Rodney: I’d like to welcome everybody back to the RSVP Health show. Our guest is Dr. Taca. Ed, have you gathered the questions from our panel?

Ed: Yes I have. The first question is from Raymond in St. Charles. “Is your treatment the twelve-step program?”

Dr. Taca: Our program is not based on the twelve-step program. However, we do it encourage it if they find that helpful. The twelve-step and AA fellowship is, as you know, widely available. We don’t want to repeat that in our program. We do a different type of therapy called cognitive behavioral therapy. It’s a little bit more sophisticated. We talk about feelings and belief systems in more depth that they find more helpful than the twelve steps. However, we’re not anti-twelve step or AA. Actually, we encourage it because it’s very widely available and many people get a lot from its teachings.

Ed: Okay, next question. This is from Susan in Farmington. “I’ve heard a lot about bath salts. What’s the danger?”

Dr. Taca: Well, when you hear about bath salts, it’s not the bath salts; it’s not the Calgon of bath salts. It’s not the ones you can get in the beauty supply stores. They’re nicknamed bath salts and they’re very dangerous synthetic stimulants. I’ve recently had a handful of people admitted to the psychiatric hospital from floor violent psychosis. It’s different from your psychosis that we see from other drugs. I find it more dangerous, the psychosis is more violent, and it does respond to anti-psychosis medications. It reminds me how PCP was described in the 70’s where there’s lots of rage and violence. It’s a very dangerous designer drug that’s actually quite popular these days. The FDA and the DEA are now fast on the track of these people who are synthesizing these bath salts in the lab. Watch out for this new drug. It’s very dangerous.

Ed: The next question comes from Joyce from Cairo, Illinois. She wants to know, “Is marijuana addictive?”

Dr. Taca: Well, if you ask people who smoke marijuana, ‘is it addictive?’ Most of them would say, ‘No, I can stop at any time.’ However, when I tell them, ‘Well, humor me. Try to stop.’ They come back and say, ‘You know doc, I really can’t stop. It helps me with anxiety or my appetite or sleep.’ We know now and we’re getting a better understanding of the actual cannabinoid system in our brain. This system in our brain has always been there. We use it, most of us, to regulate anxiety and sleep and depression and appetite. Some people depend on exogenous forms of cannabinoid peptides that actually give them a therapeutic response from smoking. If you took that away, they may end up more anxious or unable to sleep. So it’s quite addicting .We describe a syndrome where when people stop cannabis, they get more anxious, they’re craving for it. They’re very mild, but there is a syndrome that’s being described in literature and we’re changing our opinion about cannabis. So yes, it is addicting. People look for cannabis or marijuana when they quickly run out of their supply. It promotes a drug seeking behavior so yes, it is considered addictive.

Ed: Okay, the next question is from Samuel from Fenton. He wants to know, “How long is the In Synergy treatment program?”

Dr. Taca: Well, our program is a little different. My hope is that this may one day become the standard because we know the traditional twenty-eight day inpatient programs usually don’t promote long lasting sobriety. We know that the brain changes and you have to wait for those changes to happen over time. So twenty-eight days is way too short to expect the brain to change. Our program, at least, it gives us time to understand personality structure. That’s when the therapy, the group therapy, the marriage counseling, all is very important because we learn more about the patient over time, rather than a quick detox and discharge.

Ed: Francis from Webster Grove asks, “What do we do about methamphetamine?”

Dr. Taca: Well here in Missouri, methamphetamine, as you know, I don’t know if we should be proud of it, but we’re number one in manufacturing methamphetamine in the country. Right now there’s nothing that’s FDA approved for the treatment of methamphetamine. But I want to let your listeners know that methamphetamine is a type of stimulant that’s very dangerous. It works differently than cocaine. Cocaine, how it works is, it inhibits the reuptake of brain chemical called dopamine. Dopamine makes you feel good. That’s why people like using cocaine. What happens in the meth user is dopamine is literally squeezed out of the brain cell and what you’re left with is a brain cell that kind of looks like a sponge. Or, over time, methamphetamine users’ brains will shrink and will look like squished cheese. So there’s brain damage with heavy methamphetamine use over time. We don’t see that with cocaine. We see other things with cocaine. However, specifically the changes of the brain in methamphetamine use are pretty obvious. If you see a before and after picture of a methamphetamine user, the changes are quite disturbing. They look ragged, their hygiene becomes poor, their dentition is terrible, they have this characteristic meth mouth where they develop cavities and that’s from smoking the meth. When you smoke meth, the saliva disappears and you need saliva to battle bacteria. Well, if you smoke a lot of meth, that bacteria fighting saliva isn’t there and a lot of cavities grow. So you really end up looking like a gargoyle, a starving gargoyle, after years of meth use.

Ed: John from Edwardsville, Illinois asks, “What qualifications do the In Synergy staff and you have?”

Dr. Taca: Well, at least in our program, we like to take pride in recruiting the leaders in the field. I myself am board certified in addiction medicine. We have therapists who are at least master level therapists who have extensive experience in treating addiction. Some have additional advanced training, at least, for opiate use and Suboxone training. We also have PhD therapists specifically trained in marriage and couple’s counseling. We find this a very important component in our program because everybody in the family unit struggles. So when my job is done with the cravings and stabilizing the mood, a lot of times the work is done in the family with individual therapy, group counseling, and what the participants enjoy the most is access to a PhD marriage counselor.

Ed: Our next question comes from Carrie in Bonne Terre. “What are the medical advances in alcohol treatment?”

