Addiction Theory

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599

Copyright AllCEUs 2006-2020

Continuum of Substance Use

Earn CEUs at AllCEUs.com NBCC #6261, NAADAC #599 Copyright AllCEUs 2006-2020

Objectives

To provide information about substance abuse

To assist students in understanding the symptoms and consequences of substance use and abuse

To motivate students to make informed choices about substance use and abuse


Overview

Substance use can be thought of on a continuum from social/recreational use to abuse and dependence.

Many factors affect whether substance use is a problem including whether it causes significant impairments in health, social, legal or occupational functioning

No certain amount of substance use necessarily means there is a problem. It is important to consider the situation, the consequences and whether the person was in jeopardy of causing themselves physical harm by using.


What is Addiction

Three facets to the definition

– A person, substance, or activity

– Regularly used to escape from negative feeling states

– Continues to be used despite experiencing negative consequences.

– Note: Physiological dependence is NOT necessarily a part of addiction


Definition of addiction cont…

Another way to understand addiction is to apply the four Cs:

– Behavior that is motivated by emotions ranging along the Craving to Compulsion spectrum

– Continued use in spite of adverse Consequences, and

– Loss of Control.


“Trademark” Addictive Behaviors

Denial

Manipulation

Throwing focus

Blaming

Minimizing

Rationalizing


The Continuum

Powerpoint Understanding Drug Abuse

Recreational Use

Gateway Drugs

Abuse

Dependence

The “Slide”


Understanding the “Slide”

Started with occasional drinking for relief/escape/relaxation

Things keep getting worse, so relief drinking becomes more constant

Needing more of the substance to get the same high

Started having blackouts The urge to use became

more urgent

Began feeling guilty

Memory blackouts increase Unable to discuss problems Harder to stop drinking Starting to fail to keep

promises Dramatic and/or aggressive

behavior began as people started to question your behaviors

Efforts to control the use of the substance fail repeatedly

Loss of other interests


Slide cont…

You begin to avoid family and friends

You begin to have resentments (which you can later look back on as unreasonable)

You start having problems at work and with money

You have lost your will power You begin to neglect your

diet, sleep and general health

You start having a decrease in your ability to tolerate the substance

Your intoxication/use periods become longer (days or weeks instead of a few hours)

Your body begins to deteriorate under the stress of the substance

Your thinking becomes impaired---judgment is bad, memory is lost


Understanding Addictive Behaviors

Definition of addiction: Diagnosis of a Problem Spent more time that anticipated trying to get the

substance, trying to be around the person or doing the behavior (like gambling or sex)

Used the substance, stayed in the relationship or did the behavior (like gambling or sex) despite knowing the problems it could cause

Spent more money than you anticipated trying to get the substance, do the behavior or stay in the relationship

Failed to fulfill family/work/school obligations as a result of using or recovering from use


Definition of addiction cont…

Used more of the substance than intended Legal problems as a result of use, doing the behavior or

staying in the relationship Used the substance, did the behavior or stayed in the

relationship for longer than intended Work/home or family problems as a result of the use of the

substance, staying in the relationship or doing the behavior Needed more of the substance or activity for the same high Put yourself in dangerous situations while getting or using

the substance, doing the behavior or staying in the relationship


Addiction Warning Signs

Read each statement carefully. Identify

which ones are warning signs and why.

I experiment with alcohol or drugs

I drink or use drugs occasionally in social settings

I function well at work and home

I use alcohol or drugs for pleasure

I use drugs/drink regularly at social or sporting events

Using makes me feel like one of the group

My rebellion is normal midlife or college behavior

My tolerance to alcohol or specific drugs has increased


Warning signs cont…

My functioning at work remains stable

I feel like I need to drink or use drugs

When you use you feel in control

I use drugs or drink on a daily basis

Relationships with my family are becoming strained

I hide my drinking or drug use from my family

Most of my friends do drugs or drink

I devote less time and attention to school work

I drink or use drugs to feel better

I have lost control over my use


Prevalence of the problem

More than 50% of the population has a substance abuse problem at some point in their lives.

If you factor in non-drug addictions such as gambling, sex and food, the number grows to closer to 75%

Drug Abuse Statistics


Consequences of Addiction

Individual

– Psychological, Cognitive, Social/Family, Occupational, Financial, Environmental, Physical

Community

– Crime, Commerce, Poverty, Social Modeling


Readiness for Change

Precontemplation

– “I do not have a problem and nobody can convince me I do!”

Contemplation

– I may use a bit too much sometimes, but I can get it under control”

Preparation

– “Okay, I have a bit of a problem and might consider listening to what you have to say.”


Cont. . .

Action

– “I have a problem and I cannot fix it by myself. Help me.”

Maintenance

– “ I have a disease. It is in remission. I know what I need to do to keep it that way and I am willing to do it.”

Relapse

– “I recognize some of the signs of my disease coming back in how I think, act and what I want to do. I know I need to take action.”


Clean vs. Sober

Clean= I have no drugs in my body or am not engaging in the behavior to which I am addicted.

Sober= I am clean and am behaving honestly, consciously and with courage and integrity.


Other addictive behaviors of concern

Eating Disorders

Gambling

Sexual Addiction

Shopping Addiction Relationships

Generally any person, substance or activity which continues to be used as a primary means of escape despite experiencing negative consequences (legal, relationship, occupational, health, emotional etc.)


