3^rd International Congress on Addictive Behavior & Dual Diagnosis August 16-17, 2018
Quality Hotel Globe, Arenaslingan 7, 121 26 Johanneshov, Sweden

Biography:

Scott has 38 years experience in the delivery of clinical health care focused on treatment for chronic pain, addictive and combat stress disorders.  He is Board Certified in the Addiction Psychiatry. His post-graduate training in psychiatric medicine began at the Mayo Clinic 1975-1979. He is most indebted to early Mayo consultants for pioneering novel addiction and pain medicine treatment practices which serve as a foundation for his practice at the VA medical center Minneapolis.

He has had a lifelong interest in using evidence-based psychopharmacology, blended with alternative and complementary treatment approaches. Scott was an early board member for Minneapolis Pathways, one of the first health crisis resource centers for life-threatening medical illness in the country. Many of those practices are now well–integrated in to treatment for cancer and end of life care.

He champions greater use of addiction pharmacotherapy in primary care and psychiatry and trains physicians for the DEA buprenorphine waivered licensure. Another current interest is the utilization of pharmacy data mining for monitoring treatment outcomes that will enhance patient safety and care.

His clinical outcome studies have included 1) development of a medication management support group for opioid dependent patients treated with buprenorphine to promote treatment success and 2) the use of parenteral depot naltrexone for high medical risk, chronic and treatment refractory alcohol dependent veterans which dramatically reduces overall costs of care and disease progression.

At the University of Minnesota - VA campus he directs the fellowship in addiction psychiatry and site directs the ABAM addiction medicine fellowship newly recognized by ABMS and the Board of Preventive Medicine. He is recognized for his excellence in teaching and modeling positive clinical encounters. He places primary emphasis on restoration of function and prevention of deterioration as outcomes for success. Scott is an integral part of a treatment team comprised of physicians, nurses, social workers and psychologists without whom he could not have achieved the success that he has had.

Abstract:

BACKGROUND

According to the Center for Disease Control (CDC), abuse of prescription opioids and heroin is an ever-growing epidemic in the United States

Methadone has been the long-standing treatment of choice in patients who are deemed appropriate for medication-assisted treatment (MATx) of opioid dependence

Buprenorphine/naloxone (bupe/nx) became a second option for patients in the United States suffering from opioid dependence when it received FDA approval in October 2002

The Minneapolis Veterans Affairs Health Care System (MVAHCS) started utilizing buprenorphine/naloxone therapy in 2004 in veterans with opioid dependence

Approximately 300 veterans have received treatment  with bupe/nx between 2004 and 2016

There are currently 150 veterans on active bupe/nx maintenance treatment as of 2016

The original Drug Abuse Reporting Program (DARP) outcome criteria is a 10 item rating scale that can be utilized in clinical practice to easily quantify a patient’s treatment success or unsuccess over the course of buprenorphine/naloxone therapy 1

OBJECTIVES

Primary Objective:

Determine if treatment success is maintained after treatment discontinuation in patients no longer receiving buprenorphine/naloxone therapy

Secondary Objectives:

Identify if the length of buprenorphine/naloxone therapy increases the likelihood of treatment success

Evaluate if any correlation exists between outcome success and patient participation in group therapy

METHODS

Retrospective chart review and interview of patients at the MVAHCS who have received at least six months (180 days) of buprenorphine/naloxone therapy.  A cut-off of 180 days of therapy was chosen due to previous data demonstrating universally poor outcomes in patients with less than 90 days of treatment. 2

Obtain demographic information and modified DARP ratings:

Two DARP scores in patients currently receiving therapy:

At treatment initiation

Current score within the past three months

Three DARP scores in patients no longer receiving therapy:

At treatment initiation

When treatment was completed

Current score within the past three months

Inclusion Criteria: on buprenorphine/naloxone for >6 months

Exclusion Criteria: lost to follow-up

CONCLUSIONS

Significantly more patients who are still on active bup/nx have a current-time DARP score decrease of > 7 compared to those who have discontinued therapy (81% vs. 16%, respectively)

In those who have completed therapy, 77% of patients experienced worsened DARP scores after discontinuation, suggesting that positive results achieved while taking bup/nx may be undone when therapy is stopped

Average length of time for those retained on bup/nx treatment beyond 180 days were on therapy for an average of 334 days longer than those who discontinued therapy for any reason; however, no correlation was identified between length of bup/nx treatment and likelihood of achieving outcome success (DARP < 15)

Participation in group therapy was not a predictor in whether patients would experience outcome success

Utility of DARP in the Clinical Setting

The modified DARP scale displays great utility in the clinical setting to track global improvements in function and achievement of positive patient recovery outcomes

Study Limitations

More than half of the patients who completed or discontinued   therapy identified both heroin and prescription opioids as their drug of choice prior to treatment, while only 31% of patients on active therapy reported both as their drugs of choice.

Biography:

David Stanton is the co-creator and consultant at TATVA and founder/owner of EDAS. He started his career in mental health in the UK over thirty years ago, in a community based project giving counselling, advice and information. For the past nineteen years he has been an international psychotherapist, supervisor, trainer, lecturer, consultant and coach. He has helped establish and manage a number of non-profits, private, community and residential addiction and mental health services in Europe, Africa and Asia. His goal is to continue helping people through his experiences, knowledge and research. He is dedicated to furthering mental health awareness through therapy and education and is especially interested in working with diverse cultures in various settings.

Abstract:

EDAS takes addiction/dependency treatment to a client's home, or a location of their choosing; any where in the world. This is called 'home based' or 'direct' treatment. They only work with one client at a time; so they are fully focused to their clients' recovery. EDAS is a group of international professional addiction specialists including psychiatrists, psychologists, psychotherapists, doctors, recovery coaches and alternative practitioners; who have many years of experience providing evidence based treatment for substance abuse and all addictions/dependencies. This treatment option is for those that don't wish to enter a residential facility (rehab) for whatever reason; these can include family and/or work commitments, disability, confidentiality, cultural differences, cost etc. It has advantages over residential treatment in that clients usually feel more comfortable in their own environment, are near to their local support networks and can continue their day to day lives without the disruption of having to travel or be away. It is considerably cheaper than most residential and other service providers and gives excellent value for money. Home based treatment can also be more effective and work quicker; due to the fact that the therapists are on the spot and available in person to the client 24/7. De-tox is often the first stage for the client; then after helping them understand why he/she is self-medicating, we help them to heal with various therapeutic approaches. We support the client in identifying the changes needed and then putting those into practice in their lives immediately. Therapy and coaching provides a safety net for the clients in their early recovery, which then leads to a strong successful recovery. EDAS is a unique organisation as they are with you in every stage of the recovery process. As EDAS professionals are on the spot with their client, they are also able to support those close to them such as their family, friends, colleagues; who are often affected by the clients dependency or substance abuse - so support is readily available through education, counselling, information and advice. Our services range from overseeing detoxification, intensive counselling, comprehensive relapse prevention planning, real time recovery coaching and a full after-care package; all to enable our clients' mental, physical and spiritual wellness.

Biography:

I have been a senior lecturer at LJMU since 2004. My mental health nursing career spans three decades and I teach on postgraduate and undergraduate programmes. I am a former specialist practitioner/manager in drug services in Liverpool and continue to maintain links with frontline services. I specialise in drug and alcohol awareness, dual diagnosis and motivational interviewing. I have authored several chaters on alcohol and drug use and collaborate with others in the field of addiction and mental health to promote awareness and recovery

Abstract:

Biography:

After a 25 year academic and clinical career as a pain and addiction trained psychologist at Memorial Sloan Kettering Cancer Center, University of Kentucky and Vanderbilt University, Dr. Passik spent the past 4 years in the toxicology and most recently the pharmaceutical industry. His research has focused on psychiatric aspects of cancer and non-cancer pain and symptom management and the interface of pain management and addiction. He has served as editor and reviewer for multiple journals in pain and psycho-oncology. He has authored over 200 scholarly publications.

