Dall T.M.,IHS Healthcare and Pharma |
Storm M.V.,IHS Healthcare and Pharma |
Chakrabarti R.,IHS Healthcare and Pharma |
Drogan O.,American Academy of Neurology |
And 6 more authors.
Neurology | Year: 2013
Objective: This study estimates current and projects future neurologist supply and demand under alternative scenarios nationally and by state from 2012 through 2025. Methods: A microsimulation supply model simulates likely career choices of individual neurologists, taking into account the number of newneurologists trained each year and changing demographics of the neurology workforce. A microsimulation demand model simulates utilization of neurology services for each individual in a representative sample of the population in each state and for the United States as a whole. Demand projections reflect increased prevalence of neurologic conditions associated with population growth and aging, and expanded coverage under health care reform. Results: The estimated active supply of 16,366 neurologists in 2012 is projected to increase to 18,060 by 2025. Long wait times for patients to see a neurologist, difficulty hiring new neurologists, and large numbers of neurologists who do not accept new Medicaid patients are consistent with a current national shortfall of neurologists. Demand for neurologists is projected to increase from ;18,180 in 2012 (11% shortfall) to 21,440 by 2025 (19% shortfall). This includes an increased demand of 520 full-time equivalent neurologists starting in 2014 from expanded medical insurance coverage associated with the Patient Protection and Affordable Care Act. Conclusions: In the absence of efforts to increase the number of neurology professionals and retain the existing workforce, current national and geographic shortfalls of neurologists are likely to worsen, exacerbating long wait times and reducing access to care for Medicaid beneficiaries. Current geographic differences in adequacy of supply likely will persist into the future.© 2013 American Academy of Neurology.
Doepp F.,Sclerosis Research Center |
Doepp F.,Charité - Medical University of Berlin |
Wurfel J.T.,Charité - Medical University of Berlin |
Wurfel J.T.,Max Delbrück Center for Molecular Medicine |
And 5 more authors.
Neurology | Year: 2011
Background: Chronic cerebrospinal venous insufficiency (CCSVI) was proposed as the causal trigger for developing multiple sclerosis (MS). However, current data are contradictory and a gold standard for venous flow assessment is missing. Objective: To compare structural magnetic resonance venography (MRV) and dynamic extracranial color-coded duplex sonography (ECCS) in a cohort of patients with MS. Methods: We enrolled 40 patients (44 ± 10 years). All underwent contrast-enhanced MRV for assessment of internal jugular vein (IJV) and azygos vein (AV) narrowing, graded into 3 groups: 0%-50%, 51%-80%, and > 80%. ECCS analysis of blood flow direction, cross-sectional area (CSA), and blood volume flow (BVF) in both IJV and vertebral veins (VV) occurred in the supine and upright body position. Results: MRV identified 1 AV narrowing. IJV analysis yielded 12 patients for group 1 (30%), 19 patients for group 2 (48%), and 9 patients for group 3 (22%). By ECCS criteria, 4 patients (10%) presented with venous drainage abnormalities. Jugular BVF was different only between groups 1 and 3 (616 ± 133 vs 381 ± 213 mL/min, p = 0.02). No other parameters in supine position and none of the parameters in the upright body position, apart from the IJV-BVF decrease in groups 1 and 3 (479 ± 172 vs 231 ± 144 mL/min, p = 0.01), were different. Conclusions: Our ECCS data contradict the postulated 100% prevalence of CCSVI criteria in MS. MRV seems more sensitive to detect IJV narrowing compared to ECCS. A measurable hemodynamic effect only exists in vessel narrowings >80%. Our combined data argue against a causal relationship of venous narrowing and MS, favoring the rejection of the CCSVI hypothesis. Copyright © 2011 by AAN Enterprises, Inc.
Valdueza J.M.,Neurological Center |
Doepp F.,Charité - Medical University of Berlin |
Schreiber S.J.,Charité - Medical University of Berlin |
Van Oosten B.W.,VU University Amsterdam |
And 3 more authors.
