Hello Dr. Volkow, I enjoyed watching this video, and I am curious to see where the research goes regarding how addiction affects some but not others. I feel they will find that the people who have addictions may have more childhood or adult trauma than those who do not have an addiction. I appreciate the information you presented, and I look forward to more videos! Best, Savannah
Dr. Volkow. I worked for a methadone program for about 20 years. One issue that came up frequently was - what dose to reinstate a patient back on out patient treatment methadone. For example, if a patient reached a therapeutic dose of 100 mg methadone daily and they missed say 6 days of clinic attendance. Patient denied any illicit drug/etoh use during their abscence. Since the half life of methadone can vary from 5 to 95 hours, we take average as 24-38 hours. For math convenience we say 24 hours. Our policy was for 3 days of methadone missed decrease by 10 mg methadone. So our example patient would be reinstated back on methadone at 80 mg methadone daily x 3 days then 90 mg methadone daily x 3 days then 100 mg methadone daily. This was not based on any literature findings just clinic policy. What are you thoughts? Is the reinstated dose too high ? Is the taper up schedule too quick ?
Hello Daniel, We appreciate your question about methadone dosing. NIDA is not the lead agency on recommending methadone dosing policy for opioid treatment programs. We encourage you to contact the Substance Abuse and Mental Health Services Administration (SAMHSA) www.samhsa.gov/. The publication, “Federal Guidelines for Opioid Treatment Programs” recommends that “caution should be exercised when a patient has missed several doses of medication because their tolerance may have changed” and clarifies that “under no circumstances should standing orders be used to address these situations” (page 53): store.samhsa.gov/sites/default/files/d7/priv/pep15-fedguideotp.pdf. These guidelines indicate that, in the event of missed methadone doses, a physician should evaluate a patient and recommend a course of action. We hope this is helpful.
Me gusta mucho escuchar y aprender de la Dra, Volkow, tuve la oportunidad de coincidir con ella en un evento en Ciudad de Mexico hace unos años, y saludarla, hasta me tomé una foto con ella (es mi heroína :P ) No solo es una gran profesional sino una mujer sensible y accesible.
I've been reading the work of Dr. Gabor Maté, Prof. David Nutt, and Prof. Carl Heart. Does your research coincide with theirs? I'm still not sure about the general view of this channel, it doesn't have much in the way of information. You don't seem to propose solutions or express any opinions about the use of substances to alter one's brain, mind, or perception of reality...?
your comment is irrelevant. she's referenced alcohol before in her other videos. perhaps she just chose to reference marijuana in this video. both are commonly abused, mind-altering substances. she's talking about addiction not deaths caused.
@@malloryarthur8676 I'm curious. Would you consider moderate drinking alcohol abuse? Can alcohol be consumed for recreation, and not be considered "abuse"?
THC is a creation of God, ethanol is a product of man. Ethanol is poison, THC is medicine. The fact that THC is universally banned is evidence of universal control over governments. In America ethanol is advertised on TV and sold in department stores as well as convenience stores. It's the only recreational drug which enjoys this accessibility. Taverns, bars and lounges are established specifically for sale and consumption of the recreational drug/poison ethanol. Regularly using medicine is not abusive to it or self.
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Hello Dr. Volkow,
I enjoyed watching this video, and I am curious to see where the research goes regarding how addiction affects some but not others. I feel they will find that the people who have addictions may have more childhood or adult trauma than those who do not have an addiction. I appreciate the information you presented, and I look forward to more videos!
Best,
Savannah
Dr. Volkow. I worked for a methadone program for about 20 years. One issue that came up frequently was - what dose to reinstate a patient back on out patient treatment methadone. For example, if a patient reached a therapeutic dose of 100 mg methadone daily and they missed say 6 days of clinic attendance. Patient denied any illicit drug/etoh use during their abscence. Since the half life of methadone can vary from 5 to 95 hours, we take average as 24-38 hours. For math convenience we say 24 hours. Our policy was for 3 days of methadone missed decrease by 10 mg methadone. So our example patient would be reinstated back on methadone at 80 mg methadone daily x 3 days then 90 mg methadone daily x 3 days then 100 mg methadone daily. This was not based on any literature findings just clinic policy. What are you thoughts? Is the reinstated dose too high ? Is the taper up schedule too quick ?
Hello Daniel,
We appreciate your question about methadone dosing. NIDA is not the lead agency on recommending methadone dosing policy for opioid treatment programs. We encourage you to contact the Substance Abuse and Mental Health Services Administration (SAMHSA) www.samhsa.gov/.
The publication, “Federal Guidelines for Opioid Treatment Programs” recommends that “caution should be exercised when a patient has missed several doses of medication because their tolerance may have changed” and clarifies that “under no circumstances should standing orders be used to address these situations” (page 53): store.samhsa.gov/sites/default/files/d7/priv/pep15-fedguideotp.pdf. These guidelines indicate that, in the event of missed methadone doses, a physician should evaluate a patient and recommend a course of action.
We hope this is helpful.
Me gusta mucho escuchar y aprender de la Dra, Volkow, tuve la oportunidad de coincidir con ella en un evento en Ciudad de Mexico hace unos años, y saludarla, hasta me tomé una foto con ella (es mi heroína :P ) No solo es una gran profesional sino una mujer sensible y accesible.
personally legal gets better results. hopeful.
All addictions can be linked to trauma.
Wow, that is fascinating to think about. Do you mind unpacking that bro so I may learn from you?
I've been reading the work of Dr. Gabor Maté, Prof. David Nutt, and Prof. Carl Heart. Does your research coincide with theirs?
I'm still not sure about the general view of this channel, it doesn't have much in the way of information. You don't seem to propose solutions or express any opinions about the use of substances to alter one's brain, mind, or perception of reality...?
This woman is a criminal.
Yup
Why are you still talking about marijuana and not alcohol. More deaths from alcohol. No deaths from Cannabis....
your comment is irrelevant. she's referenced alcohol before in her other videos. perhaps she just chose to reference marijuana in this video. both are commonly abused, mind-altering substances. she's talking about addiction not deaths caused.
@@malloryarthur8676 I'm curious. Would you consider moderate drinking alcohol abuse? Can alcohol be consumed for recreation, and not be considered "abuse"?
THC is a creation of God, ethanol is a product of man.
Ethanol is poison, THC is medicine. The fact that THC is universally banned is evidence of universal control over governments.
In America ethanol is advertised on TV and sold in department stores as well as convenience stores. It's the only recreational drug which enjoys this accessibility. Taverns, bars and lounges are established specifically for sale and consumption of the recreational drug/poison ethanol.
Regularly using medicine is not abusive to it or self.