Abstract:

Evans et al. (2017) have pointed out how frequently and pervasively nonmedical prescription opioid use is associated with severe pain in young adults, especially young white males. This is a subset of such nonmedical users at tremendous risk of overdose (indeed 1/3 of the study respondents had an overdose event), especially given their concomitant use of benzodiazepines. Avoiding further contributing to the catastrophic rise in overdoses requires access to comprehensive pain care for these young adults. If they were to require opioid therapy, it would have to be in the context of a highly complex and expert variety of such care. If we fail to make it available, we will fail to address the root cause of overdoses for a sizeable subset of nonmedical prescription opioid users. In this lecture, Dr. Passik will use the findings of the Evans study to a jump off to a discussion of the history of the opioid crisis and suggest suggestions to enhance and introduce the safe use of opioids in patients who need them.

Biography:

David Stanton is the co-creator and consultant at TATVA and founder/owner of EDAS. He started his career in mental health in the UK over thirty years ago, in a community based project giving counselling, advice and information. For the past nineteen years he has been an international psychotherapist, supervisor, trainer, lecturer, consultant and coach. He has helped establish and manage a number of non-profits, private, community and residential addiction and mental health services in Europe, Africa and Asia. His goal is to continue helping people through his experiences, knowledge and research. He is dedicated to furthering mental health awareness through therapy and education and is especially interested in working with diverse cultures in various settings.

Kripi Malviya is a psychologist, experiential psychotherapist and advocate with a Masters in Clinical Psychology with an International Certification in Addiction Counselling and Training.​ She has worked with​ adolescents, adults, couples and families with multi-disciplinary teams of international mental health professionals, from varied cultures and therapeutic backgrounds. She facilitates addiction treatment and general mental health training workshops in the South Asian and South East Asian regions; including Bhutan, Afghanistan, Sri Lanka, Malaysia and Thailand including her role as a Regional Resource Training Coordinator in India. Kripi is an existentially inclined psychotherapist and a poet who promotes and facilitates the reciprocal connection and relationship between creativity and psychotherapy with respect, openness and vulnerability.

Abstract:

An Anglo/Indian mental health awareness and emotional wellness organisation is the only one in the whole of Asia that is providing harm reduction welfare areas at festivals/events. This is a new initiative/concept and part of our work is to crate safe places and communities to encourage group work to identify the needs of those attending such gatherings.Festival producers are increasingly recognizing the necessity for spaces dedicated to helping individuals through the challenges that can result from the consumption of psychoactive substances. Psychological support services are beginning to be seen as equally important as medical care services in festival environments, where many individuals choose to use these substances. They offer peer to peer counseling with individuals who are trained to work with overwhelming experiences. Many of our volunteers are mental health professionals, psychedelic researchers, and medical service providers. Others have training in holistic healing modalities or other relevant experience. We provide our volunteers with an on-site comprehensive training which further prepares them for offering harm reduction services.

Biography:

Dr. Papamalis is a public health researcher and practitioner. He has extensive clinical and research experience in diverse settings, served as a member of various advisory boards, EU Expert Groups and worked as scientific advisor and consultant at (inter) governmental and non-governmental bodies in country and abroad. Dr. Papamalis has been trained in several psychotherapeutic approaches with focus on contemporary psychodynamic and interpersonal approach. He has extensive experience in working in inpatient/outpatient clinical settings as a counsellor, team leader 

Abstract:

This workshop shall be divided into three interrelated sections. The first section is devoted to the exploration of the scientific and applied research and its role in increasing the effectiveness of prevention strategies, assuring quality and raising standards. The second section involves the importance of the systematic evaluation and monitoring at the forefront of the social policy development and formulation of evidence based practices. Finally, the third session introduces an innovative conceptual database framework based on an automated optical representation of dimensional diagnostic indicators that could contribute to the identification of individual vulnerabilities. The tool enables automated data collection and real time graphical representations of service users or target group profile. This provides a framework to bridge the gap between research and practice, as beyond a valuable research tool (automated administration, data safety etc.), it also offers a unique optical presentation of key indicators of individuals dimensional profile relevant to their severity levels, psychosocial adaptation and personality. Finally, this conceptual database framework also entails a powerful incentive for clinicians and prevention personnel participation, as it clearly indicates practical applicability of the data for conceptualization, planning and identification of red flags and warning signs. Its implementation could allow researchers to identify vulnerable individuals who are more prone or vulnerable to develop drug problems, reformulate their prevention planning and enhance targeted intervention.

Main themes of the training involve:

• The current state of evidence base - Evaluation as a process tool for conceptualizing and formulating prevention intervention and treatment planning

• Treatment Engagement as a multidimensional construct: Key indicators of favorable outcome

• The role of contemporary psychodiagnostic database framework in designing prevention strategies and clinical interventions

• Exchange of know how and exploration of the economic impact in terms of prevention & treatment effectiveness, organisational functioning and service delivery"

Biography:

Jales Clemente has completed his Psychiatric Course at the age of 30 years from Federal University of São Paulo.

Abstract:

The aim of this study was to evaluate the prevalence of paraphilic thoughts/behaviors (including paraphilic disorders) with and without sexual addiction and sexual-related conditions in a sample of substance disorder patients. This was a cross-sectional study of substance-dependent individuals who sought outpatient treatment in São Paulo, Brazil. Data included sociodemographic information, drug of choice, responses to questions about sexual behavior, and to the following standardized questionnaires: (a) Sexual Addiction Screening Test, and (b) Childhood Trauma Questionnaire. Results: The sample comprised 134 persons who use drug, predomi- nantly men (76.1%), 39.6% were aged between 18 and 29 years, and 54.9% were single. Most were persons who use polydrug, 73.9% were alcohol and cocaine users, 63.4% marijuana users, 81.1% tobacco users, and 5.2% steroid users. Prevalence of paraphilic thoughts/ behaviors (including paraphilic disorders) with and without sexual addiction was 47%. The HPV/herpes and hepatitis B rates were 7.9% (P1⁄40.021) and 6.3% (P1⁄40.046) respectively. Paraphilic and non- paraphilic thoughts/behaviors were associated to the presence of childhood physical neglect (odds ratios [OR] 1⁄4 4.7, 95% confidence interval [CI] 1.0 to 21.9), low educational level (OR 1⁄4 7.2, 95% CI 1.4 to 36), heterosexuality (OR 1⁄4 3.8, 95% CI 1.1 to 12.8) and youth (age 18 to 20 years) (OR 1⁄4 5.6, 95% CI 1.4 to 11.8). Conclusions: The high prevalence of paraphilic thoughts/behaviors with or without sex addiction in persons who use drugs may be related to the experience of physical and emotional neglect during childhood and this possibility should routinely be investigated in clinical practice.

Biography:

Robertas Badaras MD, PhD, Head of Toxicology Centre in Vilnius University Faculty of Medicine, and also Head of Toxicology Centre in Vilnius University Emergency hospital, also working as the consultant in Lithuanian Poison bureau. The fields of his interests: intensive care in toxicology, methods of extracorporeal detoxifications, detoxification from psychoactive substances, clinical nutrition in ICU. Last few years he started to provide opioid detoxifications for cancer and non-cancer pain patients, who became addicted to prescription opioids. He is the teacher for students, residents, provide courses for doctors, participating in national and international professional meetings with scientific presentations.

Abstract:

Antagonist induction in opioid antagonist assisted abstinence remains problematic due to its pronounced withdrawal effects. This study aimed to compare stress response by using two naltrexone induction protocols. A double-blind, randomized clinical trial was registered in ClinicalTrials.gov (Identifier: NCT02362256). For antagonist induction, the Control Group (CG) received a single 12.5 mg oral dose of naltrexone while the Intervention Group (IG) received an escalating regimen, starting with 50 µg, followed by gradually increasing doses to a cumulative dose of 12.5 mg. All patients received 25 mg of naltrexone on the following day and 50 mg on the day after. Both groups received a fixed protocol of clonidine and lorazepam, with additional doses given when marginal thresholds were exceeded on the Subjective (SOWS) and Objective (OOWS) Opioid Withdrawal scales. Adrenocorticotropic hormone (ACTH), cortisol levels, and SOWS and OOWS were markers of stress response and severity of withdrawal.

