1. Family Education 1-1 Session 1: Triggers and Cravings

2. Family Education Matrix IOP1-2 Changes in the Brain Limbic System Prefrontal Cortex

3. Family Education Matrix IOP1-3 Conditioning

4. Family Education Matrix IOP1-4 I.P. Pavlov (1849–1936)

5. Family Education Matrix IOP1-5 Pavlov’s Dog

6. Family Education Matrix IOP1-6 A Definition of Addiction American Society of Addiction Medicine A primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. Addiction is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving. Graham, A.W.; Schultz, T.K.; Mayo-Smith, M.F.; Ries, R.K.; and Wilford, B.B. eds. Principles of Addiction Medicine, Third Edition. Chevy Chase, MD: American Society of Addiction Medicine, Inc., 2003.

7. Family Education Matrix IOP1-7 The Addictive Process  Introductory phase  Maintenance phase  Disenchantment phase  Disaster phase

8. Family Education Matrix IOP1-8 Addictive Process Introductory Phase Positives Relief from Depression Anxiety Loneliness Insomnia Euphoria Increased status Increased energy Increased sexual/social confidence Increased work output Increased thinking ability METHAMPHETAMINE (METH) Negatives May be illegal May be expensive May cause missing work

9. Family Education Matrix IOP1-9 Conditioning Process During Addiction Introductory Phase Triggers Parties Special occasions Other events Responses Pleasant thoughts about meth Infrequent use Strength of Conditioned Connection: Mild

10. Family Education Matrix IOP1-10 Development of Obsessive Thinking Introductory Phase Sports Food School TV Girlfriend Hobbies Job Meth Family Exercise Parties

11. Family Education Matrix IOP1-11 Development of Craving Response Introductory Phase Entering Using Site Use of Meth  Heart/pulse rate  Respiration  Adrenaline  Energy  Meth taste Meth Effects

12. Family Education Matrix IOP1-12 Positives Depression relief Confidence boost Boredom relief Sexual enhancement Social lubricant Negatives Employment/school disruptions Relationship concerns Financial problems Beginnings of physiological dependence Addictive Process Maintenance Phase

13. Family Education Matrix IOP1-13 Strength of Conditioned Connection: Triggers Parties Friday nights Friends Alcohol “Good times” Sexual situations Responses Thoughts of meth Eager anticipation of meth use Mild physiological arousal Cravings occur as use approaches Occasional use Moderate Conditioning Process During Addiction Maintenance Phase

14. Family Education Matrix IOP1-14 Meth Food School TV Girlfriend Hobbies Job Meth Family Exercise Parties Development of Obsessive Thinking Maintenance Phase

15. Family Education Matrix IOP1-15 Entering Using Site Physiolog- ical Response Use of Meth Meth Effects  Heart  Breathing  Adrenaline effects  Energy  Meth taste  Heart  Blood pressure  Energy Development of Craving Response Maintenance Phase

16. Family Education Matrix IOP1-16 Positives Sociability Occasional euphoria Relief from fatigue Relief from stress Negatives Withdrawal depression Paranoia Tweaking Relationship disruptions Family distress Impending job loss Addictive Process Disenchantment Phase

17. Family Education Matrix IOP1-17 Strength of Conditioned Connection: Triggers Fatigue All friends Stress Boredom Anxiety Free time Sexual arousal Loneliness Responses Continual thoughts of meth Strong physiological arousal Psychological dependency Strong cravings Frequent use STRONG Conditioning Process During Addiction Disenchantment Phase

18. Family Education Matrix IOP1-18 Meth Food Meth TV Girlfriend Meth Job Meth Family Meth Parties Meth Development of Obsessive Thinking Disenchantment Phase

19. Family Education Matrix IOP1-19 Thinking of Using Mild Physiological Response Entering Using Site  Heart rate  Breathing rate  Energy  Adrenaline effects Powerful Physiological Response Use of Meth Meth Effects  Heart rate  Breathing rate  Energy  Adrenaline effects  Heart  Blood pressure  Energy Development of Craving Response Disenchantment Phase

20. Family Education Matrix IOP1-20 Positives Relief from fatigue Relief from stress Relief from depression Negatives Weight loss Paranoia Loss of family Seizures Severe depression Unemployment Bankruptcy Addictive Process Disaster Phase

21. Family Education Matrix IOP1-21 Strength of Conditioned Connection: Triggers Any emotion Day Night Work Free time Responses Obsessive thoughts about meth Powerful autonomic response Powerful physiological dependence Automatic use Persistent paranoia OVERPOWERING Conditioning Process During Addiction Disaster Phase

22. Family Education Matrix IOP1-22 Meth Development of Obsessive Thinking Disaster Phase

23. Family Education Matrix IOP1-23 Thoughts of Meth- Using Place Powerful Physiological Response  Heart rate  Breathing rate  Energy  Adrenaline effects Development of Craving Response Disaster Phase

24. Family Education Matrix IOP1-24 Trigger Thought Craving Use

25. Family Education Matrix IOP1-25 Interruption Trigger Thought Craving Use

26. Family Education Matrix IOP1-26 Thought Stopping  Visualization  Rubberband snap  Relaxation  Calling someone

27. Family Education Matrix IOP1-27 Thought Stopping Visualization

28. Family Education Matrix IOP1-28 Thought Stopping Rubberband Snap

29. Family Education Matrix IOP1-29 Thought Stopping Relaxation

30. Family Education Matrix IOP1-30 Thought Stopping Calling Someone