Scientific Program

Sessions:

Abstract

Nicotinic acetylcholine receptors (nAChRs) are widely distributed ligand gated ion channels throughout the peripheral and central nervous systems of mammals.There are 16 different nAChR subunits, α1-7, α9, α10 and β1-β4, as well as γ, δ, and ε, which assemble into pentamers to form different nAChR subtypes with distinct pharmacological properties in mammals. Among them α6β2* (* designates other possible subunit), α3β4 and α4β2 nAChR subtypes are potential therapeutic targets for the treatment of addiction.HowevervariousnAChR subtypes are very difficult to pharmacologically distinguish from each other.The α6* nAChRsare expressed by dopaminergic neurons in the CNS, which modulate the release of dopamine and are believed to be important in mediating tobacco, morphine, cocaine and ethanol addiction. The α3β4 nAChRs present in the medial habenula with important role in influencing nicotine addiction. Blockage of α3β4 nAChRs in the medial habenula decreased the dose of nicotine that rodents would self-administer.Thus, new antagonists of α6β2* or α3β4 nAChR subtypes are of considerable interest, which would give strategies to selectively modulate α6β2* or α3β4nAChR function. We characterized an alpha-conotoxin (α-CTx) TxIBwith 16 amino acid and an α-CTxTxID with 15 amino acid from Conus textile.The sequence of TxIBis GCCSDPPCRNKHPDLC-amide. The sequence of TxID is GCCSHPVCSAMSPIC with C-terminal amidation too. Both peptides with a I–III, II–IV disulfide connectivity were chemically synthesized. The residues between Cys-II and Cys-III and Cys-III and Cys-IV of α-conotoxins are commonly referred to as loops 1 and 2, respectively. The number of residues in each of these loops is used to further classify the α-conotoxins. So TxIB is classified as a 4/7 α-conotoxin, whereas the α-CTxTxIB has a 4/6 spacing.Both peptides were tested on rat nAChRsheterologously expressed in Xenopus laevis oocytes. The α-CTxTxIB blocked α6/α3β2β3 nAChR with an IC50 of 28 nM, which showed little or no block of all the other tested subtypes at concentrations up to 10 μM.TxIB blocking α6/α3β2β3 nAChR is rapidly reversed after toxin washout. The ability of α-CTxTxIB to discriminate between α6/α3β2β3 and the other nAChR receptors is unique. There are no small molecules have this selectivity profile. Previously described α-conotoxins that potently block α6/α3β2β3nAChRs also block either α6/α3β4nAChRs, α3β2nAChRs and/or other nAChRs subtypes. TxID was the very potent α3β4 nAChR antagonists blocking rat α3β4 nAChRs with an IC50 of 12.5 nM. However,TxID also blocked the closely related α6/α3β4 with an IC50 of 94 nM.In fact, the expression profile of α3β4 nAChRs and α6/α3β4 nAChRs overlap in a variety of tissues. So TxID can't differentiate α3β4 nAChR from α6/α3β4 nAChR effectively. To distinguish between these two close subtypes, positional-scanning mutagenesis ofTxID was performed to identify critical residues that confer potency for α3β4 nAChRs, and hope to obtain more selective mutant to discriminate between these two close subtypes. The effects of fifteen analogues and TxID were tested on both α3β4 and α6/α3β4 nAChRs. An analogue, i.e. [S9A]TxIDhad 46-fold greater potency for α3β4 versus α6/α3β4 nAChRs, which showed significantly improved selectivity for α3β4 versus α6/α3β4 nAChRs. Both TxID and [S9A]TxID had little activity on other nAChR subtypes.The three-dimensional solution structures of TxIB, TxIDand [S9A]TxIDwere determined using NMR spectroscopy.α-CTxTxIB, TxID and [S9A]TxID represent uniquely selective ligand for probing the structure and function of α6β2*and α3β4 nAChRs respectively.It is known about 20% people have used drugs recreationally resulting in a substance use disorder finally. Therefore, structural insights derived from these ligands may facilitate the development of novel therapeutics for addiction involving α6β2* and α3β4nAChRs.

Biography

Prof. Luo acted as President of 19th World Congress of the International Society on Toxinology (IST). Presently she is secretary of Asia-Pacific Section of IST. She established a new center for experimental biotechnology and department of pharmacy in Hainan University. She is the author of 150 scientific publications of various journals, including , , etc. She is also the inventor of 16 patents, including two USA patents and three PCT patents etc. Prof. Luo discovered six new Hainan conotoxins target nicotinic acetylcholine receptors (nAChRs) subtypes, including atypical α-conotoxin LtIA targets a novel microsite of the 32 nAChR, α-conotoxin TxIB that selectively targets 6/323 nAChR relating with addiction, α4/7-conotoxin LvIA selectively blocks α3β2 vs. α6/α3β2β3, α-conotoxin TxID that potently blocks rat α3β4 nAChR linking with addiction, a novel inhibitor of 910 nAChR delineates a new conotoxin superfamily, and αO-conotoxin GeXIVA is a potent α9α10 nAChR antagonist with anti-hypersensitive effect of neuropathic pain. Structure and function characterization of more Hainan conopeptides is ongoing. The nAChRs are potential targets for the treatment of various neuropsychiatric diseases, including pain, addiction andcanceretc. These Hainan conotoxins show great potential in medical applications.

