topic 3 - addiction

Question 1

define addiction. what is it?

Answer 1

addiction is a mental health problem where people feel that they need to ‘have’ or ‘do’ something constantly to avoid negative or uncomfortable feelings. They need to participate in this activity in order to be able to go about their normal routine.

Question 2

what is withdrawal? define it, how is it related to addiction? when does it occur?

Answer 2

withdrawal is when a set of unpleasant feelings both physical and psychological. It occurs when a person with an addiction is trying to quit or cannot satisfy their addiction.

Question 3

what does the ICD-10 refer addiction as? clue: there are two labels

Answer 3

dependence disorder and behavioural addiction.

Question 4

in dependence disorder, according to the ICD-10, what are the symptoms?

Answer 4

for dependence disorder the abbreviation is : DIRT PF

d-difficult to stop or reduce the substance
i-ignores the evidence that the use of the substance is harmful to them.
r- replaces normal and fun activities by spending time using the substance or recovering from it
t- tolerance to the substance has developed so the person may need to increase the amount used to get the effect over time.
p- physical withdrawal symptoms such as shaking, sweating or vomiting when the substance is not used for a period of time.
f- feels the need to take the substance

Question 5

in behavioural addiction, according to the ICD-10, what are the symptoms?

Answer 5

for behavioural addiction the abbreviation is : SINNR
s- spend more time doing the activity than other things they used to enjoy.
i- ignore arguments that the activity is unhealthy or damaging.
n- need to the activity more often or do something ‘risky’ to get the same buzz
n- need to do the activity regularly
r- reducing the activity is very difficult

Question 6

according to the ICD-10, what are the features of addiction?

Answer 6

the most treated substances for addiction were opiates such as heroin or painkillers including morphine and the next highest being alcohol.

it is very difficult to estimate the number of people with addictions because many people don’t always realise or recognise that they have an addiction or may not seek help.

addiction is not a rare problem as the NHS have estimated that about 2 million people in the UK suffer from it.

Question 7

how have the incidences of addiction changed over time?

Answer 7

one of the key issues in assessing how has the incidences of addiction changed over time is the change of the definition to the term ‘addiction’. addiction now includes internet addiction or video game addictions. now addiction is mostly behavioural addiction rather than before when addiction mainly concerned substance misuse.

another change of addiction is the view in society. in the past opiates such as heroin were prescribed medically but now we might consider someone using opiates regularly to be an addict.

statistics suggests that the incidences of addiction is rising. A report suggested that many sources of addiction such as alcohol, heroin or cannabis are becoming cheaper, therefore, making them more accessible to more people as they are more affordable.

Question 8

how does addiction affect individuals and society?

Answer 8

for individuals:

neglect responsibilities. they disregard their family and they things they usually participated in such as work or school. They may spend their money on their addiction rather than essentials such as food and their accommodation decreasing their quality of life and their health because they are unable to invest to look after themselves.

for society:
criminal behaviour. not only is it a danger for the community but there is a cost to investigate these crimes. The cost goes from the police being involved and investigating the crime, policing costs, trying the case in court, cost of punishment, cost of treatment programmes and the cost of supporting the victims of the crime.

impact on the workplace. Normally people with addiction develop health problems as a result of their substance misuse or lack of self-care due to the time concentrated on their addiction. This causes them to take time off of work which results in costs for the company in covering the workload of that individual.

Question 9

what did dorit carmelli et al say about how genes explained addiction?

Answer 9

carmelli et al found that if one (mz) monozygotic identical twin, the other twin had a higher chance of becoming an addict as well compared to non identical twins (dz). this is because monozygotic twins share more genes than non-identical twins (dz).

Question 10

what did donald goodwin et al say about how genes explained addiction?

Answer 10

donald et al found that adopted children who had at least one biological parent who had an addiction were likely to show signs of that addiction themselves. This suggests that they could have inherited that gene from their biological parents.

Question 11

what did remi cadoret et al (1987) say about how genes explained addiction?

