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Reach: 72.4k Reg & 86k+ Facilities & 26.8M Social Media + (Email Community Total 180k) Nations largest organic addiction related community. Welcome Andrea Grubb Barthwell, M.D., F.A.S.A.M., is the founder and CEO of Two Dreams and past president of ASAM

Everything was going fine for her. She had a great job, a solid marriage, and two wonderful kids.

Slowly she became easily annoyed by the least distractions or inconveniences. Then what seems like all of a sudden out of nowhere, her husband filed for divorce. A week later she was terminated from her seven-year career as a bank executive. And then, even worse, she came home unexpectedly to find her oldest teenage child naked in the bathtub with his six-year old sister. Her life unraveled quickly.

It started with routine surgery. The doctor prescribed a 30-day supply of pain medication for post-surgical symptom complications. A month later, she got her a refill – and the month after that – and another month. The problem was the pills were not working as well as they did three months ago. So she’s now taking two pills instead of one every four hours and washing them down with a shot of vodka. And so it goes, until she was running out of medication halfway through the month and drinking a half-liter of vodka daily. And then she realized she had a problem with drugs and alcohol.

Sound far-fetched? Not hardly. There are similar stories like this one, with similar results. Why is it that some people get so easily off track and others are able to keep a steady course? I this story she was from a family with good morals and upbringing. She had it made. Let’s look at one major human condition that affects tens of millions of Americans but manifests in different ways. It’s called the Reward Deficiency Syndrome or RDS for short.

 

In order to understand RDS it’s important to know about dopamine.

Dopamine is a neurotransmitter substance that is in the brain. RDS involves dopamine resistance, which is a form of sensory deprivation of the brain’s reward or pleasure mechanisms RDS occurs as a consequence of a person’s inability to derive reward from everyday activities. Addiction is one manifestation of RDS. DS can be anywhere along in a range from mild to severe. RDS is a disorder of the chemistry of the brain. RDS is not always easily recognized by the affected person, those who know that person, or by health professionals.  It is estimated that RDS affects over 110 million Americans. A more comprehensive definition of RDS is available in the reference list. 


Dopamine is a foremost component of brain function and RDS.

It is also the key to feelings of well-being. For example, feelings of happiness depend on excellent brain functioning that involves dopamine. This is brought about by normal function of a specific neurological chemistry pathway that leads to the release of dopamine. Dopamine causes “pleasure” and reduces “stress”. The release of dopamine at the reward site of the brain Nucleus Accumbens (NAc) involves a complicated process of neurotransmission called the “Brain Reward Cascade” or simply BRC. 
The reward site of the brain occurs in a segment called the Nucleus Accumbens or NAc.

Dopamine released into the reward site of the NAc results in feelings of well-being and reduced stress. The ultimate release of dopamine also involves a complex multi-step process, which not only controls dopamine release, but its quantity as well. This process of neurotransmitters such as serotonin, endorphins, and GABA causing dopamine is the neurological chemistry pathway called the BRC.

The BRC plays an important role in controlling the reinforcement of natural rewards, like food and sex, as well as unnatural rewards such as drugs of abuse or gambling.

Natural rewards are related to physiological satisfaction such as hunger and reproduction. Unnatural rewards are learned from acquired pleasures such as high-risk behavior. Dopamine release is the end result of external stimulation such as alcohol, drugs, food, gambling, and sex. The dopamine release minimizes negative feelings and satisfies abnormal cravings for alcohol, cocaine, heroin, and nicotine associated with low dopamine function.

Additional extensive research has revealed the relationship between dopamine release and addictive behaviors.

Research has also shown alcoholism acts similar to opioids, cocaine, nicotine, food, and repetitive behaviors like gambling and sex addiction in dopamine balance. These described drugs and certain other behaviors produce a surge of dopamine, which initiates addictive behavior. Individuals who are genetically predisposed to addictions “crave” this dopamine release. These individuals crave dopamine because they have a reward deficiency that constantly drives them to actions to fill this deficiency.

Reward deficiency has been associated with flawed dopamine metabolism and function that creates the conditions for low dopamine. Also, other DNA combinations affect the function of the genes involved in the Brain Reward Cascade.

What’s being said here is that this is not necessarily the patient’s fault. It isn’t because she just went off. It was an easy transition from a prescription to a full-blown addiction. The message to take away from this is that there is enough evidence to conclude the genetic connection with environmental risk factors to be predisposed to addictive behaviors, caused by imbalances in neurological chemistry.

