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RESEARCH & PUBLICATIONS

EDUCATION AND CLINICALLY-RELEVANT RESOURCES

Urine Drug Monitoring: Opioids

Monitoring patient usage of scheduled controlled substances is a major concern and responsibility of prescribing clinicians. This handbook collects the most effective techniques for monitoring pharmacotherapy, with an emphasis on opioids, into a practical, objective and comprehensive strategy. Download: Urine Drug Monitoring Opioids.pdf

Unchain Your Brain: 10 Steps to Breaking the Addictions that Steal Your Life

Authored by: Daniel G. Amen, MD and David E. Smith, MD Unchain Your Brain: 10 Steps to Breaking the Addictions that Steal Your Life is a practical, easy-to-follow, step-by-step program that shows you how to boost your brain so you can kick your bad habits. When you have a healthy brain, it makes it so much easier to stick with a program designed to help you quit smoking, drinking, gambling, doing drugs, overeating, or whatever your addiction may be. Purchase the Book

Understanding Elimination Patterns with Creatinine Adjusted Drug Values

Creatinine is a product of muscle contraction. Because it is produced from within and released into body fluids at a relatively constant rate, the level of creatinine in urine may be used as an indication of body hydration. Since measured drug levels can fluctuate with the level of creatinine, a key aspect of your laboratory testing is creatinine adjustment. With creatinine adjusted drug levels, you can better monitor drug usage and redefine program goals to increase treatment eff ectiveness. Creatinine adjusted values are for clinical pharmacokinetic comparison only; these values are not intended for forensic or punitive use. Download: Creatinine Adjusted Drug Values.pdf

Withdrawal from Buprenorphine/Naloxone and Maintenance with a Natural Dopaminergic Agonist: A Cautionary Note

Authors: Blum K, Oscar-Berman M, Femino J, Waite RL, Benya L, Giordano J, Borsten J, Downs WB, Braverman ER, Loehmann R, Dushaj K, Han D, Simpatico T, Hauser M, Barh D, McLaughlin T. While numerous studies support the efficacy of methadone and buprenorphine for the stabilization and maintenance of opioid dependence, clinically significant opioid withdrawal symptoms occur upon tapering and cessation of dosage. We present a case study of a 35 year old Caucasian female (Krissie) who was prescribed increasing dosages of prescription opioids after carpel tunnel surgery secondary to chronic pain from reflex sympathetic dystrophy and fibromyalgia. Read the Full Article

Neurogenetic Impairments of Brain Reward Circuitry Links to Reward Deficiency Syndrome (RDS): Potential Nutrigenomic Induced Dopaminergic Activation

Authors: Blum K, Oscar-Berman M, Giordano J, Downs B, Simpatico T, Han D, Femino J. Work from our laboratory in both in-patient and outpatient facilities utilizing the Comprehensive Analysis of Reported Drugs (CARD)™ found a significant lack of compliance to prescribed treatment medications and a lack of abstinence from drugs of abuse during active recovery. This unpublished, ongoing research provides an impetus to develop accurate genetic diagnosis and holistic approaches that will safely activate brain reward circuitry in the mesolimbic dopamine system. This editorial focuses on the neurogenetics of brain reward systems with particular reference to genes related to dopaminergic function. Read the Full Article

Urinary Analytes for Patients Taking Opiate-Based Medications

Quantitative urine analysis by UPLC-MS/MS has the capability of detecting analytes of frequently prescribed opiate-based medications; codeine, morphine, hydrocodone, hydromorphone, oxycodone, and oxymorphone. Download: Opiate Metabolism.pdf

Urinary Analytes for Patients Taking Benzodiazepine Medications

Quantitative urine analysis by UPLC-MS/MS has the capability of detecting analytes of frequently prescribed benzodiazepine medications: alprazolam, chlordiazepoxide, clonazepam, clorazepate, diazepam, flurazepam, lorazepam, oxazepam, prazepam, temazepam, and triazolam. Download: Benzo Metabolism.pdf

Systematic Evaluation of “Compliance” to Prescribed Treatment Medications and “Abstinence” from Psychoactive Drug Abuse in Chemical Dependence Programs: Data from the Comprehensive Analysis of Reported Drugs

Authors: Kenneth Blum, David Han, John Femino, David E. Smith, Scott Saunders, Thomas Simpatico, Stephen J. Schoenthaler, Marlene Oscar-Berman, Mark S. Gold This is the first quantitative analysis of data from urine drug tests for compliance to treatment medications and abstinence from drug abuse across “levels of care” in six eastern states of America. Comprehensive Analysis of Reported Drugs (CARD) data was used in this post-hoc retrospective observational study from 10,570 patients, filtered to include a total of 2,919 patients prescribed at least one treatment medication during 2010 and 2011. Read the Full Article

