The Statistics of Addiction:
Almost 80 percent of individuals suffering from a substance use disorder in 2014 struggled with an alcohol use disorder, NSDUH
Over 7 million Americans in 2014 battled a drug use disorder, per NSDUH.
One out of every eight people who suffered from a drug use disorder in 2014, according to NSUDH, struggled with both alcohol and drug use simultaneously.
Addiction & Genetics
What is Addiction?
Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life.
They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available, and people can recover from addiction and lead normal, productive lives. People with a substance use disorder have distorted thinking, behavior, and body functions.
Changes in the brain’s wiring are what cause people to have intense cravings for the drug and make it hard to stop using the drug. Brain imaging studies show changes in the areas of the brain that relate to judgment, decision making, learning, memory, and behavior control.
These substances can cause harmful changes in how the brain functions. These changes can last long after the immediate effects of the drug — the intoxication. Intoxication is the intense pleasure, calm, increased senses, or a high caused by the drug. Intoxication symptoms are different for each substance. Over time people with addiction build up a tolerance, meaning they need larger amounts to feel the effects.
Symptoms of substance use disorder and addiction are grouped into four categories:
Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use
Risky use: substance is used in risky settings; continued use despite known problems Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use
Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use
Drug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance)
Do you have a drug problem? Take this test
Other symptoms of substance abuse problems include:
Addictions can include a number of substances, such as opioid pain killers such as codeine, oxycodone, heroin, and others, as well as stimulants such as amphetamines, MDMA, and cocaine. Sedatives can be abused as well, such as muscle relaxers, alcohol, and valium-like medication.
Addiction is a disease, not a choice. It is a disease that hijacks the reward systems of the brain, resulting in compulsive use despite negative consequences. If it was a choice alone, I could simply write a prescription that says, “stop it.” and the job would be done.
Depression, Nervousness, Anxiety, Restlessness, Low Mood, Mood Swings/Moodiness, Lack of Motivation, Lack of Interest, Sleeplessness, Excessive Sleepiness, Fatigue, Body Aches, Lack of Energy, Lack of Concentration, Short Attention Span, Increased or Decreased Appetite, Obsessive Thoughts, Obsessive Eating or Eating Disorders, and changes in Weight.
Treatment of your Addiction:
The treatment varies depending on the type of addiction. You will receive a thorough history and physical to determine the nature of the problem so we can devise the best course of action and treatment plan.
As there are multiple addiction possibilities as well as co-occurring mental health issues, you may need to have a referral to evaluate and treat further mental health problems
Web-based visits (telemedicine) are available for continued care, so not all of your appointments need to occur in the office.
There are a number of treatment options for opioid addiction which include Suboxone (Buprenorphine), Zubsolv, injectable Buprenorphine (Sublocade) , and Vivitrol Therapy
Suboxone (Buprenorphine | Zubsolv) is a commonly used approach to decrease cravings and prevent relapse. Medication assisted therapy with Suboxone is proven and safe. Suboxone can allow for pain management in some individuals while preventing relapse and cravings. Suboxone partially turns on the opioid receptors but blocks maximal effects of opioids, thus placing a ceiling on any additional pain medicine or opioid you may try to add. It prevents relapse and overdosing.
We are not a methadone clinic, so we do not use methadone for opioid dependence
The best options for each case varies and is evaluated individually. For those that are seeking ‘detox’ off all opioids, Vivitrol therapy, a once a month injection, is the best option. This insures compliance in that no pain medications (opioids) can be taken to overcome the injection and prevents overdoses. Likewise, Vivitrol also diminishes cravings for opioids.
Oral Naltrexone, an opioid blocker, is also a possible treatment option, however, it requires compliance in order to maintain appropriate levels. It blocks the actions of opioids such as heroin, fentanyl, or oxycodone. The effects of a dose of the medication can last 1-2 days.
Injectable Sublocade is buprenorphine that is injects under the skin in the abdominal area once a month. It prevents withdrawals and diminishes cravings. Many insurances cover the actual medication less the cost of the doctor visit and the co-pay for the medicine.
We also evaluate for insomnia-related issues as well as mood and cravings, treating with medications and nutraceuticals (nutritional supplements) that allow better nutrition, energy, and sleep. Healthy eating habits, appropriate sleep, exercise, vitamins and herbal therapies can boost energy, immunity, sleep patterns, decrease pain related complaints, and enhance your wellness.
We offer IV NAD therapy as an option to detox from alcohol and Opioids. This multi-day therapy involves an infusion of NAD, the energy and ‘anti-aging’ molecule to prevent cravings, decrease withdrawal, and enhance health.
IV Vitamin Therapy is also helpful in cases where poor nutrition from addictions have resulted in deficiencies that cause you to produce less dopamine (the ‘reward molecule’) and serotonin (‘the happiness molecule’).
We also can arrange comprehensive metabolic and pharmacogenomic studies to evaluate the best medications to treat addiction, depression, mood-related issues, and other complicating problems.
While you are in treatment, we will refer you for the counseling of your choice and needs as we have an extensive referral base. Cognitive Behavioral Therapy can be useful in the recovery process. We have a panel of providers you can chose from.
We recommend AA (Alcohol Anonymous) and NA (Narcotics Anonymous) 12 step programs as part of the recovery process.
For those with stable co-occurring disorders, such as depression, anxiety, ADHD, or other issues, we can manage those within the practice as well. There are additional fees for the management of other disorders with the addiction treatment.