 

  1. Curr. Biol. 19(16): 1341–1350.
  2. Sage Encyclopedia of Abnormal Psychology
  3. Neuropsychopharmacology. 2017 Feb; 42(3): 766–773
  4. Alcohol and Behavior. VSP Press Utrecht; The Netherlands: 1990. p. 131-149.
  5. J Reward Defic Syndr. 2015; 1(1): 6–9.
  6. Eur J Pharmacol. 2015 Apr 15;753:73-87.

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The opioid crisis in America today is spreading so fast and is so devastating that we have been forced to fight fire with fire just to contain it.
DR Bruce

BRUCE A. HANSBROUGH, DC, DACBOH, DACACD

Using opioids to treat opioid addiction may seem like reverse logic to many. However, addiction medicine lags behind other specialties when it comes to forward thinking. Mounting pressure to stem the tide of overdose deaths and the shortage of professionals trained in addiction medicine. There are very few in the field that knows much about the emerging science of pharmacogenomics and nutrigenomics. Even fewer understand the concepts as they apply to treating today’s patients suffering with the disease of addiction.

The United States loses over 160 people per day to opioids.

The cost to treat a patient with addiction and associated co-occurring disorders is roughly $4700 annually just for methadone. This may seem expensive, but it is less costly than placing the patient through the justice system. The question might be asked, is methadone-assisted treatment (MAT) or any other opioid variant the end game or just the start in this challenging national emergency? Although, on the surface it may seem like MAT may be the answer, does it really make sense for it to be the gold standard for opioid addiction treatment? We can expect that as the demand for the MAT increases so will its costs. As insurance carriers continue their quest to reign in costs, the pressure from the opioid epidemic places additional stress on existing treatment programs in an era of declining revenues

Today’s standard addiction treatment program maintains a foundation based in what is commonly called the “12 step program.”

Originally founded as AA in the 1930s to combat alcohol addiction, 12-step programs have been spun off into many other names such as NA, Al-Anon, GA, and the like. Today, prescription and street drugs that are driving the opioid crisis have become increasingly more powerful and addictive. Although, 12-step programs provide great social and spiritual frameworks to overcoming addictive behaviors, the missing links are in the understanding of how brain processes work, especially when severe physical damage has occurred. The good news is that health science already has the understanding of why relapse rates are so common and higher today.

Focusing too much on processes and not enough on results is why things don’t get done,

Pain and simple. If the standard is to simply to stem the tide of deaths, eventually there will be newer and more powerful substances and activities that will take additional lives and destroy families and relationships. All one need to understand do is observe what personal electronic devices and social media are doing to us as a nation.  Many of today’s health professionals are entrenched in their methods of treatment without really knowing or understanding that the research world has passed them by. Getting our health professionals up to speed is vitally important to getting the right outcomes, once we establish what the end game should be.

A healthier society, one in which each individual participates in the productivity cycle, regardless of ability or opportunity, would seem like the ultimate objective.

MAT is a stepping-stone to better health and not a topping point. But public health and economic goals do not often coincide with one another. So it is in our free society that we must allow the individual to choose a path for himself and his family. But the stigma of moral failure remains deeply embedded in much of Americana. The crisis is so bad that the medical system has tacitly admitted disappointment in its results and government, corporate, and medical societies are looking closely at alternatives to MAT.  A targeted treatment solution could well provide the long-term solution to a brain disease that rears its ugly head when exposed to the powerful opioid drugs that exist today. The opioid crisis may well be the beginning of precision treatment for other serious health conditions such as cancer, cardiovascular disease and diabetes.

References:

  1. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
  2. https://ghr.nlm.nih.gov/primer/genomicresearch/pharmacogenomics
  3. Environ Health Perspectv. 2007 Dec; 115(12); A582–A589.
  4. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/drug-addiction-treatment-worth-its-cost
  5. https://www.thedailybeast.com/why-drug-rehab-is-outdated-expensive-and-deadly
  6. http://mba.tuck.dartmouth.edu/pages/faculty/petia.petrova/working_papers/The%20Effects%20of%20Outcome%20.pdf
  7. P T. 2017 Jul; 42(7): 478.

