Understanding Addiction And Recovery Flashcards
NIDA definition of Addiction
A chronic, relapsing brain disease that is characterized by compulsive drug seeking behavior and use, despite harmful consequences.
ASAM definition of addiction
A primary chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction leads to characteristic biological, psychological, social, and spiritual manifestations.
How is addiction similar to other chronic diseases?
- Dysrupts normal functioning
- Has serious harmful consequences
- Preventable and treatable
- Can last a lifetime
- May be fatal if untreated
Is the term “addiction” clinical or diagnostic?
Clinical
What does “addiction” mean in clinical terms?
Brain changes resulting from long-term use of ETOH or other drugs that may lead to harmful behaviors and other physical, psychological, emotional, and spiritual consequences.
What biological factors affect risk for addiction?
gender, ethnicity, and developmental stage
What social factors affect risk for addiction?
conditions at home, at school, or in the community
How do protective factors affect addiction risk?
They reduce it.
What percentage do genetic factors account for in a person’s addiction risk?
40-60 percent
During what stage of life are home and family factors most important?
Childhood
What type of factors at home affect a persons risk for substance use?
Parents or family members who use or engage in criminal behavior.
During what period of development is the impact of friends and school greatest?
Adolescence
What sort of friend and school factors increase risk of SUD?
Friends who use, poor academic performance, and poor social skills.
What populations are at greater risk for developing SUD?
Adolescents and individuals with mental illness.
How does the method of administration affect the addictive potential of a substance?
Drugs that are injected or smoked have increased potential.
Why are drugs that are smoked or injected higher in addiction potential?
The high comes on faster and more intense.
What area of the brain is still maturing during adolescence?
Prefrontal cortex.
What impact does drug use during adolescence have on the brain?
Can change the development of the prefrontal cortex.
How does the prefrontal cortex affect a teen’s choice to use drugs?
They are more likely to make bad decisions (like using drugs) because the prefrontal cortex is not matured.
What are the major theories of causation?
- Moral
- Disease
- Genetic
- Cultural
- Blended
How does the moral model of causation say SUD are developed?
They are human weaknesses and defects of character.
How does the moral model of addiction affect views of addicts?
Reduces sympathy.
What does the disease model of causation say impacts the development of SUD?
It is an illness caused by impairment of healthy neurochemical or behavioral processes.
What model of causation is used in most therapeutic settings?
The disease model
To whom is the disease model of causation attributed?
E.M. Jellinek
When did the World Health Organization acknowledge alcoholism as a serious medical problem?
1951
When did the American Medical Association declare alcoholism a treatable illness?
1956
When did the American Psychiatric Association start using the disease model?
1965
When did the American Medical Association begin using the disease model of SUD?
1966
How does the genetic model of causation say SUD is developed?
Individuals have a genetic predisposition for SUD
How much evidence is available supporting a genetic link for SUD?
The model is well supported by strong evidence.
How does the cultural model of addiction describe the causation of SUD?
Certain cultures are either protected or susceptible to SUD.
What is the blended model of causation?
Blends all other models together and says it can be different for each individual.
How are different SUDs described?
They lie along a continuum from risky to problematic.
What is the minor end of the SUD continuum?
Relatively “disease free” but engages in maladaptive behaviors that they have control over.
What is the most severe end of the SUD continuum?
Individuals have no control over their use.
Do individuals always advance along the continuum of SUDs?
No
When is total abstention from substances necessary?
When the individual loses control of use at first use.
What age group tends to advance on the SUD continuum faster?
Adolescents
What specific drugs increase the progression along the SUD continuum?
Meth, crack, and opioids
How does the chemical action of substances affect the brain?
Stimulates certain brain systems.
What effect does the chemical action of substances have overall?
Causes the addiction.
What factors play less a role in creating SUDs as addiction progresses?
Psychological and social factors.
By what terms is addiction usually described?
Psychological, social, and biological.
What factors exacerbate the addictive process?
Biological differences in metabolism; different levels of susceptibility to reinforcing effects of drugs; personality disorders and depression; and low frustration or distress tolerance.
What happens at the beginning of substance abuse?
