This document summarizes the key points from a mental health skills training workshop on addiction. It outlines 10 important things known about addiction, including that it is a compulsive disorder initiated outside of consciousness, about 50% heritable, and often co-occurs with other psychiatric problems. It emphasizes the importance of individualized treatment and notes that change takes time. The document then discusses how family doctors can get closer to addiction treatment by addressing common substances of abuse, using screening models, reducing treatment gaps, and maintaining empathy while setting limits.

1. 19THWONCA WORLD CONFERENCE OF FAMILY DOCTORS Mental Health Skills Training Workshop Pedro Camacho Asistant Director InstitutoMexiquense contra lasAdicciones Estado de México pcamacho4.4@gmail.com InstitutoMexiquense Contra lasAdicciones

2. 19THWONCA WORLD CONFERENCE OF FAMILY DOCTORS Mental Health Skills Training Workshop AIM: Makeyoufeelcraving Only on addiction knowledge InstitutoMexiquense Contra lasAdicciones

3. What do I need to Know?

4. The 10 most important things known about addiction Addiction is fundamentally about compulsive behaviour(disorder) Compulsive drug seeking is initiated outside of consciousness Addiction is about 50% heritableand complexity abounds Most people with addictions who present for help have other psychiatric problems as well (Co-occurrency) Addiction is a chronic relapsing disorder Different psychotherapiesappear to produce similar treatment outcomes ‘Come back when you’re motivated’ is no longer an acceptable therapeutic response The more individualized and broad-based the treatment a person with addiction receives, the better the outcome Epiphanies are hard to manufacture Change takes time

5. The 10 most important things known about addiction Addiction is fundamentally about compulsive behaviour(disorder) Compulsive drug seeking is initiated outside of consciousness Addiction is about 50% heritableand complexity abounds ↑ Orbitofrontalactivation (FDG-PET) in active cocaine users ↓ Activation prefrontal/anterior cingulatecortex (FDG-PET) in abstinent cocaine users

6. The 10 most important things known about addiction Most people with addictions who present for help have other psychiatric problems as well (Co-occurrency) Always discardcomorbidity (Depression, anxiety, cognitive disorders) Addiction is a chronic relapsing disorder If you want to help people with addiction… “you have to develop frustration tolerance” Different psychotherapies appear to produce similar treatment outcomes Don’t fight each other Addictión thinks: “Divide and conquer the enemy”

7. The 10 most important things known about addiction ‘Come back when you’re motivated’ is no longer an acceptable therapeutic response Reduce treatment GAP… Get closer If the mountain will not come to Mohammed, Mohammed goes to mountain The more individualized and broad-based the treatment a person with addiction receives, the better the outcome Collaborative work (Think as if you win a football game) Epiphanies are hard to manufacture Change takes time “you have to develop frustration tolerance” (again)

8. startfeelingcraving???

16. The most important things known aboutaddiction (Family Doctors) What is the“addictive substance” of higher prevalence and impact on the world? You can treat anxiety, insomnia and depression without benzodiazepines Question purposefully the presence of substance abuse “5 A's” model (tobacco). Just like vital signs (always on clinical record) Ask (Presence) Advise (Health risk accord age and status) Assess willingness to make a quit attempt Assist in quit attempt Arrange followup (“D” day, Addiction REHAB centre) http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=hsahcpr&part=A28163

17. The most important things known aboutaddiction (Family Doctors) Get closer to addiction field They need family physicians Reduce the treatment GAP (therefore disability) Use “love and discipline” Be empathetic Learn to set limits The first to teach “your own attitude” Love your self Put limits to your self

18. The most important things known aboutaddiction (Family Doctors) The first to teach “your own attitude” Love your self Put limits to your self

19. A leader is one who makes LEADERS Pedro Camacho pcamacho4.4@gmail.com