4.2:Addiction

Question 1

Substance Use Disorder

Answer 1

condition characterised by the uncontrollable use of one or more substances (e.g., alcohol, drugs) despite significant negative consequences on an individual’s health, relationships, work, and overall functioning. It is considered a chronic and relapsing brain disorder involving physical, psychological, and behavioural components.

Question 2

DSM-5 Substance Use Disorder

Answer 2

problematic pattern of substance use leading to clinically significant
impairment or distress

1. substance is taken for longer periods/ larger amounts than originally intended
2. persistant desire+ unsuccesful efforts at cutting down// quitting
3. great deal of time spend searching for drug/ using drug / recover from its effects
4. craving, strong desire to use the drug
5. recurrent use leading to failure to maintain daily functioning- roles at home, work
6. continued use despite consistent interpersonal issues over use
7. Important social, occupational, or recreational activities are given up
   or reduced because of substance use
8. Recurrent substance use in situations in which it is physically
   hazardous
9. use is continued despite knowledge of having a
   persistent or recurrent physical or psychological problem likely to be caused or exercebated by the substance.
10. tolerance
    a. a need for markedly increased amounts of the substance to achieve
    intoxication or desired effect
    b. markedly diminished effect with continued use of the same amount
    of the substance
11. Withdrawal, as manifested by either of the following:
    a. the characteristic withdrawal syndrome for the substance (refer to
    Criteria A and B of the criteria sets for Withdrawal from the specific
    substances)
    b. the same (or a closely related) substance is taken to relieve or avoid
    withdrawal symptoms

Question 3

definitions related terms to SUD

addiction

Answer 3

drug use to the point where the body’s normal state is the drugged state - so the body requires the drug to feel normal

Question 4

definitions related terms to SUD

Psychological Dependence

Answer 4

The user’s tendency to alter their life because of the drug and to centre their activities around the drug

Question 5

definitions related terms to SUD

Craving

Answer 5

a strong subjective druve to use the substance

Question 6

definitions related terms to SUD

Tolerance

Answer 6

the need for greater amount of the drug or substance to achieve intoxication (the desired effect) or a markedly diminished effect with continued use of the same amount of the drug or subtance.

Question 7

definitions related terms to SUD

Withdrawl

Answer 7

maladaptive behavioural change, with physiological and cognitie contamitants, that occurs when blood or tissue concentration of a sustance or drug decline in an individual who has previously maintained prolonged hevay use of the substance or drug.

Question 8

definitions related terms to SUD

Substance

Answer 8

a drug of abuse, medication, or a toxin

Question 9

Commorbidity SUD & other disorders

Answer 9

high rates of comorbidity: b/w 41-76% of indiv w SUD have at least one other psychopathology

strong association with mood and axiety disorders.

high risk groups:
- bipolar disorder
- ADHS + Schiz
- antisocial personality disorder

Question 10

explaination of comorbidity of SUD + other psychopathologies

Answer 10

1. substance use as a risk factor for psychopathology- can trigger
   BUT: there is a higher chance of SUD after psych disorder than vive versa
2. self medication hypothesis
   * Explanation:
   o Individuals with psychopathology may turn to substances to manage negative emotional and behavioural symptoms.
   o Example: Using cannabis or alcohol to cope with anxiety or depressive symptoms (Turner et al., 2018).
   * Contrasting Evidence:
   o Chapter 8 highlights the possibility of a causal link between cannabis use and psychotic symptoms, suggesting a bidirectional relationship

Question 11

Addiction as dyscontrol

Answer 11

Substance use dyscontrol: “drug usage becomes a substance use
disorder when persons are significantly impaired in their control of
this usage”

Rats given access to drugs
▪ Cease grooming and
eating (especially with
cocaine)
▪ Deterioration of health

Question 12

Stimulants

Answer 12

Amphetamine, cocaine, XTC, nicotine,
caffeine, Adderall/Ritalin
▪ Stimulate psychological and sensorymotor functioning (alertness, energy,
confidence)
▪ Therapeutic uses (amphetamines): treat
ADHD and narcolepsy, formerly for
asthma and for sinus decongestion
▪ Adverse effects: irritability, reduced
executive functions, paranoia, insomnia

