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HOPE FOR The Future How alcohol affects epigenetics

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It’s in the Genes Researchers Probe Alcohol’s Effect on Epigenetics

As scientists gain a better understanding of the human genome, one rapidly emerging area of research is the effect of alcohol on epigenetics – external modifications to DNA that turn genes “on” or “off.” Epigenetic changes alter the physical structure of DNA. One example of an epigenetic change is DNA methylation — the addition of a methyl group, or a “chemical cap,” to part of the DNA molecule, which prevents certain genes from being expressed. A recent article in the National Institute on Alcohol Abuse and Alcoholism’s Alcohol Alert reports on a growing body of research showing how alcohol’s influence on epigenetics may be associated with an array of illnesses and disorders. These include fetal alcohol spectrum disorders (FASD), cancer, liver disease and other gastrointestinal disorders, brain development, the body’s internal clock, and immune function. Researchers and clinicians are beginning to explore therapies that might be developed to target the changes occurring through epigenetics. How alcohol affects epigenetics Alcohol consumption leads to

oxygen species (ROS), which are chemically reactive molecules that at high levels can damage cells. Fetal alcohol spectrum disorders Women who drink during pregnancy put their developing fetuses at serious risk for a range of conditions collectively known as FASD. In exploring how epigenetics contributes to FASD, researchers have also begun to investigate two complex enzymes that play a crucial role in cell differentiation during fetal development. One, called polycomb protein, remodels chromatin to turn genes off; the other, called trithorax protein, remodels chromatin to turn genes on. Research suggests that exposure to alcohol may

chemical changes within the body that can affect all the epigenetic mechanisms. For one, excessive alcohol consumption interferes with the body’s ability to process and access a chemical called folate. Folate is critical for methylation, a biochemical process that attaches a methyl group to a specific spot on DNA. DNA methylation acts to lock genes in the “off ” position. Chronic alcohol consumption leads to lower-than-normal methylation, or “hypomethylation.” Research also finds that alcohol metabolism leads to an increase in a substance called NADH, which is a byproduct of alcohol metabolism, and through production of reactive

Researchers and clinicians are beginning to explore therapies that might be developed to target the changes occurring through epigenetics due to alcohol use.

disrupt these two enzyme complexes, altering how cells differentiate during fetal development.

alcohol abuse and alcohol dependence, and may contribute to alcohol relapse and craving. Hope for the future As researchers begin to untangle the exact nature of alcohol’s interactions with epigenetics, they will be able to design better medications to treat or alleviate a wide range of alcohol-related disorders, including FASD, alcohol addiction, cancer and organ damage. In addition, researchers can now analyze DNA methylation patterns for the entire human genome. This work could yield comprehensive maps of DNA methylation changes in alcohol-associated cancers. Those maps then could potentially be used to develop pharmacological treatments that target epigenetic markers and develop new markers for cancer detection and prognosis. 

Liver disease and the gastrointestinal tract

Alcohol affects epigenetics on many levels within the GI tract and liver, where the majority of consumed alcohol is metabolized and cleared from the body. As alcohol enters the liver, it sets off what could be described as a cascade of epigenetic changes that increase the risk of liver disease, liver cancer and immunological problems. In addition, alcohol-associated epigenetic changes may play a role in what researchers call organ “cross- talk” between the GI tract, the liver and other organs. For one, epigenetic changes to genes involved in joining the cells lining the intestines may be partially responsible for “leaky gut,” which allows endotoxins to enter circulation and initiate liver damage. Alcohol-associated cancers As suggested above, alcohol-related changes involved in epigenetics can be linked to the development of liver cancer. In particular, research suggests that some epigenetic changes can transform normal liver cells back into stem cells, which then can develop into liver cancer. In addition, alcohol acts indirectly on a receptor that, when disrupted, is involved in the development of liver cancer. Alcohol’s role in changing DNA methylation patterns, leading to hypomethylation, may be one of the main routes between alcohol consumption and liver cancer as well as other types of alcohol-associated cancers. Changes in brain functioning Alcohol’s epigenetic effects within the brain are complex and intertwined. But increasing evidence suggests that they result in adaptations within the brain that ultimately influence addictive behaviors, including tolerance and alcohol dependence. As seen in other disorders, changes in DNA methylation are one of the epigenetic changes in the brain caused by chronic alcohol consumption. Although researchers still are piecing together the details, findings to date suggest that epigenetic changes in gene expression induced by alcohol consumption may underlie the brain pathology and adaptations in brain functioning associated with

