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

2. Family Education Matrix IOP Changes in the Brain 1-2

3. Family Education Matrix IOP Conditioning 1-3

4. Family Education Matrix IOP I.P. Pavlov (1849–1936) 1-4

5. Family Education Matrix IOP Pavlov’s Dog 1-5

6. Family Education Matrix IOP 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. 1-6

7. Family Education Matrix IOP The Addictive Process  Introductory phase  Maintenance phase  Disenchantment phase  Disaster phase 1-7

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

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

10. Family Education Matrix IOP Development of Obsessive Thinking Introductory Phase 1-10

11. Family Education Matrix IOP Development of Craving Response Introductory Phase 1-11

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

13. Family Education 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 Matrix IOP1-13 Conditioning Process During Addiction Maintenance Phase Strength of Conditioned Connection: Moderate

14. Family Education Matrix IOP Development of Obsessive Thinking Maintenance Phase 1-14

15. Family Education Matrix IOP Development of Craving Response Maintenance Phase 1-15

16. Family Education 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 Matrix IOP1-16

17. Family Education 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 Conditioning Process During Addiction Disenchantment Phase Strength of Conditioned Connection: Strong Matrix IOP1-17

18. Family Education Matrix IOP Development of Obsessive Thinking Disenchantment Phase 1-18

19. Family Education Matrix IOP Development of Craving Response Disenchantment Phase 1-19

20. Family Education 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 Matrix IOP1-20

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

22. Family Education Matrix IOP Development of Obsessive Thinking Disaster Phase 1-22

23. Family Education Matrix IOP Development of Craving Response Disaster Phase 1-23

24. Family Education Matrix IOP1-24 All Downhill

25. Family Education Matrix IOP1-25 All Downhill, but with Interruption

26. Family Education Matrix IOP Thought Stopping  Visualization  Rubberband snap  Relaxation  Calling someone 1-26

27. Family Education Matrix IOP Thought Stopping Visualization 1-27

28. Family Education Matrix IOP Thought Stopping Rubberband Snap 1-28

29. Family Education Matrix IOP Thought Stopping Relaxation 1-29

30. Family Education Matrix IOP Thought Stopping Calling Someone 1-30