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When substance abuse treatment methods are typically discussed amongst professionals in the industry, it usually revolves around things like therapy sessions, prescriptions, labs, and family relations of the patients. Because the system is modeled to include the various traditional medical concepts for what is considered appropriate care, it understandably has predictable outcomes. The bar for clinical expectations has been set low because the relapse rates are greater than half of the total population of patients undergoing addiction treatment, and has become the accepted measureable standard. It’s time to change that.

DR Bruce

BRUCE A. HANSBROUGH, DC, DACBOH, DACACD

There has been a popular trend in addiction treatment today, especially in residential settings, but also in the outpatient models too. The movement towards adding non-traditional medical care (NTMC) as a way of distinguishing one facility’s service compliment over another has taken hold in a manner unlike any other time in the substance abuse treatment practice. Services like chiropractic care, massage therapy, acupuncture, and other body-care programs such as yoga, therapeutic nutrition, etc. have been highlighted as part of the core culture of addiction treatment and care. These are great marketing differentiations if one understands what the purpose of promoting this way is supposed to ultimately accomplish. The question by some, then: “Is NTMC medically necessary?”

Before we can answer that question, we need to define “medical necessity.” In the United States the legal doctrine defines “medical necessity” as “any procedure provided by or through a licensed health professional that is related to activities which may be justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care.” Arguably and often, this could mean whatever a clinician wants it to mean. But most health care regulators and insurance payers look to standardized references, which are easily found online, for most treatable conditions. These guidelines are ever changing, and they are just that … guidelines.

What many well-meaning behavioral practitioners and administrators do not understand very well is the value and clinical utility of NTMC. This is mainly due to limited exposure to it and misunderstanding of how and when the services should be utilized in the clinical setting. Since pain is the major co-occurring condition to the addiction disorder, and NTMC services like chiropractic and acupuncture have well-documented, accepted, and applicable guidelines for pain, it would make clinically logical sense to utilize these types of NTMC services in the residential and outpatient settings. It doesn’t often get there simply because there are few resources to provide guidance on how to “integrate” NTMC services into the medical model. Instead it is typically outsourced to a vendor, sometimes with little or no training in addiction medicine, and with virtually no administrative or clinical oversight or methodology to track patient progress procedurally. This was a topic discussed a week ago.

Standardized references for NTMC are readily available from the National Guideline Clearinghouse for both traditional and non-traditional medicine. All we need to do is look for them here. Then, we must integrate both into bringing about the best outcomes possible for patients being treated for addiction. We can’t ignore the well-established science that addiction is a nervous system disorder of genetic origin, specifically the brain, and bring about clinical solutions for it, wherever they may be found.

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As with all addiction treatment, counseling and therapy make up the primary components of treatment and recovery. Typically, the recovering patients are suffering from underlying emotional trauma and other psychological disorders that often reflect in confusion and delusion.

The role of the specialty-trained and board certified chiropractic physician in the treatment setting is to be supportive of the therapist and work with other medical providers in the care and treatment of these patients. Understanding the root causes of these emotional life events and effectively re-training how the brain processes these events are crucial keys to successful outcomes and breakthroughs. Without the full utilization and commitment of counseling and therapy, other modalities of treatment, including drug therapy (MAT) are largely ineffective.

DR Bruce

BRUCE A. HANSBROUGH, DC, DACBOH, DACACD

Patients come and go. The substance abuse industry is insurance dependent. Insurance reimbursement limitations are part of the reason why relapse rates are high. It probably has more to do with the patient’s desire and commitment to get well however. If we believe that this is true, then we should be doing everything we can to inspire each patient to dig down deep and seek a higher place in his life. Each and every team member, whether she is an administrator, therapist, CFO, nurse, medical doctor, or chiropractor must go beyond the confines of her specialty and be a mentor.

Most of the time, it will require that we imagine what it is like being that person who suffers with the disease of addiction. Comorbidity is high in this population of patients mainly due to lifestyle choices and environmental circumstances. Regardless, when we serve in this capacity we must become better connecting humans. Let’s face it: these are not easy patients to care for or to communicate with.