Question 13

Sedatives

Answer 13

Opium, morphine, codeine,
heroin, methadone
▪ Euphoria, well-being, lack of negative
emotion
▪ Therapeutic uses: analgesia, cough
suppression, antidiarrheal,
suppression of opiate withdrawal
(methadone)
▪ Adverse effects: anxiety, pain
sensitivity, insomnia

Question 14

Psychogenics

Answer 14

Hallucinogens = LSD, mescaline, psilocybi
- Altered states of consciousness but anxiety/paranoia
▪ Psi = mystical experience; openness

Cannibinoids = marijuana, hashish
▪ Well-being; perceptual changes but agitation, anxiety, paranoia
▪ Therapeutic use: anti-nausea, appetite stimulation, analgesia

Stimulatory hallucinogens = MDMA (ecstasy)
▪ Euphoria, sociability, perceptual changes but anxiety,
depression, fatigue
▪ Therapeutic use? Adjunct to PTSD psychotherapy

Question 15

Non-substance addiction

Answer 15

Gambling disorder (DSM-IV impulse control d.o.
→ “behavioral addiction” in DSM-V)
▪ Tolerance, unsuccessful efforts to control
▪ Videogames, internet as addiction? (internet in
appendix of DSM-V)
1. A great deal of time is spent in activities necessary to
obtain the substance
2. Important social, occupational, or recreational activities
are given up or reduced because of substance use
3. The substance use is continued despite knowledge of
having a persistent or recurrent physical or
psychological problem that is likely to have been caused
or exacerbated by the substance
▪ But dyscontrol?

Question 16

Alcohol Use Disorder

Answer 16

characterised by an inability to control or stop alcohol consumption despite adverse consequences to physical health, mental well-being, and social or professional functioning

1. Binge Drinking:
   o High alcohol intake in one session (e.g., 8 units for men, 6 units for women in the UK).
2. Ethyl Alcohol:
   o The intoxicating constituent of alcoholic beverages.
3. Biphasic Effects:
   o Alcohol acts initially as a stimulant and later as a depressant.

Question 17

Physical Effects of Heavy Alcohol Consumption

Answer 17

1. withdrawl symptoms (restlessness, insomnia, anxiety, depression)
2. Delirium Tremens (DT)- severe withdrawl symptoms, delirium, hallucinations
3. long term health risks- cardiovascular, gastrointestinal, neurological, nutritional deficiencies.
4. fetal alcohol syndrome (FAS)- heavy drinking during pregnancy leading to physical deformities, heart problems.

Question 18

DSM-5 Diagnostic Criteria for Alcohol Use Disorder

Answer 18

1. Definition:
   o A problematic pattern of alcohol use causing clinically significant impairment or distress.
2. Key Features:
   o Behavioural and physical symptoms, including:
    Tolerance: Needing more alcohol for the same effect.
    Withdrawal: Symptoms developing within 4–12 hours of restricted consumption.
   o Compulsive drinking: Life revolves around obtaining and consuming alcohol.
   o Impacts on daily responsibilities: poor work performance, neglecting kids.

Question 19

Course of alcholol use disorder

Answer 19

Progression of Alcohol Use Disorders
1. Stages of Development:
o Heavy and Regular Drinking:
 Early stage involving frequent consumption of large amounts of alcohol.
o Alcohol Abuse:
 Alcohol consumption begins to interfere with daily life and responsibilities.
o Alcohol Use Disorder:
 Final stage characterised by dependency and significant impairment or distress.

Question 20

Treatment Alcohol dependence

Answer 20

1. Self-Help Groups
   Example:
   Alcoholics Anonymous (AA): Utilises a 12-step recovery program and encourages building sober social networks.

2.Motivational Enhancement Therapy (MET)
Description:
Cognitive-behavioural therapy focusing on client-driven change.
Involves feedback on drinking effects and personalised treatment plans

3.Social Behaviour and Network Therapy (SBNT)
Description:
Builds a supportive social network (family, friends, colleagues) for sustained abstinence.

4. Pharmacotherapy
   Medications:
   Naltrexone: Prevents relapse.
   Acamprosate: Doubles abstinence chances compared to therapy alone (Swift, 1999).
   Ondansetron: Effective for early-onset alcoholics

Question 21

Tobacco Use Disorder:

Answer 21

• Definition:
  o A problematic pattern of tobacco use causing clinically significant impairment or distress.