Speaker
Sulan Luo / Hainan University, China

Abstract

The decade of the 2010's shelled hospitals and first responders with an explosion of opioid-related illness, injury, and death. Preventable drug overdoses tallied 54,793 lives lost in 2016 – an increase of 391 percent since 1999. Accidental drug overdose deaths increased 327 percent over the same period. The majority of OD deaths (38,000) involve opioids, The drug category most frequently involved in opioid overdoses and growing at the fastest pace includes fentanyl, fentanyl analogs, and tramadol. The fentanyl category of opioids accounted for nearly half of opioid-related deaths. The dirty cat in the litter, heroin, accounted for the second highest number of deaths, claiming 14,606 lives. Western countries struggle with what the opioid cat dragged in: Hard-to-treat opioid addictions, fatal relapses, and needless loss of mainly young lives. Now legislators, first responders, treatment pros, and those in the medical field are forced to focus not on the death toll the cat dragged in, but instead what dragged the cat in. Every opioid related death is alcohol related The abuse of drugs, regardless of classification, begins with the permissiveness granted the world's most lethal drug and third-leading cause of all preventable deaths: Alcohol. It's a straight line. Nearly every non-Muslim civilization on this rock has embraced alcohol. As a result, ours is largely a numbing planet, especially in the sedation-happy Americas. This is the root. This is the seed of the opium trade that has gone unstemmed since prehistory. There is legit medical use for opium derivatives: What has driven growth is demand – not by the sick but by people who cannot get the mind alteration they desire through alcohol use alone. Alcoholics and non-alcoholics alike drink the first drink for the same reason: To relieve a stress. In the U.S., which has a laissez faire agenda toward alcohol since its prohibition failure, the culture embraces a drinking lifestyle. Western culture normalizes alcohol use. In other words, we normalize drug use. What you ignore, you permit. What you permit, you condone. Opioid abuse happens when a person can't get where they want to get with alcohol. The opioid crisis wasn't created by doctors overprescribing, manufacturers wooing doctors, China shipping heroin and cheaper fentanyl via cartels and postal mail. Drinking, especially binge drinking, is the pandemic that dragged in the opioid 'epidemic.' Culture condones the buzz, the sedation. We created this monster on our own. What's the way out? Legislative attempts to curb use of potentially lethal drugs resemble shooting an arrow and then drawing a target around where it hit. Locking up dealers and traffickers, creating prescription databases and prescribing limits, and promoting Narcan availability all deal with control of the supply and its aftermath. The demand is unchanged. Within a cultural adoration of the buzz, our current crisis can only be curbed by control of the demand. If a drug user wants a drug, they will get that drug. It's the American freedom thing. In 1967, 72 percent of adult men smoked. Today, 72 percent don't. Prevention works. If there is genuine interest in healthy outcomes and preventing premature death from opioids, permissiveness of the starter or feeder or gateway or predecessor drug has to be addressed on five levels to reduce demand for all antecessor drugs. One of those ways is not legalizing recreational use of marijuana. When we rethink the drink we can douse the pandemic that begat the current opioid crisis. Legislators and treatment experts must lead the transition from managing aftermaths of the current crisis to prevention of the next one. And phase out the ancient alcohol crisis – the elephant in the room – western culture ignores.

Biography

Stevens is a journalist, posting regularly on health and alcohol issues for online news services and is a founding influencer at the world's largest medical portal, HealthTap. Stevens blends intensive evidence-based research, wit, journalistic objectivity, blunt personal dialogue and no-nonsense business perspective in his four award-winning health and addiction books.

Speaker
Scott Stevens / www.alcohologist.com, USA

Abstract

We are presenting our results with the first two hundred opioid addicted patients treated with Sustained Release Naltrexone Depot Preparations (O’Neal NTX implants, Gooberman NTX implants). Naltrexone has been used as a more favorable choice of medication as a substitute in opiate use disorder than Buprenorphine or Methadone. Patient remains opioid free and have no cravings, which provides a solid ground for reconstruction of the motivational system, relationships and reintegration in the society. This, in the long term, provides better overall results in maintaining abstinence than “endless” treatment with opioid-based substitution therapy, which in essence is switching from one illegal opioid for another, legal opioid. By using standard approach OST (Outpatient Substitution Therapy) with Methadone or Buprenorphine we substitute one type of opioid addiction (Heroin) for another opioid (Buprenorphine or Methadone) which are both highly addictive substances.

Biography

Gray Surak is Director of NaltrexZone, Serbia. He is also Member at American Society of Addiction Medicine (ASAM) 2005-present Member at International Society of Addiction Medicine (ISAM) 2008-present, Member and co-founder at Serbian Society of Addiction Medicine (SSAM) 2010-present. Throughout his career he have participated in numerous conferences, public activities related to addictions and related disorders, both locally and internationally. These activities have resulted in collaborations with prominent groups and individuals actively involved in treatment of these crippling social and medical pathological conditions. He is the author/co-author on number of scientific research articles related to addictions and their medical and social consequences. These results were published and reported in scientific journals and conferences.

