Addiction 101 Flashcards
What does drug abuse flood the brain with?
NT
What does drug abuse interfere with?
Normal brain functioning:
-Specifically it causes the brain to change and remember intense feelings of pleasure
How does ASAM define Addiction?
Primary, chronic disease of brain reward, motivation, memory and related circuitry
Who is most likely to get Addiction?
There are certain RF, but potential exists for anyone
What is another definition for Addiction?
An unhealthy relationship between person and mood-altering substance, experience, event or activity which contributes to life problems and their recurrence.
What is Addiction defined as when used as a common use term?
A problematic behavior pattern or problematic experience.
What are the ABCs of addiction?
Inability to ABSTAIN Impairment in BEHAVIORAL control CRAVING DIMINISHED recognition of significant problems A dysfunctional EMOTIONAL response
What is the Biopscyhosocial Model (BPS)?
Complex interactions between biological, psychological, and socio-cultural factors
How does the biopscyhosocial model describe the origins of addictive behavior?
Complex, variable, and multifactorial
What is a Brain Disease?
Addiction
What are the changes that drugs and alcohol make to the brain?
The changes can be long lasting.
When someone uses drugs, they allow the drug to _____ the brain that drugs are ________________.
“teach”, responsible for pleasure
-With addiction, the brain has changed to a point that normal life cannot give the person pleasure
How long does the brain continue to develop?
Into adulthood and it undergoes significant changes during adolescence.
What is the prefrontal cortex responsible for?
Problem solving, emotion, complex thought.
-Enables us to assess situations; makes sound decisions: keeps our motions and desires under control
Introducing chemicals while brain is still developing may have. . .
. . .profound and long-lasting consequences
What is the initial decision to use?
Voluntary
When does addiction become involuntary?
When substance abuse takes over, the ability to exert self control can become seriously impaired
What do brain imaging studies of substance abusers show?
- Physical changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control
- These changes may help explain the compulsive and destructive behaviors of addiction
What does long term alcohol, drug, etc. use cause?
Rewiring of brain circuits
How does addiction rewire the brain?
- Trigger adaptation in habit or non-conscious memory systems
- Conditioning: environmental cues become associated with the use experience & can trigger uncontrollable cravings
- Learned “reflex” is extremely robust and can emerge after many years of abstinence
What do drugs and alcohol do to the reward system?
Drugs and alcohol interact with circuits, pathways and chemicals –> euphoria, reduces negative feelings –> this feels “normal”, cravings
What are natural rewards?
Food, sex, water, nurturing
What do all drugs of abuse directly or indirectly flood the brain’s reward circuit with?
Dopamine
What is the function of dopamine?
Regulation of movement, emotion, cognition, motivation, and feeling of pleasure
What does overstimulation of the reward system cause?
Produces euphoria and teaches the repetition of using behavior
How much excess dopamine (DA) can be released with drug use?
Depending on the drug of abuse, 2-10x the amount of DA can be released vs. natural rewards
How does the onset and duration of Dopamine vary with drug abuse?
Onset and duration of dopamine can happen immediately or very quickly and last much longer than natural rewards
How does the brain adjust to overwhelming surges in DA?
By producing less DA and fewer R
What does the overwhelming surges of DA cause?
The ability to experience any pleasure is reduced –> Now drugs are needed in larger amounts to feel high –> Eventually, this is a baseline or “normal” and no longer produces a high
What are addiction risk factors?
Genetics, earlier age onset, childhood trauma (violent/sexual), mental illness
–> No single factor determines whether a person becomes addicted
What do nearly all addicts believe at the onset of addiction?
That they can stop using on their own
What happens with most addicts?
Most attempt to control, cut-down, or stop their use without treatment
What happens when addicts try to quit?
Although some people are successful, many attempts result in failure to achieve long-term abstinence
Drug abuse is a . . .
. . .preventable behavior.
Drug addiction is a . . .
. . .treatable disease.
How is Addiction managed?
Similar to other chronic diseases
What does addiction treatment usually involve?