By giving just a little extra we can improve the outcomes of the lives of these patients in a profound way. It often takes more patience than it does more therapy. My brotherhood and sisterhood of board certified doctors and specialty-trained practitioners understand this concept fully. This is what we are taught at the ACACD in each and every course and throughout the entire residency program. We are not the DC down the street looking to generate extra cash for his practice. This is our specialty and we take great pride in creating better outcomes and integrating with all of the team members of the treatment center

My intent here is not to read like an advertisement, but to point out observations through my experiences. Making a real difference in the lives of others is really what we are after and we realize that supporting the therapists’ goals is the primary purpose. In these cases it is the lives of people who suffer with addiction. They need support to overcome their disease, which means we have to give them tools and teach them healthy lifestyles. Not all health care providers see it this way. However, we do because it is what we do. However, in the end, we realize that it all comes down to one understanding principle. There comes a time when we must let the patient go. Ultimately they are responsible for their own lives.

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Alternatives for addiction recovery

So many people over the years have questioned this concept of “alternative” or “holistic” approach to addiction recovery. Most of all I have been asked does this work? Well to be frank do we really know what works? Think about that. For some people meetings are the key for their recovery. Other people feel that MAT is their recovery. I could ask the same thing from trauma recovery. Each individual care provider based on their education and experience will in fact design their own recovery treatments and therapy.

Veronica Salber

Veronica Salber SFYB Author

With these options its difficult to know what works and what doesn’t, with or without the added benefit of you the individual having or not having knowledge based experience for each concept. Lets break this down deeper using the concepts of what Western medicine and society call alternative options. Western Medicine was designed for emergency medicine. It has become the forefront and leader in health and medicine. Leaving anything else in the dark. No one knows what people are talking about then it comes to the “alternative”, which sadly is such a discredit given it has been around since the beginning of time, and western medicine is merely a toddler. There are so many options from herbal medicine to traditional systems like traditional Chinese medicine and Ayurveda. Taking these two trtraditional systems, Chinese Medicine and Ayurveda we look at three parts.

The body mind and spirit. These components are the key points in “Healing From Addiction” and its theories of practice. This theory base was intended to show the parts as separate pieces then through self healing be brought together as one part. The basis of Chinese medicine focuses on emotional triggers that affect organs then essentially cause physical manifestation. This can be physical disease or mental. All stemming from energy and emotions. Same with Ayurveda but they use the chakra ideals where TCM is meridian energy and meridian organ based.

To understand the concept we lets use worry as the base emotion. Well for one why do we worry? We worry because we have no control over a certain situation or event. We dont know the details and we dont know the outcome. In Tcm this emotion would directly affect the heart and the energy in that major meridian. Meridian organs are linked in pairs. The yin and yang. The heart is connected to the liver, the opposing emotion to worry is anger. Anger is defined as multiple emotions triggering. Worry can cause, sadness, disappointment therefore directly causing anger in the liver to be triggered.

This can lead to heart related issues, and it can also cause issues in the liver. In the long run this will start to have a decline of energy flow and will set off a systematic discourse in the body. If viewing on a chakra view point directly connected to addiction we can focus on the root chakra. Also found in “Healing with Addiction”. The root chakra gives us the connection to ourselves and each other. Key things in this chakra are Survival and self preservation, and Physical identity.

When this becomes blocked the energy can not flow through the rest of the body effectively, and there are a lot of withdrawal of this chakra and its parts. We start having lack of trust, for ourselves and each other, we start making decisions based on survival. In the work of these traditional systems we focus on the healing of the body mind and spirit by going to the root of the issues, and not the symptoms. Symptoms are used as a guide to direct the practitioner to directly find the root energy that has been imbalanced. Sometimes we know for sure other times we find the lines that need the most healing at taht time.

Sometimes combination therapies are used to the healing. Each system has various therapies, just like in Western medicine. Each therapy is designed with the energy lines and channels for healing. One may not feel comfortable with accupuncture, where as they may want accupressure or moxibustion. All of the therapies are designed for healing the specific areas of the body mind and spirit for a positive healthy outcome. Sound confusing? It can be. This is why you find a practitioner who can work with you an explain to you how this works, and promoted self healing. With all recovery, body mind and spirit it takes the work of the individual seeking healing for it to really work effectively. There are specified points on the body that are meant to open lines, by decreasing pain, eliminating manifestations of energy causing blocks, opening lines to remove disease. Ultimately the individual needs to do self reflecting work. So how can this work and help in recovery? Well lets look at why people become addicts.

