Transcript Martien Kooyman

The different aspects of addiction
and the Therapeutic Community
approach
Martien Kooyman MD, PhD
50% of heroin addicts were
involved in criminal behaviour
before they used their first drug
Addiction is a chronic relapsing
disease
Is addiction is a chronic relapsing
disease?
Is it chronic?
Long term drug use
( excl. unknown )
100
90
80
70
60
50
40
30
20
10
0
start
20%
Deceased
20%
Problem use
20%
Integrated use
40%
Abstinent
5 year
follow-up
10 year
15 year
follow-up follow-up
20 year
follow-up
Cramer & Schippers, 1994
Recovery rate in the literature
Alcohol dependence: 60%
Psychiatric disorder: 39%
Schippers (2006)
Is it a relapsing condition?
Is addiction a disease?
If addiction is not a chronic
relapsing disease,
what is addiction?
Addiction is a self inflicted
disorder
with multiple causes
Definition of addiction
Addiction is a self-continuing harmful
process resulting from the loss of
control over adaptive behaviour which
then itself becomes a problem
heriditary
biological
trauma
family
Addiction
peer group
social
Possible causal factors in addiction
heriditary
biological
trauma
family
Addiction
peer group
social
Possible causal factors in addiction
The addict who comes to treatment
has a low self esteem and
an unabillity to sustain
intimate relationships
orientation
methadone
T.C.
Triple-Ex
detox
T.C.
Mistral
re-entry
T.C.
Emiliehoeve
day centre
project 4
Therapeutic communities will never
solve the total drug problem.
They are however part of the solution.