Introduction to Substance Misuse and Dependence Flashcards
Tolerance
– Through habituation an individual develops a tolerance to the
effects of a substance
– With repeated administration more of the substance is required in order to achieve the same effects
Withdrawal
Physical withdrawals – can be fatal particularly in alcohol, seizures, death
– Psychological withdrawal state of anhedonia characterised by dysphoria, irritability, emotional distress
Craving /Compulsion
Craving /Compulsion
Models of substance misuse were originally unidimensional
- Temperance
- Moral
- Disease
- Medical
Temperance Model
- The drug is dangerous and causes the problems
- Moderation is unreliable so the answer is prohibition..
- ‘Once you start using, can’t stop…’ • The drug takes control
Moral model
• People decide to use alcohol and other drugs based on social and/or religious norms
– Addiction is the result of weakness and defective character
• So we need to help people make better decisions with education and deterrents
• ‘They can always choose not to use…’
• But social and religious norms change over time
Disease Model
- Certain people have a specific physiological process off addiction which leads to a loss of control when the drug is used
- These people need to be identified and can not drink/use
- ‘I have a disease…’
- The individual has the responsibility of managing his/her disease but if use, then loss of control…
Medical model
- A number of potential physiological medical factors have been considered whchi put the person at risk/more vulnerable to problems
- Assess risk and address factors as possible
- ‘Alcoholism runs in my family’
- Again control is related to risk management
Psychodynamic Models
• Alcohol and other drug problems are primarily related to psychodynamic factors such as early childhood experiences or trauma
– Addictive personality disorder/self medication • People need psychotherapy to address
underlying issues
• ‘I have an addictive personality’
• Substance misuse as maladaptive coping
Sociocultural Models
• A number of sociocultural factors have been identified which increase the risk of problems within a population
• Need to address these factors
• ‘Who wouldn’t have a problem living in my
neighbourhood…’
• Sociocultural factors seen as key…
Systems and Family Models
- Need to see alcohol and other drug use in relationship to the functioning of family and social systems
- For people to change, need to consider relationships and change within the system
- ‘You cant be sober and deal with my family…’
- Much more difficult for a person to change because of system
Learning Models
- Alcohol and other drug use is learned behaviour
- If a behaviour is learned it can be unlearned and new behaviour learned in its place
- ‘I use Valium because I don’t know how else to get to sleep…’
- The person is responsible for learning and practicing…
Conditioning Model - pavlov
classical conditioning and associative learning
conditioning model - skinner
operant conditioning and instrumental learning
psychological theories - choice
a person often chooses to engage in addictive behaviour as a result of a cost benefit analysis of the alternatives (may be influenced by biases and changing preferences)
