Week 10 Flashcards
define: addiction
- an unhealthy relationship between a person and a mood-altering substance, experience, event, or activity which contributes to life problems and their recurrence
what is included in the criteria for substance abuse disorders? (6)
- cravings to use the substance
- wanting to cut down or stop but not managing to
- taking the substance in larger amounts or for longer than you’re meant to
- neglecting other parts of your life because of substance use
- continuing to use, even when it causes problems in relationships
- using substances even when it puts you in danger
what are 2 types of addictions
- process
- ingestion
define: process addiction
- when one becomes hooked on a process –> a specific series of actions/interactions
ex. gambling or shopping
define: ingestion addiction
- addictions to substances that are deliberately taken into the body
ex. alcohol & other drugs
what are the lvls of involvement of addiction
- non-involved
- irregular
- regular
- harmful
- dependent
describe the non-involved lvl of involvement of addiction
- non-using lifestyle
describe the irregular lvl of involvement of addiction
- no pattern
- causes no harm to the individual
ex. a glass of wine a few times a year
describe the regular lvl of involvement of addiction
- pattern
- harmful episodes may be seen
ex. drinking & driving
describe the harmful lvl of involvement of addiction
- everything found in regular (consistent, regular pattern) which impacts life areas and has more harmful consequences
describe the dependent lvl of involvement of addiction(5)
- cravings
- consistent use
- puts oneself as risk
- less likley to seek help
- less than 10% of people w addictions identify as dependent
describe the cycle of addiction (3)
preoccupation (with obtaining drug, persistent psychical/psychological problems) —–> binge/intoxication (persistent desire & larger amts taken than expected)—-> withdrawal/negative affect
what elements can contribute to addiction (4)
- biological
- spiritual
- social
- psychological
(biopsychosocial-spiritual model)
what are 4 drugs groups of psychoactive drugs
- depressants
- stimulants
- hallucinogens
- cannabinoids
pts w anxiety are more likely to try which drug groups (2)
- depressants
- cannabinoids
pts w insomnia are more likely to use which drug groups (2)
- depressants
- cannabinoids
pts w depression are more likely to use which drug groups (3)
- stimulants
- hallucinogens
- cannabinoids
what are examples of depressants (8)
- alcohol
- benzos
- barbs
- opioids
- codeine
- allergy meds which make you drowsy
- cough syrup
- Benadryl
describe the effect of depressants (2)
- decreases state of alertness
- diminishes the impact of the environment on thoughts and feelings
what are examples of stimulants (4)
- crack cocaine
- meth
- adderal
- MDMA
describe the impact of stimulants (2)
- increases state of alertness of the user
- can make user feel excited, euphoric, aggressive
what are examples of hallucinogens (4)
- psiliocybin mushrooms
- LSD
- cannabinoids
- ketamine
describe the impact of hallucinogens (2)
- drugs that alter the perception of reality
- induce sensory and cognitive distortions
what is an example of a cannabinoid
- cannabis
products containing cannabis are derived from which plant
- cannabis sativa
describe the impact of cannabinoids
- sedative-euphoriant-psychadelic properties
- exhibits characteristics of all categories
describe the link between cannabis and schizophrenia
- can trigger latent schizophrenia
once there has been one episode of drug induced psychosis, there is an increased likelihood of ______
- having more episodes
what are some unintended consequences of COVID-19 (4)
- opioid overdoses
- restricted access to certain drugs due to border closures (couldn’t import ingredients for meth)
- increased intimate partner violence
- alcohol use increasing in certain demographics
describe the link between substance use and mental health
- debate as to whether or not mental illness causes substance use or the other way around
what is trauma
- an experience that overwhelms a person leaving them w a sense of fear, helplessness, and horror
what is important to remember w trauma
- trauma is in the eye of the beholder
- what impacts one person does not always impact another in the same way
what can trauma look like in a person (7)(
- extreme mood swings
- difficulties w relationships
- feelings of shame
- changes in consciousness (dissociation, flashbacks)
- somatic symptoms
- struggles w “finding meaning” in life
- hypervigilance (difficulty sleeping)
what is a single or single incident trauma
related to an unexpected and overwhelming event such as:
- an accident
- single episode of abuse or assault
- sudden loss
- witnessing violence
describe a complex psychological trauma (3)
experiences that
1) involve repetitive or long-term exposure to or experience of multiple traumatic stressors
2) involve harm or abandonment by caregivers
3) occur at critical times in the person’s life, especially over the course of childhood
describe developmental trauma
results from exposure to early trauma (infants, children, youth) involving:
- neglect
- abandonment
- physical abuse or assault
- sexual abuse or assault
- emotional abuse
- witnessing violence, death, coercion, betrayal
describe historical trauma (2)
- emotional and mental wounding that builds over the life span and across generations emanating from massive group trauma
- these collective trauma are inflicted by a dominant group
provide examples of historical trauma
- residential schools
- genocide
- colonialism
- slavery
- war
- intergenerational trauma is an aspect of historical trauma
provide examples of historical trauma (6)
- residential schools
- genocide
- colonialism
- slavery
- war
- intergenerational trauma is an aspect of historical trauma
describe intergenerational trauma (2)
- mental or emotional effects that can be experienced by people who live w trauma survivors
- this can mean that methods of coping and adapting to the trauma are passed from one generation to the next
describe vicarious trauma (2)
- experienced by repeated second-hand exposure to trauma
- this particular type of trauma is often experienced by those who work in healthcare and social services in a variety of jobs
describe the cycle of trauma (6)
