Download path to dependence

Path to Dependence
How does dependence develop?
Why does it happen to some
people and not others?
Start with first experience
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First drug experience
Rewarded by
Positive
Reinforcement
Continue use
Unrewarded or
Punished
Stop use
Role of learning
From the very first encounter, see
the effects of learning.
 Learning plays a critical role in
psychological dependence.
 “craving for repeated or compulsive
use of a drug because its effects are
deemed pleasurable.”
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Learning and behavior
Learning can be used to modify
behavior.
 Behaviorism was the first scientific
paradigm for psychology.
 JB Watson, BF Skinner
 Principles widely applied at home,
school and workplace.
 And on the road: seatbelt use
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Safer to wear seatbelts.
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Well-known that
seatbelts save lives.
Usage varies greatly.
51% in Mass
91% in Calif
78% in CT
Required in CA but
only suggested in MA
External to internal control
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Forced or encouraged.
Not wearing seatbelt
might lead to
punishment.
Wearing reinforced by
others and by vehicle.
Put them on as a
matter of habit.
Internalized.
Punishment and reinforcement.
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“Click it or ticket”
Threat of punishment.
Random checks.
Car comes with
warning buzzers.
Stop if you buckle up.
Reinforces wearing.
Environment controls behavior
Extrinsic motivation.
 External rewards and punishments.
 Praise increase likelihood I’ll
participate.
 Criticism decrease the likelihood.
 Principles of operant conditioning at
work.
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Effects on behavior
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Reinforcement
Leads to an
increase in
behavior.
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Punishment
Leads to a
decrease in
behavior.
Types of reinforcement
Positive
reinforcement:
behavior leads to
reward.
Negative
reinforcement:
behavior removes
pain or anxiety
 Ex: take pill for
headache
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Types of punishment
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Goal of punishment is
a decrease in
unwanted behavior.
Behavior leads to unpleasant outcome (Type I) or
takes away something pleasant (Type II)
Add to
Pleasant
Unpleasant
Take away from
Rewards and punishments
Pleasant
Add to
Take away from
Positive
reinforcement
Type II punishment
Unpleasant Type I
punishment
Negative
reinforcement
Problems with punishment
Negative feelings towards person
giving punishment.
 Physical or psychological pain.
 Escalate in severity.
 Situational: substitute teacher
syndrome.
 Less likely to internalize.
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Initial use punished
What might be present in the
individual or the environment to
make the initial use unpleasant?
 Psychological characteristics.
 Medical concerns.
 Moral or religious beliefs.
 Family background.
 Other possibilities?
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Reasons to remember
Guest turns down the offer of a
drink.
 Proper response from host?
 Push even further.
 Grill guest about reasons.
 Remember some of reasons for
individual choice.
 1/3 US adults don’t drink at all.
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Reward leads to increase use.
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Frequent use
Body and brain adaptation
Dependence
Tolerance
Increase use to
maintain effect
Psychological and Physical
Dependence
Psychological
Abstinence causes
craving
and
Sensitivity to triggers
Physical
Abstinence causes
withdrawal and rebound
Physical withdrawal
Withdrawal and rebound
Escape pain of withdrawal by taking drug
(negative reinforcement
Avoid withdrawal by continuous use
(avoidance learning)
Anti-social and/or criminal behavior to
protect supply.
Understanding compulsion
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Getting hooked.
Beginning single hook (positive
reinforcement).
Escape withdrawal (negative
reinforcement).
Avoid withdrawal (avoidance).
High-jacked brain thru learning.