OPIATES. What Is The REAL Problem? Is There A Solution?

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1 OPIATES What Is The REAL Problem? Is There A Solution? Russell Ferstandig, M.D. Medical Director and Founder Monmouth Behavioral Medicine Center Manasquan, New Jersey monmouthbehavioralmedicine.com drruss@monmouthbehavioralmedicine.com

2 Why You Should Listen To Me Psychiatrist For 35 Years Addiction Specialist For 30 Years Board Certified In Addiction Medicine (American Board Of Addiction Medicine) Suboxone Provider For 9 Years With 100 s of Successes Recovered Cocaine Addict So I Have Lived The Life Of Addiction

3 THIS PRESENTATION IS ABOUT HOPE BECAUSE THERE IS A GUARANTEED SOLUTION FOR ANYONE ADDICTED TO OPIATES!!!!

4 In Order To Find An Opiate Solution, You Need To Understand The Opiate Problem

5 The Problem The problem has two components: Lifestyle People feel the need to hide in unreality because reality is uncomfortable. Physiologic Opiates Addict Everyone

6 The Problem Lifestyle Component No simple solution Based on unrealistic goals and expectations about life Young people feel inadequate A search to feel better NOW

7 The Basic Rule Of Human Behavior People will resist change by maintaining their current behavior until: The perceived cost of maintaining the behavior exceeds the perceived cost of changing the behavior The perceived benefit from change greatly exceeds the trouble (real and imagined) generated by the change process.

8 The Basic Rule Of Human Behavior Simplified People will change when it hurts too much not to change.

9 The Problem Opiate Physiology No one is protected from opiate addiction.

10 The Problem Opiate Physiology No one is protected from opiate addiction.

11 The Problem The Brain Does Not Like External Opiates Of Any Sort Heroin Opiates (Pills) Opioids (Opiate-Like Substances) Natural Opium

12 The Brain s Natural Opiate System Is Disrupted By External Opiates Of Any Type Natural opiates (endorphins) are secreted in very small amounts, probably less than 1/1000 th % (0.001%) of external opiates AND only for seconds or a minute or two External opiates are present in progressively large doses for hours, days, months or years The Combination Of Excessive Opiates For Long Durations Forces The Brain To ADAPT To Keep The Individual Alive

13 The Stronger The Opiate, The Faster The Individual Becomes Addicted, Their Brain Adapts To The External Opiate And Becomes

14 NJ Heroin Is One Of The Strongest Opiates Available NJ Heroin Cut With Fentanyl (Bud Light) Is The Strongest Opiate Available

15 Opiates And Opiate Withdrawal One of the biggest causes of opiate relapse is that promotes and justifies repeat opiate use occurs while using opiates AND/OR when withdrawing from opiates

16 Opiates And Opiate Withdrawal Therefore, the only way to avoid opiate logic and opiate behaviors is: 100% abstaining from opiate use AND 100% stop of withdrawal symptoms 24/7 till the brain is 100% healed

17 The Solution There Are Four Necessary Steps To Produce A Lasting Solution

18 The Four Steps To Becoming Opiate Free 1. Individual must be truly ready to stop using opiates ( should stop without commitment almost never works) 2. Withdrawal must be stopped 100% 24/7 until the brain has 100% healed (returned to the pre-opiate state. Said another way the opiate altered state TOTALLY reversed)

19 The Four Steps To Becoming Opiate Free 3. Identify and correct all psychiatric problems that are likely triggers for relapse (anxiety, depression, ADD, etc.) 4. Therapy to better identify triggers, modify opiate thinking distortions and learning new coping skills

20 The Four Steps To Becoming Opiate Free All Four Steps Are Required For Lasting Success

21 The Four Steps To Becoming Opiate Free 1. Committed to stop Summary % Removal of withdrawal symptoms till brain 100% recovered 3. Correct psychiatric triggers 4. Therapy for better life coping skills

22 Four Necessary Steps Options There Are Many Options To Treatment Design Choose The Design That Works Best For You

23 There Are No Shortcuts Shortcuts Essentially Guarantee Relapse Common Shortcuts That Produce Relapse Individual Not Ready To Stop Using Opiates Withdrawal NOT Stopped 100% Until The Brain Has 100% Healed (Returned To The Pre-opiate State)

24 How To Feel Good And Be Productive During Recovery From Opiate Use And Abuse It is impossible to feel good and be productive during active opiate use and/or withdrawal

25 The Only Solution Is 100% Elimination Of Withdrawal Currently there are only two ways to eliminate withdrawal symptoms totally: Suboxone treatment using the required medication techniques AND proper doses during all phases of treatment, especially the taper phase Methadone maintenance, which controls the withdrawal symptoms, does not end use due to the ongoing need for methadone

26 Suboxone Is The Only Option Currently Available To Stop Withdrawal AND Eliminate Opiate Influence Methadone Has Problems Because: By virtue of its maintenance approach, methadone maintains some degree of opiate influence 24/7 Methadone frequently does not have an exit strategy because of ongoing maintenance When tapered, there is a very high relapse rate

27 Suboxone Fools The Brain Into Acting Like The Changes From Opiate Use Have Totally Healed The patient functions as if they never used opiates Opiate induced brain changes are stimulated to heal and revert to the pre-opiate state

28 As The Brain Heals, Less Suboxone Is Needed To Insure Proper Function And No Withdrawal Symptoms It is the altered state of the brain that drives opiate withdrawal When the brain has totally recovered from its opiate induced alterations, Suboxone is no longer needed because the withdrawal is over

29 Dr. Russ Suboxone Rule The key to effective Suboxone treatment Insure that the Suboxone blood level in the patient is always at the lowest level necessary to insure 100% elimination of withdrawal symptoms 24/7 until the opiate induced brain alterations have 100% healed This 100% guarantees proper functioning as long as the individual does not ACTIVELY CHOOSE to use opiates

30 Dr. Russ Suboxone Rule Using more Suboxone than the minimum needed causes problems: Generates a mild opiate response than can trigger relapse Takes energy to fuel the opiate response that could be used for healing Inhibits healing because opiates appear to be present, suggesting the need for the brain alteration

31 Ideal Suboxone Blood Level

32 Ideal Suboxone Blood Level

33 Ideal Suboxone Blood Level

34 Low Suboxone Blood Level

35 There Is Life After Opiates!! It Is Wonderful And Available For Everyone

36 For More Information Please Go To monmouthbehavioralmedicine.com Click Resources And Then Addiction Medicine to Call