Do you have an alcohol problem? Take this test: MAST Test or CAGE Questionnaire
We provide FDA approved and off-label treatment for alcohol use disorders
Naltrexone therapy (oral and injectable Vivitrol) are options for blocking receptors involved with the reward effect of alcohol. The Sinclair method is one option of treatment for alcohol disorders. Naltrexone tablets can be taken before you go out to diminish cravings and abuse of alcohol in social settings. This is a form of harm-reduction, in which the goal is to curtail drinking when the person does not want to abstain.
Once a Month Vivitrol injections, as used in opioid addiction, also works for alcohol addiction. A single 380 mg injection in the buttocks can diminish the urge to drink tremendously.
Soberlink and ReSet are two other options to maintain sobriety. Soberlink maintains accountability for drinking by monitoring home use through an iphone App that acts as a breathalyzer. ReSet is a form of on-line cognitive behavioral therapy that involves FDA approved software on an iphone –type platform.
There are multiple other options for alcohol treatment, including FDA approved acamprosate, which diminishes cravings, as well as Antabuse, which causes vomiting when alcohol is consumed and hence is considered an aversive therapy. Both can be added to other therapies to maximize outcomes.
We also offer additional therapies to treat alcohol addiction, including Gabapentin, Baclofen, Topiramate, Prazosin, Varenicline, and others that decrease urges to drink. These are not FDA approved but have shown efficacy when combined with other therapies to allow successful detox.
Alcoholics Anonymous (AA) is recommended for any successful treatment plan. The 12 steps have a proven record of success in recovery.
While you are in treatment, we will refer you for the counseling of your choice and needs as we have an extensive referral base. Cognitive Behavioral Therapy can be useful in the recovery process. We have a panel of providers you can chose from.
We also can arrange comprehensive metabolic and pharmacogenomic studies to evaluate the best medications to treat addiction, depression, mood-related issues, and other complicating problems.
IV Vitamin Therapy is also helpful in cases where poor nutrition from addictions have resulted in deficiencies that cause you to produce less dopamine (the ‘reward molecule’) and serotonin (‘the happiness molecule’). Our Vitamin therapies can be tailored to your needs and include high dose vitamin C, B complex, magnesium, zinc, selenium, Calcium, thiamine, and other nutrients to replenish what you have lost during an addiction.
We offer IV NAD therapy as an option to detox from alcohol and Opioids. This multi-day therapy involves an infusion of NAD, the energy and ‘anti-aging’ molecule to prevent cravings, decrease withdrawal, and enhance health.
For those with stable co-occurring disorders, such as depression, anxiety, ADHD, or other issues, we can manage those within the practice as well. There are additional fees for the management of other disorders with the addiction treatment.
We also evaluate for insomnia-related issues as well as mood and cravings, treating with medications and nutraceuticals (nutritional supplements) that allow better nutrition, energy, and sleep. Healthy eating habits, appropriate sleep, exercise, vitamins and herbal therapies can boost energy, immunity, sleep patterns, decrease pain related complaints, and enhance your wellness.
Dr. Sendi is Board Certified in Obesity Medicine. He offers medical weight loss options, which include Optifast, IV Vitamin weight loss options, and diet medication support.
Some patients with food cravings, excess weight, and post-gastric bypass surgery suffer from co-occurring addictions such as alcohol or opioid use disorders. These too can be evaluated in conjunction with other medical issues.
What is offered:
- Evaluation with metabolic assessment through state–of–the–art resting metabolic rate testing and bioimpedance measurements to assess fat mass, metabolic rate, muscle mass, and cell health.
- Comprehensive lab evaluation and nutrigenomic testing to guide treatment and assess metabolic and inflammatory risk. Dr. Sendi is a member of the National Lipid Association and has completed their Master’s Course, to which end he can provide cardiac risk assessment through lipid and inflammatory marker testing and provide guidance for treatment.
- Dietary Counseling through web-based services
- Counseling for Ketogenic dieting
- Medical meal replacement through Optifast and Nutrimed
- Assessment and intervention on Vitamin and mineral deficiencies, with IM, IV, and oral replacement therapies.
- Medication for weight loss: Phentermine, Lorcaserin, Contrave, and others both FDA and non-FDA approved.
- MIC and Semorolin injections for weight loss.
The Here-to-Help Program is a support program provided by the manufacturers of Suboxone at no cost to patients. Click on this Link to get additional support from Here-to-Help
Attending Narcotics Anonymous (NA) Meetings is recommended for patients recovering from narcotic dependence and addiction. The best way to locate a meeting is by contacting your local helplines and accessing websites which have up-to-date information regarding meetings in your area. Click here to access local NA sites: NA Meetings
Mental Health Resources: The community Service Board offers some free services for those who qualify: CSB Link
Alcoholics Anonymous: Attending AA meetings is strongly recommended for patients recovering from alcohol dependence and addiction. Click on one of the following to locate one near you: Virginia | Maryland | Washington, D.C
Smart Recovery: Meetings for sobriety and addiction help. Find meetings at this link.
Psychiatrists | Psychology Support: Psychologists (also called therapists or counselors) and psychiatrists can play a vital role in your recovery.
Psychologists are mental health professionals who help patients explore emotional and psychological issues that may have been at the root of their addiction. They also help patients develop healthy coping skills in order to get rid of the triggers often present among substance abusers.
Psychiatrists are physicians specialized in mental health. They are trained to diagnose and treat behavior health problems such as depression, anxiety, attention deficit disorders, bipolar disorders and other conditions commonly found in patients suffering from substance abuse.
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