Chapter 1 History and Etiological Models of Addiction

  • Slides: 35
Download presentation
Chapter 1 History and Etiological Models of Addiction Foundations of Addictions Counseling, 1 st

Chapter 1 History and Etiological Models of Addiction Foundations of Addictions Counseling, 1 st Edition © 2009 Pearson Education, Inc. All rights reserved.

History and Models of Addiction n A specialized field in counseling The addiction counseling

History and Models of Addiction n A specialized field in counseling The addiction counseling field evolved like psychology, social work Early Practice n Limited education, supervision, ethics, and research Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -2 © 2009 Pearson Education, Inc. All rights reserved.

Prevention in the United States n Historical approaches to prevention n n Alcohol’s central

Prevention in the United States n Historical approaches to prevention n n Alcohol’s central role in the colonies Temperance as moderation n n Temperance as abstinence n n Original goal was moderation Women’s Christian Temperance Movement Volstead Act and Prohibition (1920) Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -3 © 2009 Pearson Education, Inc. All rights reserved.

U. S. Drug Laws n n Until 1903 cocaine was used in soda drinks

U. S. Drug Laws n n Until 1903 cocaine was used in soda drinks (“Coca Cola”) Pure Food and Drug Act, 1906 (labeling) The Harrison Act, 1914 (taxation of opium and coca products) Controlled Substance Act, 1970 Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -4 © 2009 Pearson Education, Inc. All rights reserved.

Laws and Agencies n n n National Institute on Alcohol Abuse and Alcoholism (NIAAA),

Laws and Agencies n n n National Institute on Alcohol Abuse and Alcoholism (NIAAA), 1971 National Institute on Drug Abuse (NIDA), 1974 The Anti-Drug Abuse Prevention Act of 1986 created the United States Office for Substance Abuse Prevention (OSAP) n Later became CSAP (part of SAMHSA) Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -5 © 2009 Pearson Education, Inc. All rights reserved.

Models for Explaining the Etiology of Addiction n The Moral Model Psychological Models Family

Models for Explaining the Etiology of Addiction n The Moral Model Psychological Models Family Models Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer § § 1 -6 The Disease Model Biological Models Sociocultural Models Multicausal Models © 2009 Pearson Education, Inc. All rights reserved.

The Moral Model n Personal Choice n Religious Beliefs n n Sinfulness Legal System

The Moral Model n Personal Choice n Religious Beliefs n n Sinfulness Legal System n Punishment Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -7 © 2009 Pearson Education, Inc. All rights reserved.

Psychological Models n Cognitive-behavioral models n n n Motivations Reinforcement (positive & negative) Learning

Psychological Models n Cognitive-behavioral models n n n Motivations Reinforcement (positive & negative) Learning models n Learned response n n n Use decreases anxiety, stress, etc. Aversion to withdrawal Physical dependence Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -8 © 2009 Pearson Education, Inc. All rights reserved.

Biological Models n Genetic Models n Statistical associations n n Genetic factors Neurobiological Models

Biological Models n Genetic Models n Statistical associations n n Genetic factors Neurobiological Models n Brain chemistry n Limbic system Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -9 © 2009 Pearson Education, Inc. All rights reserved.

Multicausal Models n No single model adequately explains addiction n Syndrome model n n

Multicausal Models n No single model adequately explains addiction n Syndrome model n n Integral Model n n Multiple and interacting antecedents Concepts from integrative medicine and transpersonal psychology Public Health Model n Agent, Host, Environment Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -10 © 2009 Pearson Education, Inc. All rights reserved.

Useful Web Sites n n n www. ncadi. samhsa. gov www. drugabuse. gov www.

Useful Web Sites n n n www. ncadi. samhsa. gov www. drugabuse. gov www. niaaa. nih. gov Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -11 © 2009 Pearson Education, Inc. All rights reserved.

Chapter 2 Substance and Process Addictions Laura Veach and Emeline P. Hollander Foundations of

Chapter 2 Substance and Process Addictions Laura Veach and Emeline P. Hollander Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -12 © 2009 Pearson Education, Inc. All rights reserved.

Neurobiology and Physiology Addiction Reward Circuit n Neurobiology n Brain research n Reward pathway

Neurobiology and Physiology Addiction Reward Circuit n Neurobiology n Brain research n Reward pathway http: //teens. drugabuse. gov/mom/tg_brainimages_fig 6. html Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -13 © 2009 Pearson Education, Inc. All rights reserved.