There is a significant ratio of patients becoming dependent on opioids because of pain. These therapies are designed to help eliminate pain, and also heal the root of the issue. Secondly there are many psychological issues that play in the role of addiction. This often in times comes from childhood trauma. Each one individual. Thriving for the need to fit in, or feel better because it hurts that much. In these systems we are able to get the root of the problem and eliminating it. The main benefit of taking this approach to recovery is that it is natural based and works with you body mind and spirit. There are no side effects that are going to negatively harm you. You wouldn’t have to worry about continued dependence on a “medication” that hasn’t maxed out in clinical trials to know long term effects. It would be a kick start to a new way of thinking therefore a new way of life.

 

Don’t Delegate! Integrate!

Most health professionals who have been in the game long enough know that the healthcare industry as a whole is moving in the direction of integration.

Integration of behavioral, medical, and holistic services is delivered most cost effectively and efficiently when all health practitioners treating and caring for the same patients communicate and understand how to make the team concept work. That means that mutual understanding of each clinician’s roles and access to patient data is crucial to make the system work best and produce the best outcome. That means it requires teamwork. However, the large insurance carriers are strongly resisting integration because it affects their bottom line. Notwithstanding they need control in order to be profitable. The problem is the fine line of medical decision-making is playing out by unqualified insurance company executives, negatively affecting quality care and outcomes.

DR Bruce

BRUCE A. HANSBROUGH, DC, DACBOH, DACACD

For the past ten years, there has been a popular trend in behavioral medical practices, especially in substance abuse centers (SACs). That trend is the offering of holistic treatment (or complimentary medicine), including chiropractic care, acupuncture, and other non-traditional medical services within the recovery setting. It has become popular primarily for marketing and differentiation reasons. It gives that SAC a marketing edge on its competition for the highly valued “client.” What is often overlooked is the underutilized value of what holistic treatment, integrated into the clinical system of the SAC, does for treatment outcomes. But is anyone really measuring outcomes? Some are and some are not. However, insurance carriers are finding new ways to rope in reimbursement in the form of in-network contracts that coerce SACs into restricting care and alter outcomes. Quality is at the top of their list. Costs are. Some of the contract acronyms like “bundling” and “daily rates” (code words for “cost containment”) speak volumes about the priority of profit.

The current state of most of non-traditional (and traditional) medical services in SACs can be described as fragmented, and of low quality, at best. It happens because most behavioral professionals and their business consultant counterparts are not necessarily knowledgeable nor do they care where healthcare is moving in general. They are focused on insurance reimbursement and being careful not to rock the boast. It is about survival and conformity. They mostly live in the era of the last century of managed care. Here is where privately owned medical specialties thrived but slowly became squeezed. Today SACs are heavily insurance-dependent. Outsourcing health services may seem to be the easy way to shed additional risk, overhead, and insurance issues. What should be clearly understood is that any time two treating parties or more care for a patient they become a permanent care partners with each other forever. Any good attorney could potentially connect the dots should a malpractice or liability case become litigated. So what? It’s easier to hire a private practitioner and let them do their own thing then it is to integrate them into the system.

All this integrative stuff sounds like good medicine, if one understands the advantages and disadvantages in the manner in which the non-traditional medical services are managed. When one examines closely what is taking place in most SACs that decide to offer holistic health services, it is typically done as an after thought because someone told them it was a good thing to do. Perhaps a local practitioner offered them a “no out of pocket” cost in exchange for providing the SAC with health services. This service is typified by informal business arrangement where no remuneration is transferred between the SAC and the local practitioner. Essentially, the local practitioners provide their own equipment and staff. You don’t get charged and you don’t collect. Sounds pretty easy, right? On the surface this sounds very attractive … and straightforward. However, this is not integration. This is delegation. And it comes with a different set of risks.

If you don’t believe the healthcare system is moving toward integration, then you probably didn’t notice how much more challenging it is to receive reimbursement for services these days. The integrated SAC practitioner of today understands how to maximize reimbursement, document outcomes, and justify the care, in order to help these patients get better and help you get paid appropriately. Those who embrace the new generation of health care understand that we all must get better and work within the system, and not be separate from it. It does not mean to surrender to the insurance carrier’s will either. It does require a complete and total commitment to moving forward towards integration. Delegation of medical services, whether traditional or non-traditional, focuses resources in the fragmented health system of the past and is equivalent to inviting the fox to the henhouse. So integrate all of the health services your SAC provides. Don’t delegate any of your clinical services, unless you’re comfortable leaving patients in the lurch and letting the insurance carriers call the shots. Because let’s face it, you can’t separate what you do based on an insurance carrier’s contract and the vendors you select. Neither can you improve your outcomes and reduce your risk without integration.