A single 12.5 mg naltrexone dose nearly doubled the ACTH concentration compared to baseline and caused statistically significant increase in cortisol concentration, OOWS  and SOWS in CG. These values were below baseline at 1 and 5 h time-points in the intervention group. Differences between the CG and IG were statistically significant. There were no differences between the two groups after 24 h. In contrast to a single 12.5 mg dose, the escalating naltrexone dosing regimen did not produce a measurable withdrawal or stress response during antagonist induction.

Biography:

Scott has 38 years experience in the delivery of clinical health care focused on treatment for chronic pain, addictive and combat stress disorders.  He is Board Certified in the Addiction Psychiatry. His post-graduate training in psychiatric medicine began at the Mayo Clinic 1975-1979. He is most indebted to early Mayo consultants for pioneering novel addiction and pain medicine treatment practices which serve as a foundation for his practice at the VA medical center Minneapolis.

He has had a lifelong interest in using evidence-based psychopharmacology, blended with alternative and complementary treatment approaches. Scott was an early board member for Minneapolis Pathways, one of the first health crisis resource centers for life-threatening medical illness in the country. Many of those practices are now well–integrated in to treatment for cancer and end of life care.

He champions greater use of addiction pharmacotherapy in primary care and psychiatry and trains physicians for the DEA buprenorphine waivered licensure. Another current interest is the utilization of pharmacy data mining for monitoring treatment outcomes that will enhance patient safety and care.

His clinical outcome studies have included 1) development of a medication management support group for opioid dependent patients treated with buprenorphine to promote treatment success and 2) the use of parenteral depot naltrexone for high medical risk, chronic and treatment refractory alcohol dependent veterans which dramatically reduces overall costs of care and disease progression.

At the University of Minnesota - VA campus he directs the fellowship in addiction psychiatry and site directs the ABAM addiction medicine fellowship newly recognized by ABMS and the Board of Preventive Medicine. He is recognized for his excellence in teaching and modeling positive clinical encounters. He places primary emphasis on restoration of function and prevention of deterioration as outcomes for success. Scott is an integral part of a treatment team comprised of physicians, nurses, social workers and psychologists without whom he could not have achieved the success that he has had

Abstract:

Background

According to the World Health Organization, alcohol use disorders are the third leading cause of disease burden in developing countries. Unfortunately, the percentage of patients receiving pharmacotherapy to treat this condition is still very small. Naltrexone is a mu opioid antagonist that is posited to reduce the neurobiological reward obtained from alcohol by causing reduced dopamine release, craving, and reduced alcohol intake. Naltrexone oral has better outcomes when taken consistently, but unfortunately people suffering the severe later stages of alcohol use disorders (AUD) have notoriously low medication adherence and high medical and behavioral crisis ED visits, complicated by costly hospitalizations in turn. One solution to this problem has been the development of a injectable extended-release naltrexone (XR-NTX) which provides a sustained release of medication for up to four weeks. This more aggressive sustained pharmacotherapy remains unappreciated and underused in the management of chronic AUD.

Introduction     

This study subjects comprised 25 Minneapolis VA Medical Center patients with a diagnosis of severe alcohol dependence receiving injectable extended-release naltrexone (XR-NTX) at any time during their treatment course. They had been offered this medication option because of their demonstrated treatment resistance to conventional abstinence approaches. The efficacy of the medication was determined by how many alcohol related emergency room visits took place and whether the patient was on or off the XR-NTX at the time of the visit. During both the pre and post stages the ED was the best indicator of admit to both medical and psychiatric inpatient beds for costly acute care for AWS, Delirium and Suicide intent. In most cases the time on monthly ER-NTX administrations proved to be discontinuous rather than sustained. Nonetheless a comparison of effectiveness of the medical morbidity in the year prior to intervention with XR-NTX and afterward for more than 2 years of episodic treatment was reviewed.

Methods

This study entailed a detailed, retrospective chart review of 25 Minneapolis VA Medical Center patients ≥18 years with a diagnosis of alcohol dependence, documented treatment resistance to conventional abstinence approaches, and who then received extended-release naltrexone injection at any time during their treatment course. Subjects encompassed a broad age range, with 24/25 males.

Subjects were identified by the VA pharmacy Prior Approval Requests for ER-NTX submitted by addiction physicians after its formulary inclusion in 2008. The patient had to meet the defined VA use criteria and give voluntary consent to the parenteral injection procedure.  The efficacy of the medication was evaluated by the number of alcohol related ED visits before and after the first naltrexone injection and Blood Alcohol Level (BAL) and/or breathalyzer values at the time of the ED visit. Results here focus on the number of ED visits prior to- and following the first naltrexone injection.

Data collection process.  Medical records of 25 subjects were abstracted. The study successfully extracted medical records for the 12 month interval immediately before the first naltrexone injection (reference date) for 21 of the 25 subjects (with 4, 7, 10, and 11 months of look-back available for the other 4 subjects), and  medical records were extracted for at least 12 months following the reference date for all 25 subjects.  Longitudinal data included naltrexone injection dates, blood alcohol level/Breathalyzer measurement dates and results, alcohol-related ED visits and their duration, shown in a time continuum before, during, and after receiving naltrexone.

Results

Alcohol-related ED visit results. 

The 25 subjects had an average of  1.68 alcohol-related  ED visits in the 12 months immediately before the first naltrexone injection, compared  with 0.96 visits per year in the first 12 months after treatment.  The statistically significant rate ratio of 0.56 corresponds to a  44% reduction  in the rate of  alcohol-related ED visits.

Conclusions

The number and rate of alcohol-related ED visits was reduced in patients having a diagnosis of severe alcohol dependence following  administration of  injectable extended-release Naltrexone.

Naltrexone extended release reduces the occurrence and frequency of alcohol-related emergency room visits during the approximately 4-week period it is actively released from its depot stores.

Even discontinuous monthly ER-NTX administration for up to 3 years still resulted in a 51% reduction in the rate of ED visits compared to the year prior to first dose.

The discontinuous treatment presentation may be reduced by an assertive case management model of intervention for improved adherence to care and reduced morbidity and costly ED visits.

Biography:

Dijana Mayer was born Croatia. In 1996 she graduated from the Medical School of the University of Zagreb and gained the academic title of MD. Since 2005 she has been employed at the Croatian Institute for Public Health.  in the School for Adolescent and Primary Medicine and Prevention of Addiction. Since 2006,  she has been a national coordinator of the WHO project on Global Youth Tobacco Survey, participates in publishing works, participates in various domestic and international congresses and conferences, holds lectures and workshops. In 2010, after completing the specialist's internships and passing a specialist examination, she gained the title of a specialist epidemiologist. In 2015 she defended her doctor's thesis and acquired the title of Doctor of Philosophy.

Abstract:

The aim was to determine the association of media messages about smoking to smoking habits of adolescents, depending on exposure to smoking in the environment.

The study included 3,551 children in Croatia aged 13 to 15 years. Smoking habits of adolescents grow with age. Significant association of media messages that encourage smoking to sex exists in fourteen adolescents at sporting events and television and fifteen at sporting events. Anti-smoking media messages highest perceived on television (72.3 %) and lowest in newspapers and magazines (50.7 %). Significantly over thirteen-year, teachers who perceive smoking, perceived media messages that encourage smoking through television and olds across newspapers / magazines and on television. Significant differences in the perception of anti-smoking media messages at sporting events were observed in fifteen other students who see smoking. Fourteen adolescent who see teachers smoking significantly lesser extent (46.2 %) perceived anti-smoking messages in relation to their peers who say that teachers do not smoke (62.3 %). The best predictor for start smoking for both sexes smoking closest friends, but it was more pronounced in girls and more pronounced as they were under age. Smoking habits of adolescents are becoming more common with increasing age. The most likely potential predictor of adolescent smoking is the closest friend who smokes. Although there are variations according to age, gender, and smoking in the environment (parents, teachers, friends, students), the media messages are mostly perceived through television - often of pro- than anti-smoking content.