Journal of Cerebral Blood Flow and Metabolism | Year: 2013
In 2006, Zamboni reintroduced the concept that chronic impaired venous outflow of the central nervous system is associated with multiple sclerosis (MS), coining the term of chronic cerebrospinal venous insufficiency ('CCSVI'). The diagnosis of 'CCSVI' is based on sonographic criteria, which he found exclusively fulfilled in MS. The concept proposes that chronic venous outflow failure is associated with venous reflux and congestion and leads to iron deposition, thereby inducing neuroinflammation and degeneration. The revival of this concept has generated major interest in media and patient groups, mainly driven by the hope that endovascular treatment of 'CCSVI' could alleviate MS. Many investigators tried to replicate Zamboni's results with duplex sonography, magnetic resonance imaging, and catheter angiography. The data obtained here do generally not support the 'CCSVI' concept. Moreover, there are no methodologically adequate studies to prove or disprove beneficial effects of endovascular treatment in MS. This review not only gives a comprehensive overview of the methodological flaws and pathophysiologic implausibility of the 'CCSVI' concept, but also summarizes the multimodality diagnostic validation studies and open-label trials of endovascular treatment. In our view, there is currently no basis to diagnose or treat 'CCSVI' in the care of MS patients, outside of the setting of scientific research. © 2013 ISCBFM All rights reserved.
News Article | November 16, 2016
Addiction is a complex, chronic disease. It is caused by a combination of biological, behavioral, and environmental factors, all of which have to be addressed to effect a cure. Many of the advances in treating addiction in the last twenty years have focused on how drugs change the brain and on the development of medication-assisted treatments to reverse those changes. “These breakthroughs have been remarkably successful in healing the brain,” says neurologist and addiction medicine specialist Dr. Russell Surasky with Surasky Neurological Center for Addiction. “But to reduce the risk of relapse over the course of a lifetime, sufferers must attend to their psyches, their souls, and their daily lives as well as to the biological basis of the disease. And for more than 75 years, there has been no more successful therapy than the 12-step peer-support program that became the foundation of Alcoholics Anonymous in the 1930s.” The 12-step model was developed by AA founder Bill Wilson, who saw the positive effects of sharing stories on those struggling with alcoholism. He brought together elements from various teachings that he had encountered, combining a strong spiritual component – acknowledging the need for help from a higher power – with the help of peers fighting the same fight. Over time, the 12-step model that originated with AA has been adopted and adapted by other groups to support people struggling with other addictions: Narcotics Anonymous, Heroin Anonymous, Gamblers Anonymous, and more. The program has also been modified to incorporate different religious traditions, including Native American, and to secularize the model to accommodate those who prefer a non-religious program. Narcotics Anonymous was founded in 1953 as an offshoot of Alcoholics Anonymous. It maintains the spiritual tradition of AA but is not affiliated with any religion and welcomes people of all faiths. The foundation of its model is that through regular meetings and sharing experiences, people can help each other achieve and maintain abstinence from the drugs to which they are addicted. Here are the NA 12 steps, which may be explored in order or visited and revisited more than once. 1. We admitted we were powerless over alcohol – that our lives had become 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 the care of God as we understood Him. 4. Made a searching and fearless moral inventory of ourselves. 5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs. 6. Were entirely ready to have God remove all these defects of character. 7. Humbly asked Him to remove our shortcomings. 8. Made a list of persons we had harmed, and became willing to make amends to them all. 9. Made direct amends to such people wherever possible, except when to do so would injure them or others. 