The Psychology of Addiction in detail.pptx

UNIT ONE THE CONCEPT OF ADDICTION Activity: 1. Dear student, what do you know so far about addiction? Who is addicted for you? What are the criteria to diagnose individuals with addiction ? 2. Discuss on the meaning of the following terms: Drug misuse Abuse Tolerance dependence and addiction

Chapter One 1. Introduction to Addiction 1.1. Definition of basic terms

Drug misuse , abuse, tolerance, dependence and addiction are all serious public health challenges. Since all of these deal with the use of illegal drugs and inappropriate use of legal drugs (e.g., tobacco, alcohol, prescription medication), a lot of people commonly use these terms interchangeably.

What is a drug? A drug is any chemical substance, i.e. natural or synthetic that changes a person’s mental state and that may be used repeatedly by a person for that effect. Psychoactive drug : is a chemical substance that changes brain functions and results in alterations in perception, mood or consciousness. Psychoactive drugs are described as being either legal (licit) or illegal (illicit ).

Drug Misuse What is drug misuse? Drug misuse is generally associated with prescription medicines . This is because these types of drugs can cause adverse side effects if directions are not followed. Drug misuse happens when these substances are taken for a purpose that is not consistent with legal or medical guidelines .

Examples of this include: Taking the incorrect dose Taking the drug at the wrong time Forgetting to take a dose Stopping the use of a drug too soon Taking a drug for reasons other than why they were prescribed Taking a drug that was not prescribed to you

Drug Abuse What is drug abuse ? Drug abuse happens when drugs, including alcohol, illicit drugs, or any psychoactive substances, are misused to get high or inflict self-harm. It is also known as substance use disorder (SUD) since people who abuse drugs experience significantly altered thinking, behavior, and body functions.

Tolerance Drug tolerance occurs when someone abuses a substance over a long period . When someone continuously abuses a substance, their body becomes used to it, meaning the drug will stop having as much of an effect. When someone develops a tolerance to an addictive substance, they will begin taking a higher dose to get the same effects as before . Taking high doses of a substance may lead to many negative consequences .

Dependence When someone abuses high doses of an addictive substance, they may develop a dependence. Drug dependence refers to someone feeling like they cannot function normally without the use of the substance . A drug dependence can be either physical or psychological and can have many negative effects on someone’s life.

The term addiction is derived from the Latin addīcō meaning “enslaved by” or “bound to,” and for many individuals in addiction, this derivative has meaning. Addiction a behavior that changes the brain chemistry of an individual in such a way that releases endorphins and other chemicals, making a specific behavior so enticing that an individual is unable to stop the behavior once he or she has engaged in it.

The term addiction is frequently attached to a substance and viewed as dependence . Opium and morphine were two of the first addictive substances identified because of misuse of prescriptions . Society today often also characterizes individuals who participate in repetitive behaviours as being addicted. Thus , the term addiction currently applies to the misuse of alcohol, other drugs, and substances and to a large number of behaviour patterns.

Scientifically speaking, individuals are considered addicted when they relentlessly pursue a sensation or activity, whether it is a substance such as alcohol or behaviour like gambling, despite consequences to their health or well-being. Similarly , addiction has been defined as the condition of being habitually or compulsively occupied with or involved in something.

W. R. Miller et al. (2011) identified three kinds of actions that define an addiction: ( a) an action that is habitual, done regularly, and repeated; ( b) an action that appears to be compulsive in nature and at least partially outside of one’s conscious control; and (c) an action that does not necessarily involve a drug.

The American Society of Addiction Medicine (ASAM; 2011) refers to addiction as follows: Addiction is a primary, chronic disease involving brain reward, motivation, memory and related circuitry ; it can lead to relapse, progressive development, and the potential for fatality if not treated. While pathological use of alcohol and, more recently, psychoactive substances have been accepted as addictive diseases, developing brain science has set the stage for inclusion of the process addictions, including food, sex, shopping and gambling problems, in a broader definition of addiction as set forth by the American Society of Addiction Medicine in 2011.

The National Institute on Drug Abuse (NIDA; 2012b) has put forth the following definition of addiction: Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge an addicted person’s self-control and hamper his or her ability to resist intense impulses to take drugs.

CRITERIA FOR ADDICTION Not everyone who experiments with drugs, gambles, or spends time on the Internet becomes addicted . Most professionals will refer to the DSM–5 or the International Classification of Diseases (ICD) when making their assessments . Like A persistent and recurrent problematic behaviour leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:

1. Needs to increase the frequency of the behaviour in order to achieve the desired excitement. 2. Is restless or irritable when attempting to cut down on the behaviour. 3. Has made repeated unsuccessful efforts to control, cut back, or stop the behaviour.

4. Is often preoccupied with the behaviour (e.g., has persistent thoughts of reliving past experiences, handicapping or planning the next venture, thinking of a way to partake in the behaviour). 5. Often engages in the behaviour when feeling distressed (e.g., helpless, guilty, anxious, depressed). 6. After unsuccessfully reaching an anticipated high when participating in the behaviour, tries riskier scenarios when using the behaviour.

7. Lies to conceal the extent of involvement with the behaviour. 8. Has jeopardized or lost a significant relationship, job, or educational or career opportunities by repeating the behaviour. 9. Relies on others to minimize the consequences of the repeated behaviour

ASAM (2011) further identified the following cognitive and emotional changes one should consider during the assessment process. Cognitive Changes Preoccupation with substance use Altered evaluations of the relative benefits and detriments associated with drugs or rewarding behaviours The inaccurate belief that problems experienced in one’s life are attributable to other causes rather than being a predictable consequence of addiction

Emotional Changes Increased anxiety, dysphoria , and emotional pain Increased sensitivity to stressors associated with the recruitment of brain stress systems, such that things seem more stressful as a result Difficulty identifying feelings, distinguishing between feelings and the bodily sensations of emotional arousal, and describing feelings to other people (sometimes referred to as alexithymia).

Cont, The emotional aspects of addiction are quite complex. Some persons use alcohol or other drugs or pathologically pursue other rewards because they are seeking “positive reinforcement” or the creation of a positive emotional state (“euphoria”). Others pursue substance use or other rewards because they have experienced relief from negative emotional states (“ dysphoria ”) , which constitutes “negative reinforcement .

“ Beyond the initial experiences of reward and relief, there is a dysfunctional emotional state As addiction is a chronic disease , periods of relapse, which may interrupt spans of remission, are a common feature of addiction. It is also important to recognize that return to drug use or pathological pursuit of rewards is not inevitable.

How is drug misuse different from drug abuse ? How is drug abuse different from drug addiction? How is Tolerance different from Addiction ? How is Dependence different from Tolerance?

The key difference between a person who misuses drugs and a person who abuses drugs is their intent . The former takes a drug to treat a specific ailment , whereas the latter uses a drug to elicit certain feelings . Drug addiction is a severe form of drug abuse . The distinction between the two disorders lies in how much control the user can exercise over themselves . Since a person who abuses drugs still has control over their life , they don’t experience major disruption in their life. In contrast, those with an addiction have a disorder that affects most if not all aspects of their lives .

stages of an addiction An addiction does not form spontaneously overnight. Instead , it is the result of a long process of repeated substance abuse that gradually changes how an individual sees a drug and how their body reacts to it. This process is linear and has the same progression for every person , although the duration of each step in that progression can differ greatly depending on the individual, dosage and type of drug being abused.

Stage 1. Initiation : during which time the individual tries a substance for the first time . Stage 2. Experimentation : the user has moved past simply trying the drug on its own and is now taking the drug in different contexts to see how it impacts their life Stage 3: Regular Use : its use becomes normalized and grows from periodic to regular use. This does not mean that they use it every day, but rather that there is some sort of pattern associated with it.

