Reducing Addiction

Question 1

What’s Drug Therapy?

Answer 1

Drugs are used to treat various addictions e.g. smoking.
Recently they’re been used to treat sex and gambling addictions.

Question 2

What Drug Therapy’s Used for Nicotine Addiction?

Answer 2

Nicotine Replacement Therapy (NRT).

Question 3

What’s the Aim of Nicotine Replacement Therapy?

Answer 3

To provide nicotine from a less harmful source e.g. patches, rather than a cigarette.

Question 4

How Does Nicotine Replacement Therapy Work?

Answer 4

NRT stimulates nicotine receptors, activates brain’s reward pathway, releasing dopamine into the limbic system, stimulating the nucleus accumbens and creating the same pleasurable feeling as smoking a cigarette does.

Question 5

What Does NRT Reduce?

Answer 5

Reduces nicotine withdrawal symptoms and stops cravings.
Reduction in wthdrawal symptoms is an example of negative reinforcement as NRT removes the unpleasant circumstances of quitting smoking.

Question 6

What Does NRT Desensitise?

Answer 6

Desensitises the nicotine receptors in the brain, releases small amounts of nicotine so only some receptors are full of nicotine, but not all.
Over time number of nicotine receptors reduce, meaning cigarettes become less rewarding to smoke, and relapse is less likely to occur.
Addict can gradually reduce nicotine dosage as tolerance to nicotine’s reduced.

Question 7

What’s the Aim of an Opioid Antagonist?

Answer 7

Reduces the pleasurable feeling associated with gambling.

Question 8

How Do Opioid Antagonists Work?

Answer 8

They enhance the release of the neurotransmitter GABA in the mesolimbic pathway.
The increased GABA activity reduces the release of dopamine in the nucleus accumbens and pre-frontal cortex, making gambling less pleasurable.

Question 9

AO3: Drug Therapy: Research to Support Effect of NRT

Answer 9

P: Stead et al.
E: Reviewed 150 high quality research studies that compared use of NRT with placebo.
E: Found all forms of NRT were significantly more effective in helping smokers quit than placebos and no treatment at all.
L: Supports drug therapy: found to be effective.

Question 10

AO3: Limitation of NRT and Opioid Antagonists

Answer 10

P: Negative side effects.
E: Common side effects are sleep disturbance, headaches.
E: Unlike CBT, non-invasive as individual’s identifying and challenging irrational thoughts that lead to addiction.
L: Side effects cause individual to stop treatment resulting in symptom relapse, drug therapy would be ineffective as reducing individuals addiction.

Question 11

AO3: Drug Therapy Strength

Answer 11

P: Requires little motivation from patient.
E: Because patient just has to wear a patch to reduce addiction.
E: Unlike CBT, requires more effort and motivation from patient, must commit to CBT sessions over moths, complete homework.
L: Drug therapy’s more appropriate for reducing addiction than others such as CBT.

Question 12

What do Behavioural Interventions Include?

Answer 12

They include aversion therapy and covert sensittisation.

Question 13

What do Behavioural Interventions Work On?

Answer 13

Both work on the principles of classical conditioning and aim to replace the pleasurable association with the addictive substance/ behaviour with an unpleasant association.

Question 14

What’s the Aim of Aversion Therapy?

Answer 14

The idea of therapy’s to use the principles of classical conditioning to change the pleasurable association with addictive substance/ behaviour and replace it with unpleasant association in another experience.

Question 15

How Does Aversion Therapy Work for Nicotine Addiction?

Answer 15

Specific technique is ‘rapid smoking.’
Individuals sit alone in a room taking a puff of cigarette every 6 seconds.
They begin to feel nauseous and associate this feeling to smoking.
This continues until the individual develops an aversion to smoking, reducing their addiction.

Question 16

How Does Aversion Therapy Work for Gambling Addiction?

Answer 16

Electric shocks are used (don’t cause permanent damage, only used to avert people from gambling, cause pain).
Addicted gambler thinks of phrases that relate to their gambling behaviour and write them on cards, e.g. ‘lottery.’
The ppt’s asked to read out each card, when they get to a gambling related phrase they’re given a two second electric shock.
Ppt associates gambling with painful shock, rather than pleasure, develop aversion to gambling, reducing addiction.

Question 17

How Does Aversion Therapy Work for Alcohol Addiction?

Answer 17

A client’s given an aversive drug which interferes with bodily process of metabolising alcohol into harmless chemicals.
Means person who drinks alcohol whilst taking drug will experience severe nausea and vomiting.

Question 18

What’s the Aim of Aversion Therapy for Alcohol Addiction?