Biography:

Abstract:

Biography:

Dr Stephen Bright has worked as a psychologist within the Mental Health & AOD field for the past 15 years. He is currently Senior Lecturer of Addiction at Edith Cowan University. Stephen's PhD related to the public perceptions and media portrayal of AOD use and the implications of this for drug-related harm, including the rapid emergence of new psychoactive substances. Stephen is a leading Australian voice on the role of drug policy on emerging drug trends such as synthetic cannabis and darkweb marketplaces, in addition to psyche3delic science. He is an Adjunct Research Fellow with Curtin's National Drug Research Institute

Abstract:

Over the last decade there has been an international psychedelic science renaissance. Investigators at Johns Hopkins School of Medicine, UCLA, New York University and Imperial College London have embarked on studies that could be paradigm-changing for psychiatry. These developments overturn a 30-year embargo on psychedelic research that followed political reactions to the 1960s counter-culture movement in the USA and elsewhere. 3,4-methylenedioxymethamphetamine (MDMA) is showing promise for the treatment of refractory post-traumatic stress disorder (PTSD). For people who are unable to discuss their trauma, a key component of most psychotherapies, MDMA reduces trauma-associated anxiety while allowing reprocessing of the trauma and subsequent healing. This is significant, as while most medical treatments for PTSD provide symptomatic relief, they do not cure the disease. Meanwhile, an open-label trial of 15 people examining psilocybin-assisted psychotherapy for the treatment of tobacco addiction found 66% of participants remained abstinent at 12 month follow-up. Consequently, the team at Johns Hopkins University is initiating an RCT of psilocybin-assisted psychotherapy for smoking cessation involving 40 participant. Meanwhile, a proof-of-concept study has found that treatment of alcohol dependence with psilocybin-assisted psychotherapy yielded similarly impressive effects. This team at NYU is now undertaking an RCT of 180 people that includes fMRI scanning. A study by Sessa is investigating the efficacy of MDMA-assisted psychotheraoy with peope experiencing substance use disorders that have co-mobid trauma. Such a treatments have the potential to significantly increase the efficacy of treatments for epoepl with dual diagnosis. 

Biography:

Dr Raffaella Margherita Milani is a Chartered Psychologist and Course Leader for Substance Use and Misuse Studies at the University of West London. Her main area of research has been exploring the psychological effects of ecstasy polydrug use. More recently, her research focused on evaluating interventions for people with co-occurring mental and addictive disorders. She has extensive experience in workforce development of mental health professionals and contributed to the consultation of the UK National Institute of Clinical Excellence (NICE) guidelines on the topic of “dual diagnosis”. She serves as associate editor for the Psychology and Psychological Research International Journal. 

Abstract:

Individuals with co-occurring mental and addictive disorders (or “Dual Diagnosis”) are one of the most vulnerable groups in society, yet often mental health and addiction services fail to meet their needs. Founded by Corbett Monica, the Dual Diagnosis Anonymous programme (DDA) utilises a peer-led 12 + five step approach to offer continuous support in the community and has been running successfully in Oregon since 2005. The five extra steps enable individuals with “dual diagnosis” to concomitantly address their mental health issues as well as their addictive disorders. The aim of the present study is to evaluate the first UK DDA pilot using both questionnaires and qualitative in-depth interviews. This presentation will focus on the qualitative interviews gathered at two different time points in the recovery process of 8 DDA members. Interviews addressed whether and how they thought that DDA was helping them and how the programme could be improved. Data were transcribed, coded and analysed thematically using the software NVivo. Emerging themes suggest that DDA plays a role in positive changes regarding social interaction, mental and physical health, self-development and acceptance. Identification with other members of the group was one of the key factors that enabled positive change. In conclusion, preliminary findings suggest that DDA could prove to be a cost-effective aid to recovery for individuals with co-occurring mental and addictive disorders.

Biography:

Pedro Cabral Barata has completed his MD at the age of 25 from the Faculty of Medicine of the University of Coimbra. He is a Psychiatry Trainee, currently in his 4th of the 5 years of the portuguese Adult Psychiatry Medical Residency. He has a post-graduate diploma in Cognitive-behavioural Pschotherapy, having published 6 posters and presented 6 oral comunications – between National and International Congresses. He is an Associate member of the Portuguese Association of Psychiatry Interns and of the Portuguese Society of Psychiatry and Mental Health, being also a Member of the Editorial Team of the scientific journal “Psilogos”.

Abstract:

Substance dependence is a chronically relapsing disorder characterized by compulsion to seek and take the drug, loss of control in limiting intake and emergence of a negative emotional state (e.g. dysphoria, anxiety, irritability) when access to the drug is prevented1,2. The occasional but limited use of a drug with the potential for abuse or dependence is distinct from escalated drug use and the emergence of a chronic drug-dependent state1-3. There continues to be a debate on whether addiction is best understood as a brain disease or a moral condition. This dispute, which may influence the access to treatment, as well as the stigma attached to addiction, is often motivated by the question of whether and to what extent we can fairly hold addicted individuals responsible for their actions4,5. Besides, the diagnosis of addiction is very coloured by the negative moral and social values entailed with the illness. It is difficult to perceive that addicts have a disease; acts of will or volition are usually not accepted as diseases, because volition is an act of choice or free will. However, it has been argued that, if there is a common etiology for addiction, it should be one that is basic and fundamental to the healthy functioning of a human being – a disorder of volition6. While the issue of whether addiction is a disease has a medical and philosophical importance, it is of vital significance for the addict who still suffers from the disease of addiction. Recognizing that addiction is a disease should encourage research into treatments that are effective and that address the addict’s significant brain dysfunction, allowing the addict to receive the treatment that is required from the medical community6. It is, therefore, fundamental to reflect about the relationship between addiction and free will, publishing substantiated scientific information regarding the dichotomy addiction-volition that might help deconstructing prejudiced barriers to the treatment and social reintegration of addicted individuals.

Biography:

Masha is a Psychiatrist and Consultant Ghaem General Hospital from 2011 to Present and Active in a personal office. Currently she is consultant psychiatrist in Ghaem General Hospital of Karaj. She had proposed the idea of moving parts of the medicare workflow online to increase the efficiency of the process. Currently this idea is implemented in the psychiatry field.

Abstract:

In the inspection of the patients with metamphetamine abuse, we noticed that they have severe anxiety and insatiable hunger and nightmares. To find the reason, we decided to take the GTT (Glucose tolerance test) for them and we considered hypoglycemia as a factor that maybe the reason of this insatiable hunger, anxiety and nightmares.

Method

We visited all patients that referred to “Afarinash” (an addiction clinic in Karaj, Iran). In the first visit, we requested a glucose tolerance test. In this test, we measured fasting blood sugar first, and then we gave them 75gr of glucose and we measured their blood sugar, in 30 minutes, 60 minutes, 90 minutes and 120 minutes after having the Glucose.

Results

14 of volunteers were suitable for this study. All of them were men and the age range was between 25 to 47 years. The age average was 31.21 years old.

In 5 patients out of 14 patients in this study, the serum glucose level dropped below 70 mg/dl during  GTT. In 4 other patients, the serum glucose level was not lower than 70mg/dl, but it didn’t rise up as we expected it to. This study shows that 35.7 percent of the patients with Metamphetamine abuse suffered such reactive hypoglycemia that could make anxiety, insatiable hunger and nightmares, and 28.57 percent of them needed protective therapy such as proper nutritional regime. The prevalence of reactive hypoglycemia in this study was 35.7 percent.

Conclusion

Regarding to the high prevalence of reactive hypoglycemia in patients with Methamphetamine abuse, in this field, a case control study is recommended. Regarding to the fact that hypothyroidism can make reactive hypoglycemia and VitB1 and VitB2 deficiency can make glucose metabolism disorder, measurement of thyroid factors as a research (patient study)  in the patients with methamphetamine abuse is recommended. Also measurement of serum VitB1 and B2  as a research (patient study) in patients with Methamphetamine abuse is recommended.