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Whether you manage a detox facility, PHP, inpatient center, or IOP, we hope you find the information valuable, and if you have any questions please email us at mailto:info@addictionrecovery-fl.com or call us direct at 772-288-6456.

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MAT Windsong Wellness – Grand Opening

MAT Windsong Wellness is a pure outpatient medication-assisted treatment program that looks to help when other methods have not worked.  

As a patient of MAT Windsong Wellness, we will help you work through problems that have been holding you back and made you feel like you were less than.  MAT Windsong Wellness uses a combination of one-on-one therapy and prescribed medication to work you towards the ultimate goal of being drug-free.

This process is done in a way that allows you to safely transition towards abstinence by working through those problems that had held you back in the past.  Our treatment plans are not one size fits all. Your plan will be individualized to fit your particular needs. We will treat you with the compassion and respect that you deserve. Let us help you on your path to a better life. 

Call us today 772.465.4044

Auriculotherapy: An Effective Treatment Procedure For Addiction
DR Bruce

BRUCE A. HANSBROUGH, DC, DACBOH, DACACD

Finding the least invasive treatments for addiction care appears to be an elusive concept in rehab. Yet, there has been a non-pharmaceutical procedure that has been used widely throughout the world for decades and goes largely ignored or devalued in almost all western medical systems – auriculotherapy. Auriculotherapy (aka ear “acupuncture,” auricular therapy, or auricular medicine) has been around since the 1950’s. It is a mainstream neurological technique practiced extensively in Europe and Asia for decades.

Let us be reminded that the term ear acupuncture is often used to mean auriculotherapy. But they are two distinctly different systems with important similarities.

So how does auriculotherapy work? And more specifically, how does it help the addicted brain? A thorough explanation of the ins and outs of how auriculotherapy works to benefit the addicted brain requires understanding of how it is applied. Briefly, the auriculotherapy protocol for addiction treatment affects pathways of the nervous system that promote relaxation and balances neurotransmitter production.

Most behavioral health practitioners understand the basics on why their clients abuse substances. They also understand that the vast majority of recovering addicts will relapse if the right combinations of physical, mental, and emotional components are not considered in the treatment plans. Since most patients in treatment present with co-occurring disorders or co-morbid conditions, auriculotherapy is an ideal form of treatment to consider because of the numerous tested protocols for these specific disorders and conditions.

Auriculotherapy is a fast and inexpensive non-traditional medical procedure. Training in clinical applications is relatively easy and can typically be achieved in just a few weekend seminars. Most states include auriculotherapy for certain licensed health providers in their scopes of practice. Keep in mind, that it is not a part of the acupuncture system of medicine, although an acupuncture physician or acupuncturist may practice auriculotherapy.

So why is this treatment procedure not utilized within the addiction treatment setting more? The first and primary reason is that in behavioral health it is not very widely known about. Secondly, practitioners who can and have used auriculotherapy are distracted from its effectiveness, especially when new and more glamorous pharmaceuticals come to the clinical setting.

The good news is that once auriculotherapy is employed into the medical treatment side of the equation, effectiveness of all other therapies increases significantly. Kenneth Blum, PhD in November of 2000, published the most convincing study that demonstrates this. The take home message is this: figure out how you can start using auriculotherapy in your center. If you need help, ARS can help you.

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Whether you manage a detox facility, PHP, inpatient center, or IOP, we hope you find the information valuable, and if you have any questions please email us at mailto:info@addictionrecovery-fl.com or call us direct at 772-288-6456.

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Spinal Manipulation: Is There a Missing Element In Successful Addiction Treatment?

Addiction treatment and recovery is the fastest growing segment of the healthcare industry today. From drugs and alcohol to behavioral conditions such as sex addiction and gambling, the underlying conditions of all are manifested in neuromusculoskeletal pain. Now that many insurance plans cover substance abuse under their mental health riders more people suffering with addictions are reaching out for help. Success rates in the industry are very low and relapse is topping 60 percent and growing on average. However there are promising methods that only a very small number of forward-thinking treatment providers know about and are utilizing to deal with the emotional and neurological effects of alcohol and drug use.