Quantitative Electroencephalography Analysis (qEEG) of Neuro-Electro- Adaptive Therapy 12™ [NEAT12] Up-Regulates Cortical Potentials in an Alcoholic during Protracted Abstinence: Putative Anti-Craving Implications

Authors: Roger L Waite, Marlene Oscar-Berman, Eric R Braverman, Debmalya Barh and Kenneth Blum Cranial electrotherapy stimulation (CES) is a noninvasive therapy that has been used for decades in the United States to treat anxiety, depression, and insomnia in the general population. The effectiveness of CES has been questioned by many and its use is considered controversial. In this study we are presenting data on one alcoholic patient using a newly engineered device we call Neuro-Electro-Adaptive Therapy 12™ [NEAT12]. This hybrid device utilizes TENS current characteristics yielding CES effects. This device has been found to primarily target the excitation of the Cingulate Gyrus region of the brain. Read the Full Article

Neurophysiological Measures and Alcohol Use Disorder (AUD): Hypothesizing Links between Clinical Severity Index and Molecular Neurobiological Patterns

Authors: Mario Vitali, Carmen Napolitano, Marlene Oscar-Berman, Simona Flamminii Minuto, Gemma Battagliese, Maria Luisa Attilia, Eric R Braverman, Marina Romeo, Kenneth Blum and Mauro Ceccant In 1987, Cloninger proposed a clinical description and classification of different personality traits genetically defined and independent from each other. Moreover, he elaborated a specific test the TCI to investigate these traits/states. The study of craving in Alcohol Use Disorder (AUD) assumed a greater significance, since ever more data seems to suggest a direct correlation between high levels of craving and a higher risk of relapse in alcoholics. Thus, our study aim is to explore the possible correlations among TCI linked molecular neurobiological pattern(s), craving and alcohol addiction severity measures in a sample of Italian alcoholics. Read the Full Article

Drug Abuse Relapse Rates Linked to Level of Education: Can We Repair Hypodopaminergic-Induced Cognitive Decline With Nutrient Therapy?

Authors: Blum K1, Schoenthaler SJ, Oscar-Berman M, Giordano J, Madigan MA, Braverman ER, Han D. It is well known that athletes are among individuals with high risk for all reward deficiency syndrome (RDS) behaviors, including substance use disorder (SUD). Comparing patient demographics and relapse rates in chemical dependence programs is pertinent because demographics may affect outcomes. Increased risk for relapse and lower academic achievement were found to have a significant association in recent outcome data from a holistic treatment center (HTC) located in North Miami Beach, FL. Read the Full Article

When the Servant Becomes the Master

Authored by: Jason Powers, MD The definitive guide to addiction that addresses misinformation and stigma, humanizes the disease within a framework of science, research, and personal experience, and provides a wealth of information on the various forms addiction takes as well as rich data regarding treatments. Purchase the Book

Uppers, Downers, All Arounders

Authored by: Darryl S. Inaba, PharmD and William Cohen This highly regarded textbook from one of the leaders in drug education has been adopted for courses in over 400 colleges and universities nationwide and is featured in the training curriculum of the DEA, and many law enforcement programs. It is considered by many to be the standard reference of AOD counseling certification. Authored by two of the most respected authorities in the field of addiction treatment, the content provides the reader with perceptive insights into the complexities of drug abuse, compulsive behaviors, addiction, treatment, recovery and prevention. Purchase the Book

Molecular Neurobiology of Addiction Recovery: The 12 Steps Program and Fellowship

Authored by: John Giordano, Kenneth Blum, Mark Gold, Marlene Oscar-Berman, Scott Teitelbaum, and John Femino Humans are biologically programmed to seek out pleasurable experiences. These experiences are processed in the mesolimbic system, also referred to as the “reward center” of the brain, where a number of chemical messengers work in concert to provide a net release of dopamine in the Nucleus Accumbens. In some genetically predisposed individuals, addiction occurs when the mechanisms of the mesolimbic system are disrupted by the use of various drugs of abuse. Since Alcoholics Anonymous was founded in 1935, it’s 12 step program of spiritual and character development has helped countless alcoholics and drug addicts curb their self-destructive behaviors. However, the program was developed at a time when comparatively little was known about the function of the brain and it has never been studied scientifically. This is the first book to take a systematic look at the molecular neurobiology associated with each of the 12 steps and to review the significant body of addiction research literature that is pertinent to the program. Purchase the Book

Medically-Assisted Treatment (MAT): The Counseling SidE

Presented by: Shannon Garrett, LGSW, LCADC. An Educational Lecture entitled Medically-Assisted Treatment (MAT): The Counseling Side. Presented at the 2016 Virginia Summer Institute for Addiction Studies. Download: MAT The Counseling Side – SGarrett VSAIS 2016.pdf PERMISSIONS: Please do not reproduce without written permission from Dominion Diagnostics and Shannon Garrett, LGSW, LCADC

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