi ring rates.

Biography:

Angela DB Reed has experience in working with local and national organizations and institutions as a capacity building assistance provider on behalf of the
Center of Disease Control (CDC). In this role, she assisted individuals, communities, initiatives, and organizations in the development of strategies that foster
change, assist in reaching organizational goals, and address risk determinants. She has traveled throughout the country teaching interventions that foster behavior
change. She provides expertise on logic modeling and program creation. She work as coordinator with the National Black Alcoholism and Addictions Council with
the creation and implementation of national programs with the goal of establishing support, education, and trainings in order to create change in communities
throughout the nation. She also work with the local culturally specifi c drug rehabilitation clinic Turning Point Inc. as the Director of culturally specifi c support services
division in Minneapolis, MN establishing and maintaining the programing needed to assist individuals in meeting their risk factors and help them establish holistic
lifelong goals for participants, their families and the community.

Abstract:

Presentation of the research fi ndings of a 2015 report linking culturally specifi c programing and practices to research and theory,
created by University of Minnesota’s Program in Health Disparities Research researchers and made possible through funding
by the offi ce for Business and Community Economic Development, Community Health Initiative (CHI). Th is report is a product
of the research partnership between Turning Point, Inc., the University of Minnesota Program in Health Disparities Research, and
the Offi ce for Business and Community Economic Development. Funding was provided by Medical and the Community Health
Initiative. Th e report serves to link existing culturally specifi c practices to published literature, widely studied theories and models,
and specifi c cultural values. Founded in 1976, Turning Point is a multi-service non-profi t organization whose programs have earned
local and national recognition for being among the fi rst to advance a culturally-specifi c treatment model. Turning Point’s recoveryoriented
system of care provides culturally specifi c and individually tailored approach to service delivery. Today’s social environment,
and the challenges African Americans face, warrant use and revitalization of cultural strengths. Problems such as drug and alcohol
addiction, HIV/AIDS, health disparities, high rates of incarceration, unemployment, and poverty are severe and complex. In order to
provide eff ective services, providers must understand the importance and delivery of culturally specifi c services and care.

  • Mental Health and Addiction Medicine
Biography:

Pamela Montazer has completed her M.A. from Pepperdine University. She is a licensed Marriage and Family Therapist in the sate of California and has completed EMDR training. She currently works in dual diagnosist treatment and in private practice in Orange Country, California.

Abstract:

Leading authorities and researchers in the in the field such as Gabor Mate and Jacobsen, Southwick, & Kosten, (2001) have examined the co-occurrence of trauma and substance abuse. However, despite the growing buzz on trauma informed therapy there has been relatively little discussion on the possible efficacy of trauma informed therapy in dual diagnosis treatment and there continues to be sparse implementation of evidenced based trauma informed therapy in dual diagnosis treatment. The purpose of this article is to review current literature and research examining the utility of trauma informed interventions such as EMDR (Eye Movement Desensitization and Reprocessing) in dual diagnosis treatment. Examining current literature and research on trauma and substance abuse elucidates a clear connection between the two and a need for trauma informed therapy in dual diagnosis treatment. Trauma must be adequately addressed for comprehensive and successful substance abuse/ dual diagnosis treatment. In conclusion, examining the current literature and research on trauma and substance abuse sheds new light on the need for increased implementation of trauma informed therapy in dual diagnosis treatment.

Biography:

Rudolf has been board-certified by the American Board of Addiction Medicine since 2004, by the American Board of Family Medicine since 2003, and by the American Academy of Medical Acupuncture since 2010. He divides his clinical time between inpatient addiction medicine at Cascade Behavioral Hospital in Seattle, where he is medical director of addiction recovery services, and Swedish Pain Services, where he practices outpatient pain management, addiction medicine, and medical acupuncture. His research has been inspired by his breadth of clinical experience. He has developed a novel protocol for opioid withdrawal management which has a range of clinical applications among the available treatment options for opioid use disorders, and which has been the subject of research presented at this and other conferences.

Abstract:

The clinical effectiveness of a novel non-opioid and benzodiazepine-free protocol was compared to a buprenorphine/naltrexone taper for opioid detoxification and transition to subsequent relapse prevention strategies, including initiation of extended release (ER) naltrexone treatment. Methods: Retrospective chart review of DSM IV diagnosed opioid-dependent patients admitted for inpatient detoxification examined differences between 84 non-opioid protocol (treated with scheduled 4-day tizanidine, hydroxyzine and gabapentin) and 40 bup/nx protocol (treated with scheduled 4-day bup/nx taper) subjects. Both groups received ancillary medications and routine counseling. Primary outcomes measured completion of detoxification and facil- itation to further chemical dependency treatment. Secondary outcomes in- cluded length of stay (LOS), adverse effects, Clinical Opiate Withdrawal Scale (COWS) scores, ancillary medication use, and initiation of injectable ER naltrexone treatment.

Biography:

Kun-Hua Lee is a certifi ed Clinical Psychologist in the Department of Clinical Psychology from Yuli Hospital, Ministry of Health and Welfare. He did his PhD in the
Department of Counseling and Clinical Psychology from National Dong Hwa University. His research interest is mainly on Clinical Psychology, Psychology, Health
Psychology, Applied Psychology, Medical & Health Profession Education, Psychotherapy, Cognitive Behavioral Therapy, and Evolutionary Clinical Psychology.