Changing deeply embedded behaviors.
-Often a combo of medications and behavioral therapies
What are Behavioral Therapies for Addiction?
- Engage people in treatment
- Modify attitudes and behaviors
- Increase skills to handle cravings & triggers
- Enhance the effectiveness of medications
- Help people remain in treatment longer
What is the role of medication in treating Addiction?
- Treating withdrawal symptoms
- Treating cravings so that individuals can focus on counseling and other psychotherapies
- Preventing relapse
- Tobacco addiction - nicotine replacement, buproprion, Chantix
- Opioid addiction - methadone, buprenorphine, naltrexone
- Alcohol and drug addiction - disulfiram, naltrexone, acamprosate
What is meant by Addiction treatment not being a “one size fits all” shop?
Treatment should be tailored and centered around the needs and wants of the individual client, not a “cookie-cutter” approach
What is the idea behind the Stages of Change?
- Trans-theoretical model
- Meeting people “where they are at”
What are the Stages of Change?
Pre-contemplation Contemplation Determination/planning Action Relapse Maintenance
What are the two main traits behind Addiction treatment?
Pragmatic and Flexible
What are four traits of Addiction treatment?
- Readily available - immediate access to a variety of treatment services
- Strength-based - identify and reinforce strengths and resources, successful problem solving patterns, and plans for the future
- Holistic - concerned with wholes or the BPS model rather than with the analysis of, treatment of or dissection into parts
- Empowering - validate and legitimize client’s concerns and highlight their importance
When given a choice, clients often. . .
. . .choose the right level of care
What does treatment work through?
Enhanced motivation, increased insight, learned skills
What are the traits of effective Systems of Care?
- Person-centered
- Family and other ally involvement
- Individualized and comprehensive services across a lifespan
- Systems anchored in the community
- Continuity of care
- Partnership-consultant relationships
- Strength based
- Culturally responsive
- Responsiveness to personal belief systems
- Commitment to peer recovery support services
- Inclusion of the voices and experiences of recovering individuals and their families
- Integrated services
- System-wide education and training
- Ongoing monitoring and outreach
- Outcomes-driven
- Research-based
- Adequately and flexibly enhanced
Does relapse mean failure?
NO
What is not only possible, but likely?
RELAPSE
What does relapse serve as?
A trigger for renewed intervention
What are addiction relapse rates? What are they similar to?
About 40%. They are similar to other well-characterized chronic medical illnesses like T1DM, HTN, asthma
How does trauma relate to addiction?
Over 2/3 of people seeking treatment for substance use disorder report one or more traumatic life events.
What are the 3 R’s of the Trauma-informed approach?
REALIZING the prevalence of trauma.
RECOGNIZING how trauma affect all ind. involved in the program, org., or system, including its own workforce
RESPONDING by putting this knowledge into practice
What are the underlying principles behind the Trauma-informed approach?
- Safety
- Trustworthiness & transparency
- Collaboration & mutuality
- Empowerment
- Voice & choice
- Peer support and mutual self-help
- Resilience and strength-based
- Inclusiveness and shared purpose
- Cultural, historical and gender issues
- Change process
What do studies show about jail inmates and co-occuring disorders?
Almost 3/4 of jail inmates with mental disorders have a co-occuring substance use disorder.
What do justice-invovled individuals with co-occuring disorders often have?
Complex social and behavioral health needs
What is SAMHSA’s Working Definition of Recovery?
Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life.
What are the guiding principles of recovery?
- Is self-directed and empowering
- Involves personal recognition of the need for change and transformation
- Is holistic
- Has cultural dimensions
- Exists on a continuum of improved health and wellness
- Emerges from hope and gratitude
- Involves a process of healing and self-redefinition
- Involves addressing discrimination and transcending shame and stigma
- Is supported by peers and allies
- Involves (re)joining and (re)building life in the community
- Is a reality
There are many pathways to . . .
Recovery!
Until lions have their historians. . .
. . .tales of hunting will always glorify the hunter.