trauma symptoms –> self-medication via substances, gambling, etc. –> negative impact on life areas –> increased emotional pain and decreased coping –> increased involvement w substances, gambling, etc. –> increase in complex negative impacts to life areas
psychoactive drugs can… (4) mental health symptoms and disorders
- mask
- exacerbate
- precipitate
- mimic
what are the goals of treatment for addiction & trauma (5)
- to reduce involvement or harm associated w the addiction
- to improve physical and/or psychological functioning
- to improve family and/or social functioning
- to improve employment and/or educational/vocational functioning
- to reduce systems involvement
the priorities of treatment planning includes to identify… (2)
- the individual’s priorities
- their stage of readiness to make changes around the addictive behavior
what do Addiction Foundation Manitoba (AFM) programs offer (4)
- programs for women, men, youth, and families
- community-based and in-house treatment for substances use and problem gambling
- short term intensive counselling followed by continuing care groups
- group programs: groups provide support & counter the isolation, secrecy, shame, & guilt which develop in addiction
what is among the msot influential determinants of health
- sex & gender
what does sex & gender impact r/t substance use (5)
- mechanisms (difference in biological responses to drugs)
- consequences & impacts (socioeconomic, women may have fewer financial resources)
- prevention issues (risk and protective factors differ between men and women)
- treatment issues (difference in access, readiness, retention, outcomes)
- reproduction, fertility, parenting (different roles, biological concerns, stigma, child custody)
describe the relationship between women & substance use (5)
- until recently, women were largely ignored in the literature on treatment for substance use disorders
- women drinking rates have historically been lower than men
- substance use increasing among younger women & girls
- women tend to access more health care services
- mood altering meds are more likely prescribed to women
women accessing AFM services (8)
- Lower rates of employment and household income
- Fewer supports
- Parenting challenges (including parenting alone)
- Higher rates of difficulties in life areas
- More likely to be referred by CFS
- Lower reports of “good or better” quality of life
- Higher reports of mental health issues and self-harm (higher reports of seeking help in this area as well)
- Higher reports of assault/family violence/IPV
2018 Report on the State of Public Health in Canada
- Higher rates of hospitalization for girls aged 10 to 19 due to alcohol use compared with boys the same age (women cannot metabolize alcohol at the same rate as male counterparts)
- More women are dying from alcohol consumption (26% increase between 2001 and 2017 compared with 5% increase for men)
describe the relationship between sex, gender & alcohol use
- More adverse effects in women vs men with equal alcohol intake
- In 2012, the first sex specific guidelines in Canada stated:
- –> Women: 2/day, 10/week, 4/sitting
- –> Men: 3/day, 14/week, 5/sitting
- –> Based off standard drink: 1.5 oz of hard liquor, 4 oz of wine, 12 oz of beer
describe the relationship between sex, gender & alcohol use
- More adverse effects in women vs men with equal alcohol intake
- In 2012, the first sex specific guidelines in Canada stated:
- –> Women: 2/day, 10/week, 4/sitting
- –> Men: 3/day, 14/week, 5/sitting
- –> Based off standard drink: 1.5 oz of hard liquor, 4 oz of wine, 12 oz of beer
describe the relationship between sex, gender, and prescription opioids
- Women have significantly higher rates of deaths from opioid pain relievers —> more likely to access healthcare providers for prescriptions
- more men die from drug poisoning (overdose) than women, but the percentage increase in deaths since 1999 is greater for women
why can women be more vulnerable to prescription opioid misuse (3)
- differing experiences w chronic pain (more sensitive to pain, difference in how they absorb, metabolize, eliminate opioids)
2, histories of violence and trauma - different patterns of health care use (tend to visit HCP more often, more likely to use prescription drugs, more likely to be prescribed opioids & anti-anxiety meds)
describe the relationship between sex, gender, and cannabis (4)
- different metabolism
- females transition to regular use faster than males compared w other substances
- men report higher rates of cannabis dependence
- difference reported in forms of ingestion, effects, and withdrawal symptoms
what are examples of withdrawal symptoms of cannabis (3)
- emotional reactivity
- anxiety
- insomnia
what are some key issues for women in treatment? (6)
- psychological development
- prescribing & medications
- drug effects
- stigma, shame, and blame
- treatment access
- social services, justice, and multiple systems
describe psychological development of women & its implications
- more motivated by relationship concerns
- implications: create enviro where women can experience healthy, empathic relationships
describe prescribing and medications for women & its implications
- women prescribed meds w abuse potential much more for men
- implications: meds often prescribed for a range of normal life difficulties, main substance abuse issue in older women is misuse of Rx drugs
describe drug effects for women and its implications
- women’s physiology (ex. drug metabolism) is different from men’s
- women seem to exhibit more severe consequences from alcohol and other drug abuse
- implications: socioeconomic status greatly influences health risks associated w drug use, practical needs must be considered in programming
describe stigma, shame, and blame r/t women & its implications
- women experience greater stigma/blame in media & society
- women often cite feelings of blame, feeling unwelcome/judged as barriers (social status compounds issue)
- implications: service providers require sensitivity to women seeking help; provide safe & secure environment
describe treatment access for women & its implications
- women may have less family support to enter Tx
- specific barriers –> money, transportation
- social assistance & financial support often inadequate –> women feel trapped
- implications: centralized services may marginalize women (lack of accessibility in rural settings)
describe social services, justice, and multiple systems for women & implications
- each system has different rules/guidelines/etc.
