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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

732-477-4470

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

THIS PRESENTATION IS ABOUT HOPE BECAUSE THERE IS A GUARANTEED SOLUTION FOR ANYONE

ADDICTED TO OPIATES!!!!

THIS PRESENTATION IS ABOUT HOPE BECAUSE THERE IS A GUARANTEED SOLUTION FOR ANYONE

ADDICTED TO OPIATES!!!!

In Order To Find An Opiate Solution,

You Need To Understand The Opiate Problem

The Problem

The Problem The problem has two components:

The Problem The problem has two components:

Lifestyle – People feel the need to hide in unreality because reality is uncomfortable.

The Problem The problem has two components:

Lifestyle – People feel the need to hide in unreality because reality is uncomfortable.

Physiologic – Opiates Addict Everyone

The Problem Lifestyle Component

The Problem Lifestyle Component ! No simple solution

The Problem Lifestyle Component ! No simple solution ! Based on unrealistic goals and

expectations about life

The Problem Lifestyle Component ! No simple solution ! Based on unrealistic goals and

expectations about life ! Young people feel inadequate

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

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 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.

The Basic Rule Of Human Behavior

Simplified

People will change when it hurts too

much not to change.

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

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

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

The Problem The Brain Does Not Like

External Opiates Of Any Sort

The Problem The Brain Does Not Like

External Opiates Of Any Sort ! Heroin – especially NJ Heroin

The Problem The Brain Does Not Like

External Opiates Of Any Sort ! Heroin

! Opiates (Pills- prescribed and street sourced)

The Problem The Brain Does Not Like

External Opiates Of Any Sort ! Heroin

! Opiates (Pills) ! Opioids (Opiate-Like Substances)

The Problem The Brain Does Not Like

External Opiates Of Any Sort ! Heroin

! Opiates (Pills) ! Opioids (Opiate-Like Substances) ! Natural Opium

The Brain’s Natural Opiate System Is Disrupted By

External Opiates Of Any Type

The Brain’s Natural Opiate System Is Disrupted By

External Opiates Of Any Type ! Natural opiates (endorphins) are secreted by the brain

in very small amounts, probably less than 1/1000th% (0.001%) of external opiates, AND only for seconds or a minute or two

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 1/1000th% (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 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 1/1000th% (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

The Stronger The Opiate, The Faster The Individual Becomes Addicted, Their

Brain Adapts To The External Opiate And Becomes

NJ Heroin Is One Of The Strongest Opiates Available

NJ Heroin Is One Of The Strongest Opiates Available

NJ Heroin Cut With Fentanyl (Bud Light)

Is The Strongest Opiate Available

NJ Heroin Is One Of The Strongest Opiates Available

NJ Heroin Cut With Fentanyl (Bud Light)

Is The Strongest Opiate Available

Bud Light Is The Most Addictive Opiate On The Planet

Opiates And Opiate Withdrawal

Opiates And Opiate Withdrawal ! One of the biggest causes of

opiate relapse is

that promotes and justifies repeat opiate use

Opiates And Opiate Withdrawal ! One of the biggest causes of

opiate relapse is distorted thinking that promotes and justifies repeat opiate use

!  occurs while using opiates AND/OR when withdrawing from opiates

Opiates And Opiate Withdrawal

The only way to avoid “opiate logic” and opiate behaviors is:

Opiates And Opiate Withdrawal

The only way to avoid “opiate logic” and opiate behaviors is:

! 100% abstaining from opiate use

Opiates And Opiate Withdrawal

Therefore, the only way to avoid “opiate logic” and opiate behaviors is:

! 100% abstaining from opiate use

AND

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

The Solution

The Solution There Are Four Necessary

Steps To Produce A Lasting Solution –

The Four Steps To Becoming Opiate Free

1. Individual must be truly ready to stop using opiates (“should stop without commitment” almost never works)

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)

The Four Steps To Becoming Opiate Free

3. Identify and correct all psychiatric problems that are likely triggers for relapse (anxiety, depression, ADD, etc.)

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

The Four Steps To Becoming Opiate Free

The Four Steps To Becoming Opiate Free

All Four Steps Are Required For Lasting Success

1. Committed to stop

The Four Steps To Becoming Opiate Free

Summary

1. Committed to stop

2. 100% Removal of withdrawal symptoms and opiate logic till the brain is recovered

The Four Steps To Becoming Opiate Free

Summary

1. Committed to stop

2. 100% Removal of withdrawal symptoms and opiate logic till brain 100% recovered

3. Correct psychiatric triggers

The Four Steps To Becoming Opiate Free

Summary

1. Committed to stop

2. 100% Removal of withdrawal symptoms and opiate logic till brain 100% recovered

3. Correct psychiatric triggers

4. Therapy for better life coping skills

The Four Steps To Becoming Opiate Free

Summary

Four Necessary Steps Options

Four Necessary Steps Options

There Are Many Options To Treatment Design

Four Necessary Steps Options

There Are Many Options To Treatment Design

Choose The Design That Works Best For You

Four Necessary Steps Options

There Are Many Options To Treatment Design

Choose The Design That Works Best For You

Four Necessary Steps Options

There Are Many Options To Treatment Design

Choose The Design That Works Best For You

There Are No Shortcuts

There Are No Shortcuts Shortcuts Essentially Guarantee Relapse

There Are No Shortcuts Shortcuts Essentially Guarantee Relapse

Common Shortcuts That Produce Relapse

There Are No Shortcuts Shortcuts Essentially Guarantee Relapse

Common Shortcuts That Produce Relapse:

! Individual Not Ready To Stop Using Opiates

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)

How To Feel Good And Be Productive During Recovery From Opiate Use And Abuse

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 use and/or opiate withdrawal

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

The Only Solution Is 100% Elimination Of Withdrawal

The Only Solution Is 100% Elimination Of Withdrawal

Currently there are only two ways to eliminate withdrawal symptoms totally:

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

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

Suboxone® Is The Only Option Currently Available To Stop Withdrawal AND

Eliminate Opiate Influence

Suboxone® Is The Only Option Currently Available To Stop Withdrawal AND

Eliminate Opiate Influence Methadone Has Problems Because:

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

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

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

Suboxone® Fools The Brain Into Acting Like The

Changes From Opiate Use Have Totally Healed

Suboxone® Fools The Brain Into Acting Like The

Changes From Opiate Use Have Totally Healed

! The patient functions as if they never used opiates

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

As The Brain Heals, Less Suboxone® Is Needed To

Insure Proper Function And No Withdrawal Symptoms

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

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

Dr. Russ’ Suboxone® Rule

Dr. Russ’ Suboxone® Rule The key to effective Suboxone® treatment

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

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

Dr. Russ’ Suboxone® Rule Using more Suboxone® than the minimum needed causes problems:

Dr. Russ’ Suboxone® Rule Using more Suboxone® than the minimum needed causes problems:

! Generates a mild opiate response than can trigger relapse

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

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

Ideal Suboxone® Blood Level

Ideal Suboxone® Blood Level

Ideal Suboxone® Blood Level

Low Suboxone® Blood Level

There Is Life After Opiates!!

It Is Wonderful And

Available For Everyone

For More Information Please Go To

monmouthbehavioralmedicine.com Click “Resources” And Then “Addiction Medicine”

Email to drruss@monmouthbehavioralmedicine.com

Call 732-477-4470