Stage 4: Risky Use: the individual’s regular use has continued to grow and is now frequently having a negative impact on their life. Stage 5: Dependence Stage 6: Addiction

Characteristics of people with addiction Activity: Dear student, discuss on the major characteristics of individuals with addiction show

The Most Common Characteristics of Addiction When an individual becomes addicted to something, they start to become dependent on it and need to keep repeating the activities, despite the negative consequences these behaviors bring . Some of the most common characteristics of addiction include: 1. The individual cannot stop taking the substance or engaging in different activities 2 . Health problems do not stop their addiction For example, an alcohol addict may keep drinking even after finding out they have a liver disease .

3. Giving up recreational and/or social activities Addiction can cause some people to give up or not become involved in activities. For example, an internet addict may choose not to go camping if they know they won’t have internet access. Likewise, an alcoholic may avoid long trips where they know they will not have access to alcohol . 4. Keeping a steady supply Individuals who are addicted to a substance will always have enough of it around, regardless of the amount of money they have to ensure that they have a good supply readily available. 5. Saving stashes Addicted people tend to keep small stashes of their substance hidden away in various locations, such as throughout their house or in their car.

6 . Risky behavior may engage in risky behavior to ensure they can get their substance of choice, such as by trading sex for drugs or money and stealing, reckless driving. 7. Excessive consumption With some addictions, like alcohol and certain drugs, an addict may consume it to excess. 8 . Dealing with issues often feels that they cannot deal with their problems without their drug of choice so they often abuse the substance as a way to self-medicate

9. Obsessing may spend increasingly more time and energy thinking of ways they can get more of their substance, or even other ways they can use it. 10. Secrecy and denial take their substance on their own as well as without anyone knowing about it. If anyone confronts them about their using, they either refuse to acknowledge or are not aware that they have a problem. 11. Having troubles with the law Addicts may run into problems with the law due to the risks that they take when they are using due to impaired judgment. Or they may break the law in order to obtain their drug of choice.

12. Financial problems If the substance is costly then the addicted person may sacrifice their budget for housing or groceries to ensure they have a secure supply . 13 . Relationship issues Addicts often have relationship issues due to their secrecy, which can lead to trust issues. As the relationship deteriorates, violence, anger and emotional abuse often become concerns.

Models For Explaining The Etiology of Addiction Historically , addiction has been understood in various ways—a sin, a disease, a bad habit—each a reflection of a variety of social, cultural, and scientific conceptions (Hammer et al., 2012, p. 713 ). There are numerous models for explaining the etiology of addiction ( McNeese & DiNitto , 2005); these models are not always mutually exclusive and none are presented as the correct way of understanding the phenomena of addiction. The moral, psychological, family, disease, public health, developmental, biological, sociocultural, and some multi-causal models are some of the models.

The Moral Model The moral model is based on beliefs or judgments of what is right or wrong, acceptable or unacceptable . Those who advance this model do not accept that there is any biological basis for addiction; T hey believe that there is something morally wrong with people who use drugs heavily . The moral model explains addiction as a consequence of personal choice, and Individuals who are engaging in addictive behaviours are viewed as being capable of making alternative choices

The moral model for explaining the etiology of addiction focuses on the sinfulness inherent in human nature ( Ferentzy & Turner, 2012). Since it is difficult to establish the sinful nature of human beings through empirically based research, this model has been generally discredited by present-day scholars . It is interesting to note, however, that the concept of addiction as sin or moral weakness continues to influence many public policies connected with alcohol and drug abuse

Psychological Models Another explanation for the reasons people crave alcohol and other mind-altering drugs has to do with explanations dealing with a person’s mind and emotions. There are several different psychological models for explaining the etiology of alcoholism and drug addiction, including cognitive- behavioral , learning, psychodynamic, and personality theory models.

Cognitive-Behavioural Models Cognitive-behavioural models suggest a variety of motivations and reinforces for taking drugs. One explanation suggests that people take drugs to experience variety Drug use might be associated with a variety of experiences such as self-exploration, altering moods, escape from boredom or despair, and enhancement of creativity, performance, sensory experience, or pleasure If we assume that people enjoy variety, then it can be understood why they repeat actions that they enjoy (positive reinforcement).

The desire to experience pleasure is another explanation connected with the cognitive behavioural model . Dependent behaviour with respect to the use of alcohol and other drugs is maintained by the degree of reinforcement the person perceives as occurring; alcohol and other drugs may be perceived as being more powerful reinforces than natural reinforces and set the stage for addiction. As time passes, the brain adapts to the presence of the drug or alcohol , and the person experiences unpleasant withdrawal symptoms (e.g., anxiety, agitation, tremors, increased blood pressure, seizures).

To avoid such unpleasant symptoms, the person consumes the substance anew and the cycle of avoiding unpleasant reactions (negative reinforcement ) occurs and a repetitive cycle is established. In an interesting review of the literature on the etiology of addiction it was proposed that in chemically addicted individuals, maladaptive behaviours and high relapse rates may be conceptualized as compulsive in nature.

The apparent loss of control over drug-related behaviours suggests that individuals who are addicted are unable to control the reward system in their lives and that addiction may be considered a disorder of compulsive behaviour very similar to obsessive compulsive disorder

Learning Models Learning models are closely related and somewhat overlap the explanations provided by cognitive-behavioural models. Learning theory assumes that alcohol or drug use results in a decrease in uncomfortable psychological states such as anxiety, stress, or tension, thus providing positive reinforcement to the user. This learned response continues until physical dependence develops and, like the explanation provided within the context of cognitive-behavioural models, the aversion of withdrawal symptoms becomes a reason and motivation for continued use . what has been learned can be unlearned; the earlier the intervention occurs the better, since there will be fewer behaviours to unlearn.

Personality Theory Models These theories make the assumption that certain personality traits predispose the individual to drug use. An “alcoholic personality” is often described by traits such as dependent, immature, impulsive, highly emotional, having low frustration tolerance , unable to express anger, and confused about their sex role orientation Although many tests have been constructed to attempt to identify the personality traits of a drug-addicted person , none have consistently distinguished the traits of the addicted individual from those of the non-addicted individual.

Genetic Models Although genetic factors have never really been established as a definitive cause of alcoholism, the statistical associations between genetic factors and alcohol abuse are very strong. For example, it has been established that adopted children more closely resemble their biological parents than their adoptive parents when it comes to their use of alcohol alcoholism occurs more frequently in some families than others concurrent alcoholism rates are higher in monozygotic twin pairs than in dizygotic pairs

children of alcoholics can be as much as seven times more likely to be addicted than children whose parents are not alcoholic Because of such data, some genetic theorists have posited that an inherited metabolic defect may interact with environmental elements and lead, in time, to alcoholism. Some research points to an impaired production of enzymes within the body and yet other lines of inquiry point to the inheritance of genetic traits that result in a deficiency of vitamins (probably the vitamin B complex), which leads to a craving for alcohol as well as the accompanying cellular or metabolic changes

Sociocultural Models Sociocultural models have been formulated by making observations of the differences and similarities between cultural groups and subgroups . the social context of drug use strongly influences drug definitions, drug effects, drug-related behavior , and the drug experience. These are contextual models and can only be understood in relation to the social phenomena surrounding drug use . A person’s likelihood of using drugs, the way he/she behaves, and the way abuse and addiction are defined are all influenced by the sociocultural system surrounding the individual.

Addiction is caused by :- The actions of drug abuse and generally requires repeated drug exposure. This process is strongly influenced both by the genetic makeup of the person and by the psychological and social context in which drug use occurs.

Causes of substance abuse or addiction There is no a single cause to substance abuse. But there are several predisposing factors/causes that have been identified which include: Social environment – peer pressure especially during adolescence leads to drug taking to get acceptance by their peers, for experimentation, to relieve boredom. Prior experience with the substance of abuse

Availability and cost of the substance of abuse –some of the substances can be obtained easily in most instances with a minimum cost especially khat , tobacco and alcohol so people tend to use them abundantly with eventual dependence. Unemployment and low education opportunities .

Family history : You may be more likely to become addicted if you have family members who also have addictions. Genes : Genetics is the study of genes. Genes are functional units of DNA that make up the human genome. Research suggests that genetics increases the likelihood of developing an addiction. Same people become addicted while others don't? Family studies that include identical twins, fraternal twins, adoptees, and siblings suggest that as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genetic makeup.

