-052- Happiness Isn't Brain Surgery Understanding Addiction

 
 
00:00 / 45:20
 
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Happiness Isn-t Brain Surgery:
Understanding Addiction
Presented by: Dr. Dawn-Elise Snipes
Executive Director, AllCEUs

Continuing Education (CE) credits for addiction and mental health counselors, social workers and marriage and family therapists can be earned for this presentation at
https://www.allceus.com/member/cart?c=3

Objectives
– Learn about addiction
– Prevalence
– Cause
– Functions of addiction
– Develop an understanding of how addictive behavior regardless of the origin often ends up being a form of self-medication
– Explore different approaches to addressing addiction
Addiction Prevalence
– Alcoholism
– 16.3 million adults ages 18 and older(6.8 percent of this age group) had an AUD in 2014 http://pubs.niaaa.nih.gov/publications/AlcoholFacts&Stats/AlcoholFacts&Stats.pdf
– Drug Addiction
– In 2013, an estimated 24.6 million Americans-9.4 percent of the population-had used an illicit drug in the past month https://www.drugabuse.gov/publications/drugfacts/nationwide-trends
– All Addictive behaviors
– About 47% of the U.S. adult population suffers from an addictive behavior-with serious negative consequences-in a 12-month period. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134413/

Addiction Definition
– General
– Use of a pleasurable activity or substance
– To escape emotional or physical pain
– That continues to be used despite causing problems in one or more area of life
– Other
– Tolerance -Needing more of the substance or activity or combining substances or activities to get relief.
– Withdrawal
– Physical
– Psychological
Causes of Addiction
– Neurochemical imbalance from-
– Excessive recreational use of a substance or activity (Party pooper)
– Use of a substance or activity to eliminate feelings of depression, anxiety, stress, anger or pain (open wound theory)
– Leads to-
– Unsuccessful efforts to cut down or quit
– Spending more time and/or money thinking about, engaging in or recovering from use
– Neglect of important areas of functioning
– Leads to-depression/anxiety/anger –>more use to escape
A Note About Cravings and Triggers
– Cravings are persistent thoughts or desires for a rewarding behavior.
– Cravings are for one of 2 reasons:
– To produce pleasure (chocolate)
– To eliminate pain (physical or emotional)
– Triggers remind you of the addiction and kick off a craving:
– People
– Places
– Things
– Emotions
– Memories
– Habits

Functions of Addiction
– Produce feelings of pleasure, euphoria, happiness when none exist (by altering brain chemicals).
– Numb emotional or physical pain when nothing else works (by altering brain chemicals).
– Help the person survive when they cannot tolerate the pain and feel overwhelmed, hopeless and helpless.
Self Medication Hypothesis
– Develop an understanding of how addictive behavior regardless of the origin often ends up being a form of self-medication.
– 3 consequences of excessive engagement in pleasurable activities:
– The brain -uses- the neurotransmitters faster than they can be made.
– The brain shuts down the receptors to conserve the neurotransmitters and prevent the body from being overstimulated (Think: Movie Theater)
– An imbalance is created between the neurotransmitters leading to an inability to feel pleasure without external stimulation
Example: Extreme Jobs
– Law Enforcement
– At first -tones- and -running code- get the person-s adrenaline pumping.
– After a while the body turns down the sensitivity of the adrenaline thermostat. It takes more than running code to get a rush.
– How is this protective
– Adrenaline prepares for fight or flight.
– The brain -learns- that most of the time it is not that big of a deal.
– The brain now requires something more intense- -Emergency squawk.-

Example 2: Roller coasters
– Initially roller coasters can provide a rush of adrenaline and dopamine (conqueror).
– The brain has no schema to associate it with, so when you are going downhill at 80mph with no control, it sends out the fight-or-flight response.
– Over time (and several rides) the brain learns there is no threat and quits sending as much adrenaline and dopamine, or it gets so overstimulated that it shuts down the receptors to prevent system overload.
– To get that same rush, the person must ride a more -thrilling- coaster or combine it with another excitatory activity or substance.
Example 3: Gambling
– Initially there is a tension building phase during game play. The person is essentially already in the -fight- There is a cognitive challenge standing between them and the reward.
– Upon winning, the body secretes dopamine and adrenaline which basically help the body learn:
– This was successful
– I want to do it again
– Over time the brain again turns down the sensitivity to preserve the balance of brain chemicals, so to get the same high, the person must take a greater risk or win a bigger reward.
Approaches to Recovery
– Explore different approaches to addressing addiction
– Eliminate things causing the imbalances in brain chemicals:
– The addictive behavior
– Sleep disturbances
– Negative thoughts that are maintaining the anxiety, depression, anger
– Nutritional imbalances
– Controllable stressors
– Strengthen and add:
– Coping skills
– Positive social relationships
Two-Pronged Treatment
– Eliminate the addictive behavior(s).
– Pick one or two areas the addiction has been covering up to start addressing.
– A person with depression who is not currently using is not going to stay clean long, unless reasonable other alternatives for use are available.
– A person with depression who continues to use an addictive behavior is not going to feel much better because the brain chemistry is going to stay -wonky.-
Summary
– Addiction develops over time as a result of
– Brain changes
– Increasing -stress,- -problems,- -depression- or -anxiety-
– Recovery involves:
– Identifying and eliminating activities and behaviors that are keeping the brain chemicals out of balance
– Developing effective ways to deal with what has been, to date, unmanageable.
– Patience
– Compassion
– Determination

Summary Cont.
– Addiction almost never occurs without depression, anxiety, anger, guilt and/or grief.
– Clinically significant anxiety (stress) or depression also rarely occurs without the presence of some addictive behaviors.
– Addictive behaviors are an ineffective way of coping and almost always cause more problems in the long run.
– Effective addiction treatment has to focus on identifying and addressing the causes of the -pain- for the individual.
– Stopping use is not the same as recovery.
Summary Cont.
– Recovery is creating a lifestyle in which:
– You feel happy more often than not.
– You are physically comfortable most of the time.
– You do not -need- to escape or numb physical or emotional pain.