International Conference and Exhibition on Dual Diagnosis July 18-19, 2016 Chicago, Illinois, USA

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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

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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

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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.

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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.

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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.

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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.

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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

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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.

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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.

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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.

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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.

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Chair of Department and Clinic of Psychiatry at Wroclaw Medical University, and head physician in charge at Lower Silesian Center for Mental Health (DCZP) and at Independent Public Clinical Hospital. Consultant psychiatrist and epidemiologist. Author of more than 350 articles in the field of psychopharmacology, social psychiatry. epidemiology and history of psychiatry.

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According to the definition of dual diagnosis mental disorders associated with addiction should meet the ICD-10 or DSM-5.Literature data indicate that about 30-50% addicted to alcohol or other drugs have severe mental disorder, which is twice higher rate than the population do not use psychoactive substances. Similarly, among the major mental disorder, approximately 30% used alcohol and suffering from disorders associated with it. In Poland in the years 2010-11was carried out study of the prevalence of mental disorders in the general population in adults, according to the methodology of the World Mental Health Survey Initiative. Among the most common lifetime (LT) diagnostic categories were diagnosed with alcohol abuse, males 18.6% and females 3.3% and addiction respectively 4.1% and 0.4%. In contrast, substance addiction, 1.8% in men and 0.8% among women.

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SMIs are associated with significant hidden NCD morbidity however, despite the indicative trends, the small samples of each SMI category did not allow for further investigation of associated socio-demographic and metabolic factors. A larger sample and longitudinal study design will enable further investigation of this complex relationship in this patient population.

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Mental disorders and non-communicable diseases (NCDs) commonly occur together and relate to each other in a complex way. People with severe mental illness (SMI) are at risk of the metabolic syndrome irrespective of antipsychotic treatment and are also at increased risk of other comorbid physical disorders. Because of their mental state, patients with SMI have limited access to appropriate health care and/or are not routinely assessed for these ailments resulting into poorer health outcomes. The profile of NCDs in patients with SMI in the patient population at Butabika Mental Hospital in Uganda is not well understood hence this study.

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Mickael Naassila has completed his PhD in Neurosciences in 1998 from Rouen University and postdoctoral studies from Kansas University Pharmacy School Dept Pharmacol & Toxicol. He is the director of Research Group on Alcohol & Pharmacodependecences (GRAP – INSERM Eri 24). He has published more than 50 papers in the addiction field and is the President of the Society française d’alcoologie

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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. NVHL rats displayed several signs of alcohol use disorder such as a loss of control over alcohol intake and high motivation to consume alcohol, associated with a higher resistance to extinction.

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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, Diane 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 one. Diane’s mission is to give a new perspective of mental illness and addiction; a perspective that inspires society to support the afflicted and give them hope for recovery.

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The human psyche can’t be reduced to textbooks or manuals. This reality adds to the incredible challenge for mental health professionals and addiction specialists to provide treatment from an occasional snapshot of their client. The fact that the general public is ignorant about dual diagnosis further compounds the problem, especially considering media’s continual influence on society’s bias when they focus on tragic events and provide misinformation. This ignorance perpetuates the stigma that keeps those afflicted with mental illness or addiction from getting well. The stigma dissipates when those with long-term recovery share their experience. The real-life perspective provides unique, valuable insights that only people with lived experience can provide. The 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. The public, including those who offer treatment, get more exposure to people who are managing their illnesses and their lives well. Viewing dual diagnosis through the 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.

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Patricia Allen is a Psychiatric Mental Health Nurse Practitioner and Executive Director of Nursing Services for Summit Behavioral Health. Summit provides addiction treatment services in Pennsylvania, New Jersey and Massachusetts. Pat is an Assistant Professor of Nursing and tenured faculty at Montgomery County Community College in Blue Bell, Pennsylvania. Pat is a DNP candidate at West Chester University in West Chester, Pennsylvania. Pat presented at the Cape Cod Symposium on Addictive Disorders and the Annual Conference of the American Psychiatric Nurse’s Association on topics related to pharmacogenetics and medication-assisted treatment for those with co-occurring disorders. She presented at the NEI Psychopharmacology Congress. Pat has discussed these topics in media opportunities.

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More than 65% of those with substance use disorders also suffer from a mood or anxiety disorder. For the past decade pharmacogenetics has emerged as a promising clinical tool for the treatment of those with co-occurring disorders. This testing enables individualized treatment and offers the client and practitioner valuable information that can positively impact the course of treatment. Many of our clients come to us with unresolved or worsening symptoms, a history of treatment non-compliance, or premature discontinuation of prescribed medications due to the medication not working or intolerable side effects. Genetic testing guides the prescriber, individualizes care, educates the client, and facilitates a clinical partnership that empowers the client and supports recovery. With the advances in medication assisted treatment for addictions, genetics testing can helps us work with our patients to design the most successful recovery program. When patients have appropriate treatment from the beginning, they are more likely to remain in treatment and recovery. Current use of genetic testing is helping us to achieve retention rates greater than 90% in our treatment programs. Case studies which demonstrate the clinical value of genetic testing, its impact on clinical outcomes for clients with co-occurring disorders, and reduces the stigma that is a barrier to treatment.