Biography:

H. Halil Babacan studying at undergraduate psychology department of Istanbul University

Abstract:

The memristor, a neuromorphic circuit designed by Chua in 1971, is a modeling of synaptic learning and associative learning. Scientific publications of memristor related neuroscientists, behavioral scientists, cognitive scientists and psychologists are scarce.The aim of this review is to examine the learning models built on the memristor by cognitive perspective. In this study, the learning experiments on the memristor were investigated in the literature and the results were compared.
In conditional learning experiments on the memristor, which is its own memory, the unconditional stimulus and the neutral stimulus represent different types of signals. Before the learning, the signals which are denoted as neutral stimuli can not give output from the electronic angle. But just like Pavlov's dog experiment, when the signal representing the unconditioned stimulus was presented before learning, the output is taken. When both stimuli were presented in the order of the Pavlov experiment, the output was taken from the neutral stimulus. And after learning, the output can be taken when the neutral stimulus given alone.In this way, the memristors were able to learn conditionally and to achieve synaptic modeling.

It has been found that learning procedures can be applied to hardware devices other than algorithmic devices. The learning experiments on the memristor successfully support the synaptic learning and Pavlov type conditional learning procedures.In some experiments, however, the conditional responses in the memristor do not decrease over time. This can be described as a pathological learning and may reduce the efficiency of the memristor.

Biography:

Dr. Papamalis is a public health researcher and practitioner. He has extensive clinical and research experience in diverse settings, served as a member of various advisory boards, EU Expert Groups and worked as scientific advisor and consultant at (inter) governmental and non-governmental bodies in country and abroad. Dr. Papamalis has been trained in several psychotherapeutic approaches with focus on contemporary psychodynamic and interpersonal approach. He has extensive experience in working in inpatient/outpatient clinical settings as a counsellor, team leader and organizational manager. He has experience in working in HRM, liaising with NGOs and cooperating with field experts in translational research projects on mental health, drug and crime prevention, treatment and social reintegration. He worked as a program manager for a specialized training centre and organized several international psychotherapeutic programs and training modules. He designed and conducted various expert trainings and workshops for mental health professionals, police, prison and judicial personnel.

Abstract:

Many terms are used to describe the population of individuals who have the experience of some form of mental illness along with substance use disorder. The term co-occurring disorders is increasingly being used to describe the phenomena of having multiple clinical syndromes simultaneously. Comorbidity appears to be one of the most challenging issues affecting the course and treatment as it is often associated with lack of treatment engagement, poor retention, impulsive, risky behaviours, frequent crisis, exploiting others, non-compliance with treatment, and greater risk for relapse.  Literature indicates that dual diagnosis is the rule rather than the exception in substance misuse treatment. However, high prevalence, overlapping symptomatology and lack of clarity and clear distinction between personality traits and disorders induces important implications in treatment and brings into question its usefulness in treatment planning process. In this line, research evolved towards the recognition that normal and pathological personality is distributed dimensionally and suggest progressive methods of dimensional assessment for measuring personality functioning. Acknowledging individuals’ vulnerability on a trait level, it appears that dysfunction results from their phenotypic expression in the social environment. Individuals’ tendency in selecting, shaping and forming social environments is not just a by-product of their basic pre-dispositions, but rather a result from the constant interaction with the contextual environment and their self-efficacy to develop effective adaptive capacities. Identity integration and development of symbiotic interpersonal relationships are adaptive responses that an individual must develop in order to be functionally integrated in the psychosocial process. Maladjustments in this process influence personality functioning. Beyond the constitutional vulnerability, resilience and malleability of the characteristic adaptations, contextual environment and socialization agents are the naturally regulatory mechanisms that impede or facilitate the psychosocial adaptation process. Thus, contextual environment and socialization agents may play a determining role in facilitating the constructive sublimation of basic tendencies through functional characteristic adaptations

Biography:

I did M.S.C from B.Z.U,  A.D.C.P from Sargodha University and NLP, Hypnosis from G.C university. I won three time best international research awards from OMICS and conference series research center 2015 and 2017 on the behalf of my research related to drug users and HIV patients. I also won two times Gold Model awards for my excellence performance in Global rehab center and AL-Fatah Clinic. I am also the member of (APA) American psychological association. Now a days I did the practice in ALFATHA clinic and Government Services Hospital in Pediatric Department and treat the HIV and AIDS Patients.

Abstract:

The present study explored the effectiveness the Rational Emotive Behavior Therapy in disputing the irrational beliefs persons with substance use disorder. It was hypothesized that there is likely a negative relationship between rational emotive behavior therapy exposures and the irrational beliefs in person with substance use disorder. Repeated measure research design was employed. Purposive sampling was used to draw a sample of 12 patients who had undergone treatment for substance use disorder from addiction ward. PIMH and Fountain House, Lahore (Demographic information sheet, history take examination), and MSE were used to rule out others psychiatric illness. After the careful examination, diagnosis of the substance disorder’s irrational beliefs was measured by shortened general attitude and belief scale. The new and personal invention of the study is that pictorial presentation of REBT techniques gives a better understanding and significant result. All the pictures were hand made and mind invention. The present study was able to find out the effectiveness of REBT in disputing irrational beliefs in substance use disorder. The finding of the study indicated a significant difference in irrational beliefs of persons with the substance use disorder before and after the treatment. Based on the finding, it can be concluded that present research provides justification for irrational beliefs in persons with the substance use disorder.

Biography:

Marie Danet has defended a thesis entitled "Spheres of influence of attachment schema on the Internet and in everyday life" obtained with the evaluation Very Honorable with unanimous jury congratulations. She is associate professor at University of Lille (France) and member of the Psitec laboratory. She has been working for 7 years on the links between attachment and digital uses, both on their positive and negative aspects, and has presented her research in several international congresses. Over the past two years, she has focused on the impact of digital use on access to parenting, parent-child relationships and child development.

Abstract:

Digital technology is widespread in our daily life. We mainly use it to communicate. The way we interact is deeply influenced by attachment representations. Digital technology offers a new mode of interactions which is suited for socially anxious people, and particularly for people with insecure attachment. Indeed, anonymity and asynchrony offered by online interactions allows socially anxious people to be more comfortable and more confident in expressing themselves compared with face-to-face interactions. The feeling of safety, through interactions, provided by the Internet may incite insecure people to overuse digital technology. Several studies underline that insecure attachment, in particular preoccupied attachment, is linked with problematic Internet Use (PIU). Among the factors underpinning those links, the search for a more secure communication and the ease of self-disclosure seem to play an important role. This could be explained by the negative model of self and poorer social skills, characteristic of attachment insecurity. PIU and use of digital technology will be discussed in the light of attachment theory. The way therapeutic interventions of addiction to digital technology could be improved will also be discussed, relying on the motivations related to attachment.

Biography:

“Angel” Kyle Anderson, survivor of a “Traumatic Brain-Injury” has found his calling to help heal all as seen speaking at all sorts of different events, and schools touching hearts of many. Beating the bloodshed and the suffering, coming out on top, becoming the most positive with the strongest mindset. Teaching his wisdom, audiences will learn the most powerful techniques. Talking about; mental health, the importance's of protect the most important part of our body “our brains", practicing yoga, meditation, and to love yourself beyond anything. The audiences journey of life will become healthier, stronger, wiser, and more aligned.

Abstract:

Angel Kyle Anderson, A survivor “Traumatic Brain-Injury”. Given A second chance at this life, he has found his purpose in life: helping to heal after experiencing it all. He will tell “what works" and by influencing the audience members to practice strongly the must "do's" that definitely change lives, opening minds of all. Skipping the bloodshed as Angel has already faced, beating the suffering of not being able to walk, talk, or breath, the judgements from all, and coming out on top becoming the most positive, powerful person. Now with the strongest mindset he is set to share his new found glory in life having the best experiences. Audience members can live the best life by practicing simple things that Angel speaks about; such as meditation, and Loving yourself for "just a few examples", things he know lives by today, and everyday!! Learning from a master these powerful techniques, Angel now lives by these today in which he strongly; no longer just “believes”... He “KNOW’S” are life changers. He talks about how to: beat mental health, the Importance to protect the most important part of our body “our brains", “Loving ourselves” = which is #1, and to overcome all our problems. Has been seen speaking at all sorts of different events around the world touching hearts of many connecting all to a higher source of power, identifying with something greater than the material world. Healing through mindfulness assists everyone to gain such constant manifestations, all your desires such magical results in life making life so easy! Your group will now know how to become spiritually aligned, discovering the essence of your being, the deepest values by which we live by. Continue on their journey of life to become more aware, healthier, stronger, wiser, enlightened and becoming more aligned.