Question 22

Nicotine: The Addictive Agent

Answer 22

2. Physical Effects:
   o Stimulant: Increases blood pressure and heart rate.
   o Calming Effect: Reduces stress, anxiety, and anger (Warburton, 1992).
   o Negative Effects:
    Periods of stress, irritability, and pain sensitivity between cigarettes.
    Symptoms during attempts to quit include irritability, restlessness, and mood swings

Question 23

Nicotine and the Brain

Answer 23

1. Addictive Mechanism:
   o Releases dopamine in the mesolimbic system.
   o Activates nicotinic receptors, increasing dopamine neuron firing rates.
2. Effects of Dopamine Release:
   o Elevates mood, suppresses appetite, enhances cognitive function (Stein et al., 1998).
   o Similar to addictive drugs like cocaine.
3. Withdrawal Symptoms:
   o Stress, irritability, depressed mood, difficulty concentrating, increased appetite

Question 24

DSM-5 Tabacco Use Disorder

Answer 24

tabacco use causing impairment or distress leading to at least two of the following within 12 month period.

• tabacco taken in greater amounts for longer than intended
• a continuing desire and unseccesful effort to control use
• lot of time aquiring and using tabacco
• craving, or strong desire to use tabacco
• failure to fulfil roles at work or home
• persistent use despite interpersonal problems
• tolerance and higher tabacco use
• withdrawl symptoms associated w high tabacco use

Question 25

Treatment Tabacco use disorder

Answer 25

1. E-Cigarettes
   Description: Handheld devices that mimic smoking without burning tobacco.
2. Nicotine Replacement Therapy (NRT)
   Forms: Patches, gum, lozenges, nasal sprays, inhalators
3. Bupropion
   Description: Antidepressant targeting dopamine and noradrenaline pathways.
4. Aversion Therapy
   Method: Techniques like rapid smoking to induce unpleasant effects (e.g., nausea).
5. Cognitive Behavioural Therapy (CBT)
   Focus:
   Addresses depression and negative moods as smoking triggers.
   Develops alternative coping mechanisms.

Complementary Therapies
Hypnotherapy: Limited evidence of effectiveness (Green & Lynn, 2000).
Acupuncture: Anecdotal evidence suggests gradual reduction in smoking levels.

Question 26

Barriers to Quitting - nicotine

Answer 26

Nicotine Withdrawal Symptoms:
Cravings and negative moods drive continued smoking.
Relapse Factors:
Depression (50% of unsuccessful quitters have major depression).
Negative mood states and exposure to smoking-friendly environments.
Quit Attempts:
Smokers average 2.1 attempts annually.
May take up to 30 attempts for success

Question 27

Cannabis Use Disorder - active ingredients

Answer 27

1. THC (Δ9‐tetrahydrocannabinol):
   o Primary psychoactive compound.
   o Determines the strength of cannabis’ effects.
2. Mechanism of Action:
   o Influences CB1 and CB2 cannabinoid brain receptors:
    Found in the hippocampus, cerebellum, and striatum.
   o Affects dopamine levels in brain areas associated with:
    Reward and pleasure experiences.
   o Physical Effects:
    Mild stimulant effect, increasing heart rate.
3. Addictive Properties:
   o THC has low addictive potential but can lead to dependency with regular use.

Question 28

DSM-5 cannabis use disorder

Answer 28

1. DSM-5 Criteria:
   o Includes tolerance, withdrawal, and significant impairment in daily life.
2. **Signs of Cannabis Intoxication:
   o Initial “high” feeling followed by:
    Euphoria with inappropriate laughter.
    Sedation, lethargy.
    Impaired short-term memory and judgment.
    Distorted sensory perceptions and motor performance.
    Feeling of slowed time.
   o Severe effects in some cases:
    Anxiety, dysphoria, social withdrawal.
3. Prevalence Rates:
   o US Statistics:
    12-month prevalence: 3.4% in ages 12–17, 1.5% in adults.
   o Adolescents at Risk:
    10–21% risk of cannabis use disorder by early adulthood (Farmer et al., 2015).
   o Heavy Users:
    30–50% meet criteria for cannabis use disorder (Hasin et al., 2015).
   **

Question 29

long term costs of cannabis use

Answer 29

• regular use can lead to anxiety, depression, schizophrenia
• immediate cognitive deficits and impact on psychomotor activities
• long term cognitive costs - lower IQ, loss of motivation, no evidence of permanent neuropsychological deficits.
• cancer risk
• ## reduction in testosterone