10. Continued to take personal inventory and when we were wrong promptly admitted it. 11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out. 12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to addicts and to practice these principles in all our affairs. “Twelve-step programs provide structure and support, both critically important for people who are recovering from addiction,” says Dr. Surasky. “The opportunity to connect with others facing a similar challenge and the bonds that develop as a result of sharing common experiences are a vital aspect of the recovery process and have lasting benefits.” One of the most important bonds forged in a 12-step program is with a sponsor, a recovering addict who becomes a key support, helping the new member navigate the steps and offering friendship and advice in difficult moments. “These programs work,” Dr. Surasky concludes. “The challenge of recovery and establishing a drug-free life can feel overwhelming. A 12-step program is a tried-and-true therapy that helps people accept responsibility for their behavior and accountability for their lives going forward.” Russell Surasky, FAAN, ABAM, with Surasky Neurological Center for Addiction, is board certified in both neurology and addiction medicine, is one of the few physicians with this combination of credentials. His primary focus in practice is addiction medicine. Utilizing unique medication protocols individualized to each patient, he provides specialized treatment for opiate, benzodiazepine, and alcohol addiction. http://www.drsurasky.com
Rogge A.,Neurological Center |
Doepp F.,Charite Campus Virchow |
Schreiber S.,Charite Campus Mitte |
Valdueza J.M.,Neurological Center
Journal of Ultrasound in Medicine | Year: 2015
Objectives - Routine sonography of the middle cerebral artery in acute ischemic stroke usually focuses on the main stem (M1 segment). However, stenoses and occlusions affect not only proximal but also more distal vessel branches, such as the M2 segments. Transcranial color-coded duplex sonography allows visualization of these segments; however, a formal analysis and description of normal blood flow values are missing. The purpose of this study was to analyze middle cerebral artery branching patterns with transcranial color-coded duplex sonography and to establish reference flow velocity values in the detectable M2 branches as well as the early temporal M1 branch. Methods - Transcranial color-coded duplex sonography in the axial and coronal planes was performed in 50 participants without vascular disease and with a good temporal bone window (ie, fully visible M1 middle cerebral artery segment and A1 anterior cerebral artery segment). We analyzed the course and branching pattern of the M1 segment, including anatomic variants such as an early temporal M1 branch, and measured the length and flow parameters of the detectable M2 branches. Results - Assessment of 100 hemispheres allowed classification into 3 anatomic patterns: M1 bifurcation (63%), M1 trifurcation (32%), and medial M1 branching into 2 major segments (2%). A clear distinction was not possible in 3 cases (3%). An early temporal M1 branch was detected in the coronal plane in 26%. Conclusions - Transcranial color-coded duplex sonography is a useful tool for analyzing anatomic variants and branching patterns of the middle cerebral artery as well as flow characteristics of M2 segments. Therefore, it also has potential to increase the diagnostic yield for the detection of middle cerebral artery disease in these vessel segments. ©2015 by the American Institute of Ultrasound in Medicine
Mercado M.,Hospital Of Especialidades |
Mercado M.,Neurological Center |
Gonzalez B.,Hospital Of Especialidades |
Gonzalez B.,Neurological Center |
And 11 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2014
Context: Acromegaly is usually due to the excessive secretion of GH by a pituitary adenoma. It is frequently accompanied by comorbidities that compromise quality of life and results in elevated mortality rates. Objective: To evaluate mortality and morbidity in patients with acromegaly receiving multimodal care. Setting: Tertiary care center. Design, Patients, and Methods: Retrospective evaluation of 442 patients (65.4% women; mean age, 43.5 ± 13.1 y) followed for a median of 6 years (interquartile range [IQR], 3-10). Results: Twenty-two patients died during the study period (4.9%), representing a total standardized mortality ratio (SMR) of 0.72 (95% confidence interval [CI], 0.41-1.03). Standardized mortality ratios were 1.5 and 0.44 for patients whose last GH was above and below 2.5 ng/mL, respectively; 1.17 and 0.16 for those whose last GH was above and below 1 ng/mL, respectively; and 0.94 and 0.46 for those whose last IGF-1 was above and below 1.2 times the upper limit of normal (ULN), respectively. Theprevalenceof diabetes mellitus, hypertension, heart disease,andcancerwas30%,35%, 8%, and 4.7%, respectively. The most common cause of death was cancer. On multivariate analysis, diabetes, heart disease, and cancer were related to a baseline GH > 10 ng/mL; the presence of cancer and the last IGF-1 were significant predictors of mortality. Survival decreased as the latest GH levels increased from < 1 ng/mL to > 5 ng/mL and as IGF-1 increased from < 1.2 to > 2 times the ULN. Conclusions: Mortality in acromegaly can be successfully reduced, provided patients are treated using a multimodal approach with careful management of comorbidities. Copyright © 2014 by the Endocrine Society.