Answer 11

Cadoret supported Goodwin in how an adopted child who had at least one biological parent with an addiction problem were more likely to have an addiction problem themselves. however, Cadoret also found that if the adopted child had an adoptive parent who had an addiction problem, had greater risk of developing that addiction as well. so while it has some support for how genes affect addiction, it shows some environmental influence.

Question 12

what gene has a great influence on developing addiction?

Answer 12

the DDR2 gene

Question 13

what does the DDR2 gene do? how does it affect addicts etc?

Answer 13

The DDR2 gene has been proven to be related to the development of addiction. The DDR2 gene is thought to affect the way the brain reacts to pleasurable activities, therefore, this may cause the person to have to the activity more often to gain the same ‘buzz’ from it or do something risky or increase the dosage depending on what type of addiction it is.

Question 14

what did Diana Martinez et al find on how the DDR2 affected addiction or how people became addicts?

Answer 14

Martinez’s study found that genetic variations of people’s receptors can make some people more likely or prone to developing a cocaine addiction or any other addiction but cocaine users were used in her study.

Question 15

what are the strengths of the genetic explanation of addiction?

Answer 15

another strength of the genetic explanation is that it explains why only some people are more prone to becoming addicts. This makes some people seem more likely to develop addictions while others can participate in the activity but find it easier to stop and start. This makes people be more understanding towards addicts as they may have no control over the way they behave.

Question 16

what are the weaknesses of the genetic explanation of addiction?

Answer 16

another weakness is that research is unable to find what specific gene causes addiction, therefore, making it hard to pinpoint and solve the gene which makes some people more prone to becoming an addict. One gene which has been linked to developing addiction in genes is the DDR2 gene, however, this gene has also been linked to autism and autism and addiction have very different symptoms therefore making it unclear how this gene exactly relates to addiction.

Question 17

what is a learning theory?

Answer 17

a learning theory is an explanation that believes behaviour is learned though associations and experiences.

Question 18

what is classical conditioning?

Answer 18

learning through associations.

Question 19

what is operant conditioning?

Answer 19

learning from the consequences of actions

Question 20

what is social learning theory?

Answer 20

behaviour is learned through observation and imitations of role models. role models can be adults such as parents or just adults in general or older siblings.

Question 21

what is reinforcement?

Answer 21

reinforcement is an outcome resulting from behaviour that increases the chance of the behaviour being repeated or avoided in the future. The outcome may be the result of gaining something positive or of something negative being removed.

Question 22

how does classical conditioning relate to addiction in the learning theory as an explanation of addiction?

Answer 22

classical conditioning is when two or more things happen at the same time and our brain links them together. These two things become connected and when we experience one of the these things the other one is automatically triggered.

an example is;
you get sick from eating miso soup. one you smell or eat miso soup the feeling of being sick goes through you again. they are associated with one another.

this explains addiction as when people first become addicted they associate the activity with a positive feeling and in some way the person begins to link the positive feeling and that activity so when they want to feel good they want to do that activity because they associate it with the required outcome.

Question 23

how does operant condition relate to addiction in the learning theory as an explanation of addiction?

Answer 23

this relates to the reinforcement and punishments. When experiencing a positive consequence of an action it is a form of positive reinforcement so it is more likely to be repeated.

this relates to addiction as for example if a gambler is in a casino and they insert 100$ in the slot machine and they win, they will want to do it again and the next night they do the exact same thing because they are repeating their reactions through getting a positive outcome. If the addict tries to reduce or stop the activity they could undergo negative reinforcement where they experience withdrawal symptoms which makes them feel uncomfortable so they want to participate in the activity to remove the uncomfortable feelings.

Question 24

how does social learning theory relate to addiction in the learning theory as an explanation of addiction?

Answer 24

the social learning theory claims that we learn our behaviour through observing other people, especially those we consider as role models.

This relates to addiction as if a person who looks up to someone such as a close family member or celebrity who has an addiction they may go on to copy it in fake ways while they are young and when they get older they would be more inclined to try it for real as they have been exposed to this behaviour before.

Question 25

what are the strengths of the learning theory as an explanation of addiction?