Speaker
Gary Surak / NaltrexZone Hospital, Serbia

Abstract

Pathological alcohol use affects more than 2 billion people and accounts for nearly 6% of all deaths worldwide. There are 3 medications approved for the treatment of alcohol use disorder by the US Food and Drug Administration (FDA); disulfiram, naltrexone (oral and long-acting injectable) and acamprosate. Acmprosate also approved from regulatory authorities in Japan. Of growing interest is the use of anticonvulsants for the treatments of alcohol use disorder, although currently none are FDA approved for this indication. Baclofen, a GABA-B receptor agonist, used for spasticity and pain, received temporary approval for alcohol use disorder in France. Despite having effective pharmacotherapies, only 10% of patients who are receiving any form of treatment are actually receivingpharmacotherapies for alcohol use disorder. The objective of this presentation is to provide knowledge on practice parameters for evidenced-based pharmacological treatment approaches in patients with alcohol use disorder.

Biography

Shirshendu Sinha M.B.B.S. is a Mayo Clinic trained addiction psychiatrist, Regional Chair and Senior Associate Consultant, Psychiatry and Psychology, Mayo Clinic Health System, SWMN Region; Assistant Professor, Psychiatry and Psychology, College of Medicine and Science, Mayo Clinic, MN, USA. He graduated from North Bengal Medical College and Hospital, West Bengal, India. He traveled across the continents and joined the division of Hematology as a post-doctoral research fellow at the Mayo Clinic, Rochester, MN. He later completed adult psychiatry residency training at University of Connecticut School of Medicine, Farmington, CT where he also served as Teaching/Academic Chief Resident. He subsequently completed clinical fellowship in addiction psychiatry at the Mayo Clinic, Rochester, MN. He has received awards from Janssen Academic Research Mentorship Program, American Society of Clinical Psychopharmacology, Neuroscience Education Institute and American Psychiatric Association Research Colloquium.

Speaker
Shirshendu Sinha / Mayo Clinic College of Medicine and Science, USA

Abstract

Scalable therapeutics that deliver expert quality, evidenced-based psychosocial treatment programs online are emerging as a new and powerful approach to treating mental illnesses, including addiction disorders. This novel care delivery model leverages recent and continuing advances in social networking, privacy and security, analytic, and artificial intelligence technologies to safely and affordably deliver complete programs of psychotherapeutic care with consistently expert quality to anyone with a treatable mental illness. It employs peer group-based scalable therapeutics, the standard of care in addiction treatment, to improve social functioning, increase program completion rates, and reduce relapse rates. Comorbid conditions, such as anxiety, depression and trauma, are concurrently treated. It is intended to support convenient and affordable access to care on a mass scale, reaching patients in many areas of the United States and around the world were there are no affordable options for safe and effective treatment because of seemingly insurmountable intrastructural barriers, including cost, stigma, the dearth of skilled psychotherapists, and adherence to traditional one-to-one psychotherapy. The recent emergence of this new treatment modality has the potential to transform the delivery of addiction care at a time when 90% of Americans suffering from drug use disorders cannot access specialty treatment because of shortages in the supply of care. This presentation will (i) report our experience and early proof of concept data with ongoing validation studies conducted at the UCSF Department of Psychiatry of this novel psychotherapeutic care services delivery model, and (ii) propose strategies for employing it in the treatment of addiction disorders.

Biography

Kim P. Norman, MD is the UCSF Distinguished Professor of Adolescent and Young Adult Health, UCSF Weill Institute for Neurosciences, University of California, San Francisco. Dr. Norman founded and directs the UCSF Young Adult & Family Center, whose research program studies scalable therapeutic methods for behavioral health. He also founded and advises the UCSF Eating Disorders Program and the UCSF Dialectical Behavior Therapy Program. Dr.Norman is an expert in the treatment of addiction in adolescent and young adult populations. He is an advisor to Salesforce.com and Tiatros Inc. Dr. Norman graduated from the Albert Einstein College of Medicine.

Speaker
Kim Norman / University of California, USA

Abstract

N-methyl-D-aspartate (NMDA) receptors, widely found in the mesocorticolimbic system, are critically involved in opioid addiction.On the other hand, opioid addiction may itself affect the expression level of NMDA receptor subunits. Existence of GluN3 subunits in the tetramer structure of NMDA receptor reduces the excitatory current of the receptor channel. Here we have evaluated the changes in the mRNA expression pattern of GluN3B subunits of the NMDA receptor in the rat brain following acute and chronic exposure to morphine. Chronic escalating intraperitoneal doses of morphine or saline were administered to male Wistar rats twice daily for 6 days. Two other groups were injected with an acute single dose of morphine (30 mg/kg) or saline, respectively. The mRNA level of GluN3B subunit of NMDA receptor in the striatum, hippocampus, and nucleus accumbens (NAc) was measured by real-time PCR technique. The mRNA expression level of GluN3B subunit was considerably augmented (3.15 fold) in the NAc of animals chronically treated with morphine compared to the control group. The difference between chronic morphine administered and control rats in other evaluated areas of the brain was not statistically significant. In acute morphine treated rats, no significant difference was found in the expression of GluN3B subunit in examined parts of the brain in comparison to the control group. It is concluded that chronic exposure to morphine notably increases the GluN3B subunit of the NMDA receptor in the NAc. The exact effect of this finding in the process of opioid addiction and its features needs to be more evaluated in the future.

