Addiction 101 - WCA Conference

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Presented by Jason Schwartz at the Washtenaw Counseling Association Spring Conference in March 2009.

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Addiction 101 - WCA Conference

  1. 1. ADDICTION 101 A primer on addiction
  2. 2. Definition of addiction “Alcoholism is a primary, chronic disease with genetic, psychosocial and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by continuous or periodic impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial.” (National Council on Alcoholism and Drug Dependence, Inc. 2/3/90)
  3. 3. What is a disease? The causal model: 1. cell, organ or system 2. defect or injury 3. measurable symptoms
  4. 4. A broken leg? The causal model: 1. bone 2. defect? 3. symptoms? 4. treatment?
  5. 5. Diabetes? The causal model: 1. pancreas 2. defect? 3. symptoms? 4. treatment?
  6. 6. Alcoholism? The causal model: 1. brain? liver? 2. defect? 3. symptoms? 4. treatment?
  7. 7. The causal model works for easy diagnosis • The model favors simple • In the absence of easy organs. causality, what models work? – Addiction? – Moral – Brain disease? Liver disease? – Personality – Environment
  8. 8. Learning to drink priming early experimentation being adult designated driver
  9. 9. The mathematics of drinking priming early experimentation building trust reliable effect learning how to use signature experience
  10. 10. More is better priming early experimentation building trust reliable effect learning how to use signature experience
  11. 11. The rules of drinking priming early experimentation building trust reliable effect learning how to use signature experience
  12. 12. How alcoholism develops priming early experimentation building trust reliable effect learning how to use signature experience
  13. 13. THE HIJACKED BRAIN
  14. 14. The Hijacked Brain
  15. 15. The limbic system
  16. 16. Maslow’s Hierarchy of Needs Self Actualization Esteem Belonging Safety Physiological (Food, air, water)
  17. 17. Maslow’s Hierarchy of Needs (Revised by addiction) Self Actualization Esteem Belonging Safety Physiological (Food, air, water & DRUGS)
  18. 18. HOW POWERFUL IS THIS?
  19. 19. Here’s your number 0239 or 0923489
  20. 20. We’d like to thank you!
  21. 21. AN IMPERFECT ANALOGY
  22. 22. I’m concerned about you, but…
  23. 23. HOW HAVE WE RESPONDED?
  24. 24. Souce: (Mark & Coffey, 2004. Health Affairs 23:6)
  25. 25. Length of Stay 28 days to 7 days (in 1998) Source: NAPHS
  26. 26. Type of Care Outpatient Inpatient
  27. 27. The other winner
  28. 28. Treatment and Prevention Spending
  29. 29. Federal prison inmates whose most serious conviction was a drug crime rose from 4,749 in 1980 to 77,867 in 2004. (1540%) Source: Maguire, Kathleen and Ann L.Pastore, eds. Sourcebook of Criminal Justice Statistics [Online]. Available: http://www.albany.edu/sourcebook/ [7/3/05].
  30. 30. State prison inmates whose most serious conviction was a drug crime rose from 19,000 in 1980 to 246,100 in 2001. (1195%) Source: Prisoners in 2002 & Prisoners in 1994, Bureau of Justice Statistics [Online]. Available: http://www.ojp.usdoj.gov/bjs/pubalp2.htm#Prisoners [7/3/05]
  31. 31. Jail inmates whose most serious charge was a drug crime rose from 20,420 in 1983 to 155,249 in 2002. (660%) Source: Maguire, Kathleen and Ann L.Pastore, eds. Sourcebook of Criminal Justice Statistics [Online]. Available: http://www.albany.edu/sourcebook/ [7/3/05].
  32. 32. From 1986 to 1999 the average term drug offenders entering prison could expect to serve rose from an average 30 months to 66 months. (120%) Source: Federal Drug Offenders, 1999 with Trends, 1984-99, Bureau of Justice Statistics [Online]. Available: http://www.ojp.usdoj.gov/bjs/abstract/fdo99.htm [7/3/05]
  33. 33. Think We’re Immune?
  34. 34. “Our clients are not your typical irresponsible alcoholics”
  35. 35. “Some of these people will never get better. The most humane thing that we can do for them is provide hospice care.”
  36. 36. Local hospital cabs woman to detox in nothing but a hospital gown.
  37. 37. G et O ut of My E mergency R oom
  38. 38. ARE WE VIEWING ADDICTION TREATMENT APPROPRIATELY?
  39. 39. Treatment for Hypertension: Did Treatment Work? Blood Pressure: mm Hg No Tx Tx Tx No Tx Tx Treatment Status Over Time
  40. 40. Treatment for Alcoholism: Did Treatment Work? Alcohol Consumption No Tx Tx Tx Tx No Tx Treatment Status Over Time
  41. 41. IS ADDICTION TREATMENT AS EFFECTIVE AS TREATMENT FOR OTHER HEALTH PROBLEMS?
  42. 42. How does asthma compare? Medication compliance: 30% Relapse Rate: 60 to 80%
  43. 43. How does hypertension compare? Medication And Diet Compliance: 30% Relapse Rate: 60-80%
  44. 44. How does diabetes compare? Medication, diet and foot care Compliance: <50% Relapse: 30-50%
  45. 45. Alcoholism? Compliance: 30-50% Relapse: 50%
  46. 46. Opiates? Compliance: 30-50% Relapse: 40%
  47. 47. Tobacco? Compliance: 30-50% Relapse: 70%
  48. 48. Cocaine? Compliance: 30-50% Relapse: 45%
  49. 49. Is the addicted person viewed as… Dr. Jekyll: Real Mr. Hyde: Real person is the sober person revealed by self; addiction is intoxication and about goodness disinhibition; corrupted by addiction is the sickness revelation of badness (White, 2004)
  50. 50. “If you want to treat an illness that has no easy cure, first of all, treat them with hope” George Vaillant

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