DR Bruce

BRUCE A. HANSBROUGH, DC, DACBOH, DACACD

Chiropractic medicine is the second largest health discipline in the United States. Chiropractic physicians (aka doctors of chiropractic or DCs) care for patients of all ages, with a variety of health conditions. DCs are especially well known for their expertise in caring for patients with back pain, neck pain and headaches…particularly with their highly skilled manipulations or chiropractic adjustments. They also care for patients with a wide range of injuries and disorders of the neuromusculoskeletal system, involving the nerves, muscles, ligaments and joints, especially those of the brain and spinal cord. These painful conditions often involve or impact the nervous system, which can cause referred pain and dysfunction distant to the region of injury. The benefits of chiropractic care extend to general health issues, as well, since the human body structure affects our overall function. DCs also counsel patients on diet, nutrition, exercise, healthy habits, and occupational and lifestyle modification.

 The human spine plays an important role in maintaining the proper mechanism for controlling electrical input into the brain. Think of the spinal column as a breaker panel that controls neurological functioning to muscles, organ systems, and endocrine secretion. It also is an important organ in maintaining immunological stability. Many people who abuse drugs or are habitually compulsive suffer from immunological disorders, which impede their overall ability to successfully beat addiction and fully recover. Torque Release Technique (TRT) and spinal manipulation are chiropractic systems for treating conditions through the spine (also called spinal adjusting) in which vertebral segments are “reset” or moved so that the nerve switches that are turned off are turned back on and functioning properly again. TRT and spinal manipulation are crucial components of achieving proper neurological tone balance and spinal joint integrity.

One study has shown that chiropractic care, along with auriculotherapy, decreased the “AMA rates” in a residential setting. This is very promising not only for patients being treated for addictions of drugs and alcohol but other compulsive disorders like over over-eating. Additionally, it is good news for the treatment providers for effectiveness reporting. What has prevented some from embracing this more holistic approach is the misunderstanding of cost and insurance coverage, and frankly, ignorance. Notwithstanding the effectiveness of this approach there are a few forward-thinking centers who have embraced this and are realizing amazing success in reduction of AMA rates among their census. Even better is that these few centers are being reimbursed by insurance profitably and fairly compensate their providers who have the advanced training in addiction care.

 

Obviously more research in this and other areas of addiction treatment will be constructive for the mental health and substance abuse treatment profession and ultimately the patients receiving the care. However, it is becoming increasing obvious that the substance abuse treatment providers who embrace inclusion of chiropractic and other holistic therapies into their clinical settings will benefit not only financially but competitively as well.

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Whether you manage a detox facility, PHP, inpatient center, or IOP, we hope you find the information valuable, and if you have any questions please email us at mailto:info@addictionrecovery-fl.com or call us direct at 772-288-6456.

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Just call or text 772-288-6456 or email us at info@addictionrecovery-fl.com today!

Medication Assisted Treatment (MAT) for Addiction: Are There Effective Alternatives?

MAT has been utilized for the treatment of substance use disorders for way more than a hundred years.

Obviously, this has been refined much better since the early 1900’s and we know a lot more about addiction than we did then. MAT is still an effective form of treating addiction even today, but only when used by the highly trained licensed health professional.

Under the Diagnostic and Statistical Manual of Mental Disorders, it’s not enough for someone to be using or even physically dependent on drugs to qualify for a substance use disorder, the technical name for addiction. After all, most US adults use drugs — some every day or multiple times a day — without any problems whatsoever. Just think about that next time you sip a beer, glass of wine, coffee, tea, or any other beverage with alcohol or caffeine in it, or any time you use a drug to treat a medical condition.

DR Bruce

BRUCE A. HANSBROUGH, DC, DACBOH, DACACD

The qualification for a substance use disorder is that someone is using drugs in a dangerous or risky manner. So someone with an opioid use disorder would not just be using opioids but potentially using these drugs in a way that puts him or others in danger — perhaps by feeling the need to commit crimes to obtain the drugs or using the drugs so much that he puts himself at risk of overdose and inhibits his day-to-day functioning. Basically, the drug use has to hinder someone from being a healthy, functioning member of society to qualify as addiction. This is an important distinction for us to understand. Societal stigmatization has a firm foothold in understanding the differences between diseases and criminal behaviors.

