Exam 1 Review

List some examples provided in the reader on how millions of people/families have recovered from addiction:

-12 step communities (AA, NA, etc) -faith based programs -treatment -individual and family therapy -help from clergy, friends, family

What are some key pieces discussed about addiction in the US 1600-1830:

-Alcohol was prevalent as settlers colonized -Puritans: distinction b/w "drinking" (appropriate) and "drunkenness" (inappropriate) -Alcohol played a normal role in people's lives, not seen as problem -Settlers introduced it to Native Americans in turn for tobacco -"Drunkenness" began to cause problems; "slums" were created to separate from higher society -Benjamin Rush, first to call drunkenness an "Odious Disease"-- early temperance movement began---> be moderate in temptations. Ran by mostly Woman b/c of the rampant domestic violence (86% involve intoxication)

What are some key pieces discussed about addiction in Ancient Civilizations:

-Existed for centuries; used in ancient Greek and Roman -Used medication for soldiers, religion, enjoyment -Most common substances: alcohol, opium, shrooms, weed, nicotine (5,000 B.C.)

Be familiar with family dynamics

-Parents can't reach her or stop her -worried son would follow -father wants her in rehab and his money when she visits -relatives; genetics -no Carrick=family flourished

What are some key pieces discussed about addition in the US 1933-1950:

-Prevalence on rise in prescription drugs -Birth and Growth defects of AA (1935) `Bill Wilson and Dr. Bob Story `Borrowed Oxford Group meeting sale for alcoholics `Oxford group feedback of the Big Book and the six principles that later became the 12-steps of AA! -AA's impacts on Addiction--big, very big! -Modern Alcoholism Movement -Early Diseases Models (bio-psycho-socisl) v. Medical model (biological)

What are some key pieces discussed about addition in the US 1830-1919:

-Prevalence on the rise -Men impacted more than women; social acceptability and other factors -Women stereotyped (comical, sexual behavior) -Harrison Act of 1914: narcotics under Federal Regulation; needed prescription -Washington Movement: men alienated from temperance movement; faded as quickly as it developed. No sustainable recovery program in place =First self-help group we know of. Spiritual group, not successful -Etiology (cause) of Addiction =drunkenness, inebriety instead of "alcoholism" or "alcoholic" =theories of "use" began to emerge

What are some key pieces discussed about addition in the US 1919-1933:

-Second wave of Temperance Movement -Woman banning together to save families -Right to vote and stop scourge of alcohol and promote prohibition (Women's Christian Temperance Union [WCTU]) -Prohibition of Alcohol-- 18th amendment and Volstead Act (legislation for 18th) ='the failed experiment'- usage went up among certain groups; Roaring 20's =Social consequences: increased potency, crime (bootleggers and black market, Capone) -21st Amendment- what amendment did this repeal? 18th -What did the 19th amendment accomplish? Women right to vote -Oxford Group =foundation of AA =spiritual, not religios, though based in Judeo-Christain teachings =no requirement of abstinence, just change in life

What are some key pieces discussed about addition in the US 1980s-2000s

-War on Drugs (it work?) Debatable. Some, definitely not -Multiple Pathways - not just abstinence -Neurological Advances - support for disease model, no not? -Biology - all evidence not absolute -Addiction and the Family - enabling and CODA -Process addictions - evidence activate reward system similar to substance addictions

What theories are used to explain addiction?

1. Genes--blueprint, 40-60% vulnerability 2. Reward--release/surge of dopamine Two Gumball analogy:tells you to hang onto reward than others for survival 3. Memory--Reminds you long term through glutamate. Can leave you prone to relapse 4. Stress-- release of CRF leads to anhedonia; the inability to gain pleasure from enjoyable experiences 5. Choice--influenced by problems in levels below. Hypofrontality; reduction in a previously 'normal' cortex `Craving defeats this theory--> not using for pleasure but for survival. Experience is miserable and involuntary Problem with first level, it continues to impact subsequent levels. Think nesting dolls

What are some symptoms of addiction?

1. Loss of control 2. Craving 3. Persistent drug use, despite negative consequences

Any addiction is likely to have: __________, ___________, and __________.

1. biological 2. psychological 3. social components

Neurotransmitters: 1. Dopamine 2. Serotonin 3. Glutamate

1."feel good"--depletion of dopamine accounts for binges, tolerance, cravings, and obsessive behavior 2. Involved in sleep and sensory experiences, governs sense of well-being. Decreased levels associated with intoxication, depression, anxiety, suicidal behavior, aggressiveness 3. Stores all of the relevant details and sense experiences in connection with the use. Acts like a flash flood, knocking over everything else in its path. Hypermemory--reminds you long term. Can you leave you prone to relapse

Based on the previous question, what are the two parts of the brain responsible for?

