Drug And Addiction

Front 1

Jellinek thought that alcoholism was a disease with three key symptoms

Back 1

1) Loss of control over drinking

2) progression of symptoms to severe addiction

3) Death if left untreated

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Alcoholism

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A primary chronic disease, progressive and fatal, continuous over a periodic impaired control, distortions in thinking

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"Primary" refers to

Back 3

the nature of alcoholism as a disease entity in addition to and separate from other pathophysiologic states

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Disease

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an involuntary disability

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"Progressive and fatal"

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The disease persists over time and alcohol causes premature death

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Four stages of alcoholism

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1) Prealcoholic Stage

2) Early/Prodromal

3) Middle/Crucial

4) Late/Chronic

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1) Prealcoholic Stage

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Alcohol used for relief from social tension

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2) Early/Prodromal

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Increasing tolerance, blackouts, sneaking and gulping drinks and guilt

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3) Middle/Crucial

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Loss of control over drinking, personality changes, loss of friends and jobs, preoccupation with protection supply

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4) Late/Chronic

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Morning drinking, violation of ethical standards, tremors and hallucinations

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"invisible line"

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One crossed, you cannot go back to social drinking

Front 12

Recovering alcoholic

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Implies that one is never cured, but once ingested the disease process will continue as if the person never stopped even if they have not taken a drink for many years

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Impaired control

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inability to limit alcohol use or to consistently limit on any drinking occasion the duration of the episode, the quantity consumed, and/or the behavioral consequences of drinking

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Preoccupation

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excessive, focused attention given to the drug alcohol, its effects, and use

Front 15

Adverse consequences

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alcohol-related impairments in physical health, psychological functioning, interpersonal functioning, occupational functioning, and legal, financial, and or spiritual problems

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Denial

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a reduced sign of awareness of the fact that alcohol use is the cause of an individuals pxs rather than a solution

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Strength of model

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removal of social stigma that leads to humane treatment of people with pxs, more understanding

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Limitations of model

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May not be accurate, may remove a sense of personal responsibility and lead to passivity "there is nothing I can do now"

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What they used to call addiction and alcoholism until 1980

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Sociopathic personality disorder

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External or overt

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drinking alcohol, snorting, injecting

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Internal or covert

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a thought such as "If I dont get something to drink soon I wont make it"

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Classical conditioning

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Learning through temporal association. When two events repeatedly occur together in time they become conditioned. ex: Pavlov's Dogs

Bell and food became associated. When ringing bell without food dog salivated

Environmental cues evoke craving.

Man at bar with friends. UCS is social interaction UCR is warm feeling CS is alcohol

Or Pairing injection with your location, if move to another you overdose

Front 23

CC treatment:

Cue exposure treatment

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Craving develops as a result of SR bonds (pairing drugs with environmental cues) Treatment aims at presenting environmental triggers in lab, but not having them result in use causing them to extinguish SR bonds and gain control

Front 24

CC treatment:

Aversion therapy

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pairing a noxious stimulus with a highly attractive behavior (creating new SR bonds)

ex: Shick Shadel- pairing of vomiting and shock with alcohol

Antabuse- medication that results in alcoholics becoming ill when ingesting

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Operant Conditioning BF Skinner

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Humans learn behavior bc of rewards from environment.

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Operant Cond:

Reinforcement

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Defined as any event that increases the frequency of behavior

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Operant:

Positive reinforcement

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Adding a positive stimulus (smile, money) leads to increase of behavior

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Operant:

Negative Reinforcement

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Removing an averse stimulus (seat belt clicking turns off buzzer)

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Operant:

Extinction

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Removal of reinforcement that results in change (loss) of learned behavior

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Operant:

Punishment

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Results in decrease of behavior

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Positive Punishment

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Joe smoke Mary J then gets arrested, stops smoking (ADDITION of a negative)

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Negative Punishment

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Joe smokes Mary J, arrested, girlfriend leaves him, stops smoking (REMOVAL of a positive)

Front 33

Treatments based on OC:

Contingency management

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reinforcement applied systematically

Front 34

Treatments based on OC:

Behavioral self-control training

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brief educational approach to achieve abstinence . Setting limits on drinking, changing rate of drinking, setting up rewards when goals achieved

Front 35

Social learning theory: Bandura

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People learn by observing and imitating others. Attitudes toward drinking and drugs are likely formed through observational learning

Front 36

Treatments based on modeling:

Social skills training

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drink/drug refusal skills, intrapersonal skills, coping

Front 37

Treatments based on modeling:

Self-help groups

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watching others face life difficulties