Addiction studies (Graduate Student)
L Anderson
2-2TheoriesofAddictionAS2000-5000SU2021pptx.pptxTheories of Addiction
Overcoming addiction is simply a matter of willpower
Myth or Reality
Myth: Prolonged exposure to AODs alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it extremely difficult to quit by sheer force of will.
People who are addicted have to hit rock bottom before they can get better.
Myth: Recovery can begin at any point in the addiction process—and the earlier, the better.
Addiction is a disease, so there’s nothing that can be done about it.
Myth: Although the disease model is widely accepted, this doesn’t mean people are helpless. The brain changes associated with addiction can be treated and reversed
People who are forced (e.g., courts) into treatment are just as successful as those who volunteer
Reality: People who are pressured into treatment by their family, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own
Defective spirit and the inner choice of conscious.
THEORIES OF ADDICTION
MORAL MODEL
Moral weakness and character defects lead to addiction
Very little sympathy or empathy for people that have chronic addictions.
Individual choices are the main theme of this model.
Treatment?
Recovery or abstinence is achieved through the use of willpower and discipline, and the development of a virtuous lifestyle
Religion is required in order to be ethical and moral
It wasn’t until the 1930s that other theories were being introduced academically.
ENLIGHTENMENT MODEL
Addiction is considered a disease that is lifelong and progressive.
The dominant proponents of this model are twelve step fellowships such as Alcoholics Anonymous and Narcotics Anonymous.
Individuals are held responsible for the problem but not the solution.
They become enlightened to the nature of their problem and to the action deemed necessary to
overcome the concern.
Problems were caused primarily by their impulse and behavior
Control of these problems are outside their power - Solution lies outside of the individual.
“Every addict, including the potential addict, suffers from an incurable disease of mind, body and spirit”
From this perspective the answer for the “addict” is to desist from substance use or any other behaviors fueled by the addiction.
To change the “addict” must become enlightened, by realizing that change is possible only by relinquishing personal control to a ‘higher power’.
THEORIES OF ADDICTION
HEREDITY
Traits are passed through generations by genetic make-up.
Genes determine eye color, initial structure and chemistry of the nervous system etc .
Determine responses to stress, temperament, and internal reactions.
There are over 100 genes associated with alcohol/drug abuse.
DRD2A1 Allele (shortage of dopamine receptors)
MAO-A Monoamine Oxidase (“Warrior Gene”)
Enzymes responsible for breaking down the neurotransmitters—serotonin, dopamine, and adrenalin
5
THEORIES OF ADDICTION
MEDICAL/DISEASE MODEL
This model defines AOD addiction as a medical disorder
There is something that is uncharacteristic which leads to behavioral impairment.
The individual is unable to control their craving for AODs.
An individual is not cured even if they are able to stop using AODs (dormant).
Substance addiction affects both behavior and the brain, thus neurochemical and behavioral processes are impaired during the development of the disease
Treatment?
This concept places a higher priority on neurotransmitter regulation as a treatment approach and, originally, it was believed that medical professionals were the most competent to effectively treat addiction; however, the model has evolved to include behavioral therapies and self-help groups as part of the treatment approach.
Psychological or Character Logical Model
Concentrates on what takes place in order for a person to start using substances.
Biology does not cause a person to take that first drink or drug - It must be psychologically motivated - views everyone as being vulnerable to addiction
An abnormal character or personality trait is what causes a person to become addicted
Degrees of personal and psychological defects that pre-dispose an individual to these “addictive personality” traits
Assisting in changing the personality of these individuals
Treatment?
Examples?
Poor impulse control, ineffectual coping mechanism to stress,
being manipulative, portraying a big ego
Learning Theory
A series of behaviors, rewards, and experiences that all work in tandem to reinforce the learned habit of addiction.
There are three different types of learning that reinforce addiction: classical conditioning, operant conditioning, and social learning.
*People who find relief in a pleasurable behavior are more likely to engage in that behavior again.
2 fundamental types of learning that apply to humans and animals
learning by paired association, called classical conditioning Examples?
learning from the consequences of a behavioral choice, called operant conditioning. Examples?