Biography

Nasim Vousooghi became Pharm. D. At the age of 26 and completed her PhD of pharmacology at the age of 33 years from Shahid Beheshti University of Medical Sciences. She is working in the Department of Neuroscience and Addiction Studies at Tehran University of Medical Sciences from 2010 till now. She was the director of research deputy in the mentioned department in the years 2010-2017. She is also the head of the genetics laboratory of the Iranian National Center for addiction studies (INCAS). Her main area of interest is the molecular mechanisms of drug and behavioral addictions and genetics and epigenetics of drug abuse. She is also interested infinding biomarkers that may predict one’s vulnerability to drug addiction. She has published more than 40 papers in prestigious journals.

Speaker
Nasim Vousooghi / Tehran University of Medical Sciences, Iran

Abstract

Background The incidence of psychiatric disorders is higher among people who use substances than among people who do not. While strong evidence of gender differences in comorbidity of psychiatric and substance use disorder exists, there is a gap in understanding of different predictive factors for men and women. Biological and psychosocial differences between men and women influence the prevalence, presentation, comorbidity, and treatment of comorbidity. Research questions This study explored 1) gender differences in lifetime substance use and psychiatric disorders among people using different substances recruited from treatment and non-treatment settings; 2) risk factors for psychiatric disorders among substance users, independently by gender; and 3) associations between specific psychiatric disorders and specific substance use disorders, independently by gender. Methods Secondary analysis of five cross-sectional studies conducted in Barcelona, Spain during 2000-2006. Lifetime DSM-IV substance use and non-substance use psychiatric diagnoses were assessed using the Spanish Psychiatric Research Interview for Substance and Mental Disorders among 629 people who use substances (68% male) recruited from treatment (n=304) and out of treatment (n=325) settings. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression. Results The prevalence of any lifetime psychiatric (non-SUD) disorder was 41.8%, with major depression (17%) and antisocial personality disorder (17%) being the most prevalent disorders. After adjusting for age and study, the odds of having any lifetime non-SUD (OR 2.10; 95%CI 1.48, 2.96); any mood disorder (OR 2.13; 95%CI 1.46, 3.11); any anxiety disorder (OR 1.86; 95%CI 1.19; 2.92); any eating disorder (OR 3.09; 95%CI 1.47, 6.47); or borderline personality disorder (OR 2.30; 95%CI 1.36, 3.84) were greater for females than males. Females were less likely than males to meet criteria for antisocial personality disorder (OR 0.59; 95%CI 0. 36, 0.96) and attention deficit disorder (OR 0.37; 95%CI 0.17, 0.78). The prevalence of any lifetime substance-induced disorders was substantially lower (15%) than primary or independent psychiatric disorders (64%). Women who met criteria for a lifetime Axis I psychiatric disorder were more likely than those who did not to have ever been in prison or to be HCV sero-postitive; and for men lower educational attainment or ever been in prison (marginally significant) were associated with a lifetime axis I psychiatric disorder. Key conclusions Psychiatric disorders (mostly independent rather than substance-induced) are common among people who use substances, with gender differences reported for specific disorders. Gender-sensitive integrated treatment approaches are required to prevent and to address comorbidity psychiatric disorders among this population.

Biography

Yasmina Frem: Currently works as the project coordinator withina research team of multiple hospitals in the easternsuburbs of Paris. She graduated from Goldmsiths University of London with a masters in clinical psychology and health services, a year later she did a masters in the science of addictions at Kings college London. She moved to Paris in 2016, where she worked part time at a few hospitals while doing her cognitive behavioral therapy diploma. Her thesis of kings college was published and then presented at the first world congress of the world association on dual disorders in Madrid (march 2017)

Speaker
Yasmina Frem / King’s College London, UK

Abstract

Disrupting addictive lifestyles by healing the underlying trauma and pain through integrating spiritual and forgiveness therapy into the short-term and long-term treatment plan.

Biography

Paul F. Singh MA, LP is an addiction licensed psychologist and an international executive life coach in Beverly Hills, California-USA. Singh specializes in working with patients who have experienced PTSD, trauma and or abuse and are currently medicating those core issues with a lifestyle of multiple addictions, codependent relationships, anxiety, anger, depression and suicidal ideation. Singh has lectured at the former “Meet the Expert “ series at the Mayo Clinic in Rochester, Minnesota. Paul Singh has also been a preferred interventionist for the Betty Ford Clinic in Rancho Mirage, California. Paul has two private practices in Minneapolis, MN and Santa Monica, CA. Singh has spent much of his just about30-year clinical career developing short-term and long-term intensive therapy programs to accelerate the therapeutic treatment process. In 1989, Singh developed his first weekend intensive counseling program in Minneapolis, MN. The weekend was so efficacious for the patient that he designed a formal one-week clinical intensive counseling format, which he has now used for just about the last 30 years in clinical practice. Singh has also pioneered a unique holistic clinical and spiritual model, which integrates the human spirit, soul and body. He has written a self-help book on this model entitled, “Rekindling Your Spirit”. In this book, he addresses how most traditional therapy fails people. It targets only 25% of a person’s story. Who would seek surgery that removed just one-fourth of a cancer? Singh not only insightfully addresses the 25%, he skillfully unveils the remaining 75%. By understanding 100% of their pain and what they’re doing with it, people will no longer just be managing their symptoms. They’ll be healing from the inside out. Singh routinely uses the week intensive counseling format and his holistic clinical model with spiritual and forgiveness therapy to offer state-of-the-art addiction therapy to his patients. He has found that when addicts are in an accelerated intensive counseling week and understand how their individual spirituality can heal their core pain-new hope is birthed and realized. Lasting change comes from healing from the inside out. Singh’s newest book is entitled“Unrestrained HOPE: Touching the Ache of Your Struggle”. This upcoming self-help book is about how to overcome addictions by integrating addiction therapy with spiritual and forgiveness therapy. There is rock solid hope available to heal and change from the inside out.

