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when they seek treatment, they will not necessarily receive MAT. The most recent treatment admissions data available show that only 18 percent of people admitted for prescription opioid use disorder have a treatment plan that includes MAT. How- ever, even if the nationwide infrastructure were operating at capacity, between 1.3 and 1.4 million more people have opioid use disorder than could currently be treated with MAT due to limited availabil- ity of opioid treatment programs that can dispense methadone and the regulatory limit on the number of patients that physi- cians can treat with buprenorphine. Coor- dinated efforts are underway nationwide to expand access to MAT, including a re- cent increase in the buprenorphine patient limit from 100 patients to 275 for qualified physicians who request the higher limit. The NIDA is supporting research needed to determine the most effective ways to implement MAT. For example, recent work has shown that buprenorphine maintenance treatment is more effective than tapering patients off of buprenor- phine. Also, starting buprenorphine treat- ment when a patient is admitted to the emergency department, such as for an overdose, is a more effective way to en- gage a patient in treatment than referral or brief intervention. Finally, data have shown that treatment with methadone, buprenor- phine, or naltrexone for incarcerated indi- viduals improves post-release outcomes.


Reversing an Opioid Overdose with Nal- oxone The opioid overdose-reversal drug naloxone is an opioid antagonist that can rapidly restore normal respiration to a person who has stopped breathing as a result of overdose on prescription opioids or heroin. Naloxone can be used by emer- gency medical personnel, first responders, and bystanders.


Treating Addiction to CNS Depressants Patients addicted to central nervous


system (CNS) depressants such as tranquil- izers, sedatives, and hypnotics should not attempt to stop taking them on their own. Withdrawal symptoms from these drugs can be severe and—in the case of certain medications—potentially life-threatening. Research on treating addiction to CNS depressants is sparse; however, patients who are dependent on these medications should undergo medically supervised


detoxification because the dosage they take should be tapered gradually. Inpatient or outpatient counseling can help indi- viduals through this process. Cognitive- behavioral therapy, which focuses on modifying the patient’s thinking, expecta- tions, and behaviors while increasing skills for coping with various life stressors, has also been used successfully to help indi- viduals adapt to discontinuing benzodiaz- epines.


Often CNS depressant misuse occurs


in conjunction with the use of other drugs (polydrug use), such as alcohol or opi- oids.71 In such cases, the treatment ap- proach should address the multiple addic- tions.


At this time, there are no FDA-ap-


proved medications for treating addiction to CNS depressants, though research is ongoing in this area.


Treating Addiction to Prescription Stimu- lants


Treatment of addiction to prescription stimulants such as Adderall® and Con- certa® is based on behavioral therapies that are effective for treating cocaine and methamphetamine addiction. At this time, there are no FDA-approved medications for treating stimulant addiction. The NIDA


is supporting research in this area. Depending on the patient, the first steps in treating prescription stimulant addiction may be to taper the drug dosage and attempt to ease withdrawal symptoms. Behavioral treatment may then follow the detoxification process. To learn more about prescription


drugs and other drugs, visit the National Institute on Drug Abuse (NIDA) website at drugabuse.gov or contact the DrugPubs Research Dissemination Center at 877-NI- DA-NIH (877-643-2644; TTY/TDD: 240- 645-0228). The NIDA's website includes:


• information on drugs and related health consequences • NIDA publications, news, and events • resources for health care professionals • funding information (including pro- gram announcements and deadlines) • international activities • links to related websites (access to websites of many other organizations in the field)


• information in Spanish (en español)


Reprinted with permission from the Na- tional Institute on Drug Abuse (NIDA) at the National Institutes of Health. www. drugabuse.com


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Neurofeedback is direct training of brain function, by which the brain learns to function more efficiently.


We are proud to offer the


19 channel LORETA brain training, which is able to target more precise regions in the brain than traditional surface neurofeedback. This method is so superior that it is currently being used by the US Army at 2 of its


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AUGUST 2017


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