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Corporate - Why NPAMATEM? (Addiction Clinic)

- NPAMATEM treats its patients with a multidisciplinary approach,

- The treatment is based on evidence, patient-centered, individualized therapy,

- Treatment is conducted in joint collaboration of psychiatry, psychology and the social worker,

- Provides services with treatment team that includes experts in addiction fields of Turkey,

- As far as treatment is concerned, understanding preventive services and rehabilitation is taken seriously,

- Drug treatment, individual and group therapy as well as family and marriage therapy are applied to every treated patient,

- It is the only center in Turkey where additional psychiatric illnesses with addiction are treated in a separate service,

- In the Advanced Toxicology Laboratory, the most advanced technology in the world is used to determine whether the patient is using the substance during the treatment,

- Advanced Toxicology Laboratory is accepted as a reference institution in Turkey,

- After inpatient treatment, preparation of treatment plans, follow-ups, structured & personalized drug treatment as well as psychosocial treatment and rehabilitation continue,

- Depending on the genetic condition of the patient, drug therapy, drug selection and dosage are adjusted,

-24/7 patient follow-up is possible and the patient is provided with immediate intervention,

- Neuromodulation treatments (Transmagnetic stimulation techniques-TMU) are used for the first time in Turkey for behavioral addiction such as drug addiction and / or gambling addiction in the field of science that is evidence-based

-In-patient treatments are offered in behavioral addictions,,

-Contributes to national and international literature of clinical and pre-clinical studies with the publications and articles written on addiction,

-Cooperation with many international organizations in regards to education and treatment of addiction,

- There are important trainings conducted to the development of the addiction treatment in our country and the training of the professionals of this field (Graduate Program in Addiction in cooperation of Üsküdar University and BAUMER)

- Addiction Congress for the professionals working in the field of addiction are organized in our country with Addiction Psychiatry Association,

-Long-acting drugs (implant / chip) are used to increase treatment compliance in the patient's addiction treatment.

Mission and Vision

Mission
Providing in-patient and outpatient health services to help society solve problems related to alcohol, drugs and stimulants, as well as contemporary science method and an institution that aims to provide conditions.

Vision
To be to first option to provide services in Istanbul, then in Turkey, and finally in the Middle East and Balkan countries, for the treatment of alcohol, drug and stimulant problems, rehabilitation and to be known as an organization involved in all activations related to the prevention of depression, to provide easy accessibility of addiction treatment, And establishing a quality-focused approach to the development of trust; to be the preferred service provider in the first place, for patients and patients’ relatives.

Why NPAMATEM? (Addiction Clinic)

WHAT IS ADDICTION AND WHAT ARE THE CAUSES?

Addiction is to keep using a substance even it has negative effects on life and health. Another characteristics of addiction is that the individual cannot stop using the substance after he/she started using it. Addiction is a brain disorder and absolutely must be treated.

There are behavioral, social, biological and genetic causes of addiction but none of them, on its own, are sufficient to give a proper explanation. Although there are numerous factors contributing to the transformation of substance use into an addiction, it is a biological process in basic terms. The most important factors causing the individual to start using a substance and become an addict are individual’s mental state, genetic predisposition, environmental factors, access to substance, family structure, social environment and cultural feature.

WHO BECOMES ADDICTED?

Firstly, it must be stated that all people using substance have the risk of becoming an addict. There is no substance we can safely use. In addition, people who are in search for new things, who easily take risks, people with a degenerate family structure, neglected adolescents, impulsive individuals and people with genetic predisposition are under higher risks.

HOW ADDICTION DEVELOPS?

Addiction is a vicious cycle. The individual first take interest in the substance but, at the same time, he/she is afraid of the substance’s effects. If curiosity prevails over fear, the individual who starts using with the thought of “using for one won’t harm anyone” assumes that he/she will never use it again but the expectation never comes true. In the following phase, he/she denies that he/she has a problem regarding substance use and presumes that he/she has control and he/she can quit whenever he/she wants. To him/her, warnings of other people are nothing but exaggerated concerns.

People who develop substance abuse begin to get more because they design their addictive substances. They go through an ever-wasting effort to release or use in a controlled way. They spend a lot of time getting, using, or getting rid of the drugs they use.

As a result, they disrupt their daily work. Students' school continuity and academic performance diminish, conflicts with the family starts. As a result, the group of friends changes, coming home late starts, as well as telling lies and spending a lot of time in the room.

Adults start to experience problems in the workplace, do not spend enough time on their families and ignore them, they become a constant conflict and debate. In addition to all these, they continue to use substances when they know that they have physical and psychological problems. They decide to quit many times, but they cannot make it. They feel guilty and unsuccessful because they cannot succeed. Therefore, they get more substances to get rid of these feelings.

AT WHAT AGE ADDICTION STARTS?

There are numerous studies in many countries conducted with statistical methods regarding the starting age of addiction. In a study performed in Turkey, 2003, students in elementary and middle schools are included from 6 provinces picked from various geographical regions. This and similar studies indicate that the age of addiction has considerably dropped down. The ESPAD’s results on related study indicate that the age of addiction has diminished.

WHAT IS THE BIOLOGICAL ASPECT OF ADDICTION?

It is known that a lot of areas in the brain such as Ventral Tegmental Area, known as the reward center of brain; Frontal Cortex, which is responsible from numerous functions such as judgment, decision-making and impulse control; Amigdala which deals with the management of feelings and Nucleus Accumbens and Striatum which is related with learning etc. play an important role in the development of addiction. In each stage of addiction, changes appear in different areas of the brain. There for the development of addiction is a very complicated process.