Speaker
Paul F. Singh / Holistic Life Change International, USA

Abstract

INTRODUCTION: To accomplish the objectives of the FCTC, WHO has developed the MPOWER policy package which contains six important measures intended to advance tobacco control. These six measures are as follows: Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, Raise taxes on tobacco. Obviously complete implementation of these rules could substantially decrease the use of tobacco. AIM: The aim of study was to compare MPOWER programs among the countries of the 6 WHO regions to highlight what has been achieved and what till needs to be addressed by the countries to strengthen these programs and also to find the best parties on it. METHODOLOGY: This was a cross-sectional study by filling out a validated check list from the data on pages 138 to 149 of the 2017 WHO MPOWER report. A checklist of 10 indicators such as 6 plus 1 policy in MPOWER, 1 adult daily smoking prevalence and 2 compliance, was initially designed by Iranian and international tobacco control specialists which was validated in 2 studies. There were 7 questions with 5 options ranging from minimum 0 to maximum 4 scores, and 3 questions ranging from minimum 0 to maximum 3 scores. Each point, for which data was not available (NA), would be scored as 0. So, the total possible score was 37 (7*4 + 3*3. The scores were compiled by two raters separately, and compared and confirmed by third person as acting supervisor. Two raters administered the assessment, and the Interclass Correlation Confidence (ICC=0.85) was use to assess agreement between the two rater. The scores were summed and the rankings were computed. FINDINGS: Countries which had at least 85% of total score (32 from 37) and percentage by the regions were as below: AFRO: Seychelles and Mauritius 33, 2 from 47 countries, 4.2% of region AMRO: Costa Rica 36, Brazil and Panama 35, Surinam and Colombia 34, Canada Uruguay and Argentina 33, 8 from 35 countries,22.8% of region SEARO: non EURO: United Kingdom and Turkey 36, Portugal Russia Ireland 33, Romania Estonia Denmark Spain and Norway 32, 10 from 53 countries, 18.8% of region EMRO: Iran 34, 1 from 22 countries, 4.5% of region WPRO: Australia 35, New Zealand 34, 2 from 27 countries, 7.4% of region These 23 countries may indicate as a best model for other parties to implementation and enforcement of tobacco control program. Comparison of scores of different countries in this respect can be beneficial since it creates a challenge for the health policy makers to find weakness of the tobacco control programs to work on it. The highest mean points were scored by Europe (26.41) and in the other regions were as below: South-East Asia (25.09), West Pacific (24.88), America (22.05), East Mediterranean region (21.40) and Africa (17.40); There was a significant differences (p<0.05) for means in this regard. CONCLUSION: Comparison of scores of different countries in this respect can be beneficial since it creates a challenge for the health policy makers to find weakness of the tobacco control programs to work on it. This kind of comparison could create a stronger incentive for tobacco control concerned authorities in different countries to consider adopting more of the MPOWER package policy in the future.

Biography

Gholamreza Heydari currently is director of Tobacco Prevention and Control Research Center and WHO Collaborating Center on Tobacco Control in Eastern Mediterranean region and also chairman and editor in chief of monthly tobacco control journal in Iran. Heydari completed his MD in 1996 and he had MPH and PhD degree on epidemiology from Shahid Beheshti University of Medical Sciences.

Speaker
Gholamreza Heydari / Shahid Beheshti University of Medical Sciences, Iran

Abstract

Addictions to psychotropic drugs represent a major public health problem. They are often the result of inappropriate prescriptions. Among the psychotropic drugs, benzodiazepines and the like have a very marked addictive potential. 20% of the French population has received at least once a benzodiazepine or related prescription. 60% of these subjects are women. The harmful use of health results in the occurrence of medical complications or prolonged social repercussions. Dependence must be recognized as a major risk for treatment for more than one month, which is what should guide the prescription or not of a BZD . If addiction is established for patients treated in the long term, it will be difficult to withdrawal these patients otherwise than by hospitalization. This is the reason why many elderly people continue to benefit from poorly adapted treatment by BZDs. Many patients are able to take BZDs for a short period of time provided the practitioner fully explains the issues. The corollary is therefore that they should not be prescribed if the minimum level of understanding is not reached. In case of dependence, there is a risk of abrupt cessation syndrome. The principle of care is based on weaning, which must be very progressive and is most often outpatient. Prevention is based on good patient education and compliance with good clinical prescribing practices.