Question 30

cocaine use disorder

Answer 30

Mechanism:
Blocks dopamine reuptake, increasing neural activity and facilitating pleasure and confidence

o Long-term Impacts:
 Erratic behaviour, social isolation, and sexual dysfunction.
 Risk of psychological disorders (e.g., depression, social phobia, panic disorder, generalised anxiety disorder, eating disorders).
3. Mechanisms of Dependency:
o Prolonged exposure induces long-term changes in dopamine neurons, making the brain more vulnerable to dependency

Question 31

Costs of Cocaine Use Disorder

Answer 31

cogntive = impaired decision making
developmental effects if prenatal exposure- increase ADHD, visual-motor deficits.

heart problems- increases blood pressure

Question 32

Amphetamine use disorder

Answer 32

1. Characteristics:
   o Tolerance:
    Rapid onset- quicker than other drugs; larger doses required for the same effect.
   o Dependence:
    Regular use despite family or work-related problems.
    Neglect of responsibilities.
   o Intoxication Symptoms:
    Initial “high” with euphoria, energy, and talkativeness.
    Can lead to:
    Stereotyped, repetitive behaviour.
    Anger, aggressive behaviour, and impaired judgment.
    Physical symptoms:
    Pupil dilation, perspiration or chills, nausea, chest pains, seizures, or coma.
   o Withdrawal Symptoms:
    Depression, fatigue, vivid unpleasant dreams, insomnia, agitation

Question 33

cost of amphetamine use disorder

Answer 33

1. brain damage - inhibit dopamine production in orbitofrontal cortex
2. damage to dopamine and seretonin systems - result in poor decision making
3. slow or poor decision making
4. chronic use reinforces compulsive drug-seeking behaviour

Question 34

Opioid Use Disorder

Answer 34

Definition: A condition marked by tolerance to opioids, requiring increasing doses for the same effects.
- Accompanied by severe withdrawal symptoms.

Key Opioids:
- Includes illicit drugs (e.g., heroin) and prescription opioids.

Mechanism:
* Opioids interact with brain receptors that process endorphins, increasing feelings of euphoria and pain relief.

Question 35

types of opioid users

Answer 35

1. Uncontrolled Users:
   o Struggle with dependence, neglect responsibilities, and engage in criminal activities to sustain their use.
2. Controlled/Unobtrusive Users (Shewan & Dalgarno, 2005):
   o Long-term heroin users who have never sought specialised treatment.
   o Maintain levels of occupational status and educational achievement similar to the general population.
   o May use heroin periodically and avoid dependency.
3. Temporary Users:
   o Use linked to life stressors.
   o Example: US soldiers during the Vietnam War became heroin abusers but stopped after returning home (Bourne, 1974).

Question 36

Lysergic Acid Diethylamide (LSD) - effects

Answer 36

2. Effects:
   o Physical Effects:
    Dilated pupils, raised body temperature, increased heart rate and blood pressure, sweating, sleeplessness, dry mouth, and tremors.
   o Sensory and Psychological Effects:
    Sharpened perceptions: Enhanced colours, attention to small details.
    Hallucinations: Distorted perceptions of space and time, perceiving nonexistent objects or people.
    Dangerous Misbeliefs: Users may believe in abilities they do not have (e.g., the power of flight), leading to risky behaviours.
   o Bad Trips:
    Exaggerated feelings of anxiety or stress, leading to extreme terror or panic.
   o Flashbacks:
    Vivid re-experiencing of a prior “trip,” occurring days, months, or even years later (Abraham & Wolf, 1988).

Question 37

cost of LSD use

Answer 37

1. Unpredictable Effects:
   o Users cannot predict whether they will experience a “bad trip.”
2. Psychiatric Risks:
   o Rarely associated with psychotic symptoms or chronic depression.
   o Empirical studies suggest hallucinogens are not a significant independent risk factor for mental health problems (Krebs & Johansen, 2013).
3. Mortality:
   o UK data (1993–2014): Five deaths recorded from LSD use, none since 2003 (ONS, 2016).
4. Tolerance Effects:
   o Regular users may need increasing doses for similar experiences.

