Week 4: Stages of Addiction

Question 1

Adolescent Brain

Answer 1

• brain develops through life. Most during adolescence:
  
  • seeking out new experiences
  • very responsive to rewards
• Prefrontal cortex: Last region to develop (into 20s)
  
  • impulse control, behaviour/emotion regulation
• Striatum: key component of reward system
  
  • involves dopamine (reward chemical)
  • more responsive (activated) to rewards than adults
• Prefrontal cortex & striatum connected
  
  • connections in adolescence between risk-taking & reward strongest

Question 2

Stages of Use

Answer 2

Key in determining which stage the patient’s level of substance use is: identify negative consequences of use and family history of addiction.

Question 3

Early/Late Stages of Use

Answer 3

Early | Late

More Freedom | Lack of freedom

Fewer risks/less damage | More Damage

Possible abuse | Present abuse

No Illness | State of illness

Linear operating factors | Viscious cycles

Easier to treat | Harder to treat

Question 4

Nonuse by Adolescents (Stage)

To help their at-risk adolescents, parents should:

Answer 4

• establish clear, consistent rules
• model nonuse of drugs
• clearly establish the hazards and potential harm
• encourage alternative, active (vs passive) activities
• promote social involvement
• promote trust & healthy boundaries (relationships)

Huge developmental phase: Individuation/identity development must be supported/encouraged!!

Question 5

Nonuse by Children (Stage)

Children less likely to develop drug addiction later if parents:

(MAPPED)

Answer 5

• Model healthy behavior
• Are sensitive to children’s feelings (about boundaries)
• Promote positive alternative activities to drug use
• Provide structure, discipline, consistency
• Encourage participation in developmental activities
• Develop a climate of discussion

​It’s all about the parents. Kids must learn active coping strategies, not passive

Question 6

Initial Contact with Drugs (Stage)

Answer 6

• First use or contact. Usually harmless, although hazards exist:
  
  • possible emotional overreaction, overdose, etc. even first time.
• Set and setting are crucial: can exacerbate depression, etc.
• Positive initial contact usually leads to the next stage… experimentation

Question 7

Experimental Stage

(PRUDE)

Answer 7

• Polydrug use, etc.
• Recreational or social use terms are too positive / seem harmless
• Use in different situations/circumstances
• Dose variety, frequencies of use, methods of ingestion
• Experiment with Set, Setting, and Drug adjustment • reaction determined

Question 8

—Integrated Use (Stage)

(MADBuy)

Answer 8

• More time, thought, and energy on use of drugs.
• Associate with other drug users
• Drug use becomes more important
• Buy drug to ensure its availability

Question 9

—Excessive Use (Stage)

Answer 9

increase in drug use resulting in significant problems or negative consequences.

• Hard to define because there are many different kinds of excessive use
• Could be periodic (binge use) or regular use
• Much time, thought, and energy into buying / using drug / maybe selling

Question 10

Addiction (Stage)

(BAAM)

Answer 10

• Best recovery strategy total abstinence & treatment (basic needs, counseling)
• Addiction is a disease
• Addict spends major portions of life addicted to drug. chronic
• Maintenance of dignity essential