Genetics Reports have found that 40% to 60% of predisposition to addiction is a result of genetics, and furthermore, that the children of individuals who suffer from addiction have a 25% greater likelihood to also develop addiction compared to children of non-addicted parents. Gender is also one of the potential causes of addiction or at least predisposition to addiction. While men have generally been found to have higher rates of addiction than women .

A recent study presented by the APA found that although women begin using substances at much smaller dosages than men, however , their drug use escalates into addiction much more rapidly than for men. Women also face a higher rate of relapse than men and are more prone to mood and anxiety disorders, and therefore, addiction.

Environmental causes Aspects of a person’s environment that may play a role in the development of addiction include : Peer pressure: Friends are significant in adolescents’ lives. Peers may expose adolescents to drugs and influence their beliefs on what is right and wrong. Parental drug use and criminal activity: Children of parents who use drugs and alcohol and are involved in criminal activity are at risk of abusing substances . Parents may introduce children to drugs, model negative behaviors, and create environments that increase stress .

Unstable home environment: A person may experience various types of abuse at home and other chaotic events . Presence of drugs at home and/or school: Exposure to drugs and alcohol can provide additional opportunities for children to experiment and possibly go on to develop an addiction. Community attitudes and influence: If a community accepts substance use it may affect whether an individual develops an addiction. Poor academic achievement: If a person isn’t performing well in school, they may turn to using substances.

CHPAPTER TWO Common Types of Addiction Addiction can be broadly classified as substance and P rocess/Behavioural addiction Substance addiction (or drug addiction) is a neuropsychiatric disorder characterized by a recurring desire to continue taking the drug despite harmful consequences . This drug-seeking behavior is associated with craving and loss of control.

A drug is any chemical substance that causes a change in an organism's physiology or psychology when consumed. Drugs are typically distinguished from food A drug is any substance other than food which changes the way the body or mind functions. Psychoactive drug : is a chemical substance that changes brain functions and results in alterations in perception, mood or consciousness. Psychoactive drugs are described as being either legal (licit) or illegal (illicit ).

Legal drugs are either non-prescribed or prescribed drugs. Non-prescribed drugs include alcohol, tobacco, caffeine (found in tea, coffee, cola drinks and some over the counter preparations), and prescription drugs such as tranquillizers, painkillers, and some amphetamine preparations, which are sanctioned by the government. Illegal drugs are those that are prohibited by law because their use is considered to be dangerous to the individual and society. Illegal drugs include heroin, cocaine (some restricted medical use is allowed), cannabis, amphetamines, hallucinogens and “designer” drugs such as ecstasy, gamma hydroxybutyrate (GHB) and phencyclidine (PCP).

Whether a drug is classified as legal or illegal depends on any combination of the following: The age of the person consuming/purchasing it. Many drugs cannot be used legally by people under a certain age. For example, a person under 18 years of age is not legally allowed to purchase alcohol. Whether the substance is registered as illegal by the Government. For example, there are many drugs that are illegal to obtain and use in Australia – such as heroin and methamphetamine.

How the drug is obtained. Some drugs are illegal if not obtained through authorised channels – such as methadone is legal if it is obtained via prescription; however it is illegal if it is obtained from a dealer . Time also affects whether a drug is deemed to be legal or illegal. For example, many drugs were once classified as legally obtainable ( eg , heroin was once used in cough syrups). Over time, governments can change their stance towards a drugs legal status and deem them unsafe for use, and therefore illegal.

Most substances that are abused are mood-altering. They usually affect the mental state of the person ingesting them. Psychoactive drugs interact with particular target sites or receptors found in the nervous system to induce widespread changes in physiological or psychological functions.

Ways of administration Individuals take psychoactive substance through: Oral- drink, swallow smoking Nasal- snorting, Inhalation Topical – Rub on skin Injection- Intramuscularly (IM), Intravenously (IV), Subcutaneous (SC).

Drug categories Drugs can be categorized by the way in which they affect our bodies: depressants – slow down the function of the central nervous system hallucinogens – affect your senses and change the way you see, hear, taste, smell or feel things stimulants – speed up the function of the central nervous system. Some drugs affect the body in many ways and can fall into more than one category. For example, cannabis appears in all 3 categories

Depressants/downers Depressants slow down the messages between the brain and the body — they don’t necessarily make you feel depressed. The slower messages affect: your concentration and coordination your ability to respond to what’s happening around you. Small doses of depressants can make you feel relaxed, calm and less inhibited. Larger doses can cause sleepiness, vomiting and nausea, unconsciousness and even death. Examples include: alcohol benzodiazepines (minor tranquillisers such as Valium) cannabis GHB (gamma- hydroxybutyrate ) ketamine opioids ( heroin , morphine, codeine ).

Depressants are drugs that impede the activity of the nervous system, by causing neurons to fire more slowly. If they are taken in small doses , depressants cause drunkenness, euphoria, a sense of self-confidence and joy . When large amounts are taken, however, speech becomes slurred and muscle control becomes disjointed, making motion difficult . Ultimately, heavy users may loss consciousness entirely. Depressants are often called downers

Types of drugs Depressants (downers) – Slow down the brain and central nervous system. Examples are alcohol, beer, wine, vodka, gin etc heroin, tranquilizers, sleeping pills.

Types of Depressants There are four major groups of depressants. These are : Alcohol : is a classic CNS depressant, which affects virtually every organ and system People use of alcoholic beverages has a very long history, beginning before the eras of ancient Egypt, Greece, Rome, etc , when using wine and beer was very common.

People experience of drinking alcoholic beverages is influenced by age, sex, and socio-cultural factors. In terms of age , its prevalence more in adolescence and early adulthood period . Regarding sex , males drink more than females With regard to culture , alcohol use varies widely across cultures. People who abuse alcohol drink heavily on regular basis and suffer social, health, economical, occupational and legal problems are called problem drinkers/alcoholics .

2. Benzodiazepines : are synthesized drugs which are legally manufactured and sold by prescription usually for the treatment of anxiety and insomnia . Some of the examples of benzodiazepines are Xanax, Valium, Halcion, Librium and Klonopin

3. Barbiturates: Just like Benzodiazepines, Barbiturates are synthesized drugs which are legally manufactured and sold by prescription usually for the treatment of anxiety and insomnia. Quaalude , Nembutal, Seconal , and Phenobarbital are some of the common examples of Barbiturates .

4. Inhalants : are volatile substances that produce chemical vapors, which can be inhaled and which depress the CNS. One group of inhalants is solvents, such as gasoline, glue, paint thinners, and spray paints . Users inhale these vapors, which reach lungs and bloodstream very rapidly. Others are Medical Anesthetic Gasses, such as Nitrous Oxide (“Laughing Gas”.)

The Effects of Depressants The effects of depressants can be classified as: Short term effects, withdrawal symptoms and long term effects Short term effects Anxiety reduction Dramatic mood swings Impaired speech and judgment Lack of coordination A narrowed range of attention Sexual, memory and sensory problems

2. Withdrawal symptoms, such as: Hyperactivity and restlessness Insomnia , and anxiety Nausea and vomiting Seizures, muscle tension, agitation and irritability Perceptual disturbances 3. Long term effects, such as: Health problems (such as liver, stomach, pancreas, esophagus, heart, etc problems; permanent cognitive disorder/dementia, sensory problems) Appetite problems Disabilities (e., g., LBW , Premature Births, etc ) Legal, social, economical, and occupational problems.

Stimulants/uppers Stimulants speed up the messages between the brain and the body. This can cause: your heart to beat faster your blood pressure to go up your body temperature to go up – leading to heat exhaustion or even heat stroke reduced appetite agitation

sleeplessness. You can feel more awake, alert, confident or energetic. Larger doses can cause anxiety, panic, seizures, stomach cramps and paranoia. Examples include: caffeine (coffee, tea) nicotine (cigarettes), amphetamines , speed , cocaine and diet pills.