News Article | October 28, 2016
Addiction is a disease – a devastating disease that lays waste to families and entire communities. It is a complex, chronic illness that changes the structure and functioning of the brain and puts its sufferers at risk of relapse for a lifetime. And it burdens them with an additional affliction – the stigma of being labeled an addict, of being treated as a second-class citizen, guilty of moral turpitude and unworthy of respect. “Over the years, we've become more sensitive to language that disparages and stigmatizes people,” says neurologist and addiction medicine specialist Dr. Russell Surasky with Surasky Neurological Center for Addiction. “We don't refer to people with mental and physical impairments as crazies, cripples, and spastics. And we don't define sick people by their illness. Yet most people don't think twice before labeling someone struggling with a substance use disorder an 'addict,' dismissively defining an individual's entire identity and humanity with a single word that has overwhelmingly negative connotations.” The language we use to describe people suffering from addiction is important. It influences how we frame issues and solutions – whether an individual should be punished or treated, whether we afford them the full measure of human dignity or condemn them to cower in guilt and shame. The stigma of addiction has serious repercussions for an individual's likelihood of recovery. Apprehension about social ostracism, anxiety about how they will be received by the medical community, and fear of legal consequences keep many from seeking help. Even those who recover from addiction continue to be viewed with suspicion – “once an addict, always an addict” – making it harder to build a healthy, addiction-free life. Tips for Language that Supports rather than Stigmatizes “Removing the stigma from addiction would help everyone,” says Dr. Surasky. “It would influence funding decisions, medical research and insurance coverage. It would help the general public understand that this is an illness not a moral failing, and most important, it would make it easier for people to seek treatment and regain their self-esteem. Simply choosing words that support and inform rather than discourage and embarrass can go a long way toward de-stigmatizing addiction.” Better: Person struggling with addiction, person with a substance use (not abuse!) disorder, patient (if in treatment). These phrases are more cumbersome than a single descriptive word but they accomplish something important – they put the person before his or her illness and de-stigmatize the condition. Better: Substance misuse, substance use disorder, addiction. Addiction, unlike addict, refers to the condition rather than the person – a condition that can be treated – and is not a label that stigmatizes an individual. “We must fight addiction,” says Dr. Surasky. “But to do so, we must separate the illness from the individual who suffers from it. We must erase the tinge of character flaws and immorality from addictive disorders and restore dignity and humanity to the people who struggle to overcome them. Being careful about the language we use is an important step toward that end.” Dr. Russell Surasky, FAAN, ABAM, with Surasky Neurological Center for Addiction, is board certified in both neurology and addiction medicine, is one of the few physicians with this combination of credentials. His primary focus in practice is addiction medicine. Utilizing unique medication protocols individualized to each patient, he provides specialized treatment for opiate, benzodiazepine, and alcohol addiction. http://www.drsurasky.com
News Article | November 2, 2016
"We are creatures of habit and breaking them isn't easy, but to successfully overcome addiction, people must not only quit drugs, they must break out of old routines. They must change the unhealthy behaviors that dominated daily life – irregular sleep, haphazard eating, risky relationships – and develop new routines that will support a healthy, drug-free existence. Structure is critically important in recovery,” says neurologist and addiction medicine specialist Dr. Russell Surasky with Surasky Neurological Center for Addiction. “Facing life after addiction can seem overwhelming. Developing structured routines provides comfort, and stability. Having a plan for the day keeps you on track, makes it easier to avoid drifting back into unhealthy patterns, and helps you prove to yourself that you're making progress one day at a time.” "If you randomly ask people for words they associate with 'routine,' you might get