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Integrative Approaches to Post-acute Withdrawal and Relapse Prevention 

Integrative Approaches to Post-acute Withdrawal and Relapse Prevention
Chapter:
Integrative Approaches to Post-acute Withdrawal and Relapse Prevention
Author(s):

Shahla J. Modir

, Walter Ling

, and George E. Muñoz

DOI:
10.1093/med/9780190275334.003.0031
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date: 13 August 2020

Dr. Walter Ling begins this chapter by discussing the distinction between the process of detoxification and role relapse prevention. He reviews the post acute withdrawal period, its neurobiological underpinnings, and discusses the role of stress hormones, neuro-circuity, and the importance of relapse prevention. The existential question as to why people take drugs is posed. Complex aspects of the neurobiology of post-acute withdrawal and subsequent treatment ramifications are reviewed. Drug-specific neurochemical changes are explained, including treatment to reduce cortisol and noradrenergic responses pharmacologically. Then the integrative approach to relapse prevention is reviewed by Dr. Munoz. The concept of “relapse prevention plan” is introduced and the roles of exercise, 12-step social support, and the use of novel neuro-diagnostics including Event Related Potentials (ERP) to aid in personalized risk stratification of potential future relapse. The importance and evidence of multidisciplinary approaches and social 12-step-type support are also reviewed and close out the neuroscience of the first 2 sections.

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