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Preve M is from Psychiatric Clinic, Sociopsychiatric Organization, Mendrisio, Switzerland

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Pregabalin (Lyrica) is widely used in neurology, psychiatry and primary healthcare. Pregabalin has shown greater potency than gabapentin in preclinical models of epilepsy, pain and anxiety, and pregabalin may have potential in the treatment of some aspects of cocaine addiction. The purpose of this report is to review the clinical evidence for the potential of abuse and misuse of pregabalin. We propouse ten different cases and literature review. Method Ten inpatients with misuse of pregabalin were assessed with: the SCID-P, Anamnestic Folio to qualify all the possible clinical correlates linked to drugs abuse, Hamilton Anxiety Scale (HAM-A) and Drug Abuse Screening Test (DAST). All patient received a complete internistical examination, blood test exams and as well as a urine drugs screening. We conducted a systematic review of the literature.

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well known to increase morbidity and mortality. Results in increased health care costs, due to brain damage etc. A rise in drug use, abuse and a loss of trust in the medical profession, harm reduction & addictions counsellors. Be assured Ontario's Public Health staff will give rescue breaths to family and friends His article: Emergency Medicine News

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I read with grave concern the article by Leece, et al. about Toronto's opioid overdose prevention program and teaching laypersons the signs of respiratory emergency and training them to give chest compressions only. Omitted from the training literature were the signs of opioid overdose. Those include not being able to wake up the person; slow, erratic, or stopped breathing; deep snoring or gurgling sounds; blue or purple fingernails or lips; limp body; and very small pupils. These signs would indicate a poisoned patient in coma suffering a respiratory emergency. Cardiac arrest is secondary to respiratory arrest and is associated with severe hypoxia. Prognosis is poor. The patient now needs ACLS beyond the scope of laypersons. The authors note that “significant numbers of opioid-related deaths involve polysubstance overdose with cardiotoxic drugs.” The author's 29th reference makes slim mention of cardiotoxic drugs. Stimulants and other toxins may cause a dysrhythmia, and drugs of abuse cause death from acute respiratory failure. Cyanosis can be cardiotoxic, myocardial infarction can be from lack of oxygen in bloodstream, and every tissue and all organs are dying from lack of oxygen. The authors write, “Painful stimulation may be an effective means of increasing respiratory drive.” This needs redress (primum non nocere); the complications of chest compressions are endless. BLS adds oxygen to the bloodstream. I could find no consensus for chest compressions only for respiratory emergencies, including opioid poisoning (overdose).

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Helen Northcot has completed her MA from Andrews University in Berrien Springs, Michigan and her PhD from Almeda University. She is the director of Choose A Lifestyle, which is her private practice for Psychotherapy, Addiction Counselling, Anger Mgt and Alcohol Education classes. She is a Registered Psychotherapist with the new College of Registered Psychotherapists of Ontario. She is a Registered Practical Nurse and is registered with the College of Nurses of Ontario. She is a Vegetarian Cooking Instructor and an Ordained Minister. She has published two books and written for newspapers in Canada and Indonesia.

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Thinking erroneously can be dangerous to your health. Volunteers of the National Hopeline Network have answered over seven million calls with the highest percentage(60%) of calls being for those in mental health crisis. Health care systems are challenged to do mental health promotion and prevention to lower costs. Screening for mental health and one’s ability to learn could provide the needed information to be proactive towards faster healing times. The ability to make good choices and to reason from cause to effect is important for a healthy mind.

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Michael Groat, Director of the Division of Adult Services at the Menninger Clinic, is 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 a current candidate in adult psychoanalysis at the Houston Center for Psychoanalytic Studies..

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Individuals troubled by addictive illness present clinicians with serious challenges regarding the experience, understanding and management of dual diagnosis disorders. Among them, the difficult-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 often 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 findings from work with difficult-to-treat patients, this presentation will discuss multiple issues involving the vagaries of working with such patients within the framework of psychodynamic treatment. The presenter will lead a discussion with the audience encouraging dialogue from everyone’s clinical experience.

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Linda Devlin I.C.A.D.C. C.I.P Board Certified Interventionist - International Certification & Reciprocity Consotium (IC&RC) CEO Successonlinecoaching, Co Founder Addiction-Fighters.com Linda's work in the Social Services Industry for over two decades and continued onto being one of the top Executive Management Leaders in the Health Care Industry in Canada. Involved in many Provincial and National Strategies in Health Initiatives including the Council on Workplace Health and Wellness in which the building a Psychological Safe Workplace “practical approaches to Success” were implemented and the creation of the New National Standard of Canada for Psychological Health and Safety in the workplace. Linda’s commitment to service provision is to provide creative solutions that are easily accessed for today’s issues. Linda has been Intervening, teaching and coaching adults in a variety of settings including lectures, discussion groups, seminars, classroom teaching, tutoring and one-on-one coaching.

