Medication KindlinG

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It doesnt take a lot of sense to stay sober.it
just takes all youve got!
Dr John Mooney 1910 -1983
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Thank You

• I would like to thank the staff of CAPTASA
  for allowing me the opportunity to present this
  information. I continue to believe that CAPTASA
  represents the finest gathering of committed
  addiction professional in existence today.
• ( Sandy P. you know Burns cant help it !!)

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Avoiding GoofBall pitfalls in Sobriety

• Robert W. Mooney, MD

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Thanks

• I would like to thank District 32 of the Florida
  AA community for the willingness to request
  information on a subject that will become more
  important as newcomers become old-timers, then
  become really old-timers.

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Financial Disclosure

• I am employed at Vista Taos Renewal Center in
  Taos, New Mexico as Medical Director and
  Addiction Psychiatrist. They have supported my
  attendance at this presentation but have declined
  to present any information considered to be
  marketing materials. I will have contact
  information available for anyone having questions
  about information presented today.

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Presentation Disclaimer

• The information presented is considered by
  Alcoholics Anonymous to be an outside issue. AA
  encourages cooperation with medical and
  psychiatric professionals when needed. However,
  the number of medications that have the potential
  to threaten recovery has increased dramatically
  over the past several decades. This presentation
  is meant to be informative only. Please see your
  personal physician about any questions which may
  be raised concerning your medical condition.
• Thank You

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Bills Writing on Medications
Morphine, codeine, chloral hydrate, Luminal,
Seconal, Nebutal, amytal, these and kindred drugs
have killed many alcoholics. And I once nearly
killed myself with chloral hydrate. Nor is my own
observation and experience unique, for many an
old-time AA can speak with force and fervor on
the subject of goof balls. Language of
the Heart 1945
Bill Wilson 1895 - 1971
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Bills Writing on Medications
Some of us, perfectly sober for months or years,
contract the habit of using sedatives to cure
insomnia or slight nervous irritability. I have
the impression that some of us get away with it,
year after year, just as we did when we first
began to drink alcohol. Yet experience shows, all
too often, than even the controlled pill taker
may get out of control. The same crazy
rationalizations that once characterized his
drinking begin to blight his existence. He thinks
that if pills can cure insomnia so may they cure
his worry.
Language of the Heart 1945
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Bills Writing on Medications

• Our friends the doctors are seldom directly to
  blame for the dire results we so often
  experience. It is much too easy for alcoholics to
  buy these dangerous drugs, and once possessed of
  them the drinker is often likely to use them
  without any judgment whatever.
• 
  Grapevine 1945

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The Doctors Opinion

• More often than not it is imperative that a
  mans brain be cleared before he is approached,
  as he has then a better chance of understanding
  and accepting what we have to offer.
• William
  Silkworth, MD
• Alcoholics Anonymous

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Cooperation

• Try to remember that though God has wrought
  miracles among us, we should never belittle a
  good doctor or psychiatrist. Their services are
  often indispensable in treating a newcomer and in
  following his case afterward.
• 
  The Family Afterward
• 
  Alcoholics Anonymous

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What Do You Believe?

• Traditional Psychiatric Approach
• Excessive drinking is a deviant pattern of
  behavior which is secondary to an underlying
  emotional or mental disorder..

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What Do You Believe?

• Traditional Psychiatric Approach
• if the underlying emotional or mental disorder
  is properly diagnosed and treated, then the
  deviant behavior pattern of drinking will resolve
  and normal drinking behavior will ensue.

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What Do You Believe?

• Traditional Psychiatric Approach
• Excessive drinking is a deviant pattern of
  behavior which is secondary to an underlying
  emotional or mental disorder..
• if the underlying emotional or mental disorder
  is properly diagnosed and treated, then the
  deviant behavior pattern of drinking will resolve
  and normal drinking behavior will ensue.

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• The idea that somehow, someday he will control
  and enjoy his drinking is the great obsession of
  every abnormal drinker.
• Alcoholics Anonymous Chap 3 Page
  30

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What Do You Believe?

• An almost allergic like response in roughly 1 out
  of 10 individuals to chemicals which change brain
  activity and reward systems. This response can be
  immediate, such as cravings. Or, it can be more
  gradual where thinking and perceptions become
  altered such that motivation for sobriety
  decreases and they return to previous patterns of
  behavior linked to drug of choice.

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What Do You Believe?

• Because this type of response does not occur in
  the other 90 per cent of the population, they
  will not be at risk for addictive complications,
  they usually wont take what they are given
  anyway!
• The previous 10 per cent is the focus of this
  presentation. What constitutes a hazardous
  substance for them?