Stimulants are drugs that activate the CNS , causing feelings of happiness, and power; a decreased desire for sleep and a diminished appetite. They are drugs which have an arousal effects on the CNS, causing a rise in heart beat, blood pressure, alertness and muscular tension . Stimulant drugs are a class of psychoactive drug that provides temporary improvements in physical or mental functioning, thus elevating mood and increasing feelings of wellbeing, energy and alertness. Stimulants are often called uppers .

In higher doses, stimulants make people feel nervous, jittery and restless or they can cause trembling and interfering with sleep. Stimulants are abused in several ways, depending on the type. Stimulant drugs can be: swallowed in pill form, snorted as a powder, injected with a needle or syringe, or heated into crystal form and smoked. Injected or smoked stimulants reach the brain faster and therefore produce the most intense highs. Snorting or swallowing stimulants produces a high that is less intense but longer lasting

Types of drugs Stimulants (uppers) – Speed up the brain and central nervous system. Examples are caffeine (coffee, tea) nicotine (cigarettes), amphetamines, speed, cocaine and diet pills.

Types of stimulants 1.Cocaine :

is a white powder extracted from the coca plant and one of the most highly addictive substances known. Cocaine, which in its free-base form is known as crack It is inhaled, or “snorted” through the nose, smoked or injected directly in to the bloodstream. It is rapidly absorbed in to the body and takes effects almost immediately. It has direct effects on dopamine in that it blocks the re-absorption of dopamine by neurons. As a result, the brain is flooded with dopamine-produced pleasurable sensations.

2. Amphetamines:

: such as Dexedrine, desoxyn , Adderall and Benzedrine, popularly known as speed , are strong stimulants which can be swallowed as pills, injected intravenously or smoked. They have their effects by causing the release of the neurotransmitters dopamine and norepinephrine and by blocking the reuptake of these neurotransmitters. High levels of these substances in the blood can cause delusions, hallucinations, aggressiveness and disorganizations .

3. Nicotine : is an alkaloid found in tobacco. Cigarettes are the most popular nicotine delivery device. Nicotine operates both on the CNS and PNS . It results in the release of several bio-chemicals that may have direct reinforcing effects on the brain, and neurotransmitters. 4. Caffeine: is by far the most heavily used stimulant drugs, which is found in coffee, tea, chocolate, soft drinks, candy , etc. It stimulates the CNS, by increasing the levels of dopamine, norepinephrine and serotonin . Generally, caffeine make people mentally alert and can help them stay awake.

5. khat sometimes called kat , qat , chat, Mira, or quaadka , is a stimulant drug derived from the leaves and young shoots of a wild shrub found in East Africa called Catha edulis . Chewing khat has its roots in cultural norms going back thousands of years . indigenous people in East Africa, the Middle East, and the Arabian Peninsula have used khat recreationally for its stimulant effects since the thirteenth century, including both adults and children.

Some users chew the leaves and hold them in their mouths in order to absorb the juice in them or convert them into a paste they can chew. Other users use the leaves to make tea or sprinkle them on their food, which provides a less intense effect, while some users smoke khat leaves . Using khat can produce side effects that affect a person’s physical and mental health. They typically last from about ninety minutes to three hours , depending on how much is consumed.

How stimulants affect users? Desired effects of stimulants Enhanced alertness Wakefulness and endurance Increased productivity, motivation and arousal Short-term side effects of stimulants Increased heart rate, blood pressure, and body temperature Other cardiovascular irregularities that may include heart attack or complete heart failure Hyperactivity Weight loss

Cravings Nausea Muscle spasms Overdosing on stimulants can lead to heart problems, strokes, convulsions, and, if not treated immediately, death. Long-term effects of stimulant drug abuse Addiction Severe dental problems Delusions Visual and auditory hallucinations Anorexia Problems thinking Aggression Paranoia Psychosis

Hallucinogens Hallucinogens change your sense of reality – you can have hallucinations. Your senses are distorted and the way you see, hear, taste, smell or feel things is different. For example, you may see or hear things that are not really there, or you may have unusual thoughts or feelings. Small doses can cause a feeling of floating, numbness, confusion, disorientation, or dizziness .

Types of Hallucinogens: - The major types of hallucinogens include the following Marijuana : is the most commonly used hallucinogen, whose active ingredient- Tetrahydrocannabinol (THC)-is found in a common weed, Cannabis.

It is a green, brown or gray mixture of dried, shredded leaves, stems, seeds and flowers of the hemp plant Cannabis sativa . Botanical name: Cannabis sativa other common names: weed, pot, herb, bud, dope, spliff , reefer, grass, ganja, 420, chronic, Mary Jane, gangster, boom, skunk. There are over 200 street names for marijuana The cannabis plant has been used in China, India and the Middle East for approximately 8,000 years for its fiber and as a medicinal agent. It is the most commonly used illicit drug in the United States and, by most estimates, around the world as well.

LSD (D-lysergic acid diethylamide): It is the most common synthetic drug , which bears a strong chemical resemblance to serotonin. Thus it acts as serotonin antagonist by blocking serotonin receptors in the brain. LSD was first synthesized in 1938 by Swiss chemists. It was not until 1943 that the substance’s psychoactive effects were discovered, when, Dr. Albert Hoffman accidentally swallowed a small amount of LSD and experienced visual hallucinations similar to those in schizophrenia.

3. PCP ( phenylcycladine ): is another common synthesized drug, which was originally developed as a pain killer . It is more toxic than other hallucinogenic drugs. 4. Psilocybin: Its chemical structure resembles that of serotonin . It is found in different types of mushrooms . 5. Mescaline: Its chemical structure resembles that of norepinephrine . It is the active ingredient in a small, spineless cactus called peyote .

Types of drugs Hallucinogens – These drugs alter the user’s state of consciousness. (Distort auditory and visual sensations) Examples are LSD, ecstasy, magic mushrooms, marijuana.

Larger doses may cause hallucinations, memory loss, distress, anxiety, increased heart rate, paranoia, panic and aggression. Examples include: cannabis ketamine LSD (lysergic acid diethylamide) psilocybin (magic mushrooms)

NB:- Cigarette is acting both stimulant and depressant because it contains nicotine . All forms of tobacco contain nicotine, an extremely addictive drug that can act as both a central nervous system stimulant and depressant Khat is a stimulant drug , which means it speeds up the messages going between the brain and the body. Chewing khat is part of some social traditions in parts of the Middle East, such as Saudi Arabia and Yemen, and in Eastern Africa, such as Somalia Marijuana is a psychoactive narcotic drug rendered from the leaves and flowering tops of a cannabis plant, especially Cannabis sativa, used for recreational or medical purposes by smoking, vaping , or ingesting

Common groups of drugs Drugs can also be grouped by how or where they are commonly used. Analgesics Analgesics – or painkillers – relieve the symptoms of pain. Some people take more than the recommended dose to get high, or to self-harm. They can also be overused by people who have chronic pain .

Some are available over the counter, such as: A spirin , paracetamol , ibuprofen . Others require a prescription from a doctor, such as: codeine and paracetamol combination products fentanyl morphine oxycodone pethidine .

Alcohol Physical Effects Co-ordination is impaired, clumsiness, slower reflexes High blood pressure, damage to the heart Liver damage If drinking when pregnant, FASD Life threatening when mixed with other drugs Mental and Emotional Behave in ways that you normally wouldn’t Increase in aggressive and violent behaviour Problems with school and learning

ALCOHOL and the LIVER The liver removes poisons – include alcohol from the body People who drink regularly can have serious liver damage and may even get liver cancer If the liver is damaged badly enough, it can stop working, causing the person to die.

ALCOHOL Alcohol is the oldest and most widely used drug in the world. About two-thirds of Grade 6 students say they have experimented with alcohol. By Grade 10, over 90% of young Canadians have tried it. Leading cause of death for teens and young adults in Canada is motor vehicle accidents-many of which involve alcohol use.

