JEFFERSONVILLE, IN Sometimes the most important part of achieving something is simply believing you can do it. The confident, focused brain can accomplish many things. Sometimes, it can even undo the damage caused by a diseased mind.
Asad Ismail, MD, sees many patients battling psychological issues, neurological issues, dementia and addiction. Many of his patients feel broken and hopeless. Ismail’s care and treatments differ per patient, but the goal is the same: Help the patient believe they can get better.
“When these patients come for treatment, they have a lot of losses in their lives,” says Ismail, who has been the medical director of Wellstone Regional Hospital in Jeffersonville, Indiana for the past decade. “We have to give them hope, so they see they can get better and that they can go back to their lives.”
Born and raised in Pakistan, Ismail was driven to learn more about psychiatry and neurological disorders after his brother was stricken with polio resulting in mental impairment and epilepsy. Ismail saw the impact it had not only on his brother, but also on his parents. He wanted to learn how to make a difference.
Ismail completed medical school in Pakistan, then came to the United States. He completed a psychiatry residency at Bergen Pines County Hospital, which is affiliated with the University of New Jersey. Then he completed a neurology residency at the University of Louisville, where he also did fellowship in neurophysiology. He is a diplomat of the American Board of Neurology and Psychiatry and is board certified in addiction medicine.
“When I finished psychiatry, I decided to go into neurology so I could feel comfortable treating patients not only with psychiatric problems but also with neurological problems,” says Ismail, who also practices at Clark Memorial Hospital in Jeffersonville.
Ismail’s extended training and education allows him to diagnose and treat patients from a variety of angles. This limits the number of patients he has to refer to other specialists and allows him to create stronger relationships and better understanding of his patients’ needs.
“When I see a patient who has an addiction problem, at the same time I can address that patient’s psychiatric problem, whether they are bipolar, or suffer from depression or schizophrenia,” Ismail says. “In my neurology practice, when I see a patient about headaches and they start talking about depression, I don’t have to send them to a psychiatrist.”
Ismail treats a variety of addictions including alcohol, opioids, methamphetamine, and cocaine. He says that research has led to a better understanding not only of the treatment of addiction, but also of the actual impact it has on the brain.
Treatment Beyond Detoxification
“It is more neurochemical or neuroscience-based practice now,” Ismail says. “We used to treat patients with addiction as criminals and drug addicts with no hope. Science has proven that when people start using drugs, they have significant changes in their brain. At that point it is not under the patient’s control. We know now that this person who keeps relapsing needs more help rather than just detoxification.”
The reason detoxification isn’t enough, Ismail says, is that drug use changes the brain’s reward center and tells it the only way to get that feeling of pleasure and euphoria is via more drugs. Hence, the frequent relapses after detoxification only. The method Ismail finds effective is medication-assisted treatment.
Ismail points to new medications such as Suboxone for opioid patients and Vivitrol for alcohol dependence as examples of prescription drugs which can help patients with their cravings. While on these medications, Ismail’s patients go through intensive outpatient treatment, then transition to standard outpatient treatment. Ismail says his opioid patients usually are treated with Suboxone for one to two years, then are closely monitored for relapses as they are weaned off the medication.
“We expect good results after two years,” Ismail says, noting that drugs like Suboxone and Vivitrol do require monitoring for potential side effects such as impacted liver function. “I have so many patients whom I have treated with Suboxone who have gotten their families back, they are working, they are functional, they are healthy, and they believe this medication has saved their lives.”
Ismail adds that the treatment goes well beyond medication and science. The stigma of drug addiction leads to loss of jobs, isolation from friends and family, and alienation from society.
“We have to help them socially too,” he says. “Many of these patients lose their friends, their family. They are deprived socially. The only people they know are drug addicts who use drugs with them. We have to do some social rehab so this person is ready to go back to society and be functional.”
That, Ismail says, is why medical professionals must change their view of addiction patients. A negative attitude from a physician can feed into the patient’s feeling of despair and lack of self-worth.
“If I treat someone as a drug addict and I don’t treat him with respect, that patient will use drugs again,” Ismail says. “You have to treat addiction as a disease, not a crime. These patients are as human as any other patient. When you treat a patient who is a drug addict with respect and understand that he has a disease, that patient has a very high chance to get back to his life, his family and be a productive member of the community.”
Ismail credits treating addiction patients with a wide scope of expertise, treatment, and care for the success of the Wellstone addiction unit. The focus on the patient’s overall health is central to the treatment program.
“We have group therapy so they can learn how to discuss their issues and socialize,” Ismail says. “We have individual therapy sessions to discuss their family issues, their treatment options, and we can also help them to find a job. We are trying to make a model program where a patient can come and get treatment for their addiction and whatever kind of addiction they have, we can address it.”
The goals are big, but are they attainable? Ismail believes they are.