Various drugs used in MAT, such as buprenorphine, naltrexone, and methadone has been shown to be effective in the treatment of addiction. It has saved countless lives. However, it is expensive, requires administration of the drugs by licensed health professionals, and is, for the most part, a labor-intensive form of treatment. Since we now know that addiction is a genetic disease of the brain, we can better understand the physiology of addiction and deal with the chromosomal aspects of the disease. A normal neurological mechanism called the Brain Reward Cascade is a natural physiological cycle, a combination of a series of biochemical reactions at the cellular level in which the four major neurotransmitters (and several others) that are utilized in the “survival brain” (serotonin, dopamine, GABA, and norepinephrine.) It comes down to imbalanced neurotransmitters that the brain needs for normal functioning in the addicted brain.

We now know, and the evidence supports this, that addiction is a brain disease. And we also know that it is more common than we originally thought. Certain drugs and exogenous substances affect the brain and nervous system in persons affected with the disease in ways that it doesn’t in persons who do not. It is the genetic disorder that causes what is known as the Reward Deficiency Syndrome (RDS). To understand this we need to study the human brain’s system of reward, which resides in that part of the brain called the limbic system. The limbic brain is our ancient survival mechanism for food, water, sex, and “fight or flight” response. So the natural response is to fulfill that need, one way or another. Or get away from danger or pain, one way or another.

Alcohol and drug addiction is a very difficult disease to treat. Since we now know that substance abuse disorders are recognized as diseases of the brain, wouldn’t it make sense to also know more about less expensive and direct methods to treat addictions of all kinds? At the very least it is important to understand the basic neurology of the disease of addiction.

There are five non-pharmaceutical medical procedures, covered by most insurance plans that are found to be extremely useful and effective for treating the disease of addiction:

  1. Amino acid therapy. These are basic building blocks of protein molecules. Intimately connected with the function of neurotransmitters in the brain amino acids are the crucial first steps in the Brain Reward Cascade. People with chronic addiction to alcohol and drugs have an imbalance of neurotransmitters in the brain, and so this perpetuates the problem. The addicted brain does not have enough reserves to restore the amino acid imbalance and therefore operates in a deficit, thus triggering RDS. Amino acid therapy has been an inexpensive alternative to MAT for decades and is a natural rejuvenation technique for producing inadequate reserves of neurotransmitters needed for proper brain balance.
  2. Spinal manipulative therapy (SMT) aka chiropractic adjustments. A substantial body of evidence exists indicating that spinal manipulation impacts primary afferent neurons (the sensory nerves) near spinal tissues, the motor control system and pain processing. Pain is a primary activator of the “fight or flight” response mechanism. It has been concluded that spinal manipulation, primarily performed by trained chiropractic physicians, is highly effective in reducing lower back pain, but also joint and somatic pain of all kinds.
  3. Massage therapy. Nearly all types of manual therapy have been shown to elicit a neurophysiological response that is associated with pain and anxiety reduction, common co-occurring disorders in patients suffering with the disease of addiction. Massage therapy appears to elicit an endogenous opioid response, which is a primary reason why it is popular with people in all walks of life, and is available in the modern addiction treatment center.
  4. Exercise conditioning. Recent studies have shown that the three most consistent cognitive and behavioral effects of a single bout of exercise in humans are improved executive functions, enhanced mood states, and decreased stress levels. One of the most positive and dramatic effects seen after moderate duration of exercise (16 to 45 minutes) is the change in neurochemical levels including neurotransmitters, metabolites, growth factors, and neuromodulators.
  5. Auricular therapy AKA ear “acupuncture.” The understanding of the importance of basal heart rate (HR) and heart rate variability (HRV) is crucial in overall health performance and established normal physiological measurement criteria. A recent study concluded that, HR decreases and HRV total increases significantly during ear acupressure and/or ear acupressure vibration. Practicing clinicians mostly agree that this is directly related to patient reported post treatment mood improvements.

Although no MAT of non-MAT treatment methodologies can claim to be the end all for the cure of the disease of addiction, it is wise for the clinician, therapist, and executive to look at all the options available that have value. This writing is proposed for the decision-maker who may not understand or know about effective non-pharmaceutical methods for treating addiction. These five non-pharmaceutical methods for treating addiction may be used as stand-alone treatments or in combination with MAT. People are unique. There is no “one size fits all.”

..

Whether you manage a detox facility, PHP, inpatient center, or IOP, we hope you find the information valuable, and if you have any questions please email us at mailto:info@addictionrecovery-fl.com or call us direct at 772-288-6456.

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Just call or text 772-288-6456 or email us at info@addictionrecovery-fl.com today!

 

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