NICOTINE Most addictive drug Causes more long term health problems than any other drug Adults are smoking less, younger people under 18 smoke more When someone stops smoking they have: strong cravings irritability (everything gets on nerves) thoughts of it-can’t stop thinking about it

NICOTINE What it does to your body, brain and behavior depression lung cancer lung diseases heart disease skin becomes thinner and wrinkled

NICOTINE

MARIJUANA Marijuana is the most common illegal drug around Comes from a plant called “cannabis” Some people call it pot, weed, grass, hash, smoke or ganja Cannabis has the chemical “tetrahydrocannabinol” or THC When you smoke a joint the THC goes into the lungs, then into the heart which pumps into the bloodstream which takes it directly to brain

MARIJUANA Only takes few minutes for THC to get to brain when you smoke marijuana Eating takes longer to get to brain-passes through digestive system first In brain, activates “receptors” gives you the feeling of being high Marijuana changes physical and chemical balance in your brain

MARIJUANA Short Term Effects: Increase in heart rate, lead to anxiety and paranoia Distorted concept of time and space Decrease in concentration skills, short-term memory capacity Feeling tired after the “high” wears off Increase in appetite, weight gain Long Term Effects : Breathing problems Lung cancer Damage cells and tissues in the body that fight disease Lack of motivation Difficulty processing new information

MARIJUANA Marijuana and cigarette smoke have some of the same cancer-causing substances. Benzopyrene (cancer-producing agent) higher in marijuana 400 chemicals in marijuana smoke affect lungs, throat and esophagus

INHALANTS Attract younger children, or adults who can’t afford alcohol or street drugs Poverty, history of child abuse, poor grades and dropping out of school are associated with inhalant abuse.

INHALANTS Risks lack of coordination dizziness euphoria difficulty speaking brain damage organ damage death caused by choking high only lasts a few minutes, abusers inhale repeatedly and can lose consciousness or die

INHALANTS Risks Long term users show weight loss, muscle weakness, irritability, depression

Certain drugs have become popular among teens and young adults at dance clubs and raves. CLUB DRUGS MDMA/ECSTASY ROHYPNOL GHB KETAMINE

HEROIN Processed from morphine – obtained from opium poppy “downer” affects brain’s pleasure systems – interferes with brains ability to feel pain

HEROIN white to dark brown powder or tar-like substance is cut with other drugs or substances (sugar, starch, powdered milk) abusers don’t know actual strength of drug or true contents = high chance of overdose or death sharing needles and equipment cause other diseases and problems for users

HEROIN leads to flushing of skin, dry mouth, collapsed veins, liver disease additives don’t dissolve leading to clogs in blood vessels that lead to lungs, liver, kidney or brain tolerance develops with regular use – user needs more heroin to achieve same intensity

Cocaine + CRACK Cocaine is a stimulant drug-more alert and energetic Cocaine is a white powder comes from the leaves of coca plant Can be one of the hardest drugs to quit

Cocaine + CRACK Cocaine makes people feel energetic, talkative, alert and euphoric More aware of senses (increases sound, touch, sight and sexuality) Reduces hunger and need to sleep Increase in self-control and confidence High doses cause panic attacks, psychotic episodes (paranoia), violent behavior

Cocaine + CRACK Blood vessels thicken and constrict, reduce flow of oxygen to heart Heart muscles work harder can lead to heart attack or stroke Raises blood pressure, can explode weakened blood vessels in brain Small amount can lead to overdose Overdose can cause seizure or heart failure Snorting cocaine can cause sinus infection and loss of smell

Cocaine + CRACK Damage tissues in nose, cause hole in nose Damage lungs-severe chest pains, breathing problems, high temperatures Cocaine increases the same chemicals in the brain that make people feel good when they eat, drink or have sex

CRYSTAL METH Man-made drug Easy to produce (15 chemicals used) Main ingredient pseudo ephedrine ( cold remedy), is cooked with chemicals found at hardware store-red phosphorous, iodine, ammonia, paint thinner, ether, Drano, lithium from batteries Investment of $150 can yield up to $10,000 worth of the drug Each kg of meth produced 5-7kg of chemical waste dumped down the drain or dumped in backyard

CRYSTAL METH By-product is toxic gas which causes fires or explosions Drug was used during Second World War to keep pilots awake on long missions Methamphetamine releases high levels of dopamine in the brain a neurotransmitter that is associated with pleasurable or rewarding experiences After it is taken user feels increased wakefulness and physical activity and decreased appetite

CRYSTAL METH Higher doses cause irritability, insomnia, confusion, hallucinations, anxiety, paranoia and increased aggression Even higher doses can cause hypothermia, convulsions and lead to death When body is stimulated by meth it causes irreversible damage Increased heart rate and blood pressure damage blood vessels in the brain, causing strokes, irregular heart beat causing a collapse or death

Sex risks Substance abuse is correlated with risky sex… In one study a woman coming off of meth reported 100 different sexual encounters with 60 different partners in the past month. Risky sex is correlated with many diseases

PRESCRIPTION DRUG ABUSE Prescription drug abuse is using prescription medication in a way that isn’t prescribed by a health care practitioner, or using someone else’s prescription. Kids as young as 12 are trying prescription drugs to get high Prescription drugs are easier to obtain (can be stolen from medicine cabinet) Teens think they are safer because they have been prescribed

PRESCRIPTION DRUG ABUSE Misuse of laxatives, diuretics and diet aids to improve personal appearance Mixing alcohol and prescription drugs to achieve and enhance a “high” Use of codeine cough syrup to achieve intoxication Misuse of stimulants to enhance performance

Frequent use of laxatives as a form of weight control can cause serious problems: severe dehydration, heart attack, nervousness hallucinations, high blood pressure, insomnia, confusion, death

Concept of behavioral addictions B ehavioral addictions are defined as, “an intense desire to repeat some action that is pleasurable or perceived to improve wellbeing or capable of alleviating some personal distress.” What classifies some behaviors as addictive is the difficultly those affected have with stopping or reducing their participation in it.

Some motivating factors for behavioral addictions include the perception of temporary decreased depression and anxiety, making it a seemingly logical way to achieve calm or happiness. For example, gambling addiction lights up similar parts of the brain as some drugs, providing a dopamine rush to the user or player.

Sex addiction impacts the brain in similar ways to gambling addictions, and much like substance abuse treatment. Sex , pornography , or masturbation-based addictions can endanger the individual by complicating relationships, or possibly bringing unwanted pregnancies or STIs. They may struggle to gain control of their sexual behavior, followed by shame or regret. The inability to stop compulsions associated with behavioral addiction often signals a possible addiction.

Behavioral Addiction: Types And Examples Individuals can form behavioral addictions similar to a dependence on drugs and alcohol to combat anxiety, depression, or other mental health disorders . Increases in drug and alcohol use have signaled that many people are abusing harmful chemicals;

H owever , some don’t factor in non-substance addictions like food, sex, phone , video game , or gambling addiction, which often manifest as a behavioral addiction due to underlying mental health challenges. painful emotions .. Those who become addicted to specific activities seek out feelings of comfort, happiness, and chemical releases (dopamine and serotonin) or can form behavioral addictions to escape reality or

Some of the most common types of behavioral addictions are: Sex/pornography Gambling Internet Shopping Video games Plastic surgery Binge eating/food addiction Thrill-seeking activities

Gambling Gambling addiction—also known as pathological gambling, compulsive gambling or gambling disorder —is an impulse-control disorder. If you’re a compulsive gambler, you can’t control the impulse to gamble, even when it has negative consequences for you or your loved ones. You’ll gamble whether you’re up or down, broke or flush, and you’ll keep gambling regardless of the consequences—even when you know that the odds are against you or you can’t afford to lose.

Problem gambling is any gambling behavior that disrupts your life. If you’re preoccupied with gambling, spending more and more time and money on it, chasing losses, or gambling despite serious consequences in your life, you have a gambling problem.

Gambling addiction signs and symptoms Gambling addiction is sometimes referred to as a “ hidden illness ” because there are no obvious physical signs or symptoms like there are in drug or alcohol addiction. Problem gamblers also typically deny or minimize the problem—even to themselves. However , they may have a gambling problem if they: Feel the need to be secretive about their gambling. they might gamble in secret or lie about how much they gamble, feeling others won’t understand or that you will surprise them with a big win. Have trouble controlling your gambling.