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Hazardous Drugs

• Hazardous Drugs are those substances which in our
  experience have contributed to relapse. Our 50
  years of experience have shown this to include
  most if not all CNS active substances.

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Sources

• Recreational/Street Drugs
• Prescription/Pharmaceutical Drugs
• Over The Counter/Dietary Supplements

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Hazardous Medical Procedures

• Dental Procedures Nitrous Oxide, local
  anesthetic with epinephrine, Rx
• Diagnostic Procedures Versed, propofol,
  Fentanyl
• Surgery Adverse brain effects last for about 3
  months following general anesthesia.
• Pregnancy OBs like their patients calm.

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In addicts, doses of drugs that are too low to
produce any conscious recognition that they
received drugs are still capable of inducing
changes in the brain and influencing
behavior
Mark S. Gold, MD
Dept of Psychiatry University
of Florida
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Willingway Tranquilizer Rule
There are two types of tranquilizers
habit-forming and non habit-forming. The
habit-forming ones are the old ones and the non
habit-forming ones are the new ones. When the new
ones become old, they become habit-forming and
are replaced by new non habit-forming ones.
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Approved Medications

• Antabuse
• Methadone
• Buprenorphine (Suboxone/Subutex)
• Naltrexone (Revia/Vivitrol)
• Acamprasate (Campral)

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Medications Used in Addiction Medicine

• Prozac
• Effexor
• Paxil
• Cymbalta
• Zoloft
• Trazodone
• Depakote
• Neurontin
• Klonopin
• Xanax
• Ultram
• Soma
• Adderal
• Concerta
• Lithium
• Seroquel
• Abilify
• Geodon
• Zofran

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Psychiatric Training

• Increase Meds
• Change Meds
• Add Meds

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• Once you have committed to a chemical
  solution, it is almost impossible to revert to a
  spiritual solution.

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Problem Child of History

• Alcoholics and more recently drug addicts have
  been resistant to cures since earliest
  recordings of history. The Bible records cases of
  alcoholism but no cure. Early medical attempts
  included Typhoid treatment, VD cures, ice baths,
  insane asylums, lobotomy and electro-convulsive
  therapy. Then something occurred in 1941 which
  has changed everything

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Prior to 1941 alcoholism relied primarily on
psychiatrists and mental institutions for
treatment which was mostly ineffective.
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Where Are We Heading?

• There is rush to develop strategies and
  pharmaceutical agents to treat alcohol/drug
  addiction at the expense of 12 step programs. The
  expectation of changes in delivery of healthcare
  will increase the pressure from pharmaceutical
  and insurance companies as a result of the
  billions of dollars which are at stake. The
  belief that 12 Step recovery is ineffective will
  push healthcare providers to encourage
  alternative approaches, which may in fact
  increase risks of failure in continued sobriety.

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Research Intent

• ADial is developing compounds that affect the
  reward center of the brain, thereby decreasing
  the craving for alcohol and reducing alcohol
  consumption. Our medications appear to be
  effective based on a combination of an ability to
  leverage propriety targeted genetic efforts with
  synergistic treatment mechanisms targeting
  multiple neurological pathways in the brain,
  thereby enhancing efficacy while reducing side
  effects. In addition, our compounds can be given
  to patients currently drinking, no abstinence
  prior to treatment required. This significant
  improvement not only increases access to
  treatment it increases the likelihood of
  success, which can now be measured as a reduction
  in alcohol consumption and control over ones
  drinking.
• Adial Pharmaceuticals
• Bankole Johnson, MD

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Stuart Gitlow, MD

• There are risks in leading the patient to
  believe that a pill or injection can save them
  from an illness where that patient mistakenly has
  believed that problems can be cured by taking
  something.

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• It doesnt take a lot of sense to stay sober
  It just takes all youve got !!!
• Dr. John
  Mooney
• Founder
  Willingway Hospital

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I would like to thank my parents, Dot and Dr.
John Mooney who believed in what they saw and
gave me an opportunity to be part of an amazing
experience that one day may no longer exist.
I hope we never forget.
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Resources

• Anatomy of an Epidemic Magic Bullets,
  Psychiatric Drugs, and the Astonishing Rise of
  Mental Illness in America by Robert Whitaker
• Mad in America by Robert Whitaker
• A Voice from the Wilderness by Andrew D. Bennett
  (Article in March/April issue of Addiction
  Professional)

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You can read, study and learn everything about
alcoholism but if you cant laughyoure screwed!
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Vista Taos Renewal Center