Comorbidity and What is Addiction?

What are the behavior pathways of addiction?

1. A rewarding behavior becomes a routine. 2. "Subconscious" control of the behavior. 3. It is hard to extinguish the behavior: I am not always aware when it is started. 4. The person resists change. 5. It is a habit

What information is needed when assessing someone for an alcohol or drug problem?

1. Age of initial drug and alcohol use. 2. Frequency of use, amounts used, set and setting of use. 3. Patterns of use, binges, periods of non-use. 4. Stage of current use. 5. History of negative consequences. 6. Medical history. 7. Use of coffee, cigarettes, and medication.

What are the three models of anxiety comorbidity?

1. Anxiety disorder promotes pathological alcohol use. 2. Pathological alcohol use promotes anxiety disorder. 3. A third factor promotes both conditions.

What are the two potential specific mechanisms of anxiety disorder?

1. Anxiety sensitivity 2. Tension reduction as a alcohol expectancy.

What are the multiple factors that is involved with addiction?

1. Biology/Genes 2. Environment 3. Drug 4. Brain mechanisms

What are the four models of Schizophrenia and Cannabis?

1. Cannabis causes schizophrenia (no evidence). 2. Cannabis precipitates schizophrenia in those with an underlying susceptibility. 3. Cannabis worsens symptoms.

What are the three needed support lines for self-medication model?

1. Patients would report beneficial effects of substance use on their symptoms. 2. Epidemiology would report that a specific psychiatric disorders. 3. Psychiatric patients with severe symptoms would be more likely to abuse substances than those with mild symptoms.

What are the seven consequences of alcohol/drug use?

1. Physical 2. Psychological 3. Sexual 4. Relationship/social 5. Financial 6. Legal 7. Must be concerned about risk of suicide.

What are the five consequences of comorbidity?

1. Poor medication compliance. 2. Physical comorbidities. 3. Poor health and self-care. 4. Increased risk of suicide or risky behavior. 5. Even possible incarceration.

What are the six most common symptoms of addiction?

1. Severe loss of control. 2. Continued use despite serious consequences. 3. Preoccupation with using. 4. Failed attempts to quit. 5. Tolerance and withdrawal. 6. Often involves cycles of relapse and remission.

How many Americans ages 12 and older (more than 1 in 7 people) abuse or are addicted to nicotine, alcohol or other drugs?

40 million

Complex disease, often chronic in nature, which affects the functioning of the brain and body. It causes serious damage to families, relationships, schools, workplaces, and neighborhoods.

Addiction

Problems related to alcohol use and anxiety tend to occure within the same individual. Research evidence suggests that this disorder and alcohol use disorders can both serve to initiate the other.

Anxiety Comorbidity

Fear of arousal-related bodily sensations due to beliefs that they are signs of an impending catastrophe.

Anxiety sensitivity

Obsession with alcohol and/or drugs.

Compulsion

Continued use despite adverse consequences.

Consequences

Inability to stop using alcohol and/or drugs.

Control

Causes may include self-medication, genetic vulnerability, environment or lifestyle, underlying shared origins, and/or a common neural substrate.

Etiology

Chambers et al (2001). Authors suggest that increased vulnerability to addictive behavior may reflect the impact of the neuropathoology of schizophrenia on the neural circuitry mediating drug reward and reinforcement (schizophrenic patients may have a predilection for addictive behavior as a primary disease symptom.

Neurobiology Model

Co-occurance of severe mental illness and substance abuse is so common that it is more the expectation than the exception.

Prevalence

Numerous studies have shown that patients with psychosis are more likely to use illicit drugs than the general population, with cannabis being the most popular. About half of patients are thought to abuse alcohol or other drugs. Little support for the self-medication model. Literature points more towards an affect-regulation model. Common factors models.

Schizophrenia and Cannabis

Model preferred by most psychiatrists. Using drugs to treat symptoms. Need three lines of support. Not well with supported by research findings.

Self-Medication Model