Johnson’s Model of Substance Dependency Disease - Alcoholism and chemical dependency are a disease. ( A disease has its own symptoms and is describable) Primary Disease-It is not a secondary symptom of some thing else Progressive Disease-It progressively gets worse. People become physically, psychologically, and spiritually ill. Chronic Disease-There is no cure, There is no way to safely use substances again. Fatal Disease-The disease can only be arrested. If it is not arrested, the person will die from it.

Phase 1: The Learning Phase Pain Normal Euphoria ________________[_________]________________

Phase 2: The Mood Swing Pain Normal Euphoria ________________[_________]________________

Phase 3: Harmful Dependency Pain Normal Euphoria ________________[_________]________________

Phase 4: Chronic Stage Pain Normal Euphoria ________________[_________]________________

Alcoholism As A Disease Jellineck (late 1940’s) established that alcohol dependence progressed through a natural sequence. Disease concept includes the notions that alcoholics are out of control and abstinence is the only answer.

Alcoholism: A Genetic Link? Nature VS. Nurture Twin Studies: 3,000 children ion Sweden showed children with one biologic alcoholic parent was at a greater risk of developing an alcohol problem Even when raised by adoptive parents

Cognitive/Behavioral Approach to Substance Problems (1) Problematic substance use arises based on a number of motivations Individuals lacking coping/life skills may use substances to self-medicate Abusive patterns of use can be changed Concept of controlled drinking

Cognitive/Behavioral Approach to Substance Problems (2) Problematic use is a result of Nurture, not Nature Problematic use does not always result in death Physical dependence does not occur (Vietnam vets) Problematic use is a learned behavior that can be unlearned Use is a way of coping yourself and your world

Disease Concept: Treatment Abstinence Alcoholics Anonymous Narcotics Anonymous Turn life over to a higher power Once alcoholic, always an alcoholic Treatment Services

Cognitive/Behavioral: Treatment Controlled drinking Counseling focusing on: Rational Thinking Cognitive Restructuring Development of life skills Development of self-awareness and self efficacy