Transcript Use Abuse & Addiction

Use
Abuse
&
Addiction
Presented by Tonya Slager
Preview
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Definitions
Assessment tools
Stages
MN Model
Brain/Body
Use
 Debatable for drug use
 Social drinking 1-2 x wkly
 1 drink per hour
 Below .08
Abuse Criteria
at least 1 in the past 12 months
 Recurrent use despite failure in major obligations
i.e. work/school
 Recurrent use in which it’s physically hazardous
 Continued use despite legal problems
 Cont. use despite persistent/recurrent social or
interpersonal problems due to use
 Social/family networks suffer
 Arguments due to use
Criteria for Dependence
3+ in the past 12 months
 Tolerance
 A need for markedly increased amounts to achieve
intoxication or desired effect
 Marked diminished effect with cont. use of the same amt.
 Withdrawal
 Characteristic withdrawal syndrome for substance
 Used to relieve or avoid withdrawal
 Substance taken in larger amounts or over longer
period than was intended
Criteria …
 Unsuccessful effort to cut down – loss of control
 Consumes a great deal of time – obtaining, using,
recovering
 Loss of interest in non-using activities – give up or
reduced
 Cont. use despite knowledge of having persistent or
recurrent physical/psychological problems due to
use
Dependence
 With physiological dependence
 Evidence of tolerance or withdrawal
 Without physiological dependence
 No evidence of tolerance or withdrawal
CAGE
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Have you ever felt you should Cut down?
Have people Annoyed you by criticizing your use?
Have you felt bad or Guilty about your use?
Have you ever had a drink in the morning to steady
your nerves or get rid of a hangover? (Eye-opener)
 1 pt per ?
 Clinical significance 2 +
Behavioral Characteristics
Addiction
Preoccupation
Increased Tolerance
Blackouts
Loss of control
Used to medicate
Rapid intake
Solitary use- hiding or use alone
Protecting your supply
Classifying Alcoholism
 Alpha- relieve stress
 Psychological dependence
 Have the ability to control use
 No progression
 Beta- serious problems to the body
 Physical deterioration
 No withdrawal symptoms
 Gamma
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Withdrawal symptoms
Loss of control
Noticeable behavior changes
Primarily recognized in AA
Categories …
 Delta
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Daily use
Tolerance increase
Inability to sustain at all
Functioning alcoholic
 Epsilon
 Least known
 Binges
 Periodic
McAuliffe Stages
Stages
Initial
Chronic
Acute
Terminal
Motivation
Pleasure
Transition
Abuse
(abuse AND live)
Relief
Abuse
(live to abuse)
Maintenance
Abuse
(abuse to live)
Escape to oblivion Abuse
(abuse to die)
Schedule Drugs
I.
II.
Heroin, marijuana, MDMA (ectasy)
Opium, morphine, codeine, cocaine,
amphetamine, meth
III. Codeine, morphine, barbiturates,
IV. Barbiturates (downers/sleep aids),
benzodiazepines (Valium/Xanax), anabolic
steroids
V. Codeine - Rx
Minnesota Model
 1873 NY State Inebriate Asylum
 Willmar State Hosp.
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Typical 28 day inpatient program
AA/12 steps
Group therapy
Aftercare
3 Key Components of the MN
Model
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Addiction can be identified and described
Involuntary disablement
Responsive to tx
Multiple phases
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Prodromal phase
Crucial/Basic phase
Chronic
Death or rehabilitation
Physical Damage
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Liver
Sleep cycle (REM)
Blood pressure increases
Alcohol poisoning
Wernicks Syndrome- form of brain damage due to
years of heavy drinking
Malnutrition
Low resistance to disease
Amphetamine Psychosis- paranoid delusions,
compulsive behavior, hallucinations
Etc.
Facts About Drugs and the Brain
 Nicotine, alcohol, cocaine, barbiturates, and
caffeine cross the blood-brain barrier easily
 Heroine crosses faster and more completely
than morphine
 Vomiting center in the medulla is sensitive to
the presence of poison - induces vomiting
otherwise the medulla’s respiratory controls
would be inhibited resulting in death
(asphyxiation)
Facts …
 Dizziness/lack of coordination- drugs
depressant effect on the cerebellum
 Pons- part of the brain that allows us to be
alert enough to survive
 Just above the medulla
 Part of the hindbrain structure
 Drugs that affect sleep pattern influence the sleep
centers in the pons
Tolerance
 Metabolic (dispositional) tolerance
 A drug may facilitate over repeated administrations the
processes that produce the drug’s biotransformation in
the liver
 Liver breaks down the drug faster after repeated use >
smaller amt is left available to be absorbed into the blood
stream
 Cellular (pharmacodynamic) tolerance
 Changes occur in the synapses of neurons themselves
 Repeated stimulation over time results in desensitization
Questions?