- navigating systems can be overwhelming
- implications: recognize barriers esp. regarding child custody
describe the relationship between men, boys, and substance use (3)
- many men are “traditionally” socialized
- masculine “ideals” (aggressive, intense, strong, etc.) can contribute to substance use & mental health issues
- men are more likely to engage in substance use for sensation seeking or social reasons
what are the key issues for men in treatment (4)
- men less likely to seek help
- men have often been ignored as victims and survivors of trauma
- many men w substance use problems need to learn nurturing skills in their roles as partners & families
- service providers should consider how to create safer ways for men to engage in treatment
why include family in treatment? (2)
- Research on the long-term well-being of people recovering from addictions has demonstrated the crucial impact of healthy family environments
- A requirement of Accreditation Canada, recommended by Virgo Report, considered a best practice in addictions treatment
how might a family be impacted by addiction (7)
- family survival roles
- rules
- rituals
- hierarchies
- boundaries
- communication
- interactional patterns
summary of a painful family system (5)
- deny
- don’t talk (silence)
- don’t feel (non-emotional)
- don’t trust
- isolate
what are the different family survival roles (5)
- enabler
- super hero
- scapegoat
- lost child
- mascot
how might family members feel about having a loved one living w addiction issues (6)
- betrayed
- fearful of loss (financial, relationship, material possessions)
- exhausted
- isolated
- guilt & shame
- anxious to solve problems and change the person
what are some thoughts, feelings, and behaviors that can keep families “stuck” (8)
- trusting that everything will be okay
- believing that trust is “all or nothing”
- “in sickness and in health”
- if you love someone, there is no limit to helping
- good spouses don’t complain
- family matters are private
- my loved one has to hit “rock bottom”
- love is stronger than the AODG
what are some enabling behaviors that family can exhibit? (7)
- keeping secrets
- lying/covering up for person
- paying for damage or other fines
- rationalizing the behavior
- blaming self or others
- undermining others who express concern
- minimizing
often come from a place of love
describe functional communication & defense mechanisms r/t addictions (2)
- it is normal for people to be defensive about their relationship w substances
- families are encouraged to reflect on how they communicate w their loved one
common roadblocks r/t functional communication and defense mechanisms include: (5)
- nagging
- shaming/blaming
- diverting
- not listening
- “hooks and games” –> includes 1st, 2nd, and 3rd degree verbal games
what are 3 most common questions asked by family members
- how do i get them to stop?
- why do they do this?
- what can i do?
what are the benefits of including family in treatment (7)
- addiction lives in the family system –> not just the person
- all family members are affected and deserve attention
- more people in the room provides a richer description of the family dynamics or the “family dance”
- helps remove isolation & stigmatization of the person who uses substances
- can focus on the collective issues rather than the individual as “the problem”
- provides opportunities for everyone to learn about addictions and recovery
- encourages team approach to making changes & healthy choices
what should be done in the initial meeting w family members (5)
- provide info
- set realistic expectations of change
- family can prepare to meet own needs
- safety for discussing hot topics (emotion, money, time away)
- begin to safely look at patterns in relationship
crisis management includes (7)
- are there any pressing concerns regarding safety of the family member?
- suicide
- abuse
- financial risk
- care of children
- housing
- food
describe encouraging self care r/t addiction (6)
- focus on self
- acknowledge own stress, feelings, needs
- trust issues
- rebuilding, pacing, realistic expectations
- connecting w supports
- inner resources, informal and formal resources
describe the importance of self positionality (6)
consider how your own attitudes, values, and beliefs around substance use & addiction have been created:
- personal involvement
- a loved one’s involvement
- what you see on the job
- what you see in the media & popular culture
- religion
- upbringing
what are some myths about substance use (7)
- People with addictions are weak and do not have morals
- People must hit “rock bottom” before they will get serious about getting help
- People of certain races are more likely to become addicted to substances
- People who are addicted can only be helped by those
who have been addicted themselves - If you try once, you’re hooked for life (simply not true, not even with cocaine)
- People should avoid medication as much as possible
- You don’t treat drug problems with drugs
