What Is Addiction or Dependence A syndrome defined

  • Slides: 4
Download presentation
What Is Addiction or Dependence? A syndrome defined by the presence of 3 or

What Is Addiction or Dependence? A syndrome defined by the presence of 3 or more features as defined in ICD-10 (and DSM-IV) consisting of: – 4 psychological features – 2 biological features (tolerance & withdrawal) • I. e. It is primarily a psychological state, the treatment of which is primarily psychological • Not just “physical addiction” - a characteristic withdrawal state (which need not be present) The ICD-10 Criteria for Drug Dependency • Need 3 of 6 criteria in last 12 months: • 2 drug related criteria: – Compulsion/cravings to take drug – Difficulties in controlling drug use • 2 consequences of use criteria: – Progressive neglect of alternative pleasures/interests due to drug use – Persistent drug use despite harmful consequences • 2 physiological criteria: – Characteristic drug withdrawal state – Evidence of tolerance to the drug • Note: No mention of frequency or amount or chronicity of drug use

Drugs Licensed for Use in Opiate Addiction Treatment Substitute opiates: • Methadone oral soln

Drugs Licensed for Use in Opiate Addiction Treatment Substitute opiates: • Methadone oral soln or mixture 1 mg/ml (& branded Methadose® 10 mg/ml & 20 mg/ml for dilution - but not recommended) – NOT injectable methadone, tablets or linctus (2 mg/5 ml) • Buprenorphine (Subutex/Suboxone or generic) sublingual tabs 0. 4, 2, 8 mg (Suboxone also contains naloxone) – NOT Temgesic (0. 2 & 0. 4 mg tablets or 0. 3 mg ampoules) , not the patches, films or depot • NOT codeine, DF 118, MST, diamorphine or any other opiate Detox agents: • Lofexidine (NOT clonidine) Maintenance of abstinence: • Naltrexone tablets (NOT implant or depot)

Prochaska and Di. Clemente (1983, 1992, 1997) Long term change Maintenance Action Preparation Lapse

Prochaska and Di. Clemente (1983, 1992, 1997) Long term change Maintenance Action Preparation Lapse Relapse Contemplation Pre-contemplation

Four Simple Steps to Recovery: 1. Connect… With people around you. Go to meetings

Four Simple Steps to Recovery: 1. Connect… With people around you. Go to meetings (AA, NA, CA, SMART) 2. Be Active…do something, go for a walk, exercise, do anything. 3. Give… Do something for someone else. Volunteer. 4. Keep Learning… Try something new. Become a student of recovery? 5. Take Notice… Be curious. Be present. ‘The Power of Now’ (Ekhart Tolle)