Biography:

Abstract:

Biography:

Abstract:

Biography:

Professor WK Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. Professor Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong.

Abstract:

Background and objectives:

To identify the risk factors, frequency, symptoms, pathomechanism and treatment of IIP through a comprehensive literature review.

Design: Systematic literature review.

Main outcome measures:

The first author screened the titles and abstracts of all 288 records. One hundred and two studies that do not meet the eligibility criteria. Full-text version of the remaining 186 articles (151 original articles and 35 review articles) were then screened by the principal investigator. After this screening, 14 original articles and 3 review articles were excluded, leaving 169 articles (137 original articles and 32 review articles).

Results:

Psychotic symptoms are common amongst Ice users, the frequency of any psychotic symptoms ranged from 16% to 81%, with a median of 78%. The prevalence of IIP ranged from 24% to 76%, the median of prevalence of IIP is 42%. The most frequently reported symptoms of IIP are delusions of persecution and auditory hallucinations.

Conclusions:

Long-term studies that track the Ice users for a decade or more are necessary to collect sufficient evidence to understand the relationship between Ice use and the development of IIP.

Biography:

Masha is a Psychiatrist and Consultant Ghaem General Hospital from 2011 to Present and Active in a personal office. Currently she is consultant psychiatrist in Ghaem General Hospital of Karaj. She had proposed the idea of moving parts of the medicare workflow online to increase the efficiency of the process. Currently this idea is implemented in the psychiatry field.

Abstract:

Introduction

Regarding to the fact that hypothyroidism can cause reactive hypoglycemia, measuring the prevalence of hypothyroidism in methamphetamine abuser patients can guide us to the reason of the existence of reactive hypoglycemia in the methamphetamine abuser patients1.

Method

We visited all the patients that suffer from methamphetamine abuse and who referred to “Afarinesh” addiction clinic (Karaj, Iran); we asked them if they have any history of hypothyroidism or not. If the answer was negative, we measured serum their TSH level.

Result

15 of the volunteers were suitable for this study. All of them were men and the range of their ages was between 25 to 47 years. The average of their ages was 31.06 years.

In two of the patients that got inspected in this study, the serum TSH level was higher than 5mU/L. In one of them, serum TSH level was higher than 10mU/L. This study shows that 13.3 percent of the patients with methamphetamine abuse suffer from subclinical hypothyroidism2. The overall prevalence of hypothyroidism was 4.8% [95% confidence interval (CI) 3.7, 6.1] in men and 12.8% (95% CI 10.9, 14.6) in women3. As we see in methamphetamine abuser men, It is three fold higher than normal population.

Conclusion

Regarding to the percentage of the methamphetamine abuser patients that suffer from hypothyroidism, the rate of hypothyroidism in men who are methamphetamine abuser are about three fold higher than normal population. According this finding, the Tehran Institute of Psychiatry must decide if  a case control study in this issue is useful or not.

Biography:

Hossein Ansari has completed his PhD at the age of 34 years from Tehran University of Medical Sciences, Iran. He is Faculty member of Zahedan University of Medical Sciences, Iran. He has published more than 85 papers in reputed journals and has been serving as a researcher in Health promotion Research Center, Zahedan, Iran. 

Abstract:

Substance abuse is one of the most important problems in Iran and around the world. On the other hand, the recurrence of addiction is the major problems among  addicted people. Thus, this research was aimed to investigate the relationship between happiness and self- confidence with the recurrence of addiction in methadone treated addicts. In this study, 250 addicts referring to addiction treatment centers of Zahedan city were studied prospectively. The data were collected through an interview using a structured questionnaire including demographic characteristics, addiction related characteristics, and standard self-confidence and happiness questionnaire. The recurrence of addiction was approved by physician. The data were analyzed in Stata.12 software using chi-square test and multiple logistic regression. In this study 206 (82.4%) males and 44 females (17.6%) addict persons with age mean of 35.77±11.2 were studied. The recurrence rate during at least 6 months follow-up was 64.8% (n=162). Although in the final model the chance of recurrence of addiction in low self-confidence (OR = 1.60, CI=95%: 0.89-2.89), and low happiness addicts (OR = 1.57, CI=95%: 0.92-2.70), was more but did not reach significant level. The model was adjusted for potential confounder such as drug use, history of previous drug withdrawal, history of alcohol consumption an demographic varibles.There was a high rate of addiction relapse in southeast of Iran. Regarding psychological factors; the self- confidence and happiness are poorly correlated with addiction recurrence. However, more psychological studies relevant to the recurrence of addiction in other societies and the monitoring of addicts by families considering with recurrence related  variables, are recommended.

Biography:

Abstract:

Biography:

I did M.S.C from B.Z.U,  A.D.C.P from Sargodha University and NLP, Hypnosis from G.C university. I won three time best international research awards from OMICS and conference series research center 2015 and 2017 on the behalf of my research related to drug users and HIV patients. I also won two times Gold Model awards for my excellence performance in Global rehab center and AL-Fatah Clinic. I am also the member of (APA) American psychological association. Now a days I did the practice in ALFATHA clinic and Government Services Hospital in Pediatric Department and treat the HIV and AIDS Patients.

Abstract:

The present study explored the relationship overcoming destructive beliefs with the use of Rational Emotive Behavior Therapy among HIV patients. It was hypothesized that there is likely to be relationship between rational emotive behavior therapy to challenge the destructive beliefs among HIV patients. Repeated measure research design was employed and purposive sampling was used to draw a sample of 12 patients who had undergone treatment for HIV disease from Mayo hospital, Jinnah hospital and Services Hospital, Lahore. Demographic information sheet, history take examination, MSE and destructive beliefs measure by shortened  general attitude and belief scale. The new and personal invention of the study is the pictorial presentation of REBT techniques give a better understanding and significant result. All the pictures were hand made and my mind invention. The finding of the study indicated a significant difference in irrational beliefs of HIV Patients before and after treatment. Based on the finding, it can be concluded that present research provides justification for irrational beliefs in HIV Patients.

Biography:

Abstract:

Biography:

James Giordano PhD is Professor in the Departments of Neurology and Biochemistry, and Chief of the Neuroethics Studies Program of Georgetown University Medical Center, Washington, DC, USA; and is a Senior Research Fellow of the European Union Human Brain Project. His ongoing work focuses upon mechanisms, diagnosis and treatment of neuropsychiatric spectrum disorders, and neuroethico-legal issues fostered by the use of emerging neurotechnologies in research and clinical care.  The author of over 275 publications, his recent books include Pain: Mind, Meaning and Medicine; and Neurotechnology: Premises, Potnential and Problems.  In recognition of his achievements, he was elected to the European Academy of Science and Arts, the Dana Alliance of Brain Initiatives, and the Royal Society of Medicine.

Abstract:

The DSM-5 is frequently used, either alone or in combination with the ICD, to categorize psychiatric disorders, and in so doing, establish better criteria from which to plan and execute clinical care. Clarifying diagnostic terms is vital to standardize what they signify, and this may be even more important when considering the dual-diagnoses and the care comorbidity may require. In this lecture I will address practical ethico-legal issues and concerns generated by dual diagnosis of chronic pain and substance-use/addictive disorder.  Specifically, I will describe how diagnostic labels – and particularly those related to mental illness- can be stigmatizing, and may evoke medical, legal and social biases that affect the ways that patients are regarded and treated. I will explicate the complexities of these disorders apropos the current opioid crisis, and argue that diagnosis demands action. I will posit that the philosophy of medicine defines a moral obligation to develop improved assessment and care of those who are burdened by both chronic pain and substance use/addictive disorders. Toward these ends, I will propose ways that newly developing neurotechnologies, such as types of genetic assays, neuroimaging, novel pharmaceutical preparations, and non-invasive and deep brain stimulation could – and should – be engaged to improve the focus, scope, safety, effectiveness – and efficiency – of care. As well, I will describe how the realization of any such effort will require conjoint participation of economic and administrative infrastructures of medicine, as well as the development of supportive guidelines, policies and law(s).