Abstract:

Introduction: Literature indicated depression could be a signifi cant predictor of withdrawal symptoms. Th en, people could
compulsively seek and use more heroins in order to improve withdrawal symptoms. Despite evidence proved these relationships
among depression, withdrawal symptoms and compulsion on heroin abusers, little study proposed hypothesized model and
comprehensively examined the relationships among these factors. Furthermore, the present study proposed a hypothesized model
of depression, withdrawal symptoms and compulsion (DWC model) and examined the hypothesized model by heroin abusers with
methadone replacement treatment.
Methods: Cross-sectional study was conducted to examine the hypothesized model. Two hundred and thirty fi ve participants were
recruited from the inpatient of methadone replacement treatment in Southern Taiwan. Aft er informed consent, all participants were
asked to complete the questionnaires in terms of depression, compulsion to use heroin, the severity of withdrawal symptoms and
daily consumption of heroin use. Descriptive analyses were to present the distributions of demographic variables. Structural Equation
Modeling (SEM) was to examine the model-of-fi tness indices of the DWC model. Th e signifi cant level was at 0.5.
Results: Our results found full DWC model showed good model-of-fi tness indices (X2=1.61; df=48, p<0.05; CFI=0.98; RMSEA=0.05).
However, the relationship between depression and use of heroin did not reach signifi cant level. Aft er deleting insignifi cant relationship,
the reduced DWC model showed proper model-of-fi tness indices (X2=1.68; df=50, p<0.05; CFI=0.97; RMSEA=0.05). Th rough Sobel
Test, compulsion to use not only played as mediated role between depression and use of heroin, but also mediated the relationship
between withdrawal symptoms and use of heroin.
Discussion: Despite depression and withdrawal symptoms are signifi cant predictors of use of heroin, compulsion to use plays as a
crucial role for taking heroin. Moreover, the patients with heroin use disorder could be treated to decrease consumption of heroin in
terms of behavioral modifi cation on compulsively drug taking, for example, mindfulness-based training. By mean of mindfulnessbased
training, people with heroin use disorders could be taught to non-judgmentally and objectively accept the urge of compulsively
taking drugs. Further study could pay more attention on the eff ectiveness of mindfulness-based training on heroin use disorder.

Diane Mintz

Mental Health Advocate & Business Owner, USA

Title: The impact of hearing stories of recovery from dual diagnosis
Biography:

Diane Mintz is an author, speaker, business owner and mental health advocate. She serves on the board of the Sacramento National Alliance on Mental Illness. In
her book and presentations, she reaches a diverse audience and gives an intimate insight into what it is like to battle and live successfully with a dual diagnosis.
She presents at Crisis Intervention Trainings for law enforcement; to students, health professionals, church members and families who want to know how to help
their loved ones. Her mission is to give a new perspective of mental illness and addiction; a perspective that inspires society to support the affl icted and give them
a hope for recovery.

Abstract:

The human psyche can’t be reduced to textbooks or manuals. Th is reality adds to the incredible challenge for mental health
professionals and addiction specialists to provide treatment from an occasional snapshot of their client. Th e fact that the general
public is ignorant about dual diagnosis further compounds the problem, especially considering media’s continual infl uence on society’s
bias when they focus on tragic events and provide misinformation. Th is ignorance perpetuates the stigma that keeps those affl icted
with mental illness or addiction from getting well. Th e stigma dissipates when those with long-term recovery share their experience.
Th e real-life perspective provides unique, valuable insights that only people with lived experience can provide. Th e catch twenty-two
is that stigma prevents people from disclosing their lived experience. When the silent successful are willing and encouraged to tell
their stories of recovery to the public in schools, churches, and various organizations, the impact is profound. Th e public, including
those who off er treatment, get more exposure to people who are managing their illnesses and their lives well. Viewing dual diagnosis
throughthe lens of those who have struggled will foster a paradigm shift of society’s view of mental illness and the disease of addiction,
making recovery possible for those paralyzed by stigma. Without the cloak of shame, those struggling with a dual diagnosis can get
support and make more progress with recovery. Without the barrier of stigma, more people would seek early treatment, resulting in
a widespread improvement in a myriad of mental and physical illnesses.

Melissa Alton

LMHC, NCC, CCMHC, EMDR in Private Practice, USA

Title: To use or to be used: The relationship between trauma and substance use
Biography:

Melissa Alton, LMHC, NCC, CCMHC, EMDR earned her Masters’ from Nova Southeastern University in 2011. She has experience working with trauma, substance
abuse and mental health which has developed through working with clients in crisis care and outpatient counseling. She currently works as a Licensed Evaluator
at DACCO. In this role, she meets the clients when they fi rst walk in for help, gets to know their stories and pieces of their troubles. Subsequently, balancing the
intuitiveness of the therapeutic relationship with evidence based theory to facilitate care at level of need to guide clients towards lowering their distress level through
changes in choice and feeling.

Abstract:

Substance use and trauma typically manifests metaphorically through to use or to be used. For in one moment, a substance
is used to feel happy, numb while in the next a person is used for another to feel happy, numb. In this instance both the
substance and that person become an object. When occurring together they are oft en mutually reinforcing to one another
and feed off the reward of instant gratifi cation. Th is object is simply for use and it becomes ingrained into identify, self. Th us
facilitating the illogical disconnect of use and being used to believe that the ones needs are truly fulfi lled or perhaps not caring
if one it is used. For an example a young woman who works as a prostitute to pay for her substances. She will oft en share that it
does not feel real to her, she had to do what she had to do to get her fi x. However, due to this cyclic relationship, the pain gets
buried and forms scars.