Download "The Cycle of Addiction," Kenneth L. Osborne, M.S.

The Cycle of Addiction
We can never forget about
this brain disease
July 21, 2011
Kenneth L. Osborne, M.S.
This project was supported by grant No. 2010-RT-BX-K001 awarded by the Bureau of Justice Assistance. The Bureau of
Justice Assistance is a component of the Office of Justice Programs, which also includes the Bureau of Justice Statistics,
the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the SMART Office, and the
Office for Victims of Crime. Point of view or opinions in this document are those of the author and do not represent the
official position or policies of the United States Department of Justice.
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DEFINE ADDICTION
DEFINE THE DIFFERENCE BETWEEN ABUSE AND ADDICTION
DISCUSS THE STAGES OF CHANGE WITHIN ADDICTIVE
PERSONALITIES
EXPLORE THE ETIOLOGICAL PATHWAYS OF ADDICTION
EXPLORE THE CULTURE OF ADDICTION
ADDICTION IS A PATHOLOGICAL LOVE TRUST RELATIONSHIP
WITH AN OBJECT OR EVENT
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Addicts objectify themselves and others
These objects or events are predictable
Priorities are misplaced
Addiction is seductive
Intensity is mistaken for intimacy
DRUGS
DRUGS ARE SUBSTANCES (CHEMICALS) OTHER THAN FOOD
TAKEN WITH THE INTENT OF ALTERING THE FUNCTIONING
OF THE BODY, MENTAL FUNCTIONING,OR FUNCTIONING OF
DISEASE GERMS THAT ARE IN THE BODY.
Two categories of drugs: Psychoactive and Non psychoactive
Psychoactive – drugs that change feeling perceptions and
behaviors. These are the ones most often taken or sold by
offenders.
Non psychoactive – drugs that do not effect perception,
emotional state or behavior taken in normal doses. (I.e.
antibiotics, blood pressure medicines)
DEFINITIONS
DRUG ABUSE
Abuse – the use of a substance in a manner, in amounts
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or in situations that creates problems in an individuals
social, occupational, psychological or physical
functioning with one or more of the following features
within a 12 month period:
Recurrent use resulting in a failure to fulfill obligations at
work, home or school
Using in situations that are potentially hazardous
Recurrent use related problems (arrest, etc.)
Continued use despite persistent problems or recurrent
problems caused by or exacerbated by the effects of
using
DRUG ADDICTION
Addiction – a maladaptive pattern of use , leading to clinically
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significant impairment or distress, as manifested by three or
more of the following within a 12 month period:
A need for increased amounts to achieve intoxication
Markedly diminished effects with continued use of the same
amount
The substance is taken in larger amounts over a period of
time
Inability to control use
Constant preoccupation with using , getting or seeking drugs
Use continue despite persistent problems that are mental,
physical or social in nature
DEFINITION TAKEN FROM THE DSMIV (THE DIAGNOSTIC AND STATISTICAL MANUAL OF
MENTAL DISORDERS)
Drug use and abuse creates
distorted thinking
Addiction is linked to decision
making functions…..
We must face the fact that we are
dealing with people whose Brains
may have been permanently
changed by Drug use
Simple Brain Structure
• Frontal Lobe
• (Cortex)
– Judgment and
reason
• Mid brain (Limbic)
– Emotions and
reward sites
• Hind brain ( Stem)
– Bodily functions
Stage one: Internal change
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The emergence of the addictive personality
The illusion of control
Formation of Addictive logic
Self care
self
Stage two: Lifestyle Change
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Behavioral dependency
Addictive promises
Addictive rituals
External responses to the addict
Internal struggle
Completion of delusional system
Spiritual emptiness begins
Stage three: Life breakdown
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Acting out breaks down
Addictive logic breaks down
Coping becomes impossible
Interacting breaks down
Antisocial personality traits set in
Consequences are more severe
Physical breakdown
AN INFORMAL SOCIAL NETWORK IN WHICH GROUP NORMS
(PRESCRIBED PATTERNS OF PERCEIVING, THINKING, FEELING AND
BEHAVING) PROMOTE ILLICIT BEHAVIOR AND EXCESSIVE DRUG
USE. THIS CULTURE ENCOMPASSESS A DIVERSE COLLECTION OF
SUBCULTURES ORGANIZED GEOGRAPHICALLY, ETHNICALLY,
SOCIOECONOMICALLY AND THROUGH EACH SUBCULTURE’S DRUG
(S) OF CHOICE.
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In the United States there has been historical race assignation or blame
regarding illicit drug use and the resulting problems from use (1895-1915
Blacks and cocaine, 1875 the Chinese Opium Crusade, 1920 The Mexican
Marihuana problem,)
The War on Drugs Has resulted in the disproportionate incarceration of the
young, poor black and Hispanic underclass
Caucasians, African Americans and Hispanics do not differ greatly in their
illicit drug use or drinking
The poor and ethnic minority groups are often disproportionately effected
experiencing higher incidents of drug induced crimes and violence
Under the War on Drugs the correctional system has become our principal
public agency for providing disadvantaged young men and women with
housing, nutrition,medical care and education and escape from the
ravages of drug related street crime
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Genetic / Physiological
Personality/ Intrapsychic
Coping / Social
Conditioning / Reinforcement
Compulsive / Excessive behavior
Biopsychosocial
Tribal Networks
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Celebrated Drug Tribes- drugs that have been blessed
for social consumption (I.e. alcohol, caffeine)
Tolerated Drug Tribes- drugs whose consumption
society discourages,but not antagonistically so
(nicotine)
Instrumental Drug Tribes- psychoactive active drug
citizens can legally obtain and abuse ( prescription
meds)
Prohibited Drug Tribes- drugs defined as having
highly limited or no utilitarian use whose presence is
seen as potentially disruptive ( cocaine, PCP, heroin,
LSD
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HAVING PARENTS WHO ARE ADDICTS
EMOTIONAL INSTABILITY
GROWING UP IN ABUSIVE FAMILIES
NEGLECTFUL FAMILIES
SHAME BASED FAMILIES
INCONSISTENT MESSAGES
DEATH OF A FAMILY MEMBER
TRANSTHEORETICAL
MODEL- the Integrating
Principle for Change
TTM consists of four
dimensions of change and
their interactions:
Stages of change
Processes of change
Markers of change
Context of change
Stages of Change- the road
map in and out of addiction
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Concerned about the need
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Precontemplation
Convinced and the decision
to change
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Contemplation
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Preparation
Create and Commit to a
viable plan
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Carry out the plan
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Action
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Consolidate the plan
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Maintenance
Skills:
Behavior
Firm,
Fair,
Consistent
Cognitive Structure
Risk Reduction:
Skills:
Internal focus
Effective communication skills
Dynamic Risk Factors
Reflective listening
Anti-social attitudes and beliefs
Elicit self motivating
statements
Roll with resistance
3 Keys of Successful Change
efforts
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The client must stand in the place of decisional balance
Clients can change through structured therapeutic processes
that get to the heart of the matter
The individuals and systems who serve the client must change
as well
What works in Addiction
Treatment
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The client must stand in the place of decisional balance
Clients can change through structured therapeutic processes
that get to the heart of the matter
The individuals and systems who serve the client must change
as well
General Findings
“What Works” Research
Treatment Works
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Intensity (40 to 70 percent of time)
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Duration (depends on the severity of the
disorder)
 Risks, Needs, and Responsivity.
 Punishment alone, does not reduce recidivism for
antisocial offenders.