Gamble even when you don’t have the money. They may gamble until they’ve spent their last money, and then move on to money they don’t have—money to pay bills, credit cards, or things for their children. They may feel pushed to borrow, sell, or even steal things for gambling money. Have family and friends worried about you. Denial keeps problem gambling going.

Causes of behavioral addiction No one cause explains why some people develop compulsive or addictive tendencies, although there are different social, biological, and psychological factors that make some people more vulnerable to them. For starters, those with a family history of addiction or mental health issues are generally thought to be at higher risk for addiction, as are those who experienced childhood trauma, abuse or neglect.

There is a high rate of co morbidity between mental health and addictive disorders, so those with an existing diagnosis are likely at higher risk. Those with existing substance use disorders are also more likely to develop behavioral addictions. Of course, behavioral patterns and personal choices also influence a person’s risk

In order to develop a behavioral addiction, they need to have engaged in the behavior, usually on multiple occasions. Those who do so often and for long periods of time are also probably more likely to develop a problem. Specifically, those who use the behavior as a method of coping with stress or other difficult emotions could be more likely to develop problematic patterns and addictions .

Certain personality traits could also heighten a person’s risk for developing a behavioral addiction. Research on drug, alcohol, and behavioral addictions suggests that people who are more impulsive and prone to risk-taking are more likely to develop addictions. Across all behavioral addictions, teens and young adults are over represented , suggesting that young people are especially vulnerable.

Chapter Three Assessment and Diagnosis of Addiction Counsellors are considered to be facilitative gatekeepers when they play a significant role in helping clients obtain appropriate treatment for substance abuse. The components of the concept are information gathering, assessment, referral, prevention and education, and tracking and follow-up

Information Gathering The first aspect, information gathering, occurs as counsellors collect and organize information from clients and other referral sources. The gathering process starts with the first contact, when counsellors are listening for and observing signs of alcohol and drug use in their clients as well as other mental health disorders. Simultaneously , counsellors are evaluating client motivation, environmental support, and potential complicating factors that might affect the counselling relationship.

Assessment The second aspect of the facilitative gate-keeping role is assessment. Although similar to information gathering, assessment is structured and occurs when counsellors take information from clients (both verbally and nonverbally) during the assessment and develop a preliminary alcohol and drug diagnosis from which treatment and counselling options are recommended.

Referral (How, When, and Where?) The third aspect to the facilitative gate-keeping role is referral. Once information is gathered and assessed, the counsellor makes a clinical decision on what to do clinically with the client and where to refer Counsellors need to understand how to refer clients, be familiar with the resources in the community and surrounding area, and recognize when to refer clients.

counsellors need to understand the how, when, and where of referring . How . Once clients have entered into counselling, it is the counsellor's responsibility to work within the limits of their competence When. Counsellors provide assessments and referral to addiction counsellors for intensive work on the alcohol and drug use

As a result, counsellors in a mental health setting refer clients to addiction programs first and then work with those clients following their alcohol and drug treatment. Where. Counsellors need to find out all the possible treatment programs in the community, around the state, and the funding sources. Actually visiting the outpatient and inpatient facilities and meeting the counsellors creates a working relationship with the community .

Being aware of which psychiatrists are knowledgeable about addiction and substance abuse is critical for counsellors and clients. Counsellors must know the programs that address co-occurring disorders (e.g., sexual addiction, gambling, eating disorders) to best provide resources for clients.

Prevention and Education The client may signs a release of information (ROI) to parents before entering detoxification for them to take care of their children . The client may also gives permission for the counsellor to speak with his/her parents regarding once condition. At this point, the counsellor can provide education to her parents as well as prevention efforts with her children.

Tracking and Follow-Up Once the client is referred to the detoxification centre, the counsellor should follow up to determine compliance and to determine what help she might need after the detoxification efforts. Furthermore , counsellors can make themselves available at any point in the follow-up process.

The referral to detoxification could be streamlined through an ROI, which would allow follow-up contact with the hospital. Students find the description of the facilitative gate-keeping role helpful in understanding how they, as generalist counsellors, have the potential to be significant components in counselling

Components of a Comprehensive Assessment A thorough assessment begins with information pertaining to the events leading up to the referral; in other words, “Why here?” “Why now?” Getting the specifics of the precipitating events provides information on the client’s defensiveness, awareness, and understanding of what has brought him or her to counselling. It is also important to determine the referral source.

Some referral sources spend a great deal of time preparing clients for counselling whereas others do not, resulting in more time for counsellors to orient clients to counselling. Many times paperwork for assessments is filled out by clients before arrival for the appointment or 30 min before their appointment. As such, more time can be devoted to clients’ needs.

Depending on the therapeutic setting, clients typically present with a host of issues (e.g., depression, relationship problems, anxiety) not necessarily related to alcohol or drug use. Counsellors thereby are challenged to determine over the course of the assessment process whether or not alcohol or drugs are connected to the presenting problem.

Counsellors should ponder two questions: “ Is the presenting problem a symptom of the chemical use (e.g., tardiness and/or absence from work because of hangover or intoxication), or is the presenting problem unrelated to chemical use (e.g., depression)?”

Alcohol and Drug Evaluation Obtaining accurate information from clients regarding their alcohol and drug use can be quite challenging because of two significant factors: T he defence system and dishonesty . A thorough alcohol and drug history includes the client’s first use (age), last use (when date), types of drugs used, the pattern of use (daily, weekends, etc.), and methods of ingestion

It is important to obtain responses to all categories of drugs and determine whether a substance-abuse or addiction problem exists. Questions during the assessment are most helpful when presented in an open-ended format . For example, “Have you been drinking alcohol these last 3 weeks?” is a close-ended question where the response is either “yes” or “no.”

In addition to the close-ended nature of the question, the description of alcohol for clients’ needs to be clarified by the counsellor. For example, beer and wine may not be considered alcohol to some clients. This means counsellors need to include all the variations (i.e., beer, wine, liquor) in an open-ended format . The open question now sounds like this, “If you would be willing, could you tell me a little bit about your use of beer, wine, and liquor over the last 2 months ?” Not only is it open-ended, but also it specifically asks about all the alcohol amounts within the past month.

The DSM-5 (American Psychiatric Association, 2013) describes substance use disorders as a maladaptive pattern of substance use, which leads to clinically significant impairment or distress, as manifested by two of the following criteria occurring within the same 12-month period:

Criterion A: Criteria 1–4 (impaired control) Substance is taken in larger amounts or over a longer period than intended 2 . A persistent desire or unsuccessful efforts to cut down use 3 . Disproportionate time is spent obtaining, using, or recovering from substance—daily activities revolve around substances 4 . Craving—an intense desire or urge for the drug—more likely in environment where using previously occurred

Criteria 5–7 (social impairment) 5 . Inability to fulfil major role obligations at work, school, or home 6 . Continued use despite social or interpersonal problems 7 . Priority shift—social, occupational, or recreational activities are given up

Criteria 8–9 (risky use) 8 . Recurrent substance use in situations in which it is physically hazardous 9 . Continued use despite known psychological or physical problems

Criteria 10–11 (pharmacological) 10 . Tolerance (Exceptions for prescribed medication) 11 . Withdrawal (Exceptions for prescribed medication)

Severity and Specifies The range of severity is from mild to severe and is based on the number of criteria endorsed as the result of an evaluation. A mild substance use disorder is suggested when two to three symptoms are present. Moderate is suggested to be four to five symptoms and S evere by six or more.

Adolescent Substance Abuse Assessment The challenge in evaluating substance abuse problems with adolescents is differentiating between normal adolescent behaviour and change from alcohol and drug use or abuse. The following questions can help counsellors differentiate as well as use the substance abuse assessment tools:

Has the student’s behaviour changed significantly in class over time? For example , the student has begun talking back to the teacher or the student appears lethargic or hyperactive in school (which differs significantly from his or her known behavioural presentation).