Comprehensive Treatment

Individual

Family

School/Work

Community

Society at large


Types of Recovery Programs

Treatment Methods Overview Self Help

12-Step (pg. 247)

Recovery SMART Recovery (pg. 249)

Faith Based

Client Centered

Therapeutic Communities (Daytop, Samaritan Village, Phoenix House)


Duration and Frequency of Recovery Programs

Self-Help– Meets daily or weekly

– Usual involvement: several years

Outpatient– Meets weekly

– Usual involvement 12 weeks


Recovery Programs cont…

Intensive Outpatient– Meets 3-5 days per week 4 hours per day

– Usual involvement 12-24 weeks

Residential– 24/7 care

– Usual involvement 28 days for addictions programs and 6-12 months for dual diagnosis (addictions and mental health)


Levels of Prevention

Primary

– Goals are to prevent the problem from occurring in the first place

Secondary

– Goals are to prevent the problem from getting worse

Tertiary

– Goal are to prevent the problem from getting worse and prevent any other complications

Information on Prevention Programs for Those Interested


Risk and Resiliency Factors

INDIVIDUAL

RISK FACTORS

Certain physical, emotional or personality traits

Inherited genetic vulnerability

Low self esteem

Psychological disturbances

Inappropriate coping responses

Violence/ aggression

Risk taking propensity/impulsivity

Alienation and rebelliousness

Rejection of pro-social values/religion

Lack of peer refusal skills

Early and persistent problem behaviors

Early sexual activity/teen pregnancy

Early anti-social behavior

Peer rejection in elementary grades

Academic Failure

Less involved in recreational, social, activities

Lack of information on positive health behaviors

PROTECTIVE FACTORS

Knowledge regarding risks associated with substance abuse/use

Negative attitudes toward substances and substance use

Bonding to pro-social culture

Positive relationships with adults

Views parents, teachers, doctors, law enforcement officers and other adults as allies

Social competence

Youth involvement in alternative activities

Sense of well-being/self confidence

Has positive future plans


Peer Risk Factors cont. . .

RISK FACTORS • Reinforcement of negative norms and

expectations within peer group • Thinks alcohol and drug use is "cool" • Inappropriate sexual activity among peers • Ties to deviant peers/gang involvement

PROTECTIVE FACTORS • Involved in substance-free activities • Friends disapprove of alcohol and other

drug use


Family Risk Factors

RISK FACTORS •Family members with a history of alcohol or other drug abuse •Family members don't spend much time together •Parents have trouble keeping track of teens, who they're with and where they go •Lack of clear rules and consequences regarding alcohol and other drug use •Parents use drugs, involve youth in their use ("Get me a beer, would you?") or tolerate use by youth •Parents have trouble setting consistent expectations and limits •Family conflict/abuse •Loss of employment

PROTECTIVE FACTORS •Close family relationships •Consistency of parenting •Education is valued and encouraged, and parents are actively involved •Copes with stress in a positive way •Clear expectations and limits regarding alcohol and other drug use •Encourages supportive relationships with caring adults beyond the immediate family •Share family responsibilities, including chores and decision making •Family members are nurturing and support each other


School Risk Factors

RISK FACTORS

Lack of clear expectations, both academic and behavioral

Students lack commitment or sense of belonging at school

High numbers of students who fail academically at school

Parents and community members not actively involved

PROTECTIVE FACTORS

Positive attitudes toward school

School bonding

Regular school attendance

Communicates high academic and behavioral expectations

Encourages goal-setting, academic achievement and positive social development

Tutoring available

Positive instructional climate

Provides leadership and decision making opportunities for students

Fosters active involvement of students, parents and community members

Sponsors substance-free events

School responsive to students' needs


Community Risk Factors

RISK FACTORS •Alcohol/other drugs readily available •Irresponsible servers and sellers •Laws and ordinances are unclear or inconsistently enforced •Norms are unclear or encourage use •No sense of "connection" to community •Neighborhood disorganization •Rapid changes in neighborhood High unemployment •Residents at or below the poverty level •Lack of strong social institutions •Lack of monitoring youths' activities •Inadequate media portrayals •Misleading advertising •Pro-use messages

PROTECTIVE FACTORS •Opportunities for community involvement •Community religious composition •Laws are consistently enforced •Informal social control •Policies and norms encourage non-use •Community service opportunities Resources (housing, healthcare, childcare, jobs, recreation, etc.) available •Comprehensive risk focused programs available for youth•Programs for parents of children and adolescents •Early childhood and family support programs


Additional Resources

The Higher Education Center for Alcohol and Other Drug Prevention http://www.edc.org/hec National Clearinghouse for Alcohol and Drug Information http://www.health.org National Council on Alcohol and Drug Dependence http://www.ncadd.org Center for Substance Abuse Prevention (CSAP) http://www.coresoft.comlcsap.html Virtual Clearinghouse on Alcohol, Tobacco, and Other Drugs http://www.ccsa.calatod.htm National Center on Addiction & Substance Abuse http://www.casacolumbia.org Promising Practices - Campus Alcohol Strategies http://www.promprac.gmu.edu Training for Intervention Procedures (TIPS) http://www.gettips.com Harvard School of Public Health College Alcohol Study http://hsph.harvard.edu/cas National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov National Institute on Drug Abuse http://www.nida.nih.gov AI-Anon http://www.al-anon.org Health finder http://www.healthfinder.gov Drugs Awareness Online: Use, Abuse, & Treatment http://www.mhhe.comlhper/health/drugs


Summary

Substance abuse is defined by impairment in one or more areas of functioning over a 12 month period as a result of substance use

More than 50% of people have an addiction

There are a host of outpatient and more intensive programs and styles

Addiction Theory

Documents

Transcript of Addiction Theory