Cesar A. Fabiani MD's Books

LIBERATION FROM ADDICTION

By: Cesar A. Fabiani, MD

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Liberation from stigma is the first step in freeing from addiction. Historical and clinical scientific considerations of alcohol, cocaine and stimulants are reviewed. As an example of stigma, E.O'Neill's master-piece playwright "Long Day's Journey Into Night" is given. Primary, secondary and terciary prevention of addiction with evidence based pharmacological treatment of alcohol, cocaine and other stimulants and opiates addiction is discussed. Especial attention is given to simultaneous and combined pharmacotherapy of addiction and co-occurring disorders. The new Portugal law which decriminalizes addiction and captures liberation of stigma is reviewed. Ending with the movie "Flight" which embraces the concept of freedom from addiction and stigma.

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190

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Xlibris Corporation

Published Date

ISBN 10

1483630269

ISBN 13

9781483630267

Addictions And Buprenorphine

By: Cesar A. Fabiani, MD

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Addictions And Buprenorphine

By: Cesar A. Fabiani, MD

This book starts with the Celtic cross as a symbol of faith and peace. It emphasizes the biopsychosocial medical model for the treatment and prevention of this chronic illness we call addiction versus criminalizing them. What we do not know enough is the spiritual or astral aspects of it, for instance, the use of acupuncture among addicted persons who may have several medical and psychiatric comorbidities. Hopefully in the future, we will. Meantime, nothing replaces the physician acumen to select the appropriate patient for the appropriate type of treatment. “One size does not fit them all.” Each addicted person is a challenge and different from the next one. To treat them with the utmost respect and acknowledging their suffering of a severe medical illness should be our motto. It describes historical, genetic, and neurochemical as well as clinical aspects of the three more common addictions: alcohol, cocaine, and opiates. It also makes reference to their usefulness among nonaddicted persons where moderation is the name of the game. It claims that buprenorphine is the best medication currently available for the treatment of opioid addiction, which should be used only in the appropriate patient plus all the supports available to help addicted persons achieve “a spiritual awakening,” which will help them succeed in their recovery, becoming productive members in our society.

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Xlibris Corporation

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ISBN 10

1469158655

ISBN 13

9781469158655

Addiction the Enigma of Stigma?

By: Cesar A. Fabiani MD

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Addiction the Enigma of Stigma?

By: Cesar A. Fabiani MD

Substance use disorder is a legitimate medical disorder with its locus in the pleasure centers of the brain. People who have addictions frequently also have medical and psychiatric comorbidities that complicate their addictions. With perseverance, all of these challenging disorders can be prevented and treated. Prevention can be classified as primary, secondary, and tertiary. The sine qua non of treatment and prevention is the biopsychosocial model. Classification is crucial in science. As an example, the DSM-5 publication has been an important scientific achievement. In it, Substance- Related and Addictive Disorders can be diagnosed using the four Cs: craving, control (loss of), compulsion, and use despite negative consequences. Thanks to pharmacogenetics and epigenetics in the future, the high risk for different addictions can be clarified. Tragic cases of celebrities can be changed, and their triumphs celebrated instead of their deaths mourned from substance use disorders. Examples of tragic cases in the past are Ernest Hemingway, whose family also suffered five suicides (including Hemingway himself), and Eugene ONeill with three suicides in his family. On the other hand, Bob and Bill W., Betty Ford, and Robert Downey Jr. and Drew Barrymore all succeeded in their fights against addiction. As far as I know, Hemingway and ONeil were never told they had an alcohol use disorder and were never referred to AA. Although it is speculation, if both authors and their families were treated with lithium (used for mania first in Australia in 1949 and approved for the treatment of mood disorders in the United States in 1972) or, in the future, ketamine, their suicides could have been prevented. Bob Smith and Bill Watson, who experienced a spiritual transformation experience, were able to abstain from alcohol for the rest of their lives. Evidence-based studies can be used along with FDA-approved addiction medication as part of the biopsychosocial model. For alcohol use disorders, three medications are recommended: disulfiram, acamprosate, and naltrexone. The key is determining which medication is indicated for a specific patient. For cocaine and stimulant use disorders, FDA-approved medications for the treatment of ADHD are an alternative for patients trying to self-medicate with cocaine. For opiate use disorders, three other medications are also FDA-approved: naltrexone, methadone and buprenorphine. I favor buprenorphine due to the fact that is a partial mu blocker (the mu receptor is the most important analgesic opiate receptor)the risk of respiratory depression in cases of overdosing is low, and the success rate is high. Buprenorphine can be paired with naloxone, which is an opiate blocker, to prevent the illegal distribution. Kits with naloxone, Evzio (brand name of naloxone 0.4-milligram auto-injector), are being distributed to patients and family members, making it a life-saving medication similar to EpiPen for the treatment of anaphylactic shock. In order to diminish the risk of diversion, many deterrent techniques are being developed by manufactures of opiates. All these precautions will be almost superfluous if an implantable version of buprenorphine becomes available. Effective and updated medical education is the best antidote against stigma. Above all, all patients with substance use disorders should be treated with respect and humane care.

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241

Publisher

Xlibris Corporation

Published Date

ISBN 10

1514403749

ISBN 13

9781514403747

Addiction the Enigma of Stigma?

By: Cesar A. Fabiani MD

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Addiction the Enigma of Stigma?

By: Cesar A. Fabiani MD

Average ratings

N/A

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Solve jigsaw puzzle

Age

Page Count

241

Publisher

Xlibris Corporation

Published Date

ISBN 10

1514403749

ISBN 13

9781514403747

Book's by Cesar A. Fabiani MD

LIBERATION FROM ADDICTION

LIBERATION FROM ADDICTION

Addictions And Buprenorphine

Addictions And Buprenorphine

Addiction the Enigma of Stigma?

Addiction the Enigma of Stigma?

Addiction the Enigma of Stigma?

Addiction the Enigma of Stigma?

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