Biography

Michel Bourin has held the position of Professor of Pharmacology at the University of Nantes since 1985. After completing his pharmacist and medical training at Tours University he was awarded degrees in neuropsychopharmacology, clinical pharmacology and general pharmacology in Paris and completed his psychiatric training in Nantes.Since 1988, Professor Bourin has been Head of Research: Neurobiology of Anxiety and Depression. He has also served as an Adjunct Professor in the Department of Psychiatry at the University of Edmonton (Alberta) since 1995 and visiting Professor at University of Craiova (Romania). He is Doctor Hononoris Causa of the University of Tartu (Estonia) and University of Craiova (Romania)He is now Psychiatrist in a centre for mental handicapped adults in Montredon (near Narbonne) He has published more than 300 original papers in the field of psychopharmacology and more than 250 educational/review papers both in French and English.

Speaker
Michel Bourin / University of Nantes, France

Abstract

Addiction is a serious medical and mental health disorder. It is a universal problem, all countries/societies suffer a lot from addiction. However, addiction is not an arbitrary behavior, there are mechanisms beyond, while these mechanisms are well-known/addressed,the management will be as easy as it is expected. Treating addiction requires phases:- 1. Detoxification, making the body is free from toxics. 2. Psychological interventions, focusing on individual psychological mechanisms behind addiction and intervening them. 3. Psychosocial rehabilitation, normalizing addicts life in order to be normal. 4. Relapse prevention, aiming at promoting healthy behaviors and preventing recurrences of addictive behavior. Stigma refers to the disapproval and shame felt by lay people towards people exhibiting addictive behaviors. There is an impact of stigma on people with substance abuse, stigma influences seeking mental health services and participating on care from addicts side, moreover stigma affects social distances dealing with addicts,making their life is miserable, which may lead conversely to fuel more drugs use. However, stigma spreads out over the world, it may be fluctuating ups and downs due to social and cultural variations/backgrounds. This presentation attends to focus on stigma across-culturally and the impact of stigma on seeking and participating in mental health care. Moreover, destigmatization will be discussed for lives without drugs.

Biography

Saeed Wahass is Ph.D. degree holder in Clinical Psychology from the Department pf Psychiatry, Faculty of Medicine, Sheffield University with Post-Doctorate in Neuropsychology from the Department of Psychological Medicine, Faculty of Medicine, Glasgow University. Academically, He is an Associate Professor of Behavioral Sciences in Medicine, teaching behavioral sciences for medical students and residents. Saeed Wahass practicing clinical psychology and Neuropsychology as a Subspecialty Consultant. Saeed Wahass is Coordinator of the Division of Behavioral Sciences in Medicine. Moreover, he is teaching masters students in Clinical Psychology, supervising them in practices and research projects. Saeed Wahass an Associate Fellow of the British Psychological Society and an Affiliate Member of the American Psychological Association. Saeed wahass a Licensed Practicing Psychologist within the Health and Care Professions Council, UK and the Saudi Commission for Health Specialties, Saudi Arabia

Speaker
Saeed Wahass / Immam Abdulrahman Bin Faisal University, Saudi Arabia

Abstract

Drug abuse is a common problem in Palestine due to the political, financial, and complicated social status of the country. There are limited resources, specialists and scarcity in facilities that deal with drug addiction. Clonix is a drug prescribed for anxiety disorders and antiepileptic and as a mood stabilizer. This drug is highly abused by patients and has caused addiction problems. This presentation describes three case reports of clonix addiction and discusses the management protocols for such cases.

Biography

Speaker
Ziad Arandi / Palestinian Psychiatric Association, Palestinian

Abstract

Background: Depression is the most common mood disorder in the world, and is an important cause of suicide, burden of disability, dissatisfaction, loss of social function, morbidity and mortality worldwide, reduce quality of life, and increased mortality and desire for hastened death, yet is widely undetected, undiagnosed and untreated. It affects the treatment and prognosis of diseases. Methods: A meta-analysis has conducted of more than two hundred studies using the method to evaluate and treat depression for make available to health care providers a simpler and faster method for evaluate and treat the burden of depression in the world. Results: The PHQ-2 (Patient Health Questionnaire) and BDI-FS (Beck Depression Inventory-Fast Screen) are not only valid instruments for depression in university life, primary care, daily clinical practice but also in mental health settings and wartime. These two brief tools can easily be implemented into daily clinical practice. The SIHS (Suicidal ideation and hopelessness scale) allows us to evaluate suicidal ideation, desire for suicide and hopelessness related with depression. The brief psychotherapy (positive thoughts, cognitive and physical activities, relaxation, and music therapy) have the biggest impact on depression in all population and are the most efficient, most reliable and safest in the world. Conclusions: Conclusions: Depression is associated with global burden. Yet there are few clinical trials on treating depression in population and no agreed recommendations for its assessment and follow-up. We present evidence-based recommendations for screening, diagnostic and therapy of depression in all people in world under any conditions.

Biography

Muaweah Ahmad ALSALEH has completed his PhD from University of Caen Normandy, France and psychology researcher studies from CHU of Caen, France. He has completed his MS psychological studies from University of Aleppo, Syria and MS health ethics from University of Caen Normandy, France. He has published more than 25 papers in reputed journals and has been serving as an editorial and reviewer board member of repute.

