1. Addiction: What is it or what is it Not
Lecture Three
Addiction: What is it or what is it Not

2. Short Group Exercise
Your row’s task is to create a definition of addiction and then present it to the class

3. Looking at the MAST

4. Let’s Look at the MAST Score one point if you answered the followingNo
Yes
7 through 22: Yes

5. Scores mean? 0 – 2 no apparent problem
3 – 5 Early or Middle Problem drinker
6 or more Problem Drinker

6. Why do people abuse chemicals?
But why then are we not all addicts?
The simplest answer is because it feels good!

7. Is it not a choice?
What do folks think?

8. Is it simple a choice?

9. Physical reward potential
Increased sense of pleasure
Decreased discomfort
Thus I use again and again

10. Social Learning Component
We learn how to use drugs and substances
In order to maximize their potential both physically and psychologically.
Individual Expectation of Drug/Alcohol / Substance

11. Cultural influences on chemical use patterns
People’s decision to use or not can be a result of the community, subculture, family, and social group, to which you belong.
Peele [1985] holds that “cultures where use of a substance is comfortable, familiar, and socially regulated both as to style of use and appropriate time and place for such use, addiction is less likely and maybe practically unknown”.
And yet with new emerging addictions this may not hold as true as it did 20 years ago!
What is Peele Smoking?
We also can’t forget social groups within a culture

12. Individual Life Goals Present Past Future
It’s Important to remember that chemical abuse patterns are not fixed
Moreover, no one sets out to become addicted

13. Medical model of addiction
or Disease Model

14. Basic Tenet: Medical Model / Disease Model
A great deal of the individuals behavior is based on predisposition
However, there is no universally accepted disease model that explains addiction
Instead there exists loosely related theories that addiction is (unproven) psycho-biomedical processes that can be called a disease state.

15. Otto Jellinek (1952) Influenced physicians
Shifted from moral disorder to medical disorder
Became recognized as formal disease in 1956
Proposed alcoholism to be a progressive / predictable disorder

16. Jellinek’s Four Stage Model
Prealcoholic Phase
Prodromal Phase
First Blackouts; preoccupation with use, development of guilt
Alcohol used for relief from social tension
PROGRESSIVEE COURSE LEADING TO DEATH
Crucial Phase
Chronic Phase
Loss of control; withdrawal, preoccupation
Loss of tolerance; obsessive drinking, alcoholic tremors

17. Genetic Inheritance Theories
More or Less sensitive to alcohol effects – (reward pathway); (like dislike substance)
Decision making (frontal cortex)
Make it harder to quit
Affect withdrawal syndrome
Different studies suggest that genes account for 20% to 50% of addiction risk
No signal gene causes addiction
Vulnerability not Destiny

18. Cloninger’s Type 1 and Type 2 Alcoholics
3,000 adoptees
Reared by non-alcoholic parents
Great deal of adoptees became alcoholic
Cloninger observed two distinct groups

19. Type 1 (larger subgroup)
¾ children had biological parents who were alcoholic
These children drank in moderation in early adulthood
Later life developed dependence
Functioned in society as responsible adults
If raised in higher socio-economic family – less likely to become alcoholic

20. Type 2 Males More violent than Type 1 Father’s were violent alcoholics
Later studies confirmed findings
10% of sample became alcoholics
Low Levels of MAO

21. Neuro-Biological Processes, Dopamine, and Drug Addiction
Addicts are biologically different from non-addicts
An addict’s brain acts differently before and after using
Addicts metabolize and bio- transform substances differently

22. Ego States and the Characterlogical Model of Addiction
Personality and its relationship with self and world (internal and external)
How we then deal with world
Addiction then helps to self-regulate via pharmacologic effects, attendant rituals, practices, and drug culture