Answer 25

a strength of this explanation is assuming that addictions are the result of learning we can be re-learn. using punishments addicts can be taught through the association of positive and negative punishments when they participate in that activity. This can cause the addicts to avoid this behaviour.

classical conditioning helps explain why previous addicts relapse which means go back to their addiction. even after an addict has stopped for a long time, they still associate the feeling of happiness or another positive emotion with their addiction, making it more likely for them to go back to their addiction so they can experience that positive emotion again.

Question 26

what are the weaknesses of the learning theory as an explanation of addiction?

Answer 26

one weakness is through the learning theory and how it ignores the biological factors and how it could influence addiction. If a child who has a role model that has an addiction and they go on to have that addiction as well, they may not have the ‘addiction gene’ making it easier for them to start and stop ultimately making them not much of an addict.

another weakness is that the conditionings don’t explain why people try drugs, alcohol and gambling but only a small number become addicted. If the cause was simply learning from associations and consequences, then everyone that experiences taking in substances or participating in an activity should go on to become addicted.

Question 27

what is positive reinforcement?

Answer 27

positive reinforcement is increasing the chance of the behaviour being repeated because it is good. eg. giving a reward.

Question 28

what is negative reinforcement?

Answer 28

negative reinforcement is again increasing the chance of the behaviour through taking away something bad. e.g. have a headache, take paracetamol. take away the pounding in the head

Question 29

what is positive punishment?

Answer 29

positive punishment is to decrease a behaviour through inflicting something undesirable. e.g coming home late, put on an electric shock bracelet when you need to come home.

Question 30

what is negative punishment?

Answer 30

negative punishment is again to decrease a behaviour but through taking away something desirable. e.g failed a test , phone is taken away.

Question 31

what are the two stages in treating addicts through cognitive behavioural therapy as a treatment for addiction?

Answer 31

functional analysis and skills training.

Question 32

what is functional analysis in cognitive behavioural therapy as a treatment for addiction?

Answer 32

functional analysis is the first stage in the the CBT in identifying what makes an addict turn to their behaviour. basically the trigger. The therapist might make the addict look at what emotions cause the addict to have the feeling to take a substance or participate in an activity. By understanding the source of the addiction, the addict with the help of the therapist can learn what places, people and or feelings to avoid in order to stop them participating in their addiction.

Question 33

what is skills training in cognitive behavioural therapy as a treatment for addiction?

Answer 33

skills training is the second stage of the CBT after the functional analysis, where the patient learns ways they can use to avoid engaging in the addictive behaviour.

examples are;

• how to cope with cravings (useful for drug addicts and alcoholics)
• assertiveness training (useful if other people are peer pressuring the addict to participate in the activity which they are addicted to) e.g saying no etc.
• improving motivation (useful for committing to the therapy and stopping the addictive behaviour)

Question 34

what is the homework given to the patient in the cognitive behavioural therapy as a treatment for addiction? and what are they supposed to do?

Answer 34

in between sessions patients will be asked to keep a diary/ journal, they are supposed to record important events such as times they felt tempted, how they felt, what they did and how this made them feel.

Question 35

what are the strengths of the cognitive behavioural therapy as a treatment for addiction?

Answer 35

one strength is that it gives the patient control to stop their own addictive behaviour. This may be seen as a weakness but they patient learns skills on how to deal with their addiction by themselves and stay away from their addiction in the future. As long as the patient is willing to change their behaviour they can reduce their addiction by using their skills.

another strength is the CBT is supported by research evidence. A study found that the CBT was effective in treating people with an internet addiction both in short term and up to 6 months ended. This suggests that the CBT is an effective way of treating addiction as well as a long term treatment.

Question 36

what are the weaknesses of the cognitive behavioural therapy as a treatment for addiction?

Answer 36

one problem of using the CBT as a treatment is that the addict is put in charge of themselves. The addict has to be motivated to change their behaviour and one of the symptoms of addiction is the addict finds it difficult to stop their addiction and they will refuse evidence that their addiction is harmful, this means that they may find committing to the treatment difficult.

another weakness is research has suggested that even though addicts can learn better coping skills from the CBT it does not always mean that they will reduce their problem behaviour. Addicts will be able to cope with their addiction but they will not always put the skills they learn through the CBT into practice and they will eventually turn back to their addiction.

