Cesar Fabiani's Books

E Pluribus Unum

By: Cesar Fabiani

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This book describes the importance of America being unitede pluribus unumaccording the original US motto. It contrasts what happened in the United States with the rest of the Americas. The United States, because of its manifest destiny or exceptionalism, one common language, and immigration assimilation, is a nation that, because of its union, should be emulated. Following geographical distribution, only three Americas should exist: North America (Canada, United States, and Mexico), Central America, and South America, which could be seen in figure 3. It starts with the United States of North America; the English colony; the American Revolution in 1776; its founding father, George Washington; and Abraham Lincoln. Then more recently, Barack Obama and Donald J. Trump are reviewed as well as their titanic efforts to maintain the union. This union was achieved after the original thirteen colonies were expanded with the Mexican-American war, the purchase of Louisiana and Florida, and the annexation of Alaska, Texas, and Hawaii. It triplicated its surface size. It is the third largest country in the world at 9,826,675 square kilometers. As a contrast in Latin America with rampant division, more than twenty countries were founded. Efforts to unite Central America, the Peru-Bolivian Confederation, and the South American Free Countries (Federal League of the Free Countries) have been unsuccessful with many caudillos and heroes like Marti, Bolivar, Artigas, Juana Azurduy de Padilla, OHiggins, and San Martin, whose efforts have unfortunately been a failure. Many revolutions, civil wars, and corruption among its presidents, such as Cristina Kirchner, Evo Morales, and Luiz Inacio Lula da Silva, have eroded the rest of the Americas. In the USA, the common language and the embrace of a multicultural nation with exceptionalism manifest destiny has been the formula of success. Two parties, Republicans and Democrats, vs. many parties in the rest of the Americas have contributed to the preservation of the union. This country has been successful in maintaining the union, but not without severe and sanguineous experiences such as the civil war and the abolition of slavery with 750, 000 deaths when the Confederate States of America existed from 1861 to 1865. Now the challenge remains. Will Donald J. Trump maintain the union and resolve the division that until now still exists? Time will tell.

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Page Count

113

Publisher

Xlibris Corporation

Published Date

ISBN 10

154343259X

ISBN 13

9781543432596

LIBERATION FROM ADDICTION

By: Cesar A. Fabiani, MD

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LIBERATION FROM ADDICTION

By: Cesar A. Fabiani, MD

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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Page Count

190

Publisher

Xlibris Corporation

Published Date

ISBN 10

1483630269

ISBN 13

9781483630267

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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Page Count

241

Publisher

Xlibris Corporation

Published Date

ISBN 10

1514403749

ISBN 13

9781514403747

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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