responses like 'humdrum,' 'boring,' and 'monotonous.' But you might also get responses like 'familiar,' 'regular,' and 'predictable.' For people recovering from addiction, it is precisely the familiar, regular, and predictable that can help them heal and help them cope with the challenges that might threaten their sobriety. Having a routine reduces the anxiety of waking up in the morning and wondering, 'What do I do now?'” says Dr, Surasky. “It restores a sense of control, of taking responsibility for your life beyond simply abstaining from drug use. It helps you, step by step, develop new patterns of behavior that will become your 'default setting' as you build a healthy new life.” Establishing a daily routine doesn't mean rigidly programming every minute of every day. It means having a plan and sticking to it. Dr. Surasky offers tips on things to consider when developing a daily routine, starting with the basics: Sleep: Many people slept erratically while they were using drugs and suffer from insomnia in recovery. Sticking to a sleep schedule – going to bed and waking at the same time each day, including weekends – can help establish more regular sleep patterns and more restful sleep. Meals: Eat at set mealtimes and don't skip meals. Keep the refrigerator and pantry stocked with healthy foods. Avoid frequent snacking, especially on junk foods loaded with sugar and salt. Exercise: Try to get at least 30 minutes of moderate-intensity exercise every day, preferably at the same time every day. Home maintenance: Don't rush to climb up on the roof to replace those loose tiles. But set aside some time every day and every week to keep your surroundings clean and orderly. Don't let dirty cloths pile up on a chair, dirty dishes languish in the sink, or dust bunnies colonize the corners. Work: If possible, maintain a regular or at least predictable work schedule. Family and friends: Nothing is more important than spending time with people close to you who nourish your spirit and validate your self-worth. “Having a structured plan for these everyday activities will help restore health and fitness, reduce the likelihood of boredom and loneliness, and make it easier to get things done without procrastinating,” says Dr. Surasky. “That said, it's important to not become too dependent on a routine, to be flexible as new opportunities arise and unexpected events occur.” Another critical component in a recovery plan and a key part of the routine is a program that provides a support network. For most people, a weekly counselor-led group helps prevent backsliding and is an opportunity to connect with others who are facing similar challenges. The bonds that develop with other participants can be a vital support with lasting benefits. “With a daily routine established and regular participation in a support group, you have the foundation in place for a successful recovery,” Dr. Surasky concludes. “With your commitment to openness and honesty, you can break the cycle of repeated relapse and progress toward a new, drug-free life.” Russell Surasky, FAAN, ABAM, with Surasky Neurological Center for Addiction, is board certified in both neurology and addiction medicine, is one of the few physicians with this combination of credentials. His primary focus in practice is addiction medicine. Utilizing unique medication protocols individualized to each patient, he provides specialized treatment for opiate, benzodiazepine, and alcohol addiction. http://www.drsurasky.com
News Article | November 29, 2016
Substance addiction has slowly become one of the most dangerous diseases in America with over 20 million people meeting the diagnosis. Addiction wreaks havoc on everything from brain cells to social bonds, leaving lives destroyed and communities shattered in its wake. Those afflicted experience cravings that hijack their lives, leaving family and friends disoriented and lost. “The family plays a crucial role in helping the person struggling with addiction to improve,” says neurologist and addiction medicine specialist Dr. Russell Surasky with Surasky Neurological Center for Addiction. “Providing a loving support structure for those dealing with addiction helps the person get treatment and prevent future relapse.” Here, Dr. Surasky provides 5 tips for families to help a loved one struggling with substance addiction. “When family members understand addiction and how powerful it becomes, they tend to become more compassionate. Loved ones begin to understand that the addiction changes the brain in ways beyond the person’s control,” says Dr. Surasky. “We recommend consulting