1. Use Abuse & Addiction Presented by Tonya Slager

2. Preview  Definitions  Assessment tools  Stages  MN Model  Brain/Body

3. Use  Debatable for drug use  Social drinking 1-2 x wkly  1 drink per hour  Below.08

4. Abuse Criteria at least 1 in the past 12 months  Recurrent use despite failure in major obligations i.e. work/school  Recurrent use in which it’s physically hazardous  Continued use despite legal problems  Cont. use despite persistent/recurrent social or interpersonal problems due to use  Social/family networks suffer  Arguments due to use

5. Criteria for Dependence 3+ in the past 12 months  Tolerance  A need for markedly increased amounts to achieve intoxication or desired effect  Marked diminished effect with cont. use of the same amt.  Withdrawal  Characteristic withdrawal syndrome for substance  Used to relieve or avoid withdrawal  Substance taken in larger amounts or over longer period than was intended

6. Criteria …  Unsuccessful effort to cut down – loss of control  Consumes a great deal of time – obtaining, using, recovering  Loss of interest in non-using activities – give up or reduced  Cont. use despite knowledge of having persistent or recurrent physical/psychological problems due to use

7. Dependence  With physiological dependence  Evidence of tolerance or withdrawal  Without physiological dependence  No evidence of tolerance or withdrawal

8. CAGE  Have you ever felt you should Cut down?  Have people Annoyed you by criticizing your use?  Have you felt bad or Guilty about your use?  Have you ever had a drink in the morning to steady your nerves or get rid of a hangover? (Eye-opener)  1 pt per ?  Clinical significance 2 +

9. Behavioral Characteristics Addiction Preoccupation Increased Tolerance Blackouts Loss of control Used to medicate Rapid intake Solitary use- hiding or use alone Protecting your supply

10. Classifying Alcoholism  Alpha- relieve stress  Psychological dependence  Have the ability to control use  No progression  Beta- serious problems to the body  Physical deterioration  No withdrawal symptoms  Gamma  Withdrawal symptoms  Loss of control  Noticeable behavior changes  Primarily recognized in AA

11. Categories …  Delta  Daily use  Tolerance increase  Inability to sustain at all  Functioning alcoholic  Epsilon  Least known  Binges  Periodic

12. McAuliffe Stages StagesMotivationTransition InitialPleasureAbuse (abuse AND live) ChronicReliefAbuse (live to abuse) AcuteMaintenanceAbuse (abuse to live) Terminal Escape to oblivion Abuse (abuse to die)

13. Schedule Drugs I.Heroin, marijuana, MDMA (ectasy) II.Opium, morphine, codeine, cocaine, amphetamine, meth III.Codeine, morphine, barbiturates, IV.Barbiturates (downers/sleep aids), benzodiazepines (Valium/Xanax), anabolic steroids V.Codeine - Rx

14. Minnesota Model  1873 NY State Inebriate Asylum  Willmar State Hosp.  Typical 28 day inpatient program  AA/12 steps  Group therapy  Aftercare

15. 3 Key Components of the MN Model  Addiction can be identified and described  Involuntary disablement  Responsive to tx  Multiple phases  Prodromal phase  Crucial/Basic phase  Chronic  Death or rehabilitation

16. Physical Damage  Liver  Sleep cycle (REM)  Blood pressure increases  Alcohol poisoning  Wernicks Syndrome- form of brain damage due to years of heavy drinking  Malnutrition  Low resistance to disease  Amphetamine Psychosis- paranoid delusions, compulsive behavior, hallucinations  Etc.

17. Facts About Drugs and the Brain  Nicotine, alcohol, cocaine, barbiturates, and caffeine cross the blood-brain barrier easily  Heroine crosses faster and more completely than morphine  Vomiting center in the medulla is sensitive to the presence of poison - induces vomiting otherwise the medulla’s respiratory controls would be inhibited resulting in death (asphyxiation)

18. Facts …  Dizziness/lack of coordination- drugs depressant effect on the cerebellum  Pons- part of the brain that allows us to be alert enough to survive  Just above the medulla  Part of the hindbrain structure  Drugs that affect sleep pattern influence the sleep centers in the pons

19. Tolerance  Metabolic (dispositional) tolerance  A drug may facilitate over repeated administrations the processes that produce the drug’s biotransformation in the liver  Liver breaks down the drug faster after repeated use > smaller amt is left available to be absorbed into the blood stream  Cellular (pharmacodynamic) tolerance  Changes occur in the synapses of neurons themselves  Repeated stimulation over time results in desensitization

20. Questions?