As researchers begin to untangle the exact nature of alcohol’s interactions with epigenetics, they will be able to design better medications to treat or alleviate a wide range of alcohol-related disorders.

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Youth Programs

Assessment Any par nt having concerns for an adolescent’s use of alcohol and drugs may call one of our outpatient offices to arrange an assessment. During the assessment, parents are asked what their concerns are and whether they notice any unwelcome changes (i.e., declining grades, different group of friends, moodiness) in their child.The assessor interviews the child and meets with both parent and adolescent to present a diagnosis and recommend a course of action.The assessment usually takes one and a half hours to complete. Any parent having concerns for an adolescent’s use of alcohol and drugs may call one of our outpatient offices to arrange an assessment.

Depending on the findings of the assessment the clinician may recommend one of the following: 1. No Recommendation – The assessment finds that the adolescent executed poor judgement rather than any symptoms of dependency. 2. Outpatient Education – A program designed for adolescents who have had problems with their use of alcohol/ drugs but who ate not, at the time of assessment, diagnosed as chemically dependent. Classes meet weekly for two hours and participants are also exposed to 12-step programs and monitored for drug use.The class lasts for eight weeks. 3. Intensive Outpatient (IOP) Treatment – Designed for adolescents who are diagnosed as chemically dependent.This program meets three times a week for two hour sessions. Counselor and adolescent create a recovery plan that focuses on the issues the adolescent must resolve to gain recovery while still going to school/ work and being around others who use/drink. Adolescents are asked to complete key assignments that remind them of the power of the disease of addiction and the path to recovery. NOTE: When the diagnosis of an adolescent confirms that he/she is too ill to be able to recover in an outpatient program, an inpatient regimen is recommended (see adolescent inpatient description). 4. Continuing Care -To effectively treat the chronic disease of addiction, it is essential that adolescents engage in ongoing care. The treatment team, family, and positive peers can all support the individual as they begin to apply the tools of recovery in their daily life. In continuing care, the treatment plan evolves from a focus of achieving a drug free life and education to addressing the life challenges. Lasting approximately 5 months, the final length of treatment is determined by the patient and counselor as they evaluate patient progress in their recovery.

To effectively treat the chronic disease of addiction, it is essential that adolescents engage in ongoing care.

Family Education /Support Group The disease of addiction wreaks a special havoc on the relationship between parents and addicted teens. Parents can be confused, saddened and often angered by the changes the disease brings about in behaviors, thinking and emotions.The family group teaches parents about the nature of addiction and recovery as well as behavior changes that will re-balance the family in crisis.

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Adult Programs

At Freedom

Assessment A condential pre-admission telephone assessment is conducted to gain an understanding of your specic situation. Several other assessments will be conducted after the admission process is completed and others during the entire process.

Group Therapy As one of the best drug rehab centers in Washington, Freedom offers group therapy. This gives our clients the advantage of being able to see yourself in others, having others give feedback to your potential blind spots, and learning to share true feelings and experiences.

Relapse Prevention There are warning signs of relapse long before the rst drink or drug use occurs. Core coping skills and issues are evaluated by our counselors. The content includes but is not limited to; relapse process, use of leisure time, anger management, handling social pressures, communication skills, handling/avoiding high risk situations, guilt/shame, long-term sobriety plans, managing post-acute withdrawal, and phases of recovery.

Individual Therapy Individual therapy can be helpful to begin a concentrated look at one’s own self and specic issues surrounding their addiction.

