Addiction- modification Aversion therapy Flashcards
What is aversion therapy?
Works on classical conditioning
An addict will learn to associate the thing that they are addicted to with an unpleasant stimuli
This addiction will then turn to an unpleasant response ultimately stopping addiction
2 components of aversion therapy?
Antabuse (disulfiram)
Rapid smoking
How does antabuse work?
Antabuse acts as an aversive stimulus ultimately affecting how the body metabolises alchohol
Usually alchol is broken down by acetaldehyde and then further broken down by an enzyme in the liver called aldehyde deyhydrogenase
-Antabuse causes a reaction called disulfiram reaction stopping this enxyme fro working and causes a build up of acetaldehyde in bloodstream
Diagram of antabuse?
Ethanol–> ADH (the alcohol dehydrogenase/ fast)–> Acetaldehyde–> ALDH (aldehyde dehydrogenase/disulfiram ADLH) slow–> Acetate
-Building toxin and unable to breakdown as enzyme is stopping it
What does antabuse cause?
Occurs in 10 minute of drinking alcohol causes vomiting creating an association
-Leading to person a person avoiding contact with the behaviour and may avoid triggers associated with addiction e.g. pubs
-Affects of drugs are sweating, heart palpitations, headaches and vomiting
Classical conditioning schedule for antabuse?
Before
UCS ————> UCR
antabuse vomiting
NS alcohol—-> no response
DURING
UCS + NS—> UCR
antabuse + alcohol= discomfort
AFTER
CS ———-> CR
Alcohol ——> Discomfort
NICE guidlines for antabuse?
Antabuse treatment can begin after the individual has undergone withdrawal
200mg daily but increased if reaction to alcohols not adversive enough
-Should remain under 2 week supervision for the first 2 months then monthly for next 4 month
-Be cautious with certain foods and mouthwash that may contain alcohol
What is rapid smoking?
Smokers sit in a closed room and take a puff on a cigarette every 6 seconds until they finish number of cigs or until they feel sick
-Smokers develop aversion due to strong association
-Very popular in 1970s USA but not today
Evaluation- Researchers?
Niederhofer and Staffen 2003
Jorgensen et al 2011
Evaluation- research support Niederhofer and Staffen 2003?
Compared antabuse to a placebo and assessed their participants using self report method of and screening for 90 days
Antabuse patients had higher abstinence rates than placebo
Evaluation- research support- Jorgensen et al 2011?
People taking antabuse had more days until relapse and had fewer drinking days
However- people may be able to figure out placebo
Evaluation- research support, counter arguments?
Studies looking at antabuse in the long term are rare and they tend to lack scientific rigour as they are full randomised control trials guessing placebos
-Few comparison studies between antabuse and other treatment for alcoholism and they often take place on small samples
-Difficult to carry out placebo studies as patients will be aware with condition they are in if they drink and no adverse effects are experienced so unethical
Evaluation- research support rapid smoking?
Limited and less popular
However done by McRobbie
Evaluation- research support McRobbie?
Did a study on 100 smokers attending accession clinic where rapid smoking compared with a control condition those who wanted a video about giving up smoking
-The ones taking part in rapid smoking significant decrease the urge after 24 hrs and a week
Evaluation- research support McRobbie counter argument?
After 4 weeks the difference between rapid smoking and abstinence rates were unclear but reducing urges early may kick start progress than other techniques applied
Evaluation- practicle issues: treating the symptom not the cause?
Only end up treating behaviour, starting drinking due to stress, depression or peers after creating an aversion
Problems still aren’t cured so can substitute addict in order of managing stress individuals may actually need therapy
Underlying problem in cognitive bias
Evaluation- ethics side effects?
Alcohol and antabuse nausea is not a side effect as this is intentional as well as rapid smoking is unpleasant
-Antabuse- drowsiness, tiredness, headache, taste in mouth, skin and rash, acne
-Weigh up pros and cons for alcohol and these symptoms
-Increase in lung cancer and damage
Evaluation- ethics?
Have no free will to withdrawal
Having to wait a while to get it removed
Evaluation- ethics what is covert sensitisation and why can this be an ethical alternative?
Imagine feelings of being sick or vomiting when having the urge to drink
Tom Kraft- quick and highly effective treatment and more ethical
Evaluation- social implications?
Drinking and smoking cost UK economy a lot
Any treatment that is able to reduce the rates of these addictions may be able to prevent a lot of the harm caused to save money
Evaluation- social implications Devlin?
Dramatic increase in spending than other drugs than to treat alcholism
In 2008 £2.25 mill up from 1.08 mill in 1998
Evaluation- social implications Alcohol concern?
Small amount compared with money spent on treating alcoholism on NHS investment in treatment and prevention saves money in long run