Speaker
Muaweah ALSALEH / University de Caen Normandie, France

Sessions:

Abstract

The traditional, fixed, episodic treatment interventions for youth with alcohol and other substance use disorders (AOSUD) have overlooked the most urgent challenges facing treatment including the:1) heterogeneity of response to treatment, 2) problem of poor response, and 3) difficulty to prevent relapse regardless of treatment modality. This workshop will be based on a sequence of studies that have been conducted by Dr. Kaminer and his collaborators in other U.S.A. universities. This will include: providing rationale and updated review of continuity of care (COC) in youth; addressing the importance of Adaptive Treatment (AT) approach as an integral part of COC; and discuss challenges in advancing the field including research with poor responders with or without Co-occurring psychiatric disorders (i.e., Dual Diagnosis). Continued research of predictors of outcomes (including biological and personality based factors),mechanisms of behavioral change (MOBCs), and integrated treatment modalities algorithms will be addressed in order to improve outcomes of a highly heterogeneous population of adolescents with AOSUD.

Biography

Yifrah Kaminer was promoted to a Professor of Psychiatry in 2003. Kaminer was a Clinical Associate Professor of Psychiatry from 1991 to 1993 at the adolescent substance abuse treatment program at Bradley Hospital, and faculty on the Alcohol and Addictions Studies Center, Brown University. In 1994 year Kaminer was appointed as an Associate Professor at the Department of Psychiatry and the Alcohol Research Center, University of Connecticut Health Center, Farmington.Yifrah Kaminer Completed a combined General, Child and Adolescent Psychiatry residency and then enrolled in a Child and Adolescent Psychiatry clinical research fellowship at Bradley Hospital, Brown University. Yifrah Kaminer founded and directed the youth substance abuse treatment program from 1988 to 1990 at Western Psychiatric Institute and Clinic, Pittsburgh, PA, as an Assistant Professor of Psychiatry.

Speaker
Yifrah Kaminer / University of Connecticut School of Medicine, USA

Abstract

Background and objectives: The objectives of this study were to ascertain the pattern of grey and white matter volume reduction and regional metabolic and activation abnormalities in chronic ketamine users, and to evaluate the correlations between these brain abnormalities and cognitive impairments in chronic ketamine users in Hong Kong. Design: Cross-sectional observational study. Setting: Counselling Centre for Psychotropic Substance Abusers in Hong Kong. Participants: One hundred and thirty-six participants were recruited from October 2011 to April 2014. The participants were divided into two groups: ketamine users (79) and healthy controls (57). Main outcome measures: Psychiatric assessments included screening with self-rating questionnaires and face-to-face interviews. All of the participants completed a detailed cognitive battery that covered general intelligence, verbal and visual memory, executive functions, motor speed and language. All of the participants underwent magnetic resonance imaging of the brain. Results: Many of the participants in the ketamine group also frequently used cocaine and cannabis. Among the ketamine users, 12.6% were diagnosed with a mood disorder and 8.9% with an anxiety disorder. The participants in the ketamine group had worse performance than the healthy controls on tests of general intelligence, verbal, visual and working memory and executive functioning. In terms of grey matter volumes, the right orbitofrontal cortex, right medial prefrontal cortex, left and right hippocampus and possibly the left orbitofrontal cortex were smaller in the ketamine group. In contrast, the volumes of the left basal ganglia, left putamen and possibly the left caudate were higher in the ketamine group. In terms of white matter volumes, the ketamine group had a lower periventricular white matter volume in the right hemisphere. The grey matter volumes of the left and right orbitofrontal cortex, right medial prefrontal cortex, left basal ganglia and left putamen, and right periventricular white matter volume were negatively correlated with the severity of ketamine dependence. The hippocampal volumes were correlated with performance on the arithmetic, information and digit span tests. The periventricular white matter volume also correlated with the information score. A functional connectivity examination of the default mode network revealed significantly decreased connectivity in the medial part of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral gyrus rectus, left superior temporal pole, left inferior temporal gyrus, bilateral angular gyrus and bilateral cerebellum crus II in the ketamine group. This group also displayed increased connectivity in the bilateral precuneus and right inferior occipital gyrus. Conclusions: The results provide imaging evidence of brain damage in chronic ketamine users. Chronic ketamine use was associated with reduced grey and white matter volumes in certain regions of the brain. Chronic ketamine use was also associated with altered functional connectivity with the default mode network. Abnormal brain structures and altered functional organisation of the brain network may underlie the hypersensitivity towards drug related cues but weakened cognitive control in those with ketamine addiction. Longitudinal or prospective studies would help to strengthen the evidence on the reversibility of the structural and functional brain damage caused by ketamine.

Biography

Wai Kwong Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke.WK Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong.