Increased tolerance and use.
What happens in later stages of addiction?
Life becomes centered on obtaining, using, and recovering from drug use.
What psychological factors affect the SUD continuum?
Use of substances for enhanced perception of rewards; cycle of avoidance.
What rewards may occur from substance use?
Enhanced sex; enhanced social situations; boost in self-worth; alleviation of stress and tension; and relief of pain.
What happens as an individual relies on substances as a coping skill?
Other coping skills atrophy.
What social factors affect the SUD continuum?
Substances may become a part of an individual’s social identity and they act as a social lubricant.
What biological factors affect the SUD continuum?
The brain’s chemistry changes with long-term use.
What is the role of dopamine in the mesolimbic sytem?
Dopamine is released causing pleasure.
What portion of the brain is repsonsible for the reward/pleasure pathways?
The mesolimbic system.
What happens as the brain is consistently flooded with dopamine?
The brain produces less of it.
How do drugs affect a person’s ability to enjoy life?
They lose the ability to experience pleasure as a result of life experiences without substances.
How do co-occuring mental health problems affect the SUD continuum?
Individuals with mental health problems may use substances to self-medicate.
What is the most widely used and abused substance in America?
ETOH
What type of substance is alcohol?
Sedative-hypnotic.
What sex is more likely to develop alcohol consumption problems?
Women
What effect does ETOH have on the body?
Initially causes feelings of pleasure and relaxation; followed by relaxation.
How many stages of effect does alcohol have?
Eight
Why are women more likely to develop ETOH consuption problems?
Blood alcohol typically is higher due to women being of a different composition than men (ETOH is more diluted in men than women)
What is the most common illicit drug in the US?
Marijuana
When did use of marijuana recently start increasing again among young people?
2007
What schedule is marijuana according to the federal government?
Schedule I
What happens when marijuana is smoked?
THC spreads from the lungs into the blood stream and to the brain and other areas of the body.
What brain system does marijuana affect?
The endocannabinoid system.
What does over activation of the endocannabinoid system result in?
Altered mood and perceptions, impaired coordination, difficulty thinking and problem solving, and disrupted learning and memory.
What percentage of marijuana users become addicted?
9 percent.
What names is synthetic marijuana called?
Spice, K2, fake weed, Yucatan Fire, Skunk, moon rocks.
What is synthetic marijuana?
Dried/shredded plant materials with synthetic added chemicals.
What effect does long term marijuana use have on school?
Lower school performance and increased likelihood of dropping out.
What effect does long-term marijuana use have on a person’s career?
Increased absences, tardiness, accidents, workers compensation, and job turnover.
What groups are increasing in rates of prescription drug abuse?
Teens, young adults, older adults, and women.
Where do prescription drugs rank among use of illicit substances?
It is second highest.
What contributes to high numbers of prescription drug abusers?
Ease of access.
What percentage of prescription drug abusers obtain them from a friend or family member?
60%
What substance increases risk of overdose with prescription drugs?
Alcohol.
What classes of prescription drugs are frequently overused?
Opioids, CNS depressants, & stimulants
In what ways are prescription drugs prescribed?
Taking a medication prescribed to someone else; taking more of a medication than prescribed; taking for another purpose than prescribed
What street drugs are similar to prescription opiates
Heroin
What street drugs are similar to CNS depressants?
GHB and Rohypnol
What street drugs are similar to adhd medications?
PCP or ketamine
Why are opiates particularly dangerous?
Depress breathing
From which drugs do people die of overdose most often?
prescription opioids
What has occurred (on rare occasions) from mixing ritalin (dextromethorphan) with decongestants?
Hypoxic brain damage due to severe respiratory depression
When do withdrawal symptoms appear?
Withing a few hours to several days after discontinuation of use.
What part of the brain is the “pleasure center?”
Nucleus accumbens
Why do withrawal symptoms occur?
Nucleus accumbens activity falls below normal.
What affects the severity of withdrawal symptoms?
Length and degree of addiction
What substances can be deadly?
ETOH and benzos
How does SAMHSA define recovery?
