1. Addiction and family care Together we stand stronger
Dr. Eric Blaauw
Professor in Addiction studies
Hanze University of Applied Sciences
Postbus 8003, 9702 KA Groningen
Dit is het voorblad.
De enige tekst die hier toegevoegd mag worden is de naam van de persoon die de presentatie geeft.

2. Declaration of interest
No interests

3. What is addiction? Craving or using more than intended
Taking the substance in larger amounts or for longer than you meant to
Wanting to cut down or stop using the substance but not managing to
Spending a lot of time getting, using, or recovering from use of the substance
Cravings and urges to use the substance
Tolerance and dependence
Continuing to use, even when the you know you have a physical or psychological problem that could have been caused or made worse by the substance
Needing more of the substance to get the effect you want (tolerance)
Development of withdrawal symptoms, which can be relieved by taking more of the substance.
Negative consequences, also for others
Not managing to do what you should at work, home or school, because of substance use
Continuing to use, even when it causes problems in relationships
Giving up important social, occupational or recreational activities because of substance use
Using substances again and again, even when it puts the you in danger

4. Prevalence of substance use
Recent use in the Netherlands
Alcohol: 78%
Tobacco: 27%
Cannabis: 3,3%
Cocaine: 0.3%
Opioids: 0.1%
Lifetime prevalence Substance use disorder 10%

5. Alcohol use disorder (%)

6. Drug use disorders (%)

7. Is there a need for care?1 of 2
SUD may get worse
Associated with various diseases and premature death
Comorbidity may develop. In presence of SUD, disorders are more severe and persistent
More admissions in clinics
More suicides
More loss of fixed abodes
More illnesses
More violence
More incarcerations

8. Is there a need for care?2 of 2
SUDs are associated with risky behaviours
Alcohol is most common cause of car accidents(Houwing et al, 2014)
SUDs are associated with crimes(Bennett, Holloway & Farrington, 2008)
Estimated costs in the Netherlands annually 2.5 billion Euro(RIVM, 2016)
Invested Euro in addiction health care saves six Euros(RIVM, 2016)

9. What is addiction? It is a character weakness (moral model)
It is due to the substance (pharmacological model)
It is a disease for those who are vulnerable for it (disease model)
Leshner, 1997: Chronic relapsing brain disease

11. What is addiction?
Addiction is a complex interplay of biological, psychological and social factors (biopsychosocial model)
But also pay attention to things that give meaning to addiction and life (see Frankl, 1946, 2011).

12. What is addiction? Craving or using more than intended
Taking the substance in larger amounts or for longer than you meant to
Wanting to cut down or stop using the substance but not managing to
Spending a lot of time getting, using, or recovering from use of the substance
Cravings and urges to use the substance
Tolerance and dependence
Continuing to use, even when the you know you have a physical or psychological problem that could have been caused or made worse by the substance
Needing more of the substance to get the effect you want (tolerance)
Development of withdrawal symptoms, which can be relieved by taking more of the substance.
Negative consequences, also for others
Not managing to do what you should at work, home or school, because of substance use
Continuing to use, even when it causes problems in relationships
Giving up important social, occupational or recreational activities because of substance use
Using substances again and again, even when it puts the you in danger

13. Consequences for intimate partners
Intimate partners suffer from: (Benishek, Kirby & Dugosh, 2011)
Relationship problems (100%)
Emotional problems (100%)
Financial problems (90%)
Problems with family (87%)
Health problems (68%)
Violence (70%)
Problems with the police or criminal justice system (17%)
Intimate partners have psychological, physical problems and decreased quality of life (Hussaerts, Roozen & Meyers, 2007)

14. Consequences for intimate partners
All drug use and drug-related problems are associated with intimate partner violence(Moore et al., 2008; Cafferky et al., 2016)
Drug use related to sex offences(Kraanen & Emmelkamp, 2011)
All alcohol use/problems are associated with intimate partner violence(Cafferky et al., 2016; Foran & O’Leary, 2007)
Intimate partner violence in 50-60% of alcoholics in treatment (Murphy & O’Farell, 1996)
Risk of aggression of alcoholics estimated to be 12 times increased(Murdock et al, 1990)

15. Consequences for children
Children suffer(Overview: Barber & Crisp, 1994)
Little children
Toddlers more impulsive and more behavioural problems (alcohol).
School children
More depressed and health problems (alcohol)
More problems with parents and parentification (alcohol and drugs).
Better relationships with brothers and sisters
Inconsistent findings with regard to cognitive functions
Adolescents
More emotional problems,
Less social competence
Worse physical health.
Less advanced education
Adult children. Inconsistency about (mental) health and personality disorders
Intergenerational transfer(Anthonio et al., 2016)

16. What should we know?
Know that for every person with SUD five people in their surrounding are also affected(Daley & Baskin, 1991)
Know that only one in every ten receive treatment(Ladis, 2016).
Thus, detection and support are important
BUT ALSO
Know that 70% of SUD in the community members no longer have a SUD two years later(Tuithof, 2015)
Know that people use less alcohol/drugs when they engage in activities that are not related to alcohol/drugs(Correia, Benson & Carey, 2005)

17. What should we do?
Focus on decreasing SUD related problems in family and other people in the environment
Focus on engaging the family in providing care to people with SUD
Focus on pleasurable activities

19. Help people to engage in pleasurable activities with people close to them together we stand stronger!

20. References
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