Question 37

when are drugs used to treat addiction?

Answer 37

when patients go through detoxification. when patients intake opiates such as heroin, alcohol and nicotine, they cause unpleasant side effects when the patient goes cold turkey, so the medication is used to help reduce these effects and to help the patient control their addiction.

Question 38

what is detoxification? (drug therapy as a treatment for addiction)

Answer 38

when an addict tries to stop taking the substance they are addicted too.

Question 39

what is withdrawal? and how can the drugs be used in this situation? (drug therapy as a treatment for addiction)

Answer 39

withdrawal occurs when a person stops taking or using a substance they were addicted too. They can face withdrawal symptoms as the substance leaves their system. The addict might experience;
-insomnia,
-shaking,
-lack of appetite
- headaches
- irritability
drugs are given because the withdrawal process is very painful and difficult. The drugs help reduce the withdrawal symptoms and reduce the chance of the patient relapsing and using the substance again.

Question 40

what is cravings? and how can drugs be used in this situation? (drug therapy as a treatment for addiction)

Answer 40

when a patient stops using a substance, their body has become so used to the substance that they have an urge to take the substance again in order to feel normal. Medication can be given to reduce the craving symptoms.

Question 41

what are the withdrawal symptoms?

Answer 41

• insomnia,
• shaking,
• appetite loss
• headaches
• irritability

Question 42

what is methadone and what is it used for in drug therapy as a treatment for addiction?

Answer 42

methadone is used to treat people addicted to opiates such as heroin. methadone acts on the brain similar to heroin but is less dangerous. This can reduce the cravings that the addict feels when not using heroin.

Question 43

what are patches or chewing gum and what are they used for in drug therapy as a treatment for addiction?

Answer 43

patches or nicotine patches are used for smokers as a nicotine replacement therapy. this helps reduce the cravings of the addict.

Question 44

how do drugs treat underlying mental health problems? (drug therapy as a treatment for addiction)

Answer 44

some patients with a substance addiction may also have mental health problems such as depression or anxiety. Drugs such as antidepressants and anti-anxiety medication can be offered with substance addictions as the drugs reduce the symptoms of problems which could potentially cause a relapse.

Question 45

how are drugs prescribed and used to treat people with behavioural addictions such as gambling etc? (drug therapy as a treatment for addiction)

Answer 45

naltrexone is being prescribed to treat those with severe gambling addictions despite the drug previously treating severe alcohol addictions. There is evidence that people that have severe gambling addictions experience ‘cravings’ and naltrexone can help lessen these cravings and stop gambling addicts from relapsing.

there are other drug therapies such as antidepressants and SSRI are used to treat sex addictions but it is unclear how it is effective.

Question 46

what drug is prescribed for behavioural addictions?

Answer 46

naltrexone

Question 47

what are the strengths in using drug therapy as a treatment for addiction?

Answer 47

one strength is that there is evidence which supports the effectiveness of the drug therapies to treat addictions. Evidence shows that the gambling addicts that were treated through being prescribe naltrexone showed a significant improvement in their symptoms and the number was less when gambling addicts were treated with a placebo drug, this suggests that drug therapy can be effective in treating behavioural addiction such as gambling.

another strength is that drug therapy can be combined with the CBT. The drug therapy could be used as a first stage in having the addict improve. once they are able to deal with the short term symptoms they can access help in the form of CBT where they can tackle other issues associated with their addiction.

Question 48

what are the weaknesses in using drug therapy as a treatment for addiction?

Answer 48

one weakness is the evidence for the effectiveness of drugs to treat addiction is very mixed. addiction is a complex mental health problem with many different types of addictions and while evidence shows that drugs can provide effective treatment, not all evidence agree. when a study was conducted to test the effectiveness of naltrexone treating alcohol addiction there was no significant difference in relapse rates with the placebo drug and the real drug.

another weakness is that some argue giving medication to patients who are already addicted to something, especially if the medication is another substance it could make their problems worse in the long term as they could be dependent on the medication.