professionals and learning about the latest science. We also advocate patience, since the disease tends to be a chronic struggle. Relapse is common and can be triggered by cues (buildings, bottles, etc.) that were once associated with the addiction. These habits are rigid and difficult to break, so expect an enduring struggle,” adds Dr. Surasky. “The biggest challenge for families dealing with addiction is helping the individual understand that they have an issue in the first place. People struggling with addiction are often reluctant to acknowledge that they have a problem, despite failing to fulfill responsibilities, maintain relationships, and keep up with their jobs. This is a vicious way in which addiction captures the mind. It’s important for families to understand how sensitive this can be,” says Dr. Surasky. For the first step, Dr. Surasky recommends a heartfelt intervention, where a trained interventionist and the family gather around to help the person understand their self-destructive behavior. Families should not force the person into treatment, but rather encourage the person to help themselves. Loved ones struggling with addiction can emotionally drain the family. Often times, family members become so focused on helping the afflicted person that they neglect self-care. Dr. Surasky advocates a routine of regular exercise, healthy eating, and sleep. Since people struggling with addiction can be difficult to be around, Dr. Surasky also supports family therapy and connecting with families going through similar circumstances. “Finding mental health support where families can share their feelings, such as Narconon, in a safe space provides a necessary outlet, which can build strength and unity.” Often times, families try to support the person dealing with addiction by covering for them, lending money, and picking up the slack. Dr. Surasky advocates setting strict boundaries while maintaining a loving, supportive environment. “It’s crucial that the person dealing with addiction feels loved and supported. But they also need to feel the consequences of their actions. Family members tend to think that they can control, or limit the effects of the addiction without it getting worse. This often leads the family to make excuses and cover for the mistakes, which only hurts the situation,” says Dr. Surasky. Family members should communicate clear boundaries and stay strong while the person dealing with addiction endures the negative consequences. Dr. Surasky is a leading advocate in changing the language surrounding addiction. “I’ve found that labels like ‘addict’ and ‘abuser’ are damaging to those recovering from addiction. The labels shame and ostracize these people both within and outside the medical community. We need to separate the illness from the person who suffers from it. We don’t define sick people by their illnesses and we shouldn’t do it to people suffering with addiction.” Remember, people recovering from addiction are people first. Let’s use language of respect, not shame. Russell Surasky, FAAN, ABAM, with Surasky Neurological Center for Addiction, is board certified in both neurology and addiction medicine, is one of the few physicians with this combination of credentials. His primary focus in practice is addiction medicine. Utilizing unique medication protocols individualized to each patient, he provides specialized treatment for opiate, benzodiazepine, and alcohol addiction. http://www.drsurasky.com
News Article | October 28, 2016
At his worst, 54-year old Pat Martino, was taking more than 15 Oxycodone pills per day or as much as 40 Vicodin. He left his condo only once a month to pay his bills and to get more pills. Martino said the last 4 years of his addiction were “below hell… I really wanted to die,” he said recently. In March of 2016 Martino was arrested for falsifying prescriptions. He said that when the FBI knocked on his door, it was the best thing that ever happened to him. It was the final straw that guided Martino to seek the help he needed to finally overcome a lifetime of addiction and to get his life back. After his arrest, Martino went to detox for 6 days and spent an additional 15 days in rehab. There he heard about a medication designed to prevent relapse to opioid addiction, and he saw it as giving him an “advantage” in finally being able to get and stay clean. Board certified addiction medicine specialist, and Martino’s doctor, Russell Surasky, MD, said Martino’s story is all too common. “The life of a person addicted to opioids can become so unbearable that they simply wish to die,” says Dr. Surasky. “The