Dr. Taca: With alcohol treatment, there have always been choices out there, since the 60’s and the 80’s. The three medications that are FDA approved are, at this time, Antabuse, it’s the medicine that makes you ill or nauseas when you drink. It’s not very popular, but some people will still request it. Naltrexone has been around since the 60’s and actually got the FDA approval for treating alcoholism in the 80’s. It’s one month depot formulization called Vivitrol has been approved for alcoholism in 2006, and recently got the FDA indication to treat opiates. So it’s this monthly injection of Vivitrol that can treat the cravings of alcohol and be very effective for people addicted to heroin and pain pills because it blocks the opiate receptor in the brain. So there are new advancements. There are things that have been studied in the lab that do not have indications such as Topiramate, Zofran, and Baclofen. These are generic compounds that have lots of clinical trials to suggest they may be effective in different alcohol dependents. There was one other medication called Acamprosate, or Campral, that’s also been recently approved by the FDA to treat alcoholism.

Ed: Now Kristen from Moscow Mills asks, “What’s the role of mental illness in addiction?”

Dr. Taca: That’s a very important concept because if you don’t treat the mental illness, you’re not really treating the addiction. Addiction and mental illness go hand-in-hand. If you are practicing addictionology, you’ll really have to dig deep to figure out what is really causing the drug seeking behavior or the self-medicating behaviors. The highest conditions that are associated with drinking and drugging are bipolar disorder, if you can imagine someone who has mania, feeling very energized, very grandiose, at times very reckless, and very impulsive; they are at high risk to do drugs and alcohol. The opposite pole of bipolar illness is the depress pole, and if you can imagine somebody reaching out to help the field better. Bipolars, as a group, 60% have association with drinking or drugging. ADHD is also a condition that is often times overlooked, that’s also highly associated with drinking and drugging. Mainly because of impulsive behaviors, not doing well in life and school, getting depressed about this and drinking your sorrows away, or promoting that kind of drug seeking behavior. Simple anxiety and PTSD are also associated. But, if one is treating addiction, you really have to be focused on if there is a mental illness going on at the same time.

Ed: Now we have a question from Jill in Sunset Hills. She asks, “Dr. Taca, what kinds of therapy do you use in treating addiction?”

Dr. Taca: Throughout time there have been different approaches and different therapy types that have specifically been addressed in addiction as a whole. We do something called cognitive behavioral therapy. This is a type of simple but sophisticated type of therapy which most therapists are skilled at. It addresses belief systems, it addresses cognitive distortions, and it addresses negative thinking. So as you can imagine, all of that can also lead to frustration if there is a distorted belief system, and persistent negative thoughts can also lead to drinking and drugging. So we often times when we do therapy, don’t talk or focus on the drug addiction itself, but the solid principles or belief systems that the clients may be bringing in to us. These types of approaches are more long lasting. That’s why we like to use a prolonged style for six months so we can have time to reprogram the software with the client. It gives us a better understanding what they bring to the table, how they behave, and also gives the client enough time to readjust their thinking.

Ed: Our final question comes from Tony in Cape Girardeau. He wants to know, “After going through the program, what support care is available afterwards?”

Dr. Taca: At In Synergy, I would say 70 to 80 percent of our clients continue what we call phase two, or our form of aftercare. We understand that addiction and mental illness is a lifelong battle. And so when our clients see the robust effects of our system, they don’t want to stop, most of them. They enjoy the groups, and often times they become leaders in group discussions and help the new people who come in understand a better way of thinking about their addiction, and a different way of thinking about their addiction. A lot of times they’re shameful and guilty of relapsing. We know that this is a chronic relapse illness just like diabetes or hypertension, high blood pressure, and the idea is, over time, drinking and drugging becomes a little less intense. Some people call this the harm reduction method. A lot of people have strong opinions about this method because there may be some relapses. However, we understand as field that there is no cure. So people in my field are okay with, over time, reducing intake with the hope of completely eliminating the addictive behavior and stabilizing the mood. This is a process that can’t be rushed.

Rodney: Ed, thank you for gathering all those questions. I want to thank the listeners and the audience for submitting those questions. Dr. Taca, to kind of wrap things up in this segment, what would you want the audience and the listeners to take away from these sessions with yourself and In Synergy?

Dr. Taca: I think most of the people who come to me have come with a feeling of being hopeless. Most of them have failed several treatment options including inpatient, inpatient detox; a lot of them have never been offered medications. There was one statistic that showed that only 23% of addiction programs in the United States offer medications for the cravings. At least, this shouldn’t be the standard of care. There are wonderful, new FDA approved medications that are safe and available. Many of these medications you don’t need to see a specially trained addictionologist, you can just ask your doctor. “Hey, I heard about this injection for drinking. Can you order it for me?” Maybe it’s time to educate your own primary care physicians about the wonderful, new options out there and spread the word because there is hope. I treat the ones that have lost hope and we’ve got amazing results.

Rodney: Dr. Taca, we both have seen in our medical profession and medical careers, that a lot of times it’s the communication and the trust factor. The people need to know it’s okay to talk to their physician or call you and your staff directly to start confronting these problems. It’s not something to keep locked up inside of you. That just builds on the problem.

Dr. Taca: Absolutely. We have to start educating the community. Part of my job is educating my colleagues who are uncomfortable in treating the people struggling with drinking and drugging. So it takes a unified force to really get the message out because there’s too much suffering right now and people don’t need to suffer. We’ve got great new discoveries and great new advancements in the field.

Rodney: Our guest has been Dr. Arturo Taca of In Synergy. You can find further information on his website at www.insynergystl.com Their office number is (314) 997-5208. You can also find Dr. Taca and In Synergy in the current issue of RSVP Health publication. If you haven’t gotten a copy yet, please go to our website are www.rsvphealth.com Click on the current publication. You’ll find information on articles written by Dr. Taca and be able to see some visuals that he’s talked about before. I can’t think you enough Dr. Taca for being on the show.

Dr. Taca: Thank you, Rodney. It’s been a pleasure.