Normally, pleasure inducing stimuli such as art and eating cause the dopamin level to increase, which is located in the reward system of brain. Substance use, too, cause the reward system to release increased level of dopamin. And this dopamin enables the feeling of pleasure

In the course of time the release of dopamin, triggered by substance use, affects the Frontal Cortex, which results in making wrong decisions and the fact that preferred actions are limited to substance use. Additionally, dopamin also affects learning related areas such as Nucleus Accumbens and Striatum and causes the learning ability to degrade. Additionally, substance abusers’ ability to learn, record and remember new information are deteriorated as well. The repetitive and excessive release of dopamin, prevents the individual from having pleasure from eating, enjoying art and music, which are also called as natural rewards that normally give sufficient pleasure.

Under regular conditions, an individual has numerous purposes and he/she has decided on some of them. The occurrence of purposes, giving values to these purposes and choosing the action is related with Frontal Cortex. One of the important aspects of addiction is that the selection of these purposes, most of the times, stay limited to the ones related with substance use.

Why NPAMATEM? (Addiction Clinic) 2

IS ADDICTION A GENETIC COMMAND?

Research suggest that some people are predisposed to addiction. How is this possible? Individuals having abnormal genes for some reasons produce abnormal proteins which results in the production of abnormal enzymes and receptors. These abnormal enzymes and receptors causes irregularities in neurotransmitters located in the pleasure and reward path of the brain. Consequently, this

forms the basis of control losses regarding substance use.

Therefore, the genetically predisposed individual’s use of substance doesn’t just cause chemical irregularities but also initiates the process towards addiction. However, today’s technology is not advanced enough to conclusively determine who is genetically disposed and who is not. Therefore, use of alcohol/substance poses numerous risks.

WHICH SUBSTANCES CAUSE ADDICTION?

Anything that includes rewards may cause addiction. If we need to reduce this to substance, that is, we need to call it accessible substance rather than substance. Roughly, some of the substances identified up until today are tobacco, alcohol, ecstasy, cannabis, heroin, cocaine, inhalant substances (bally, uhu, gasoline, synthetic cannabis (K2), paint remover, ether, halothane etc.), LSD, GHB, several types of mushroom, ketamine, anabolic steroids, and methamphetamine. In recent years, people started to use substances which are chemical derivatives of cannabis and that cannot be detected in routine toxicology examinations.

However, the internet, as well, is a type of addiction.

It is becoming a widespread addiction especially among adolescent and young adults. While betting and gambling are types of addiction existed for some time, online betting appeared as a new concept which is also a type of addiction. Additionally, computer games, internet addiction, and online shopping addiction are some of the addiction types which must be treated.

WHAT ARE THE PSYCHOLOGICAL ASPECTS OF ADDICTION?

There are many psychological explanations trying to explain the cause and maintenance of addiction.

HOW TO BEHAVE TO AN ADDICTED PERSON?

Alcohol or substance dependence is a very difficult disease as far as the person is concerned. As families and people close to addicts are the ones that get highly effected by this problem, they are also trained on how to behave towards the addicted person. Therefore, better and healthy communication can be obtained during this difficult process.

This article is written to give information about addiction and to help you communicate effectively with the addicted person. You can get help from our psychiatrists and psychologists about any of your questions that may arise regarding the following information.

HOW SHOULD WE COMMUNICATE?

•Make them feel that you understand what they go through…
•Making sentences that create culprit, will trigger alcohol use.
•Be forgiver. There may be some mistakes done, but do not forget that you only disagree with the behavior.
•Avoid advisory talks.
•Be a good listener. Try your best to understand and solve the reasons of alcohol and drug use.  

Addiction does not happen in an instant. The individual usually falls into the illusion that the drug and/or alcohol use can be controlled and therefore starts to abuse it casually.

There is no exact data to indicate in how long the addiction occurs. It all changes depending on different variables such as drug type, ingredients, frequency and amount of occurrence as well as the characteristic and emotional state of the individual. Addiction can be meliorated but cannot be healed. The individual should stay away from the drug for the rest of the life. Otherwise, the addiction can resurface and the problems will reoccur.  Being addicted as nothing to do with the willpower. No one starts to abuse drugs to get addicted. It all proceeds with the thought that trying for one time, will cause no harm. Do not forget that anyone can get addicted.

Addiction is a brain disease that can be healed. Addicted person should get treated and receive support to end the addiction.

HOW SHOULD I BEHAVE AFTER THE TREATMENT?

Addiction is a family disease. It doesn’t only affect the individual but also the whole family. As treating addiction consists of 3 tripod treatment system, you have an effective role in this treatment process.   There are essential roles that family has to conduct during and after the treatment.

GIVE RESPONSIBILITY

Addictive people usually abnegate from taking responsibilities in their lives. Either they don’t take their jobs seriously due to their addictions or find other people to execute their work. At this point, the roles and responsibilities should be defined clearly within the family. Giving responsibilities in the areas that are directly linked to the addicted person, is one of the aspects of the treatment.

Making new friends and being with people and environments that alcohol and drugs are used, facilitates re-use. Therefore, it is essential to reorganize life and fulfill the free time available.  Making new friends can be time consuming but the individual should not have anxiety over it. You should be patient in this period and support the decisions that are made.