Transcript DRUGS: EDUCATION, PREVENTION AND TREATMENT

DRUGS: EDUCATION,
PREVENTION AND
TREATMENT
June 2, 2008
Drugs
Continuum of behavior:
-No use
-Use
-Abuse
-Dependency
Learning the Mood Swing
Starting point… shifts mood toward
euphoria… finishing point (same as
starting point)
Seeking the Mood Swing
Begins to make a contract with the drug
Learned that the drug can improve mood
Starting point (feeling down)… moves
toward drug- induced mood… finishing
point (normal)
Harmful Use
Uncomfortable effect from drug use:
hangover… doing something wrong
Most people would say “never again”
Minority of users: drug use becomes
emerging problem (example: DUI)
Crossed a thin line from problem use to
harmful use
Starting point: normal; use to drug-induced
mood; finish worse than when began use
Use Drug to Feel Normal
The drug is essential just to feel normal
Feeling better is no longer the goal
May need to avoid withdrawal symptoms
Starting point (feeling down)…use drug to
achieve normality… finishing point
(extreme pain)
Prevention
Education
Relapse-prevention
Painful Outcomes
Domestic violence-fractured family
systems
Drug-induced depression and other
affective disorders
Financial conflicts
Loss of income
Many other losses
DSM-IV-TR (2000)
Substance abuse and substance
dependency distinguished
Substance dependency = addiction
Invisible Line: Lawrence Metzger
Treatment facilities: treat person & the
addiction
Substance Use
Alcohol: loosens inhibition
Novocain: numbs the gum
Caffeine in the morning: get going versus
sluggish, fatigued
No limitation in functioning
Can use or not use with very little difficulty
Substance Abuse
Take drug to avoid discomfort (e.g.,
anxiety)
Drug effect is first, social interactions are
second
Cocaine and amphetamines: get excited
Rely on drug versus own ability
Substance Dependency
From creative adjustment to situations
(use) to habitual response (addiction)
Drug is now primary source of comfort
Drug usually not tasted or experienced
-gulping
-snorting
-smoking
-injecting
Addiction
Compulsive use
Loss of ability to control use
Continued use despite negative
consequences
Denial
Nightmare of Addiction
Nightmare: insanity / prison / suicide
“This routine went on with few
interruptions for seventeen years. It was
really a horrible nightmare, this earning
money, getting liquor, smuggling it home,
getting drunk, morning jitters, taking large
doses of sedatives to make it possible to
earn more money…”
Physical Deterioration
May enter treatment through medical
emergency
Lying-down drunk
Crack user passed out with her pipe
Parent who passes out daily after the
children go to school
Most Well-Known Treatment
Programs
What works…
12-step programs
-Alcoholics Anonymous (AA) (2002)
-Narcotics Anonymous (NA) (1988)
Employee Assistance Programs (EAP)
American Psychiatric Association (2000)
World Health Organization
Awareness
“To Be Aware is To Take Care” (Mary Ann
Finch)
Practices: the Buddha
-meditation
-mindfulness
“When we retire at night…”
“On awakening…”
RECOVERY
From “fists” to “open hands”
-clients: px.ht.hp.tx.
-from “nightmare” to “gratitude”
Amazing Grace
“I want to keep this life of peace, serenity,
and tranquility that I have found. Today, I
have found again the home I left…”