Reward Pathway Ventral tegmental area NA Prefrontal Cortex Source: http: //www. drugabuse. gov/pubs/teaching/Teaching 3/Teaching

Reward Pathway Ventral tegmental area NA Prefrontal Cortex Source: http: //www. drugabuse. gov/pubs/teaching/Teaching 3/Teaching 2. html Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -14 © 2009 Pearson Education, Inc. All rights reserved.

Nerve Cells and Neurotransmission n Neurons n n 100 billion nerve cells in the

Nerve Cells and Neurotransmission n Neurons n n 100 billion nerve cells in the brain Neurotransmitters n n n Chemical messengers Dopamine Neuroreceptors Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -15 © 2009 Pearson Education, Inc. All rights reserved.

Cocaine Interfering with Neurons When cocaine enters the brain, it blocks the dopamine transporter

Cocaine Interfering with Neurons When cocaine enters the brain, it blocks the dopamine transporter from pumping dopamine back into the transmitting neuron, flooding the synapse with dopamine. This intensifies and prolongs the stimulation of receiving neurons in the brain's pleasure circuits, causing a cocaine "high. " http: //teens. drugabuse. gov/mom/tg_effects. php# (http: //teens. drugabuse. gov/mom/tg_brainimages_fig 7. html) Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -16 © 2009 Pearson Education, Inc. All rights reserved.

Positron emission tomography (PET) scan Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1

Positron emission tomography (PET) scan Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -17 © 2009 Pearson Education, Inc. All rights reserved.

Physiological Factors n Tolerance n n Neuroadaptation Metabolic tolerance Pharmacodynamic tolerance Withdrawal Foundations of

Physiological Factors n Tolerance n n Neuroadaptation Metabolic tolerance Pharmacodynamic tolerance Withdrawal Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -18 © 2009 Pearson Education, Inc. All rights reserved.

Substances of Addiction n n Depressants Stimulants Cannabinoids Hallucinogens Opioids Foundations of Addictions Counseling,

Substances of Addiction n n Depressants Stimulants Cannabinoids Hallucinogens Opioids Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -19 © 2009 Pearson Education, Inc. All rights reserved.

Depressants n n Alcohol Sedative/Hypnotics Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1

Depressants n n Alcohol Sedative/Hypnotics Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -20 © 2009 Pearson Education, Inc. All rights reserved.

Alcohol n Ethanol n Proof n n Mood altering effects within 20 minutes Metabolized

Alcohol n Ethanol n Proof n n Mood altering effects within 20 minutes Metabolized by the liver as a toxin n n 7% alcohol/ethanol = 14 proof 151 -proof rum = ___ % ethanol? Intoxicated Blood alcohol concentration (BAC) Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -21 © 2009 Pearson Education, Inc. All rights reserved.

Sedative/Hypnotics n Sedative/Hypnotic drugs (CNS) n n Also depress the CNS Benzodiazepines (aka “tranquilizers”)

Sedative/Hypnotics n Sedative/Hypnotic drugs (CNS) n n Also depress the CNS Benzodiazepines (aka “tranquilizers”) n n Barbiturates (Tuinal, Nembutal) n n Valium (diazepam), Xanax (alprazolam) High risk for abuse and addiction Women at risk Lethal potential Non-barbiturates (Quaaludes) Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -22 © 2009 Pearson Education, Inc. All rights reserved.

Stimulants n Tobacco n n n Nicotine Ephedrine Amphetamines Ritalin Cocaine Foundations of Addictions

Stimulants n Tobacco n n n Nicotine Ephedrine Amphetamines Ritalin Cocaine Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -23 © 2009 Pearson Education, Inc. All rights reserved.

Ephedrine, Amphetamines, Amphetamine-like Medications n Ephedrine n n Legal ban in 2004 (side effects)

Ephedrine, Amphetamines, Amphetamine-like Medications n Ephedrine n n Legal ban in 2004 (side effects) Amphetamines (“Speed”) n Methamphetamine n n Oral, snorted, smoked, injected Amphetamine-like medications n Ritalin (for ADHD) n Side effects: weight loss, insomnia, hypertension, anemia Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -24 © 2009 Pearson Education, Inc. All rights reserved.