People learn through observation that addictive behaviors can be used to: Cope with stress, depression, anxiety or anger, feel more relaxed and sociable, escape from pain.
A third type of learning is called social learning.
*Social learning occurs when we learn something by observing others. Examples?
THEORIES OF ADDICTION
DIATHESIS - STRESS MODEL
The result of an interaction between a predispositional vulnerability (biological and/or genetic) and a stress caused by life experiences.
Stressful conditions/experiences play a precipitating or facilitating role.
If the individual is resilient or has low biological vulnerability, it would take extremely high levels of stress to trigger symptoms.
If the individual has high biological vulnerability to the disorder, then it would take lower levels of stress for symptoms to be exhibited.
Until this critical level of stress is reached, the individual will function normally, and the biological vulnerability would not manifest.
Therefore, this model helps to explain why some, but not all, people exhibit psychological/behavioral disorders, even though they may all experience similar environmental stressors.
Protective vs. Risk Factors?
Implications?
As the addiction treatment field has evolved, it continues to move away from punitive dogmatic approaches to more client centered holistic approaches.
Strengths based models of addiction treatment integrate a variety of influential components that enhance our understanding and ability to effectively treat the entire individual within his or her social, cultural, psychological, spiritual and biological contexts.
Addiction is recognized as a complex disorder that involves biological, psychological, social, and spiritual components and therefore must be conceptualized and treated utilizing the biopsychosocial-spiritual model.
Biological section – includes information about the client’s medical history (past and present, including medications), family history of medical illnesses, substance abuse history, developmental history, and physical functioning and abilities
Spiritual section – includes information on the client’s spiritual beliefs, participation in faith-based activities, connections to organized religion, and spiritual practices and resources
Social section – includes information on the client’s social functioning, living situation, personal and family relationships, sexuality, family background, history of abuse, educational background, legal history, employment history, potential risks, and strengths and resources available to support the client
Psychological section – includes information about any psychiatric symptoms or illnesses the client is currently experiencing, or has experienced in the past, mental status, family history of mental illness, psychiatric medications or treatments (past and present), and psychosocial stressors or traumatic events
Cultural section – includes information about the client’s cultural background, participation in cultural activities and traditions, cultural norms surrounding health, mental health, and social roles, worldview, and cultural practices and resources
MORAL MODEL
People who become addicted are seen as morally weak with poor willpower, and they must will their way through addiction in order to recover.
THE ENLIGHTENMENT MODEL
The enlightenment model is espoused by Alcoholics Anonymous and other 12-step philosophies and requires people to seek recovery by turning the problem over to a higher power.
Emerged in response to the moral and enlightenment models that placed blame on the addict for his or her problem.
In the medical model, the addict is responsible neither for the development of the problem nor for its resolution.
Biological/genetic predisposition for addiction, an underlying disease process, and assumes that the disease is progressive.
Only treated through medical intervention and by medical professionals
THE MEDICAL/DISEASE MODEL
Most illnesses, disorders, and syndromes, including substance use disorders, are caused by the interaction of numerous factors – biological, psychological, social, cultural, cognitive, environmental, and spiritual.
As such . . . ALL must be taken into consideration in prevention and treatment efforts
BIOPSYCHOSOCIAL-SPIRITUAL MODEL (BPSS)
Timeline
How Do Drugs Affect the Brain? Sara Garofalo Narration by Addison Anderson TED-ED Video
References
Creative Commons. Open Source Images. https://creativecommons.org/
Hanselman, D. & Dudek, D. (2017). Peer Recovery Coach: The Art of Mentoring. Marygrove College.
Inaba, D. (2014). Uppers, downers, and all arounders. 8th Edition. Drug Education Textbook. CNS Productions. http://www.cnsproductions.com
National Institute on Drug Abuse (NIDA). http://www.nida.nih.gov/index.html
Noble, E. (2000). The DRD2 gene in psychiatric and neurological disorders and its phenotypes. Alcohol Research Center, Department of Psychiatry and Biobehavioral Sciences and the Brain Research Institute, University of California, Los Angeles
Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/
.MsftOfcThm_Accent1_Fill { fill:#4472C4; } .MsftOfcThm_Accent1_Stroke { stroke:#4472C4; }