Has the student’s attitude changed? For example, by teacher report, the student’s behaviour the prior year was easy going , and this year the student is combative; the student displays a significant drop in interest regarding extracurricular activities.

3. Does the student have bloodshot eyes? 4 . Has the student’s attire and peer association changed? 5 . What activities has the student engaged in, both in the past and currently? 6 . Has the student been tardy or absent from classes? 7 . Has the student’s interest in school declined?

8. Does the student appear to be high or intoxicated? 9 . Has the student’s grade point average dropped significantly ? 10 . What is the student’s attitude and behaviour during the interview? Is he or she blaming or not taking responsibility for actions?

CAGE The acronym CAGE represents a brief screening instrument used in conjunction with data collection during the assessment. This screening tool was first introduced by Ewing and Rouse (1970). The instrument provides counsellors with initial information on clients’ alcohol use.

C—Have you ever felt a need to cut down on your drinking? A—Have you ever felt annoyed by someone criticizing your drinking? G—Have you ever felt guilty about your drinking? E—Have you ever had an eye opener or drank in the morning to steady your nerves?

Responding “yes” to two or more of these questions indicates the likelihood of an alcohol problem . This series of questions focuses primarily on alcohol and not on drug use.

Substance Abuse Subtle Screening Inventory–3 Alcohol Use Disorders Identification Test Drug Use Screening Inventory–Revised

Unit four Approaches to Addiction Therapy Types of Treatment for Addiction There are many different types of addiction treatment programs for people who are struggling with drug addiction. These are some of the most common types of treatment for addiction: Medical detox: Medical detox is designed to clear all the drugs from the addicted person’s body. Medical and clinical professionals make the process more comfortable by treating physical and emotional symptoms of drug withdrawal. Individual therapy during detox also helps prepare the client for ongoing treatment in rehab.

Inpatient rehab : Inpatient rehab for addiction provides a high level of structure and accountability for people who are recovering from addiction. Clients live at the rehab center for the duration of treatment and they maintain a structured daily schedule that includes individual therapy, group therapy, participation in recovery group meetings, time for physical activity and meals, recreational outings, as well as a small amount of personal time. Outpatient rehab: Outpatient rehab allows clients to live at home or in a sober living home while they complete treatment. This also allows for more flexibility if clients need to continue working or caring for children during their treatment. Clients attend several outpatient group meetings each week, which are hosted by licensed treatment professionals at a safe, clinical location.

Online rehab: Online rehab programs allow clients to attend remote video treatment sessions from the comfort of their own homes or while traveling. Video sessions are hosted by licensed treatment professionals and cater to populations who live in remote locations or who cannot otherwise attend face-to-face treatment programs. Court –ordered rehab: Individuals who are arrested and charged with drug-related crimes may go to drug court, where they can be sentenced with rehab instead of jail time. There are strict requirements for these types of programs, but generally speaking, they allow eligible individuals to receive treatment for the underlying problem (addiction) instead of just going to jail. These programs help reduce recidivism rates among non-violent drug offenders.

Sober living programs : Sober living programs provide safe, supportive, drug and alcohol-free living environments for people in recovery. These gender-specific homes provide peer accountability and support alongside regular drug testing, house meetings. Residents also have access to clinical therapy and additional recovery support services, including individualized recovery programming, certified peer recovery support, employment assistance, educational planning, and volunteer placement. Aftercare: Aftercare services are ideal for people who have already completed detox , rehab, and sober living but who need continued support to maintain their sobriety. Aftercare programs offer peer accountability with weekly meetings and support services .

Teen drug rehab: Some drug rehab programs are tailored to teenagers who are struggling with substance use disorders. These programs address teen-specific issues that young people may face in recovery while also providing educational and social services to make re-integrating back into society after rehab much easier. Holistic drug rehab: Holistic drug rehab programs offer treatment services that are designed to enhance clients’ wellness via their mind, body, and spirit. Treatment offerings may include services like acupuncture, yoga, meditation, or nutritional counseling

There are many different types of therapeutic approach that are used in addiction treatment Biological approach Biological approaches to addiction treatment attempt to correct or modify the presumed underlying biological causes of addiction . This approach follows a logical rationale. If we know what caused something to become broken, we can fix it. Then, we can repair or restore the broken "thing" to its original purpose and function. According to biological models of addiction, a "broken" or damaged brain causes addiction. For example, perhaps someone's brain chemistry makes a particular drug a little bit too rewarding. This would make drug use very difficult to resist. One way to fix this problem is to make drug use less rewarding. For instance, a person could take a medication that causes them to become sick if they consume the drug. Thus, this faulty brain chemistry is "fixed" via the addition of corrective chemicals; i.e., medications

2. Psychodynamic approach The psychodynamic approach to addiction therapy looks at how past events, thoughts and circumstances shape a patient’s present behaviors. It is believed that these factors result in unconscious processes that cause a person to act in a particular manner. For instance, a person who was abused in the past may exhibit behaviors that get in the way of healthy relationships, despite the individual’s expressed desire to form them. These unresolved conflicts and experiences might result in the need or desire to abuse druges .

The psychodynamic approach to addiction therapy is thought to be most effective as part of a comprehensive treatment program; it also may be more effective after a person has been sober for a period of time. Therapists who employ a psychodynamic approach to addiction treatment/therapy are specifically trained and possess significant knowledge of substance abuse, 12-Step programs and related topics

What is the 12-Step Program to recover for addiction ? The 12-Step program, first developed and used by Alcoholics Anonymous , is a 12-step plan in order to overcome addictions and compulsions. The basic premise of this model is that people can help one another achieve and maintain abstinence from substances of abuse, but that healing cannot come about unless people with addictions surrender to a higher power. This higher power doesn’t need to be a traditional Christian version of God – it can be as simple as the community of the 12-step meetings, the universe, or a different version of a higher power fit for your type of spirituality.

The 12-Step movement can be a powerful and helpful force for many people, but some people struggle with what they interpret as a strong religious element of the program. Many addiction treatment programs offer alternatives to 12-Step methodology for those who prefer a more secular foundation for treatment. The 12 Steps. 1.Powerlessness over the addiction 2.Believing that a higher power (in whatever form) can help 3.Deciding to turn control over to the higher power 4.Taking a personal inventory 5.Admitting to the higher power, oneself, and another person the wrongs done

6. Being ready to have the higher power correct any shortcomings in one’s character 7. Asking the higher power to remove those shortcomings 8. Making a list of wrongs done to others and being willing to make amends for those wrongs 9. Contacting those who have been hurt, unless doing so would harm the person 10. Continuing to take personal inventory and admitting when one is wrong 11. Seeking enlightenment and connection with the higher power via prayer and meditation 12.Carrying the message of the 12 Steps to others in need

3. Behavioral Approach Behavioral therapies —including individual, family, or group counseling— are the most commonly used forms of drug abuse treatment . Behavioral therapies for drug and alcohol addiction has many benefits . Therapy engages people in substance abuse treatment. Therapy provides incentives for people to remain sober. Therapy modifies peoples’ attitudes and behaviors toward drug abuse. Therapy increases life skills and teaches people how to manage stress, triggers , and high-risk situations in recovery . Even if a client isn’t voluntarily going to treatment, therapy can help break down an individual’s resistance to trea tment and open up the opportunity for recovery.

4. Cognitive approach cognitive Behavioral Therapy for Addiction CBT aims to change harmful thinking patterns by teaching individuals how to recognize and reevaluate them realistically, use problem-solving to deal with difficult situations, develop self-confidence and self-efficacy , and gain a better understanding of the behaviors of others. Instead of focusing on the past, CBT is centered around the here and now to help clients move forward in life. Many addicted people are plagued by negative thinking patterns, which can make it very difficult to stop using drugs or alcohol.

Cont, Negative thinking patterns also heavily contribute to feelings of powerlessness and mental health problems that frequently occur alongside addiction like anxiety or depression. Instead of feeling powerless over their addictive behaviors, cognitive behavioral therapy helps people explore patterns of negative thinking that contribute to self-destructive behavior like substance abuse and adopt healthier

What Are the Benefits of Cognitive Behavioral Therapy for Addiction? CBT is focused on the present and goal-oriented. CBT helps clients develop strategies to deal with cravings, stressful situations, or triggers that may occur outside of rehab. CBT can be used in group or individual therapy. CBT allows clients and therapists to work together to identify negative thinking patterns and develop healthy ones. The skills required for CBT are practical ones that can be incorporated into everyday life.

