1. Types of Intervention

2. Addictions can result in…
And so, we have tried to find effective ways to intervene with the cycle of addiction

3. Types of Interventions
Biological – The addiction is treated like a disease. Medication is often involved.
Psychological – Many involve things like counseling or cognitive therapy.
Public Health Interventions – Involve initiatives that target large groups of people.

4. Biological Interventions – Heroin + methadone
Methadone - a powerful drug similar to morphine in its effects but less sedative that is as used as substitute drug in the treatment of morphine and heroin addiction.

5. Biological Interventions – Heroin + methadone
Methadone is less addictive compared to heroine.
It is initially prescribed in increasing amounts so that a tolerance is formed.
The dose is slowly decreased until either drug is not needed.

6. Biological Interventions – Heroin + methadone
However, some addicts can develop an addiction to methadone.
Controversy:
300 deaths in 2007.
Methadone Black market

7. Biological Interventions – Drugs + Gambling
Drugs for gambling addiction?

8. Biological Interventions – Drugs + Gambling
However

9. Biological Interventions – Drugs + Gambling
Evidence suggests that serotonin dysfunction is associated with pathological gambling.
And Holander et al (2000) showed that SSRIs were effective here.

10. Biological Interventions – Drugs + Gambling
Naltrexone, a dopamine receptor antagonist can help by reducing how rewarding gambling is.

11. Biological Interventions – Drugs + Gambling
The Hollander study had a small sample size (10) and was only carried out for 16 weeks.
Another study with at greater sample size (32) and duration (6 mo.) found that SSRIs were no more beneficial than a placebo.
Kim and Grant observed that naltrexone reduced gambling thoughts and behaviours after 6 weeks.

13. Psychological Interventions – Reinforcement
The idea: We can reduce addictive behaviour by rewarding non-engagement
Sindelar et al. (2007) -

14. Psychological Interventions – Reinforcement
Although strategies like these can be effective at reducing addictive behaviours, they often do not get to the root of the problem:
What started the addiction.

15. Psychological Interventions - CBT
Cognitive Behavioural Therapies (CBT) assume that addictions are maintained by our way of thinking. The goal CBT is to change this, and to develop new coping strategies for dealing with the determinants of past behaviours.
Example: Correcting erroneous thinking that promotes gambling behaviours.

16. Psychological Interventions - CBT
Ladoucer et al (2001) – 66 pathological gamblers
Cognitive therapy or “waiting list” group.
Those who completed treatment:
86% - no longer satisfied DSM criteria
Higher perceived control
Greater Self efficacy
Improvements were maintained in the long term.

17. Psychological Interventions - CBT
Others have gone for a more combined approach.
Sylvain et al. (1997) –
Assessed the effect of cognitive therapy, social skills training, and relapse prevention together. They found that treatment led to significant long-lasting improvements.

18. Public Health interventions!
Homework – In pairs, develop how you are going to teach a section to the class. You will have about 10 minutes each to do this at the beginning of the next class.
The most creative presentation = Silver CC

19. The “Clinician’s Illusion”
Clinicians tend to overestimate the severity of mental health problems because they are often exposed to the worse.
This leads to a bias – a belief that drug addiction is extremely difficult to treat.
The Media also promotes the idea that addiction is ‘incurable’.