good news is that there are new treatments that can be life changing. “As addiction medicine specialists, our job is to educate people about new treatments and show them that they can overcome opioid addiction and reclaim their lives,” adds Dr. Surasky. Martino has been clean and opioid-free since March 2016. He continues his recovery with the help of daily 12 step meetings and the once-a-month addiction medication called Vivitrol. “The Vivitrol blocks my obsession to use an opioid and enables me for the first time ever to work on myself and get on with my life, It has restored my brain to before I was using” says Martino. Dr. Russell Surasky adds that there are no cravings with Vivitrol. The medication heals the receptors in the brain and allows the brain to be restored to its pre-drug use stage.” According to Dr. Surasky, “drugs change the brain in ways that make it difficult to resist the impulse to continue taking the drugs. Opioids act by attaching to receptors in the brain that are stimulated to reduce the perception of pain and produce a feeling of well-being. When the drug wears off it detaches from the receptors and strong cravings compel taking another dose. After repeated use, opioids induce tolerance, meaning higher and higher doses are needed to achieve the same level of response. Over time, opioids cause long-term changes in the brain that persist even when the drugs are stopped - causing cravings and relapses years later.” Martino, a union plumber by trade, had a nice childhood. “My parents were good people,” he noted. “I got a lot of love as a kid.” He was born in Harlem and moved to Whitestone when he was 7. Martino started smoking pot when he was 14. By 19 he was using harder drugs like cocaine and amphetamines and when he was 20 he went to his first rehab. According to Martino, “the rehab was ok and it helped me for a while, but looking back I know I wasn’t fully committed.” Things got bad again for Martino in his early 30s and he went to another rehab. “The rehabs worked for me, but each time I fell back into my bad ways because the pull from opioid addiction was too strong and I failed to stick with a 12 step program,” says Martino. “Without that ongoing support, I now know that addicts like me will relapse and continue to use. That’s what happened with me time and time again.” The pattern continued for Martino into his 40s, and 7 years ago, at age 47, he suffered a painful, disabling workplace injury that left him with crushed discs in his neck. He quickly began abusing the opiates prescribed to him for pain and they soon took over his life. In January 2016, he overdosed for the 2nd time - alone in his apartment - and feels he would have died had his son not found him in time. “I couldn’t stop and I couldn’t keep going the way I was going or I was going to die,” Martino said. Today, Martino said he is happier than he has been in his whole life. He takes life one day at a time now, not thinking too far ahead. In addition to attending 12 step meetings each day, he is in outpatient treatment at Bridge Back to Life in Bethpage 3 or 4 times a week, and he sees Dr. Surasky every month for Vivitrol treatment. Without having to fight the constant obsession and compulsion to use opioids, he is able to share his experience to help others. He knows that keeping with this plan is critical to his ongoing recovery. Martino’s advice to fellow addicts is to get on Vivitrol, and get into a treatment program. He says this is the only way it can work. “Vivitrol allows me to recover, without constantly thinking about getting high,” he said. He also receives tremendous support from the Nassau County Shot at Life support group. Nassau County Executive Edward Mangano developed the program to educate the public about the medication Vivitrol and to connect people who are suffering with specialized programs and centers that can deliver this treatment immediately. Eden Laikin, who chairs the County’s Prescription Drug Abuse Task Force, heads the Vivitrol support group meeting every Tuesday night at St. Bernard’s Church in Levittown at 7 p.m. The Shot at Life program, which the County launched in February 2015, requires counseling as part of the 12-18 month Vivitrol treatment. Russell Surasky, FAAN, ABAM, with Surasky Neurological Center for Addiction, is board certified in both neurology and addiction medicine. His primary focus in practice is addiction medicine. Utilizing unique medication protocols individualized to each patient, he provides specialized treatment for opiate, benzodiazepine, and alcohol addiction. http://www.drsurasky.com