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10 Million Americans have a Dual Diagnosis and a disturbing percentage receive no treatment at all, while others receive treatment for only their addiction or mental illness. To be effective, a treatment program for co-occurring disorders should integrate treatment for both. But without an Intervention, many of Dually Diagnosis individuals may never get the help they need. The symptoms can be so disturbing that alcohol or drug abuse may seem like the only way to cope. One of the things that are so difficult to treat is that it is hard to know where certain symptoms are coming from, if a dual diagnosis patient is suffering from depression, there’s no way to initially know whether the drug addiction or the individual’s mental illness is causing the problem. Treating both the mental illness at the same time, all under “one roof”, has been a very successful method of treatment and Interventions can prevent the life-threatening consequences of drug & alcohol abuse.The Intervention Specialist must recognize the boundaries and limitations of one’s own competencies, and not offer services or use techniques outside of these professional competencies. The Intervention Specialist recognizes the effect of physical and mental impairment and make the best suited Treatment options to guide the process. It is also very effective to include case management principles of inclusion with mental health practitioners. When thoughts and perceptions are altered by mental illness, it’s easy to neglect patients own care. Depression can make you feel that your life isn’t worth saving, while anxiety may drive you away from contact with others.

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Dr Rosa Alati is a NHMRC Post-doctoral research fellow with a background in alcohol studies and Indigenous health research. During her early research career, she has taught and researched in the field of Indigenous alcohol misuse, and has had considerable experience in working with Australian Indigenous traditional and non traditional people. In 2001, Rosa Alati returned to full-time PhD studies and became associated with the Mater University Study of Pregnancy, a 21 year birth cohort study started in Brisbane (Australia) in 1981. Following completion of her PhD, she was awarded a 4 year NHMRC Post-doctoral Training Fellowship (Public Health) and joined the Longitudinal Study Unit and the Queensland Alcohol and Drug Research and Education Centre (School of Population Health – University of Queensland). Dr Alati’s research interests are in the life course epidemiology of alcohol and other mental health disorders. She has published on the association between alcohol use and mental health status and on the effects of prenatal alcohol and tobacco exposure on adverse outcomes such as asthma, obesity and alcohol disorders.

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There is a growing interest in exploring maternal mental health effects of unintended pregnancies carried to term. However, the evidence base from a small number of available studies is characterised by considerable variability, inconsistency and inconclusive findings. We present a systematic review and meta-analysis of all available studies on unintended pregnancy as these are related to maternal depression. Using PRISMA guideline, we systematically reviewed and meta-analysed studies reporting an association between unintended pregnancy and maternal depression from PubMed, EMBASE, PsychINFO and Google Scholar. We used a priori set criteria and included details of quality and magnitude of effect sizes. Sample sizes, adjusted odds ratios and standard errors were extracted. Random effects were used to calculate pooled estimates in Stata 13. Cochran's Q, I2 and meta-bias statistics assessed heterogeneity and publication bias of included studies.

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Roland is an interventionist, author, trainer, counselor and consultant specializing in addiction-related issues. He is the President and Founder of Free Life Enterprises an international counseling and consulting firm, he is the Chairman of the Clinical Advisory Board Clinical for Lionrock Recovery. He is the Coordinator of Chemical Dependency Studies at California University, State East Bay. He is the co-founder and former Executive Director of Alta Mira Recovery Programs, in Sausalito, California, as well as co-founder and former Clinical Director of Bayside Marin, in San Rafael, where he designed the initial clinical model for each facility. Roland is the past Director of Clinical Operations for DARA Thailand where he redesigned the clinical treatment model. Roland worked at Good Samaritan Hospital.

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This engaging and challenging presentation allows participants to examine the implications both positive and negative of cultural considerations in the recovery and treatment of addiction with fomerly incarcerated clients. We will examine the impact of Cognitive Behavioral Threrapy on achieving positive treatment outcomes and discuss practical applications on CBT in the clinical setting. We will examine how the Recovery movement itself is a culture, complete with rituals, language, bias and prejudices. We will explore the specific challenges members of various cultures experience as they participate in treatment and self help support groups. We will also examine symptoms experienced by formerly incarcerated clients, particularly Post Incarceration Syndome and Institutiionalized Personality Synsdrom. Participants will have an opportunity to identify their own prejudices and bias, and determine how they affect treatment outcomes in the form of counter-transference. Participants will learn specific cross-cultural counseling techniques that will increase their effectiveness and client retention rates. By exploring methods of assisting clients and treatment providers to realign themselves and their practicies we will in turn, discuss how to move past the victimization of oppression and into the Healing of Recovery.