3. Drug and alcohol dependency Flashcards
What are the 3 divisions of substances of abuse?
Results in..
- Depressants – drugs that dampen down the central nervous system (alcohol, opioids, benzodiazepines)
- Stimulants – have excitatory effects on the central nervous system (cocaine, amphetamine, nicotine, caffeine, ecstasy)
- Hallucinogens (cannabis, LSD, mushrooms, solvents)
Results in… tolerance and dependence
Acute signs of alcohol use?
Smell, slurred speech, flushing skin, disinhibition, tremor, agitation, mints/perfume
Acute signs of cannabis use?
Bloodshot eyes, brown fingers, drowsiness/slowed down, smell, lack of focus/concentration
Acute signs of stimulant use?
Agitation, pressure of speech, lack of focus/concentration, mood fluctuation
Acute signs of opiate use?
Gauching, ‘pinned’ pupils, signs of injecting, brown fingers, flu like symptoms (withdrawal)
Acute signs of sedative use?
Drowsiness, slurred speech, poor memory/recollection
What is the variable between the addiction potential of different drugs?
- High >20% - Heroin, Methadone, Nicotine
- Moderate 10-20% - Amphetamines, Ecstasy, Cocaine, Alcohol, Cannabis, Benzodiazepines
- Low 5-10% - Inhalants, Steroids
Key policies in place to try reduce the wider costs of substance abuse?
- The Road to Recovery: A new approach to tackling Scotland’s Drug Problem
- Hidden Harm: Scottish Executive Response to the Report of the inquiry by the Advisory Council on the misuse of drugs.
- Changing Scotland’s Relationship with Alcohol: A Framework for Change
What are the 6 different models of addiction?
- Moral Models
- Disease Models
- Biological/Medical models
- Personality Models
- Behavioural Models
- Biopsychosocial Model
What are the features of the moral model of substance abuse?
- Term ‘alcoholic’ introduced in 1849
- Addictions seen as wilful violations of societal rules and norms, a result of human weakness
- Individual is the primary causal factor – no biological basis for addiction, instead something morally wrong with addicted individual
- Treatment may include moral persuasion, imprisonment or spiritual guidance.
- Church, law enforcement and courts are the ‘agents of change’ who should provide ‘treatment’
What are the features of the dispositional model of substance abuse?
- Originated around 1935
- Primary causal factor is the individual, however, loss of control and restraint is a central premise
- The ‘disease’ of addiction is irreversible – no cure but can be arrested via total abstinence
- Benevolent model for individual and corporate organisations
- Move from legal domain to medicine
- AA and NA subscribe in part to this model – “addiction is my disease”
What are the features of the biological/medical model of substance abuse?
- Originated in 1970s
- Similar to dispositional disease models.
- Emphasis on genetic and physiological processes in determining addiction, therefore primary causal factor is the individual.
- Tries to identify unique biological conditions which contribute to addiction i.e. disorder of brain function
- Considers the pharmacology of the substance.
- Agent of change is medical establishment as can use expert knowledge to look at interaction between the individual and the substance.
What are the features of the personality model of substance abuse?
- Originated around the Late 1950’s
- Primary causal factor is the individual as the roots of their addiction lie in their abnormal personality
- Personality traits such as poor impulse control; low self- esteem; inability to cope with stress; egocentricity; manipulative traits; and a need for control and power + a feeling of powerlessness all contribute to addiction
- Psychoanalysts proposed a number of reasons why the individual becomes addicted
- The resolution of addiction requires the restructuring of personality, therefore the agents of change is psychiatry
What are the features of the behaviour model of substance abuse?
• Conditioning is the process of behaviour modification whereby an individual comes to associate a desired behaviour with a previous unrelated stimuli
• Taking substances is pleasurable and likely to lead to rewarding consequences resulting in continued/increased use
• Substance misuse is a learned behaviour therefore treatment must involve ‘relearning new behaviours’
2 types: Associative and instrumental learning
What are the features of the cognitive behavioural model of substance abuse?
• Central premise – in addition to unconscious processes, perception and thought influences emotion and behaviour
• “Addictive thinking” maintains drug use
• Changes in addictive behaviour occur to due
changes in motivation, cognition and appraisal
• Assumption – changing content of cognition and motivation can influence behaviour
