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Introduction
~ 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 3 categories –
~ Intoxication
~ Withdrawal
~ Substance Use Disorder
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)

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 users have some amount of control and can learn methods to cope.
~ Dependent users seem to have no control over their use.
~ One and done
~ Progression over time

Summary

-Definition of addiction

-Characteristics of a chronic disease

-Factors Influencing Addiction

-Continuum of addiction

-Theories of causation

-Reinforcers within the cycle of addiction