Biography:

TBA

Abstract:

The traditional episodic interventions for youth with substance use disorders (SUD) have overlooked the most urgent challenges facing treatment including the: 1) heterogeneity of response to treatment, 2) problem of poor response, and 3) difficulty to address co-occurring psychiatric disorders. This workshop will include: providing rationale and updated review of continuity of care (COC) in youth; addressing the importance of Adaptive Treatment (AT) approach as an integral part of COC; and response to challenges in advancing treatment while considering mechanisms of behavior change such as  self-efficacy, coping skills, goal setting and goal commitment.

The majority of youth with SUD enter treatment with co-occurring psychiatric disorders, including co-occurring depression (COD). SUD with depression has been associated with worse outcomes, high rates of additional psychiatric problems, and higher risk and shorter time for relapse after treatment.  SUD and depression are risk factors for each other and for suicidal behavior. Despite the high prevalence of, and serious functional impairment associated with comorbid SUD and depression in youth, research on treatment options has been limited. Traditionally, these disorders have been treated separately in either the mental health or substance abuse treatment systems. Presently there is no standard, evidence-based intervention or a clear policy on addressing both disorders. This workshop will address treatment outcome findings and challenges of heterogeneous treatment response for COD.

Biography:

Professor WK Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. Professor Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong.

Abstract:

Background and objectives:

The objectives of this study were to ascertain the pattern of grey and white matter volume reduction and regional metabolic and activation abnormalities in chronic ketamine users, and to evaluate the correlations between these brain abnormalities and cognitive impairments in chronic ketamine users in Hong Kong.

Design:

Cross-sectional observational study.

Setting:

Counselling Centre for Psychotropic Substance Abusers in Hong Kong.

Participants:

One hundred and thirty-six participants were recruited from October 2011 to April 2014. The participants were divided into two groups: ketamine users (79) and healthy controls (57).

Main outcome measures:

Psychiatric assessments included screening with self-rating questionnaires and face-to-face interviews. All of the participants completed a detailed cognitive battery that covered general intelligence, verbal and visual memory, executive functions, motor speed and language. All of the participants underwent magnetic resonance imaging of the brain. 

Results:

Many of the participants in the ketamine group also frequently used cocaine and cannabis. Among the ketamine users, 12.6% were diagnosed with a mood disorder and 8.9% with an anxiety disorder. The participants in the ketamine group had worse performance than the healthy controls on tests of general intelligence, verbal, visual and working memory and executive functioning.

In terms of grey matter volumes, the right orbitofrontal cortex, right medial prefrontal cortex, left and right hippocampus and possibly the left orbitofrontal cortex were smaller in the ketamine group. In contrast, the volumes of the left basal ganglia, left putamen and possibly the left caudate were higher in the ketamine group. In terms of white matter volumes, the ketamine group had a lower periventricular white matter volume in the right hemisphere. The grey matter volumes of the left and right orbitofrontal cortex, right medial prefrontal cortex, left basal ganglia and left putamen, and right periventricular white matter volume were negatively correlated with the severity of ketamine dependence. The hippocampal volumes were correlated with performance on the arithmetic, information and digit span tests. The periventricular white matter volume also correlated with the information score.

A functional connectivity examination of the default mode network revealed significantly decreased connectivity in the medial part of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral gyrus rectus, left superior temporal pole, left inferior temporal gyrus, bilateral angular gyrus and bilateral cerebellum crus II in the ketamine group. This group also displayed increased connectivity in the bilateral precuneus and right inferior occipital gyrus.

Conclusions:

The results provide imaging evidence of brain damage in chronic ketamine users. Chronic ketamine use was associated with reduced grey and white matter volumes in certain regions of the brain. Chronic ketamine use was also associated with altered functional connectivity with the default mode network. Abnormal brain structures and altered functional organisation of the brain network may underlie the hypersensitivity towards drug related cues but weakened cognitive control in those with ketamine addiction. Longitudinal or prospective studies would help to strengthen the evidence on the reversibility of the structural and functional brain damage caused by ketamine.

Biography:

Sunny is a reformed Heroin addict, who came to SUIT as a volunteer after detoxing in 2007. Within 5 months he was leading the orgnasiation and is now a social leader in the UK. Sunny’s Fellow of the RSA and Social Leadership Fellow of St Georges House, Windsor. Sunny is a key player in the drug policy reform movement in the UK. He’s the co-author of ‘OST in Prison’ which is due to be published by International Journal of Prison Health in 2018. The peer led model that he developed is seen as best practice in the UK and Europe. 

Abstract:

SUIT is widely recognised as a model of best practice in the UK for the involvement and influence of those with lived experince of addiction, in relation to addiction treatment evaluation, intervention and role modelling. Established in February 2007, the project initally held a remit of advocacy and consultation. Throughout the process of consultation and continual dialogue, the project grew organically to then enhance the service offer, based on 2 main factors – 1) The experiences of those that use substances and 2) The inability of different systems to effectively offer services that met the need of those that use substances.

SUIT have demonstrated that with little comparative funding, but with a high level of innovation that the needs of those with addiction issues can be met in a holistic manner, by making best use of resources and community empowerment measures. In 2016/17, SUIT received 2.4% of the drug/alcohol treatment local budget, with this SUIT supported 1072 vulnerable substance users and delivered 4266 one to one support sessions, making 5283 interventions that covered 72 areas of need (e.g. mental health, unemployment, homelessness, indebtedness etc.). Furthermore, SUIT worked with 486 individual companies, organisations and resources to meet individual need – each intervention cost was £24.74. Outside case management, SUIT deliver training and consultancy projects, organise community and recreactional events and are strategic influencers.

The volunteer programme developed by SUIT was awarded the highest accoldade avaiable in the UK for community organisations, the Queens Award for Voluntary Service – equivilent to MBE. 

Biography:

Elise Sloan is a psychologist and research fellow who has recently completed her Doctorate in Clinical Psychology at Deakin University, Australia. Elise’s research and clinical interests are in the area of youth mental health and her work focuses largely on the role that emotion regulation has in the development, maintenance and treatment of mental health and substance use disorders in youth.

Abstract:

Background: Individuals accessing services within the youth drug treatment sector represent a highly vulnerable population who present with complex patterns of substance use and mental health comorbidity. Deficits in Emotion Regulation (ER) have been identified as a core construct underlying both of these difficulties, and represent a promising treatment target. However, ER is a broad construct and little is known about which strategies young people are most likely to utilise to regulate their emotions, and what impact this has on their mental health and substance use.

Aim: To examine the repertoires of ER strategies engaged in by highly vulnerable young people and their relationship to psychological symptoms in order to inform the development of effective psychological interventions for this cohort.

Method: Participants were young people (N=306, M=20.8 years) accessing youth mental health and drug treatment services in Victoria, Australia. They were assisted by members of the research team to complete an online survey which asked about their use of 14 ER strategies in response to a recalled emotionally-arousing event as well as symptoms of anxiety, depression, substance, eating and borderline personality disorders.

Results: Latent Class Analysis (LCA) was used and identified three distinct ER repertoires of ER strategies: Maladaptive Regulators (n =76) characterised by heightened engagement in rumination and avoidance, High Regulators (n =81) characterised by increased use of adaptive strategies and moderate use of maladaptive and Low Regulators (n =129) characterised by low use of maladaptive and moderate use of adaptive. Overall, maladaptive regulators endorsed higher levels of symptoms across all domains of psychopathology, relative to high and low regulators.

Conclusions: Our findings identify the distinct patterns of ER responding in this population of young people, and the central role that rumination and avoidance have across all forms of psychopathology. Implications of the findings for the development of treatments that target ER in this cohort are discussed.