“a process of change whereby individuals improve their health and wellness, to live a self-directed life, and strive to reach their full potential.”
What factors affect recovery?
race, ethnicity, gender, sexual orientation, family history, life-cycle stage, environment, culture, and other factors
What two forces are part of the recovery paradigm?
1) affirmation of the real potential for resolution of behavioral health problems and 2) a public health movement offering solutions for behavioral health problems
How does the recovery management (RM) model of treatment address substance use?
Wraps traditional interventions in a continuum of recovery support services.
What is the RM continuum of recovery?
Pre-recovery –> recovery initiation and stabilization –> Recovery maintenance
What does the RM model emphasize?
Post treatment monitoring and support; long-term, stage appropriate recovery education; peer-based coaching; assertive linkage to recovery communities; and early re-intervention
What are two SAMHSA grants that help increase understanding of recovery?
Access to Recovery and Recovery Community Support
How has the addiction model of recovery affected mental health treatment?
Mental health treatment is recovery based
What does ROSC stand for?
Recovery oriented systems of care
What is ROSC?
A partnership with SUD and mental health professionals to guide the behavioral health system and promote individual, program, and system-level approaches to foster health and resilience
Aside from health and resilience, what other things does ROSC attempt to do?
Increase housing, employment, and education; reduce barriers to social inclusion
How can addiction counselors assist in designing and maintaining ROSCs?
Identify gaps in services; identify emerging client needs; and monitor system effectiveness
What are the four dimensions of ROSC essential to supporting a life in recovery?
Health, home, purpose, and community
What does the health remain of ROSC cover?
Overcoming/managing one’s disease and living in a physically and emotionally healthy way
What does the home dimension of ROSC entail?
A stable and safe place to live
What does the purpose dimension of recovery cover?
Meaningful daily activities such as job, school, volunteerism, family care taking, or creative endeavors and the independence, income, and resources to participate in society
What does the community dimension of ROSC entail?
Relationships and social networks that provide support, friendship, love, and hope
How many guiding principles of ROSCs are there?
10
What is the first guiding principle of ROSCs?
Recovery emerges from hope: the belief that recovery is real and achievable
What is the second guiding principle of ROSCs?
Recovery is person centered: self-determination and self-direction are foundations for recovery
What is the third guiding principle of ROSCs?
Recovery occurs via many pathways: built on multiple capacities, strengths, talents, coping skills, resources, and inherent value of each person.
What is the fourth guiding principle of ROSCs?
Recovery
What is the fifth guiding principle of ROSCs?
Recovery is supported by peers and allies
What is the sixth guiding principle of ROSCs?
Recovery is supported through relationships and social networks
What is the seventh guiding principle of ROSCs?
Recovery is culturally based and influenced
What is the eighth guiding principle of ROSCs?
Recovery is supported by assessing trauma
What is the ninth guiding principle of ROSCs?
Recovery involves individual, family and community strengths and responsibility
What is the 10th guiding principle of ROSCs?
Recovery is based on respect
What are the core components of ROSCs?
Collaborative decision making; continuity of services and supports; service quality and responsiveness
What is recovery management?
How the process of “continuity of care” in addition treatment and recovery services are organized
What creates success, even in involuntary substance abuse treatment?
Personal engagement with the process of recovery
Models of recovery management are founded on what assumption?
Full recovery may require multiple interventions or treatment episodes
What are the three phases of the recovery process?
Pre-recovery identification and engagement; recovery initiation and stabilization; and recovery maintenance
What is recovery capital?
internal and external assets which assist in recovery
What are internal assets assisting in recovery?
Qualities, characteristics, and skills posessed by the person in recovery
What are external assets assisting in recovery?
Resources outside the individual
What are 3 types of recovery capital?
Personal, family/social, and community
What things make up personal recovery capital?
physical health, financial assets, health insurance, safe shelter, clothing, food, and access to transportation
What is human recovery capital?
Less tangible resources such as values, knowledge, and hope
What is family/social recovery capital?
Interpersonal relationships with others willing to support a person in recovery
What is community recovery capital?
Community attitudes towards addiction and recovery, local regulations and policies, and resources available for treatment and support
