LORRIE K. GARCES, MD Board Certified Adult Psychiatrist *Dr. Garces only sees patients off-site at long term care facilities
JENNA S. SAUL, MD Board Certified Child & Adolescent Psychiatrist BRIAN M. LUKACH, PhD Licensed Psychologist CONSTANCE L. WOYTHAL, PsyD Licensed Psychologist JOANNE KEMNITZ, MSW, CAPSW Master’s Level Counselor RACHEL J. GRETEBECK, MS, CSAC Certified Psychotherapist Licensed Clinical Substance Abuse Counselor KARLA F. WILLIS, LPC Licensed Professional Counselor MAMIIE LORITZ LINTEREUR, LCSM Licensed Clinical Social Worker MICHAEL G. HUBER, MA, CSAC Licensed Psychotherapist Licensed Clinical Substance Abuse Counselor JESSE FOY, L.Ac, MSOM Acupuncturist, Chinese Herbalist JANET FRITTS, L.Ac, MSOM Acupuncturist, Chinese Herbalist ALEXANDRA LIOSATOS, MA Master’s Level Counselor Working Toward Licensure Supervised by Constance Woythal, Psy. D WALTER CATALAN Counseling Intern Supervised by Constance Woythal, Psy. D
INPATIENT SERVICES Inpatient detoxification and hospital-based treatments are available to chemically dependent individuals. Our staff can refer a client to inpatient services, and when appropriate, can assist in their discharge planning and continuing care. CONTINUING CARE & FOLLOW-UP After primary treatment, it is important for individuals to continue to meet treatment goals. A less intensive program that is consistent, dependable, and effective can help individuals maintain success and reach therapeutic goals. Continuing care treatment arrangements may involve participation in a professional or nonprofessional support group, or structured individual follow-up. EDUCATION & CONSULTATION Absenteeism, substandard performance, accidents and health problems can all result from substance abuse. Our staff can provide consultation and training to businesses, schools, and community agencies on prevention, early identification, and treatment (including formal interventions) of substance abuse and dependence.
JOHN L. OLSEN, MD Board Certified Adult Psychiatrist
PRIMARY OUTPATIENT PROGRAM This program helps individuals identify, develop, and maintain an effective plan for recovery. This program places a large emphasis on education, and self-responsibility.
CAROLYN J. BAXTER, MD Board Certified Adult Psychiatrist
BRIDGEPOINT HEALTH, LLC CONTACT US 3425 Superior Avenue Sheboygan, WI 53081 Phone (920) 458-5557 Fax (920) 458-2692 www.BPHealth.org OFFICE HOURS Monday & Tuesday 8:30AM— 8:00PM Wednesday & Thursday 8:30AM— 6:00PM Friday 9:00AM— 5:00 PM
Drug use, abuse, and dependence are responsible for significant family, social and health problems. BridgePoint Health, LLC is committed to providing comprehensive and quality chemical dependency services in an outpatient setting. Our team of physicians and licensed chemical dependency counselors provide a full range of services and treatment options
How do I know if I have A Problem with drugs?
AODA TREATMENTS TREATMENT PRINCIPLES Abuse of more than one substance is common. Obtaining information from family members, previous providers, and collateral caregivers is Important. Urine drug analysis may be useful. These are not used as a punitive tool, but rather to develop therapeutic approaches for ongoing monitoring and to reinforce abstinence. Psychopharmacology alone is inferior to combined psychopharmacologic and psychosocial therapies. For high levels of sedative and alcohol dependence, withdrawal can be dangerous. A higher level of care other than outpatient may need to be considered.
Take a moment to ask yourself:
Do you use drugs or alcohol once a week or more?
Have you ever missed work, school or an appointment because of your drug or alcohol use?
Do most of the people in your life use drugs or alcohol?
Have you had a problem with the law while under the influence of drugs?
Has anyone ever told you that they are concerned about your drug use?