Speaker
Wai Kwong Tang / Chinese University of Hong Kong, Hong Kong

Abstract

The Competitive State Anxiety Inventory-2 Revised (CSAI-2R), is one of the most frequently used instruments in the evaluation of situational anxiety in sports competition. Objectives: The objective of this study was to validate the Tunisian version based on the French version of the Competitive State Anxiety Inventory-2 Revised (CSAI-2R), including the direction and the frequency scales. Method: 418 athletes ranging in age from 14 to 34 years in different individual and team competitions, volunteered to participate in the study. Data were collected and analyzed for reliability and validity using the test-retest method, reliability, correlation analysis and confirmatory factor analyses. Statistical analysis was performed with SPSS and the IBM AMOS version 21.0.0. Results: The Confirmatory factor analyzes showed acceptable adjustments for the 3-factor model of CSAI-2R. For the intensity model [X2=343.19; X2/df=3.40; CFI=0.92; TLI=0. 90; GFI =0.91; RMSEA=0.076; p-value<0.001]. for the direction model [X2=360.83; X2/df=3.57; CFI=0.93; TLI=0.92; GFI=0.90; RMSEA=0.079; p value<0.001]. And for the frequency model [X2 =140.31; X2/df=2.58; CFI=0.93; TLI=0.92; GFI =0.92; RMSEA=0.062; p-value<0.001]. And a good internal coherence of three scales was between 0.76 and 0.90. Conclusion: This study provides support for the reliability and validity of the Tunisian version based on the French version of CSAI-2R, including the direction and the frequency scales. Among others the Tunisian version has demonstrated robust psychometric properties and can be used in other investigation.

Biography

Jamel Hajji was PhD student at Department of Sciences Education, Faculty of Humanities at Tunis, University of Tunis, Tunisia Teacher researcher at Higher Institute of Sport and Physical Education Gafsa, Gafsa University, Gafsa, Tunisia Research unit "ECUMUS", Faculty of Arts and Humanities of Sfax, University of Sfax, Tunisia

Speaker
Hajji Jamel / University of Tunis, Tunisia

Abstract

Recreational use of anabolic androgenic steroids is growing public health problem yet it remains poorly studied in Saudi Arabia. This study was conducted to assess the prevalence, knowledge and attitude of Gym members towards AAS in the city of Riyadh. Methods: This is a cross-sectional study that was carried out among male gym members at the Riyadh region from March to October 2016. 20 gyms were selected randomly from 4 different regions of the city and 482 subjects responded to the self administered anonymous questionnaire. The Questionnaire included sections covering socio-demographic data as well as data regarding, knowledge, attitude and behavior regarding using AAS. Results: Out of 482 subjects who responded to the question have you ever used AAS, (29.3%) responded positively. The mean(SD) age of study participants was 27.2(6.9) years. We found that AAS use was more prevalent in participants who are above 25 years of age, privately employed, practice weight lifting, use supplementary vitamins, have friends who use AAS, were offered to use AAS and those who use psychoactive drugs. Coaches were the main source for obtaining AAS and most study participants believed that it is easy to obtain AAS. The majority of study participants had a significant lack of knowledge regarding the adverse effects of AAS use.

Biography

Speaker
Fares Alharbi / King Abdulaziz Medical City, Saudi Arabia

Abstract

The dysfunctional management of controlled medications reflects the abandonment of the Hippocratic Oath as the major mode of medical practice. Wanton prescribing and pill-mills are at one extreme while abandonment of medication dependent chronic atypical polysyndromic patients is the other extreme. The self-righteous grandiosity of politicians, addictionologists and pharmacists imposing dogma, because of incomplete understanding of the full range of patient needs, has created this bi-polarity of causes and effects. A return to the Art and Science of Hippocratic Medicine is needed.

Biography

Samuelis working as a Research Scholar from Case Western Reserve University School of Medicine, Ohio, USA. His/Her research experience includes various programs, contributions and participation in different countries for diverse fields of study. His/her research interests as a Research Scholar reflect in his wide range of publications in various national and international journals.

Speaker
Samuel A. Nigro / University School of Medicine, USA

Abstract

Scalable therapeutics that deliver expert quality, evidenced-based psychosocial treatment programs online are emerging as a new and powerful approach to treating mental illnesses, including addiction disorders. This novel care delivery model leverages recent and continuing advances in social networking, privacy and security, analytic, and artificial intelligence technologies to safely and affordably deliver complete programs of psychotherapeutic care with consistently expert quality to anyone with a treatable mental illness. It employs peer group-based scalable therapeutics, the standard of care in addiction treatment, to improve social functioning, increase program completion rates, and reduce relapse rates. Comorbid conditions, such as anxiety, depression and trauma, are concurrently treated. It is intended to support convenient and affordable access to care on a mass scale, reaching patients in many areas of the United States and around the world were there are no affordable options for safe and effective treatment because of seemingly insurmountable intrastructural barriers, including cost, stigma, the dearth of skilled psychotherapists, and adherence to traditional one-to-one psychotherapy. The recent emergence of this new treatment modality has the potential to transform the delivery of addiction care at a time when 90% of Americans suffering from drug use disorders cannot access specialty treatment because of shortages in the supply of care. This presentation will (i) report our experience and early proof of concept data with ongoing validation studies conducted at the UCSF Department of Psychiatry of this novel psychotherapeutic care services delivery model, and (ii) propose strategies for employing it in the treatment of addiction disorders.

Biography

Kim P. Norman, MD is the UCSF Distinguished Professor of Adolescent and Young Adult Health, UCSF Weill Institute for Neurosciences, University of California, San Francisco. Dr. Norman founded and directs the UCSF Young Adult & Family Center, whose research program studies scalable therapeutic methods for behavioral health. He also founded and advises the UCSF Eating Disorders Program and the UCSF Dialectical Behavior Therapy Program. Dr. Norman is an expert in the treatment of addiction in adolescent and young adult populations. He is an advisor to Salesforce.com and Tiatros Inc. Dr. Norman graduated from the Albert Einstein College of Medicine.

Speaker
Kim P. Norman / University of California, USA

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