Biography:

Carolina Talkowski has an MD from University of Buenos Aires, and has completed her psychiatry residency program at Neuropsychiatric Hospital Borda. She has worked at Foro Foundation for Mental Health, where she practices Dialectical Behavioral Therapy as a psychiatrist and a psychotherapist. She is also staff psychiatrist at Medicus Addiction Treatment team, and has experience in therapeutic communities and psychiatric emergency rooms. She studied DBT, and DBT for substance use disorders at Behavioral Tech, LLC from the Linehan Institute.

Abstract:

The comorbidity of substance use disorder (SUD) and borderline personality disorder (BPD) is linked to severe emotional dysregulation, increases the probability of poor treatment outcomes, and the risk of suicide.

Dialectical Behavioral Therapy (DBT) is one of the best treatment available  for BPD. On the other hand, the Twelve Step programs are between the best options available for SUD. However, patients with BPD tend to be rejected by non-DBT addiction treatment programs, and patients with SUD tend to be rejected by regular DBT programs. Hence, there is a clear need for interventions that treat both disorders.

DBT requires the dialectical synthesis of acceptance and change, of validation and behaviorism, amongst other polarities. The balance between acceptance and change in DBT is consistent with the philosophical approach found in the Twelve-Step program, as expressed in the Serenity Prayer, made popular by Alcoholics Anonymous since 1935.

The substance use disorder dBT program behavioral targets are: decreasing the use of substances; making abstinence easier to cope with; diminishing cravings; avoiding opportunities to use, and increasing community reinforcement of healthy behaviors. These targets are achieved by DBT skills learning groups and individual therapy, plus family orientation and psychiatric treatment.

The Twelve-Step program promotes the achievement of complete abstinence of all kinds of drugs through the participation in mutual help group meetings and service activities, and writing the steps of the program with the guidance of a sponsor.

This presentation brings DBT and the Twelve Step programs together and explores their complementary aspects.

Biography:

Kripi Malviya is a psychologist, experiential psychotherapist and advocate with a Masters in Clinical Psychology with an International Certification in Addiction Counselling and Training.​ She has worked with​ adolescents, adults, couples and families with multi-disciplinary teams of international mental health professionals, from varied cultures and therapeutic backgrounds. She facilitates addiction treatment and general mental health training workshops in the South Asian and South East Asian regions; including Bhutan, Afghanistan, Sri Lanka, Malaysia and Thailand including her role as a Regional Resource Training Coordinator in India. Kripi is an existentially inclined psychotherapist and a poet who promotes and facilitates the reciprocal connection and relationship between creativity and psychotherapy with respect, openness and vulnerability.

Abstract:

TATVA is a harm reduction, experiential and meaning focussed project that offers psychotherapy, training and consultancy and 'home based' or 'direct' treatment; using an existential, humanistic and an integrative approach to addiction and mental health. TATVA is primarily about ​promoting and celebrating conscious self exploration​ ​and are committed to creating spaces where this can take place in a healing ​​environment. They aim to cultivate a sense of curiosity about ourselves and the world​ ​in the age of distractions and 'quick fixes.' Their therapeutic work contemplates questions like: ​H​ow do we bring a sense of calm in​to​​ ​our living spaces and inner space? How can we be more present and engaged in our lives and our relationships? How can we find meaning, direction and purpose to enable a fulfilling existence? Our work focuses on ​​celebrating authenticity and vulnerability, ​mutual ​collaboration, intersectionality and multidimensional creativity. They are one of a very few organisations in the world run by mental health professionals that mix transformational travel ​experiences ​with psychological support. At their therapeutic retreat in Goa, India; they offer counselling and other therapies  including yoga, meditation, massage, art, music, nature etc). Building on the ​ideology with nature and wilderness therapies, they create individually and group tailored programs for ​our guests​ to go into natural spaces like waterfalls, rivers, nature trails and seasides with us using the process of talking, ​sharing experiences and​ working ​together for​ an enriching experience. Psychotherapy at TATVA plays the role of acknowledgement and assimilation of individual and collective experiences, which usually go unexpressed or unexplored if they do not get the space to be heard. ​TATVA​ ​intends to ​create a sustainable echo of the internal changes and tribulations that happen in the course of risk taking, travelling, making connections with people, creating or simply ​day to day living.​

​​TATVA's​ ​focus​:

✶​ ​Working on the intersection of ​ ​arts and ​wellbeing​

✶ Prioritising therapeutic relationships

✶ Encouraging relational awareness of self, others and the world

✶​ ​Working with the whole spectrum o​f ​drug use, ​​mental health and ​lived experiences 

Biography:

TBA

Abstract:

Updated Soon

Biography:

Masha is a Psychiatrist and Consultant Ghaem General Hospital from 2011 to Present and Active in a personal office. Currently she is consultant psychiatrist in Ghaem General Hospital of Karaj. She had proposed the idea of moving parts of the medicare workflow online to increase the efficiency of the process. Currently this idea is implemented in the psychiatry field.

Abstract:

Introduction

Regarding to the fact that hypothyroidism can cause reactive hypoglycemia, measuring the prevalence of hypothyroidism in methamphetamine abuser patients can guide us to the reason of the existence of reactive hypoglycemia in the methamphetamine abuser patients1.

Method

We visited all the patients that suffer from methamphetamine abuse and who referred to “Afarinesh” addiction clinic (Karaj, Iran); we asked them if they have any history of hypothyroidism or not. If the answer was negative, we measured serum their TSH level.

Result

15 of the volunteers were suitable for this study. All of them were men and the range of their ages was between 25 to 47 years. The average of their ages was 31.06 years.

In two of the patients that got inspected in this study, the serum TSH level was higher than 5mU/L. In one of them, serum TSH level was higher than 10mU/L. This study shows that 13.3 percent of the patients with methamphetamine abuse suffer from subclinical hypothyroidism2. The overall prevalence of hypothyroidism was 4.8% [95% confidence interval (CI) 3.7, 6.1] in men and 12.8% (95% CI 10.9, 14.6) in women3. As we see in methamphetamine abuser men, It is three fold higher than normal population.

Conclusion

Regarding to the percentage of the methamphetamine abuser patients that suffer from hypothyroidism, the rate of hypothyroidism in men who are methamphetamine abuser are about three fold higher than normal population. According this finding, the Tehran Institute of Psychiatry must decide if  a case control study in this issue is useful or not.

Biography:

Gholam Hossein Javanmard has completed his MA in psychology from Tehran University and his PhD in Cognitive neuroscience at the age of 37 years from Tabriz Unniversity. He is the director and psychologist of Bahar Center, for treating addiced people, and academic member of Payam Noor university of Iran. He has published more than 20 papers in Iranian's journals and has been serving as an editorial board member of repute.   

Abstract:

The lack of balance between behavioral activation system (BAS) and behavioral inhibition system (BIS) has been related to several types of psychopathology. This causal-comparative research study aims to investigate BAS and BIS systems in addicted and non-addicted men in north east of Iran. Using purposeful sampling method 57 addicted and 57 non-addicted males were chosen and organized in two groups. The participants answered the 120-item test of activation/inhibition systems (Gray-Wilson Personality Questionnaire or GWPQ). Data were analyzed using multivariate analysis of variance (MANOVA) by SPSS software. The findings showed significant differences in activation/inhibition systems were between the groups compared. While the average scores of BIS system in non-addicted people were higher than addicts, the average scores of BAS system in addicts were higher than non-addicted people. This study showed that activity level of BAS system in addicted people is more than non-addicts, and activity level of BIS system in non-addicts is more than addicted people. The high level BAS system activity has been related with some kinds of mental disorders, e. g. substance abuse, eating disorder, histrionic and antisocial personality disorders, and some personality characteristics like guilt feeling and feel remorse. So, this result indicates a basic vulnerability in addicted people for some kinds of psychopathology. May be we could emphesis on a model, that starts with a neuro-behavioral predisposition and go to a psychopathology and finally an addicted person.  Even though, we could not ignore environmental factor to foster this special nero-behavioral predisposition.