5. Systemic approach It is proposed to combine the ideas of systemic therapy and counseling - which also do not intend to practice social control but to increase the idea of autonomy and self-confidence for the drug consumers: by supposing the independence and the competence of the clients in advance they get a chance to experience themselves as autonomous personalities - acting in a exactly the way they want to

Cont, Systemic therapists believe that an important aspect of their work is to develop new approaches for their clients: problems and difficulties arise because for one reason or another the clients view of alternative routes is blocked. The job of the therapist is to motivate and develop new ideas and to offer them to the client. The art is to „simply“ put the client into the situation that previously seemed impossible to imagine for her or him.

cont , To work „systemically“ which means includes the idea of dealing with a group, with people who are in connection with and important to each other: A couple, a family, a clique of friends or a group of people at work can be considered as a system the expressions „systemic therapy“ and „systemic advice“ now stand for far more than the mere fact that one considers also the environment of the „identified patient“, and that one invites more than one person to take part in the therapy and advice.

Unit five Therapeutic Techniques for Addiction Cognitive Behavioral therapy(CBE ) CBT Techniques for Addiction Treatment Situations that involve triggers and Situations and have been highly associated with have been highly associated with drug use are referred to as drug use are referred to as high-risk situations. situations. Other places, people, and situations that have never been associated with that have never been associated with drug use are referred to as drug use are referred to as low-risk situations.

Cont, An important CBT concept is to teach clients to decrease their time in high clients to decrease their time in high-risk situations and increase their time in low risk situations. Understanding craving :- Craving (definition) To have an intense desire for drug. To need urgently; require.

Many people describe craving as similar to a hunger for food or thirst for water. It is a hunger for food or thirst for water. It is a combination of thoughts and feelings. There is a combination of thoughts and feelings. There is a powerful physiological component to craving powerful physiological component to craving that makes it a very powerful event and that makes very difficult to resist .

Craving : Different for different people Cravings or urges are experienced in a variety of Cravings or urges are experienced in a variety of ways by different clients. ways by different clients. For some, the experience is primarily somatic. For example, “I just get a feeling in my stomach, or “My heart races,” or “I start smelling it. For others, craving is experienced more cognitively. For example, For example, “I need it now” or “I can’t get it out of my head ” or “It calls me.

In CBT, it is important to give clients tools to resist craving Strategies to cope with craving Strategies to cope with craving 1. Engage in non -drug -related activity related activity 2. Talk about craving 3. “Surf ” the craving 4. Thought stopping 5. Contact a drug -free friend or counselor 6. Pray

CBT techniques to stop drug use must be accompanied by instructions and encouragement to begin some new alternative. activities. Many clients have poor or non -existent repertoires of drug -free activities. Efforts to “shape and reinforce ” attempts to try new behaviors' or return to previous non-drug - related behavior is part of CBT

2. Rational Emotive Behavioral therapy REB t herapeutic techniques of addiction :- the founder of REBT is Albert Ellis, PhD . Also Ellis is one of the founder of CBT . Ellis major theories ( REBT $ CBT) insight that lies at the base of People tends to experiences emotional disturbances because of thoughts they have and not because of the event they experienced , these thoughts are often irrational. A person who is addicted demonstrates irrational thoughts, acts in self – defeating manner , and visualizes in a dysfunctional way.

Cont, In a session , a therapist will follow the REBT philosophy that can be summarized as: A- Action : The client will have experienced an activating event such as a trauma. B- Belief : In reaction to the event , the client will have formed a belief .When people exhibit dysfunctional behaviors , that is a sign that they likely have irrational belief.

C- Consequences : As a result of the event , the client has started to live life a certain way. D- Dispute : The therapists will challenge the client’s irrational thoughts, behaviors ,and visualizations. One method is for the therapist to ask the client to some research ( e.g , gather facts , statistics and other evidence)that will help to illuminate that the beliefs is not correct( i.e , irrational).

3. Acceptance and Commitment Therapy Acceptance and commitment therapy techniques (ACT, pronounced as a word) is an approach designed to increase psychological flexibility —a way of living characterized by openness, awareness, and engagement . Psychological flexibility can be described as willingness to accept all aspects of one’s experience without engaging in unnecessary avoidance behaviors, when doing so serves the development of patterns of values-congruent activity

The psychological flexibility model describes a set of six functional processes underlying much human suffering and adaptability: acceptance, defusion , present-moment awareness, self processes, values-based living, and committed action. The model describes functioning along a continuum, and the processes that are cultivated during treatment to promote Mindfulness and Acceptance for Addictive Behaviors .

Psychological flexibility are aimed at the prevention of psychological difficulties in the future. The psychological flexibility model is transdiagnostic , meaning it identifies common mechanisms underlying an array of psychological difficulties .

Group therapy Group therapy can be a powerful therapeutic tool for treating substance abuse. In many cases, it is as effective as individual therapy because groups intrinsically have many rewarding traits, such as reducing isolation and enabling members to witness the recovery of others.

These qualities can draw clients into a culture of recovery. Although many types of groups can have therapeutic elements and effects, the group therapy models included (1) have trained leaders and (2) are intended to produce some type of healing or recovery from substance abuse. use.

Techniques. Specific techniques may vary by the specific orientation of the leader but, in general, include the ability to 1. teach group members about self-destructive behavior and thinking that leads to maladaptive behavior, focus on problem-solving and short- and long-term goal setting, and 3. help clients monitor feelings and behavior, particularly those associated with substance

Advantages of Group Therapy There are many advantages to using group therapy in substance abuse treatment. Groups can • Provide useful information to clients who are new to recovery. • Allow a single treatment professional to help a number of clients at the same time. • Provide positive peer support and pressure for abstinence from substances of abuse. • Help members learn to cope with problems related to substance abuse by allowing them to see how others deal with similar problems. • Provide feedback concerning the values and abilities of group members. • Help clients overcome past harmful family experiences.

• Encourage, coach, support, and reinforce members as they undertake difficult or anxiety provoking tasks. • Offer members the opportunity to learn or relearn the social skills they need to cope with everyday life instead of resorting to substance abuse. • Effectively confront individual members about substance abuse and other harmful behaviors. • Support and provide encouragement to one another outside the group setting

Help clients overcome past harmful family experiences. Encourage, coach, support, and reinforce members as they undertake difficult or anxiety provoking tasks. • Offer members the opportunity to learn or relearn the social skills they need to cope with everyday life instead of resorting to substance abuse. • Effectively confront individual members about substance abuse and other harmful behaviors. • Add needed structure and discipline to the lives of people with substance use disorders, who often enter treatment with their lives in chaos.

Family therapy Family Therapy is just that, except that the one going to therapy is not just the individual struggling, but the entire family. While individual therapy focuses on the thoughts, behaviors and emotions of one person, family therapy focuses on the relationships, and aims to understand and validate the experiences of all family members. The goal of family therapy is to bring clarity to all relationships, and to foster repair and closeness if family members choose. Family therapists believe that problems exist between people, not within people.

Techniques useful during the stage when the client and the family are preparing to make changes in their lives include the following: Multidimensional family therapy • Motivate family to engage client in detoxification. • Contract with the family for abstinence. • Contract with the family regarding its own treatment.

• Define problems and contract with family members to curtail the problems. Behavioral family therapy (Kirby et al. 1999) • Conduct community reinforcement training interviews such as interviews with area clergy to help them develop ways to impact the community..

Network and family/larger system •Use the network (including courts, parole officers, employer, team staff, licensing boards, child protective services, social services, lawyers, schools, etc.) to motivate treatment. Interview the family in relation to the larger system. •Interview the family and people in other larger systems that assist the family. •Interview larger system representatives, such as school counselors, without the family present

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