1.Frontal Cortex (outside) -mortality -judgement -personality -understand consequences -options, emotions, attachment, spiritual memory 2. Midbrain (deep inside) -Site of where drugs work and where addiction begins -handles the next 15 seconds, get us from moment to moment alive. -eat -kill/defend -sex drive Need these to survive, to get us to do these things, the midbrain makes them pleasurable. Frontal Cortex keeps the midbrain in check. In addiction, something goes wrong and it's reversed.

Explain the disease model:

Biological/Hereditary disease OR psychological disease (like schizophrenia). As early as the time of Benjamin Rush (drunkenness a disease)

Elaborate on the disease argument/model discussed in the film:

Came from germ theory, and microbiologists such as Pasteur and Koch. Organ (Midbrain)---->Defect (Stress induced hedonic dysfunction)---->Symptoms (Loss of control, craving, use despite consequences) In this model, we treat the defect, not the symptoms. By using this model, doctors double the human lifespan in only 100 years!

The addiction continuum:

Consists of the order of events a would-be addict will take in their progressive disease of the mind. Their choice declines as it transitions to the negative phases. -Abstinence (all choices, never use)-----> -Experimental/ Regular Use (choice made to use)----> -Abuse (choice declining)-----> -Dependence (Physical/Emotional/Spiritual; need it to function)----> -Addiction (needing it to survive)------> -Death

Understand different drug categories and why certain drugs belong in those categories

Depressants- depresses CNS -alcohol, n=benzo, opium, ambient, valume Stimulants- increases/alerts CNS -caffeine, nicotine, methanpetamine, ADHD meds. Hallucinogens- overwhelms CNS -LCD, PCP, psilocybin (mushrooms), mescaline, peyote, designer drugs (ecstasy< GHB, and Rohypnol)

What are the symptoms (short-term and long-term) associated with each drug type?

Depressants: -depresses CNS, reduce anxiety, induce anesthesia, disorientation, poor coordination, slurred speech, nausea, vomiting, diarrhea Stimulants: -increased alert CNS -increased anxiety -triggers "flight or fight" -may have quick tolerance building effect Hallucinogens: -disorientation -dissociation -sense of insight, overwhelm CNS -not compulsively addicting but consist of rapid tolerance

Types of Addictive

Drugs Article

How does addiction affect the brain?

Drugs modify: 1.Drugs modify your mood, memory, perception, and emotional states. 2. repeated use changes the brain structure and functions in fundamental and long-lasting ways `can press after stopping `David Rosenbloom, "thing can't stop because brain changed" 3. Addiction, from array of neuro-adaptive changes and strengthening of new memory connections in various circuits. Recovery= time to rewire those circuits and connections

According to the video, label important parts of the brain, when understanding addiction:

Frontal Cortex (outside) Midbrain (deep inside) Bumps called--gyri Grooves called--sulci

Drug of choice

Heroin

Based on the film and class discussion, how is addiction define?

In reader, discussion: ...behavior pattern of compulsive substance abuse, relationships or other...behaviors characterized by over involvement with the relationship. As a Disease: stress induced defect, with genetic basis, symptoms that will eventually lead to death without treatment or recovery.

What are some key pieces discussed about addition in the US 1950-1980

Prevalence= War, hippies, disco -The AMA= disease model with the formal introduction of the term "alcoholism:, 1956 -The Minnesota Model `Foundational for current treatment programs `Many were in their own recovery `11 tenants `Integrated drug and alcohol addictions `Focus on the current problem, not the cause

Define and highlight causes for relapse and craving:

Relapse -Definition: the return to drug use after a drug-free period. Hallmark feature of addictions, and one of the most painful. -Causes: Drug-related "reminder" cues, stress, celebrations, sampling the drug `Precursors relate to ancient brain motivational circuit that can trigger overwhelming feelings and lead to poor decision making Craving -Definition: Desire. Part of the human condition -Causes: Our brains are 'hard-wired" to appreciate and to pursue natural rewards because their critical survival value `Cues activate the brain's powerful "Go!" circuit, creating cravings. `May have beginnings outside conscious awareness.

Videos: Intervention Video &

Saving Carrick

How did they find recovery?

The family moved on to let Carrick hit bottom and seek treatment to get her recovery

Talk about recovery and the brain:

There is hope: Hedonic threshold can be restored to normal -normal pleasure can be normally pleasurable . -you'll have an original set point with normal dopamine surges

Pleasure

Unwoven

Although not part of the DSM, addiction occurs when

dependency to a substance continues.