Answer 18

For the individual to associate the alcohol with the nausea and develop an aversion to drinking alcohol as it would cause a conditioned response of nausea, reducing addiction.

Question 19

What’s the Aim of Covert Sensitisation?

Answer 19

The idea of the therapy’s that the pleasurable association with the addictive substance/ behaviour has to be broken down and replaced with unpleasant association in an imaginary experience.

Question 20

How Does Covert Sensitisation Work for Nicotine Addiction?

Answer 20

Client’s encouraged to relax.
Therapist reads script asking client to imagine situation e.g. client imagines them smoking a cigarette followed by most unpleasant consequences e.g. cigarette’s covered in faeces.
the more vivid imaginary scene, better the treatment work.
Therapist goes into graphic detail about certain elements of scene (e.g. smells, sound).
Towards end of session, client imagines turning back to addiction, experiences relief.
Ppts associates addiction with unpleasant scenario, rather than pleasure, reducing addiction.

Question 21

AO3: Strength of Aversion Therapy

Answer 21

P: Could be considered ethical.
E: Because addiction to drugs and gambling in itself’s potentially dangerous to physical and psychological health, aversion therapy’s less dangerous.
E: Individuals would be fully informed of what the therapy entails, give consent, electric shocks- ppts choose intensity, may be painful but not life threatening.

Question 22

AO3: Strength of Covert Sensitisation

Answer 22

P: Suitable for most individuals.
E: Non-invasive treatment.
E: e.g. individual’s pregnant, unlikely to harm baby, whereas aversion therapy, stress/ vomiting can lead to negative effects on baby.
L: Covert sensitisation may be seen as more appropriate.

Question 23

AO3: Weakness of Behavioural Interventions

Answer 23

P: Require motivation and commitment from patients.
E: Patient must commit to attending sessions and work with therapist to unlearn addictive behaviour.
E: Place themselves in unpleasant situations e.g. feeling sick, receiving electric shocks, unlike drug therapy which requires less commitment and motivation as patient only needs to take tablet/ wear patch.
L: Individuals may drop out behavioural therapies, reducing effectiveness as method of reducing addiction.

Question 24

What’s the Aim of CBT?

Answer 24

To identify and challenge irrational thoughts that are causing an addiction, as a way of coping and replace with more adaptive ways of thinking via cognitive restructuring.

Question 25

What’s Functional Analysis?

Answer 25

Therapist asks client to identify high-risk situations/ triggers to addiction e.g. walking past casino, ask them to report what they’re thinking before, during and after addiction.
Relationship between client-therapist is critical, should be warm and responsive, not cosy.
Because therapist must challenge client’s biased cognitions and merely accept them.

Question 26

What’s Cognitive Restructuring?

Answer 26

After analysis, cognitive restructuring’s used to change irrational thoughts to rational ones.
e.g. person has addiction to gambling, may have irrational beliefs that they win more than they lose.
Could be challenged via empirical disputing e.g. therapist could ask ‘where’s evidence that you win more than lose?’

Question 27

How is the Addicted Person Taught Social Skills?

Answer 27

Therapist teaches patient how to act within social situation.
e.g. being firm in refusal to gambling, in safe and secure environment (role play).
Client taught avoidance strategies.
Client learns to avoid situations that are likely to produce addictive behaviours i.e. driving different way home to avoid casino.

Question 28

What’s the Purpose of Homework?

Answer 28

The patient practices social skills within real world on their own, report back to therapist until they feel confident within social situations, addictive behaviour/ substance is available, leads to relapse prevention.

Question 29

AO3: Strength of CBT

Answer 29

P: Avoids chemical dependence.
E: Patients are taught skills to identify and challenge own cognitive distortions which are causing addiction.
E: Unlike drug therapy, patient’s dependent on drugs to control addiction by regulating dopamine levels.
L: CBT more appropriate method, patients don’t become dependent on drug.

Question 30

AO3: Strength of CBT

Answer 30

P: Suitable for most individuals.
E: Non-invasive treatment.
E: e.g. individual’s pregnant, unlikely to harm baby, whereas aversion therapy, stress/ vomiting can lead to negative effects on baby.
L: CBT may be seen as more appropriate.

Question 31

AO3: Limitation of CBT

Answer 31

P: Require motivation and commitment from patients.
E: Commits to number of CBT sessions where they challenge irrational thoughts, set homework to complete outside e.g. avoidance strategies.
E: Unlike drug therapy, just have to take tablet/ wear patch.
L: CBT less appropriate, patients may drop out/ relapse.