INITIAL EVALUATION The purpose of the initial assessment is to identify: 1) the nature and extent of alcohol and drug use, 2) the progression of the course of the illness, 3) problem areas for which treatment can be recommended, and 4) appropriate follow-up and aftercare. A similar evaluation may be conducted with family members to assess issues related to codependency, Children of Alcoholics (COA), eating disorders, depression, and anxiety.
Treatment of co-occurring illness with dependency producing drugs is potentially harmful, and whenever possible, it is best to avoid the use of:
Opioids and muscle relaxants for chronic pain
Stimulants for attention deficit disorder
Alcohol: starting drinking before the age of 15 is associated with a fourfold increased risk for developing alcoholism compared to people who delay drinking until age 20. Four medications are FDA approved for the treatment of alcohol dependence: oral naltrexone (ReVia), injectable extendedrelease naltrexone (Vivitrol), disulfiram (Antabuse), and acamprosate (Campral). Gabapentin (Neurontin) added to naltrexone may improve drinking outcomes. Topiramate has demonstrated evidence in two clinical trials of alcohol dependence. Ondansetron (approved for nausea) shows some efficacy for reducing heavy drinking among patients with early-onset alcoholism. Nicotine: cigarette use greatly increases the risk for lung disease (emphysema, cancer) and heart disease. Varenicline (Chantix), bupropion (Zyban), and nicotine replacement therapy (gum, lozenge, and patch) are FDA approved to facilitate smoking cessation. Cocaine, amphetamine and methamphetamine: use of these drugs can lead to or exacerbate psychosis. There are no FDA approved treatments on the market for stimulant abuse. Psychopharmacologic treatment is indicated along with psychosocial treatments for stimulant dependence. Medications that may decrease craving and facilitate abstinence include topiramate (Topamax), Antabuse, aripiprazole (Abilify), lamotrigine (Lamictal), gabapentin (Neurontin), acamprosate (Campral), and N-acetyl-cysteine.
Marijuana: people who smoke marijuana are more likely to develop a psychotic disorder than people who do not use marijuana. Bipolar patients may be at risk for lengthier • Barbiturates for chronic headaches affective episodes and rapid cycling. There may be a perception that marijuana is a benign drug, however, emergency room visits associated with marijuana abuse have been rising and this is thought to be related to the increased Medication treatment for alcohol & drug problems and associated potency of marijuana in recent years. There is no specific psychiatric problems: pharmacologic treatment for marijuana dependence. Family therapy, cognitive behavioral therapy, motivational The FDA has approved several medications to treat substance abuse enhancement therapy, multisystemic therapy, and disorders. These include medicines that work by the same mechanism used by the abused drug but are longer acting (for example, methadone), psycho-education can reduce the use of marijuana. medicines that are partial agonists (buprenorphine), and medicines that * are receptor antagonists (e.g. naltrexone) at the receptor for the drug of abuse
Benzodiazepines for bipolar disorder or anxiety
Opioid Dependence: The treatment of opioid dependence in the past has only been allowed by specially licensed treatment methadone programs. Now it is possible for a physician who holds a special license to use buprenorphine (Suboxone) to treat opioid dependence. This drug is a partial agonist at the opioid receptor, so its maximal effects are less than full agonists like heroin. Tolerance to Suboxone does not develop. It is used to achieve abstinence and to prevent relapse. Naltrexone (ReVia), an opioid receptor antagonist, is FDA approved and effective in treating opioid addiction in motivated opioid users. In the presence of naltrexone, opioids are ineffective except in very high doses.
*The graphic above is courtesy of the NIAAA http://rethinkingdrinking.niaaa.nih.gov/IsYourDrinkingPatternRisky/WhatsLowRiskDrinking.asp The information in this brochure is from the National Institute of Alcohol Abuse and Alcoholism (NI AAA) as well as the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about substance abuse please visit either of their websites. NIAAA.nih.gov or SAMHSA.gov