Cocaine n Epidemics in late 1800’s, early 1900’s n n “Crack” cocaine n n

Cocaine n Epidemics in late 1800’s, early 1900’s n n “Crack” cocaine n n n Use has declined since 1990’s Smokeable, concentrated form of cocaine Physical Dependence (tolerance/withdrawal) Strong potential for abuse Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -25 © 2009 Pearson Education, Inc. All rights reserved.

Cannabinoids n Marijuana n Unique properties n n Tolerance Withdrawal Dependence Negative physical effects

Cannabinoids n Marijuana n Unique properties n n Tolerance Withdrawal Dependence Negative physical effects n n Reduced lung capacity Lowered testosterone levels Racing pulse Decreased muscle strength Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -26 © 2009 Pearson Education, Inc. All rights reserved.

Hallucinogens and Other Psychedelics n n n Lysergic acid derivatives (LSD) Phencyclidine (PCP) MDMA

Hallucinogens and Other Psychedelics n n n Lysergic acid derivatives (LSD) Phencyclidine (PCP) MDMA (Ectasy) n n The most popular psychedelic of the 1990’s Perception-altering properties Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -27 © 2009 Pearson Education, Inc. All rights reserved.

Opioids n Parent of all narcotic drugs n Opium n n Morphine Heroin n

Opioids n Parent of all narcotic drugs n Opium n n Morphine Heroin n Intravenous injection HIV Infection risks Oxy. Contin Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -28 © 2009 Pearson Education, Inc. All rights reserved.

Process Addictions n Ingestive addiction n n Chemical dependence Process addictions n n n

Process Addictions n Ingestive addiction n n Chemical dependence Process addictions n n n Addiction to a behavior, process, or action Still debated Examples n Gambling, sexual addiction, work, shopping, food Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -29 © 2009 Pearson Education, Inc. All rights reserved.

Sexual Addiction n n Varying definitions Sexaholics Anonymous (SA) n n n Sex Addicts

Sexual Addiction n n Varying definitions Sexaholics Anonymous (SA) n n n Sex Addicts Anonymous (SAA) n n “Addicted to lust”, loss of control Isolation, Guilt, Depression, Emptiness Progressive path to increasingly dangerous behaviors No DSM criteria for sexual addiction Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -30 © 2009 Pearson Education, Inc. All rights reserved.

Gambling Addiction n Pathological gambling n n Impulse Control Disorder in DSM Warning signs

Gambling Addiction n Pathological gambling n n Impulse Control Disorder in DSM Warning signs n n Secretiveness Extravagant expenditures Increased debt and worry over finances Increased alcohol, drug consumption Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -31 © 2009 Pearson Education, Inc. All rights reserved.

Work Addiction n “Workaholism” n n n Little data available on prevalence Socially accepted,

Work Addiction n “Workaholism” n n n Little data available on prevalence Socially accepted, encouraged, rewarded Self-esteem problems, inability to relax, out of control, frenetic, unsatisfied unless doing something Less productive than non-workaholics Perfectionistic, inefficient More research needed Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -32 © 2009 Pearson Education, Inc. All rights reserved.

Compulsive Buying n n Shopaholism Consistent, repetitive purchasing in response to stress n n

Compulsive Buying n n Shopaholism Consistent, repetitive purchasing in response to stress n n Overspending, Indebtedness, Bankruptcy Treatment n Teaching how to resist social forces (media, easy credit) Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -33 © 2009 Pearson Education, Inc. All rights reserved.

Food Addiction and Disordered Eating n Eating Disorders, including: n Anorexia n n Bulimia

Food Addiction and Disordered Eating n Eating Disorders, including: n Anorexia n n Bulimia n n Compulsive self-starvation Compulsive cycle – eating and purging Binge Eating Disorder (no purging) Overeaters Anonymous 10% of sufferers are male Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -34 © 2009 Pearson Education, Inc. All rights reserved.

Useful Web Sites n Alcoholics Anonymous n n Al-Anon and Alateen n n www.

Useful Web Sites n Alcoholics Anonymous n n Al-Anon and Alateen n n www. al-anon. org Narcotics Anonymous n n www. alcoholics-anonymous. org www. na. org Overeaters Anonymous n www. oa. org Foundations of Addictions Counseling, 1 st Edition Capuzzi/Stauffer 1 -35 © 2009 Pearson Education, Inc. All rights reserved.