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Integrative Psychiatry

Functional Medicine for Addiction by William Billica, MD

By February 13, 2021No Comments

Watch our short video as Dr. William Billica talks about hypoglycemia and insulin.

FULL TRANSCRIPT

You know, certainly when you’re treating people, you need to treat all of it.

I mean, there’s their psychologist, addiction counselors, there’s all the other parts of that, that go with an addiction program. As a matter of fact, I have a few people who come to me with addictions and things, and I do the biochemistry. And I try and get them plugged in with counseling and stuff, and they don’t do it. And they really struggle to stay clean. So, it really is a full picture.

Digestion and Amino Acids
Low amino acids, especially brain chain amino acids may have major impact on mood and addiction

So, most addicts have poor digestion and diets, they come in, they’re depleted of everything. It makes it kind of tough when you do organic acids and amino acids, some people are just depleted of everything, and it’s hard to tell. Is this genetic, is this just poor nutrition? If somebody hasn’t been eating well and has low amino acids, even using something like whey protein, whey protein has a lot of branched-chain amino acids, which have a big impact on mood and addictions. As long as they don’t have a dairy issue, I would do that. It’s a lot cheaper, and it tastes better than using fancier amino acid blends.

Hypoglycemia and insulin

Hypoglycemia, that’s huge. I mean, you know, go to any AA meeting, and what are they doing? They’re drinking coffee with cream and sugar, and they’re eating donuts or cookies. They are setting all of those addicts up to crash and relapse a couple of hours after the meeting.

Blood Sugar is a big factor. So, when we look at that inner balance, when alcohol is involved, it’s like 97-98% of the time, on a glucose tolerance test, they have significant hypoglycemia.

Histamine balances

Low histamine, lots of anxiety, paranoia, thought disorders, they don’t tolerate much in the way of medications, trying to give them a bunch of supplements, they often don’t tolerate those. So, you focus on trying to increase histamine, you have to be careful about over-methylating. You still can use some B12 and a little bit of methylfolate, but you don’t want to give them a big dose or a big multi. N-acetyl cysteine has good support for these people, helps balance their brains and their responses.

Kryptopyrroluria Treatment
All right, so Kryptopyrrols, we tend to use P5P. It doesn’t have as much side effects of high dose regular B6. We typically just put people on 50 milligrams, a typical capsule that you can get as a supplement. And that’s pretty much what I use there and what I use in my office.

Evaluations

So, Holistic Health lab is Amy Yasko’s lab. I haven’t used it in a few years, but they were very good. Genova does subsets, just about any lab you can do the MTHFR for the 1298 and the 677.

If you send a patient to a lab, and just say MTHFR you’re only going to get this one, 677. They won’t do the 1298, you have to request it.

A lot of these genetic panels, like a 23andMe, will take too long to get all that back when I’ve got somebody in an addiction program for four weeks. But these are ways you certainly could do with an ongoing interaction with somebody as their mental health professional.

Frederick Barrett is a cognitive neuroscientist with training in behavioral pharmacology, and the Associate Director of the Johns Hopkins Center for Psychedelic and Consciousness Research. Dr. Barrett has been conducting psychedelic research at Johns Hopkins University since 2013, and his research in healthy participants and in patients with mood and substance use disorders focuses on the psychological and neurological mechanisms underlying the enduring therapeutic and other effects of psychedelic drugs. In 2017, he received an NIH “R03” grant as Principal Investigator to investigate biological mechanisms of psilocybin effects, the first federally funded research since the 1970s administering a classic psychedelic to people with psychedelic effects as the primary focus. He has developed measures of subjective effects of psychedelic drugs, and has also published first-in-human studies characterizing the acute and enduring effects of psilocybin on the brain. He is currently leading clinical trials to investigate the use of psilocybin to treat patients with major depressive disorder and co-occurring alcohol use disorder, and he is leading a number of ongoing studies aimed at better understanding the psychological, biological, and neural mechanisms underlying therapeutic efficacy of psychedelic drugs.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.