brian heise, md

ii. Steps 2-3 get a higher power (other than your self) : dea, cops, legislature (not the one in “California”), addictionologist (who does’nt write for addictive meds), the REPUTABLE literature- internet.

3. Work steps 1-3 every day (Dr Amen “holes in the brain”), dopamine pathways, and the “allergy” Big Book of Alcoholics Anonymous, etc.

i. automatic (brain stem/”old brain” , VTA ie ventral tegmental area and NA nucleus acumbens. Give yourself “1 second only” – Dean Hickman, MD, ie to think about the addiction.

ii. programmable cortex/ “new brain” ie temporal area (time, compulsion, memory), the pre frontal cortex (action/tasks), and the frontal lobes (emotion)

“it worked before, it felt good, and I’ll do it again” Ken Roy, MD.

Re program the cortex and “laminate the beam” William Calkins, LCSW

“stop playing the old CD’s/records/tapes” Ron Breedlove LCSW

4. Learn how to focus, concentrate and pray/meditate (steps 1-12))

i. learn relaxation, focus, meditation techniques, and concentration exercises (focus on the dot on wall, muscle contraction/relaxation, deep breathing with meditation, etc. utilize the internet. Do this before/during prayer and meditation.

4. Look at character (steps 4-7). Stet 4 pp 63-71

i. Reference DSM 5TR and your diagnosed personality defects. Learn how to control emotions

ii. Steps 5-7 (it “happens when its going to happen”) . 5-7 happening is a result of a proper 1-5. Once 1-4 are completed entirely 5-7 happen when they happen.

5. List and make amends (steps 8/9)

6. Daily review of 1-9 ie step 10/11

7. AA meetings: “my name is ----- and I am a alcoholic,_____, _____, _____, _____, etc. Make good connections.

8. 12- carry message “Having had a spiritual awakening as a result of these steps we “tried” to carry this message to other alcoholics, drug addicts, over eaters, sex and love addicts, gambling addicts, etc., and practice these principals in all of our affairs”

9. Extras

i. Exercise (under doctors supervision/approval). 30-45 min /5 days a week at 65-75% predicted max heart rate HR. ie maximum is 220-age.

Once youu are in good shape and have a resting HR of 40-60 bpm, you an measure 1 and 2 min hear rate recovery ie HRR (after 20 of sub maximal exercise (MD supervision). The 1 and 2 min HRR indicate fitness 40 and 60 bpm drop at one and two minutes lying down resting after sub maxiamal exercise is excellent. Less than 15 bpm at 1 minute means you should see a MD/cardiologist. With a training program ie 4-8 weeks the resting HR should drop and the HRR should improve ie a greter drop in heart rate at 1 and 2 minutes. Also of course the work output ie speed of running, walking, cycling, swimming should improve. A increasing RHH or a poorer HRR ie lass of a drop might indicate overtraining. Generally, the HR should increase with standing. A decreased HR with standing might indicate overtraining also.

ii. Sleep get enough ie in order to wake without an alarm

iii. Balanced nutrition-google it ie internet- Wikipedia has some good information on balanced nutrition.

iv. Find a/several “fun” hobbies. Replace addiction with things that interfere with addiction. Ie exercise does not work with tobacco/ drugs. Showing up on time and holding a professional job does not correlate with drug and alcohol use. Don’t get a job that supports addiction ie construction/entertainment/food service where you will be working with many likely substance abusers. Play ie have hobbies that are inconsistent with substance use, be in relationships with sober people, and work a job that will not tolerate irresponsibility/ and substance use.

v. Regular medical/ psychiatric/addictionologist and dental checkups. Problems such as neuropsychiatric (depression, dementia, anxiety, etc), medial (heart /lung, digestive, endoocrine ie thyroid/other hormone, musculoskeletal, urogenital, others can affect the ability to maintain recovery).

10. Consider developing a support network- Karen French. If you have a brain has a disease, you need their help. This is insulation between you and the next stint in jail, dui, arrest, health consequence, etc. surround yourself with those who know you have a disease. Ask them to look at your character, attitude, appearance, and behavior. As soon as you become angry, anxious, depressed, unkempt, start missing meetings, miss drug screens, miss or are late for work, or whatever, have them confront you early

11. Doctors opinion big book introduction Dr Silkworth. Introduction 1930’s

I. Must abstain because we have allergy (now known as the dopamine pathways/then “cravings”)

II. Must have a psychic change (a cogniitive rearrangement of thoughts and ideas).

III. Must carry the message

The 12 Steps

1 we admitted we were powerless over alcohol, _____, ____, etc and that our lives were unmanageable

2 came to believe that a power greater than ourselves could restore us to sanity

3 made a decision to turn our will and our lives over to god as we under stood him

4 made a complete and searching fearless moral inventory

5 admitted to god, ourselves, and another human being, the exact nature of our wrongs

6 were entirely ready to have god remove our defects of character.

7 humbly asked him to remove our shortcomings

8 made a list of all persons we had harmed and became will to make amends to them all

9 made direct amends wherever possible, except when to do so would injure them or others

10 continued to take personal inventory and we were wrong promptly admitted it.

11 sought through prayer and meditation to improve our conscious contact with god, praying only for knowledge of his will for us and the power to carry that out.

12 having had a spiritual awakening as a result of these steps, we tried to carry this message to other alcoholics, ____, _____, etc. and to practice these principals in all our affairs.

Doctors opinion xxv

How it works 58

Another Approach-Math-Basic Laboratory Science

Curve cutting/ fitting

I. Data acquisition, fitting the curve, and optimization of results

Linear versus nonlinear curves

Differentiation- what it is ie a rate of change

i. “eye balling it”

Integration- what it is ie “area under the curve

i. Actual solution ie solving the integral

I. Weighing curve

II. Taylor series

III. “eye balling it”

Examples of curves

i. Highs and lows of substance use

ii. Consequences of substance use

iii. Tolerance of chemical use

iv. Physical and psychological consequences of substance use /abuse