Question 38

Ecstasy (MDMA)- mechanism action

Answer 38

o Acts as both a stimulant and hallucinogen.
o Releases serotonin and dopamine in the brain:
 Serotonin: Causes euphoria, feelings of well-being, sociability, and heightened sensory perceptions.
 Dopamine: In high levels, can cause psychotic symptoms, such as paranoia and confusion

Question 39

cost of MDMA use

Answer 39

short term:
- dehydration
- cardiovascular strain

long term:
- neurotoxicity
- cognitive deficits - memory and executive functions
- serotonin transporter reduction
- psychologica- increase of depression

Question 40

Aetiology of Substance Use Disorder - overview

Answer 40

1. Aetiology:
   o The study of the causes and development of substance use disorders (SUDs).
   o Explores why some individuals progress to dependency while others do not (e.g., Shewan & Dalgarno, 2005).
2. Developmental Perspective:
   o Substance dependency is a progression through stages, with unique risk factors at each stage.
   o Stages of Development (Figure 9.5):
3. Experimentation: Initial, casual use.
4. Regular Use: Frequent use without significant life disruption.
5. Substance Use Disorder: Dependency with significant interference in occupational, social, and family functioning.
   o Mediating Factors:
6. Beliefs (e.g., that a substance is harmless).
7. Environmental triggers.
8. Psychological conditions.
9. Key Processes Underlying SUDs:
   o Neurological Mechanisms:
10. Activation of brain reward pathways.
    o Behavioural Processes:
11. Conditioning external cues to drug craving

Question 41

Neurological Processes in Addiction

Answer 41

1. reward pathways in the brain- activate natural reward system poviding pleasure -Dopamine pathway, particualrly via VTA, NAc
2. Mechanisms of Action:
   o Stimulants: Increase dopamine transmission in the NAc.
   o Opiates: Indirectly increase dopamine by inhibiting GABAergic interneurons in the VTA and acting directly on NAc opioid receptors.
   o Nicotine: Activates VTA dopamine neurons directly.
   o Alcohol: Influences multiple points in the reward pathway.
   o Cannabis: Complex effects, potentially acting on NAc neurons.
   o Phencyclidine (PCP): Directly affects NAc neurons.
3. Brain Areas Involved:
   o Ventral Tegmental Area (VTA):
    Midbrain structure linked to dopamine release.
   o Nucleus Accumbens (NAc):
    Part of the limbic forebrain; critical for experiencing pleasure.
   o Additional Areas:
    Amygdala: Emotional regulation.
    Hippocampus: Memory and learning.
    Hypothalamus: Stress and reward responses.
    Frontal Cortex: Decision-making and impulse control.
4. Adaptation and Addiction:
   o Chronic drug use causes adaptive changes in the reward pathway, sustaining addiction (Taylor et al., 2013).

Question 42

Behavioural Mechanisms: Craving and Conditioning

Answer 42

1. Craving:
   o Intense desire for a substance, often triggered by external cues (e.g., sights, smells, environments).
   o Liking and wanting a drug becomes conditioned, reinforcing addiction.
2. Conditioning Processes:
   o External stimuli associated with drug use trigger:
    Psychological cravings.
    Physiological responses.
   o Conditioning strengthens over time, making cravings harder to resist.

Question 43

. Peer Group Influences SUD

Answer 43

1. Social Norms:
   o Adolescents are influenced by group norms rather than direct pressure.
    Drug use becomes a way to self-categorise as part of a group (Schofield et al., 2001).
2. In-Group Dynamics:
   o Behaviours like smoking or drinking are used to cement friendships and show commitment to the group (Stewart-Knox et al., 2005).
3. Labels and Social Identity:
   o Group labels (e.g., “rebels” or “illegal drug users”) are strongly associated with substance use (Schmitt et al., 2003).
4. Social Models:
   o Social Influence Model:
    Group dynamics initiate substance use.
   o Social Selection Model:
    Individuals select groups that reinforce their substance use.
   o Both models may apply during experimentation

Question 44

key process in abuse and dependence

Answer 44

Tolerance
* The need for larger doses to achieve the same effect.
* Often seen in alcohol use due to high inherited tolerance.
Withdrawal Symptoms
* Severe withdrawal symptoms contribute to dependency:
o Anxiety, restlessness, muscle aches, insomnia, fever (heroin).
o Emotional and physical distress reinforces continued use.