Family Program Addictions affect the entire family and Freedom Recovery Center highly encourages family participation. Research shows that recovery rates are increased when the family is involved in the recovery process. This is another reason why Freedom is the among the nest drug and alcohol treatment centers.

Recovery Systems Each person’s journey in recovery is different. Persons learn the signicance of utilizing the 12 Step programs in their personal recovery process. We believe the foundation of recovery from addictive disorders is based on the 12 Steps originating from Alcoholics Anonymous.

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Treating addiction with vaccines is a relatively new idea with many unanswered questions

ARE VACCINES THE ANSWER

that arise out of a lack of research. But a new study suggests vaccinating against illicit drugs is not only possible, it could be extremely effective. At the Scripps Research Institute in California, researchers were looking for a way to guard against the lethal and addictive effects of synthetic opioid “designer drugs.” A potentially deadly opioid, fentanyl, is often used as a heroin substitute or mix-in by drug dealers, so researchers developed a vaccine to try to mitigate its effects. Researchers injected mice with three rounds of the vaccine and then exposed them to doses of fentanyl. They found the vaccinated mice did not display any “high” behaviors even months after the last series of vaccine injections. Researchers say the immune systems of the mice developed antibodies that successfully blocked the drug from reaching the brain. “The results were the best we’ve ever seen for any drug vaccine,” says Paul Bremer, a graduate student at Scripps Research Institute who worked on the study.

A new

HAS BEEN SHOWN TO PREVENT OVERDOSES AND STOP OPIOID “DESIGNER DRUGS” FROM AFFECTING THE BRAIN vaccine

The results were the best we’ve ever seen for any drug vaccine. - Paul Bremer, Scripps Research Institute

“ WE WERE ABLE TO BLOCK EXTREMELY LARGE - Paul Bremer DOSES OF FENTANYL TO PROTECT AGAINST OVERDOSES

SAFE AND POWERFUL Not only was the vaccine able to stop intoxication (something researchers suggest could aid in opioid addiction treatment), the vaccine also proved extremely effective in blocking the potentially lethal effects of fentanyl as well. While the chemical is not necessarily toxic in itself, it does produce psychoactive effects that can shut down breathing and stop a person’s heart. Researchers say mice injected with the vaccine could withstand doses of fentanyl up to 30 times the normal rate. “It was just a rst generation vaccine, but it did prove to be very potent,” Bremer says. “We were able to block extremely large doses of fentanyl to protect against overdoses.” A SINGLE PURPOSE Researchers say the vaccine would not protect against heroin or oxycodone, and a mixture of vaccines would be needed to protect against all opioids. But that was somewhat by design. To make sure the vaccine would not interfere with any medications a person may take responsibly later in life, researchers targeted specic molecules so the vaccine would only block fentanyl and its derivatives.

“For unrelated drugs that you would be taking, there would be no effect from the vaccine,” Bremer says. LOOKING TOWARD THE FUTURE Although still in the early stages of development, researchers say the vaccine represents an exciting step forward in drug vaccine research. The lab is beginning more advanced trials on a similar heroin vaccine which should give them a better idea of how successful the fentanyl vaccine could become. But until more testing can be completed, researchers say they were pleased with the progress and excited for the future of vaccines in the treatment of addiction. “This concept of using a vaccine for addiction isn’t just an academic pursuit, it could really be used in practice,” Bremer says. “I think it’s really promising.”

WHY CHOOSE FREEDOM? Freedom provides all levels of outpatient care. There are special groups and programs for people with co-occurring mental and substance abuse disorders. Freedom Recovery Center also provides services for individuals who have been court order due to DUI or DWI violations. Freedom accepts most private insurance and personal payment plans.

New Freedom Recovery Center, LLC

www.newfreedomrecoverycenterwa.com 253.862.7374

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www.newfreedomrecoverycenterwa.com 253.862.7374

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ASSESSMENT AND PLACEMENT Freedom Recovery offers assessments and placement daily. All clients are treated with dignity, respect and a professional diagnosis.

(253) 862-7374 || 10215 214th Ave E, Bonney Lake, WA 98391 || www.newfreedomrecoverycenterwa.com

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