Summary: Review for the Alcohol and Drug Counselor Exam • Past 30 Day statistics, According to the 2012 National Survey on Drug Use and Health, • 6.5% of the population over 12 reported heavy drinking • 9.2% reported illicit drug use • The majority of people who use recreationally will not need treatment • Addiction is characterized by compulsive craving for the substance and using that substance despite negative consequences • Cravings and compulsive behavior are caused in large part as a consequence of substance use or addictive behaviors on the brain causing • Emotional • Cognitive • Physical • Behavioral changes Definition of Addiction • Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. • Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations reflected in pathological pursuit of a reward and/or relief by a substance. • Without treatment and/or engagement, addiction is progressive and can result in disability or premature death. (ASAM 2011, NIDA 2007) Characteristics of Chronic Disease • Disrupts normal functioning • Have serious, harmful consequences • Are preventable and treatable • Can last a lifetime • May be fatal if untreated Addiction—A description, not a Diagnosis • Addiction is a description, not a diagnostic term. • Addiction erodes a person’s self-control and ability to make sound decisions • The DSM V has 2 diagnostic categories • Substance abuse • Substance dependence (The medical definition of addiction) • Dependence is always characterized by dependence and withdrawal Factors Influencing Addiction • No single factor is causative • General Categories • Biological/genetic makeup • Gender • Ethnicity • Developmental stage/early use • Social environment • Proximal (neighborhood, school/work, friends, family) • Cultural/Media/Availability • Method of administration Factors Influencing Addiction • Genetic Factors • 40-60 % of a person’s vulnerability is genetic. • Expression of these genes is influenced by: • Effects of the environment • Reactions/effects of addictive behaviors • Genetic predisposition to mental health issues (self-medication) • Social Environment & Peer and School • Access • Social learning of acceptability and use patterns • Exposure to peers/family who engage in criminal behavior • Academic/work failure • Poor social skills / unstable relationships Factors Influencing Addiction • Developmental/Early Use • The earlier the initiation, the greater the likelihood it progresses to addiction • Addictive behaviors have a stronger impact on the developing brain (esp. the prefrontal cortex) • Indicative of a set of vulnerabilities/triggers • Genetics • Mental Illness • Unstable family relationships • Exposure to abuse Factors Influencing Addiction • Method of Administration • Smoking and injection increase addictive potential due to • Rapid transit to the brain (seconds) • Rapid fade of effects (crash) Theories of Causation • Moral Model • Addiction is the result of defects of character • Rejects any biological basis • Focuses on individual choices and values retraining • Disease Model • Addiction is an illness resulting from an impairment of neurochemical or behavioral processes • Presented by Jellinek leading the APA and AMA adopting the disease model • Addiction is a primary disease and not caused by anything else Theories of Causation • Genetic Model • Individuals have a genetic predisposition • Difficult to separate social causes from family and genetic causes • Cultural Model • Cultural attitudes and availability impact which addictions people develop • Blended Model • Addiction develops in each individual as a result of a unique set of factors Continuum of Addiction • Social – risky/problematic –abuse –dependence • Many individuals never progress beyond risky consumption • Recovery from addiction is a multidimensional process which differs between people and changes over time. • Risky/problematic