4. Developmental Perspective on Substance Use Disorders
5. Stages of Progression:
   o Experimentation: Initial use, often influenced by social and environmental factors.
   o Regular Use: Maintenance of use through mood regulation, social reinforcement, and cultural acceptance.
   o Abuse and Dependency: Regular use transitions to dependency when daily life is disrupted.
6. Factors Influencing Each Stage:
   o Early use: Peer pressure, availability, media influences.
   o Regular use: Mood regulation, self-medication, expectations and beliefs.
   o Abuse: Genetic predisposition, cognitive deficits, psychiatric comorbidity, poverty.

Question 45

Treatmetn SUD- comunity based

Answer 45

1. Self-Help Groups:
   o Alcoholics Anonymous (AA):
    Helps replace social networks of substance users with supportive members.
    Outcomes: Long-term abstinence possible but no more effective than structured treatments.
    High dropout rates affect efficacy evaluations.
2. Drug Prevention Schemes:
   o Aims:
    Prevent first use or regular use through education.
   o Strategies:
    Peer-pressure resistance training.
    Counter-media campaigns.
    Peer leadership: Young people trained to deliver anti-drug messages.
    Correcting misconceptions (e.g., about drug prevalence or harm).
   o Evidence:
    Effective in reducing smoking, alcohol, and drug use (Das et al., 2016).
    May delay onset of drug use.
3. Residential Rehabilitation Centres:
   o Features:
    Clients live and receive treatment in a supportive environment.
    Combines detoxification, group work, psychological interventions, and vocational training.
   o Effectiveness:
    Longer stays (≥3 months) associated with better outcomes (Simpson, 2001).
    High dropout rates hinder success.

Question 46

treatment SUD- behavioural

Answer 46

1. Aversion Therapy:
   o Uses classical conditioning to associate drug use with aversive stimuli (e.g., nausea-inducing drugs).
   o Variant: Covert sensitisation—clients imagine aversive outcomes.
   o Effectiveness:
    Short-term benefits; long-term efficacy limited (Elkins et al., 2017).
2. Contingency Management Therapy:
   o Techniques:
    Stimulus control: Avoiding triggers.
    Reward abstinence: Vouchers for drug-free behaviours.
    Self-monitoring: Keeping diaries of use.
    Structured goal-setting.
   o Used for skills training (e.g., job-seeking, assertiveness).
3. Controlled Drinking:
   o Focus: Controlled substance use rather than abstinence.
   o Benefits:
    Enhances self-esteem and personal responsibility.
    Teaches coping skills to manage lapses.

Question 47

Treatment SUD- cognitive

Answer 47

1. CBT for Relapse Prevention:
   o Identifies and challenges abstinence violation beliefs (e.g., “One lapse means I’ve failed”).
   o Teaches coping strategies for stress and negative emotions.
   o Motivational-Enhancement Therapy (MET):
    Includes communication training, peer refusal skills, and relapse prevention techniques.
2. Third-Wave CBT:
   o Metacognitive Therapy:
    Targets dysfunctional beliefs about substance use (e.g., “I have no control”).
   o Mindfulness:
    Reduces cravings and prevents relapse.
   o Efficacy:
    More effective when combined with family therapy or other interventions.

Question 48

treat

treatment SUD_ biological

Answer 48

1. Detoxification:
   o Systematic withdrawal, supervised in residential or outpatient settings.
   o Aims:
    Reduce withdrawal symptoms.
    Prevent relapse using antagonistic drugs (e.g., Antabuse for alcohol).
2. Medications:
   o Antabuse (disulfiram):
    Causes nausea when alcohol is consumed.
    Effective in supervised programmes (Krampe et al., 2006).
   o Opiate Antagonists:
    Naltrexone, Naloxone, Buprenorphine:
    Block endorphin receptors to reduce cravings.
    Used for alcohol, cocaine, and opioid dependency.
   o Replacement Therapy:
    Methadone:
    Substitute for heroin, reduces risks of overdose and disease.
    Effective when combined with structured therapy.
3. Emerging Treatments:
   o Sativex (cannabis aerosol):
    Weaker psychoactive effects than cannabis, for cannabis dependency.
   o Supervised heroin injections:
    Reduces street heroin use and crime (Strang et al., 2010).

Question 49

SUD family and couple therapy

Answer 49

• Importance:
  o Addresses dysfunctional family patterns contributing to substance abuse.
  o Engages family support to aid recovery.
• Benefits:
  o Reduces blaming behaviour.
  o Improves communication and problem-solving skills.
• Evidence:
  o Effective for adolescent substance use and as impactful as individual therapies (Waldron et al., 2001