1. Opiates: Addiction to Recovery Section 2
Dominic Vangarelli, M.A., C.A.D.C., ICADC

3. Post Acute Withdrawal Syndrome (P.A.W.S) Patterns and Symptoms

4. Post Acute Withdrawal (PAW) symptoms.
Thought Disorders - Difficulty in thinking clearly.
Affective Disorders - Difficulty with feelings and emotions.
Memory Disorders - Difficulty remembering things.
Sleep Disorders - Difficulty sleeping restfully.
Psych-Motor Disturbances - Difficulty in physical coordination.
Stress Sensitivity - Difficulty in managing stress.

5. Relapse Process myth, unrealistic expectation,
Post Acute Withdrawal: Stress Sensitivity
Crisis, Addiction, Chaos
(Comfortable) 10
Relapse Process
Healthy Stress
(uncomfortable)
myth,
unrealistic expectation,

7. Road to Recovery

9. Dialectical Behavior Therapy

11. Dialectical Behavior Therapy
Mindfulness:
Is the skill of learning to focus on the present moment in a non- attached manner.
Distress Tolerance:
Coaches patients to tolerate uncomfortable emotions and
difficult situations without making matters worse.
Interpersonal Effectiveness:
Provide a clear and concise blueprint for asking for what
one needs, or for asserting oneself in saying “no.”
Emotion regulation skills:
Coaches patients the adaptive and functional nature of
emotion and the importance of embracing feelings as
helpful rather than something to avoid in recovery.

12. Dialectical Behavior Therapy

13. The Geisinger Marworth Disease Management Program Engagement Outcomes:
In just over 9 months we are following 150 patients in our Disease Management program:
86% remain engaged in the disease management program.
96% report abstinence from mood altering chemicals and alcohol since discharge.
95 % are using Dialectical Behavior Techniques (an evidenced based therapy approach) on regular basis assisting them in maintaining their recovery.       
The Geisinger Marworth Disease Management Program Engagement Outcomes:

14. Holistic Treatment Approaches

15. ACUPUNCTURE
The most common benefits associated with acupuncture in addiction treatment include:
Decreased cravings
Decreased depression
Decreased anxiety
Decreased anger/irritability
Decreased headaches
Increased concentration
Increased sleep quality

16. Young Adult Recreation Therapy Interventions Include:
Workout groups in the Fitness Center
Adventure Therapy/Ropes Course activities
Team sports activities
Stress management
Music/Film appreciation
Expressive Art activities
Leisure education discussions
Off grounds activities (community reintegration)
Ice cream making

17. The Wall of Addiction
Each Patient is asked to identify a personal wall they are trying to overcome. Common walls are denial, fear, anxiety, anger etc. After the activity we transfer the learning and relate getting over the Wall to personal walls.

18. Music Therapy Interventions
Drum Circles
Relaxation/Guided Imagery
Song Writing
Movement to Music
Band Group
Team Cohesion Musical Games
Music Therapy Interventions

19. Sand Tray Therapy Trauma Addiction Grief and loss Attachment issues
Defense mechanisms
Verbal communication
Confronting painful emotions

20. Recovery Yoga
Yoga is a physical practice but is designed to unite the mind, body and spirit.
It helps connect what is disconnected.
Benefits: improved quality of sleep, decreased anxiety, improved attention and feeling energized.
Patients are encouraged to continue with yoga post discharge to aid in their overall recovery.

22. MAT Medication Assisted Therapy

23. MAT Medication Assisted Therapy
Buprenorphine + Naloxone
= Suboxone
VIVITROL

24. VIVITROL

25. NARCAN
Pennsylvania estimates it is spending $6.5 million a year on the overdose-reversal drug naloxone.
(Feb, )

26. The Continuum of Care Residential/Rehab/Inpatient
Day Treatment/Partial Hospitalization
Intensive Outpatient
Outpatient Treatment
Extended Care
Halfway House
Sober House
Transitional Living
MAT

27. Listen without prejudice.
Separate the person from the disease.
Always look through a lens of compassion.