KNSFHP Addictive Behaviors study 3/3

Which of the following have been shown to be the biggest factors in an individual's risk of addiction? Choose all that apply.

AGE GENETICS PERSONALITY NOT wealth education

These are some attitudes and behaviors that may make us susceptible to addictions:

ANXIETY: Prone to various fears; seems to be exaggerated in those with addictions; possibly generalized as in free-floating anxiety. IMPULSIVENESS: A heightened sense of impatience, particularly with people or situations that make us frustrated or uncomfortable; difficult to stay with a task or experience; the need for immediate gratification or "quick fix." SELF-CENTERED: Arises out of a poor sense of self and low self-esteem; everything is for me or against me; it's all about me; arrogance. OBSESSED WITH IMAGE: An extreme need for approval; extraordinary fear of rejection; tendency to censor oneself. DEPENDENCY: Rely on relationships to meet emotional, psychological, physical needs; personally insecure. DENIAL: Dishonesty; not able to admit one's weaknesses; a false sense of what is responsible, independent behavior; "no problems." JUSTIFICATION: Justify what we think is okay to feed our addictions; make assumptions and rationalize behavior. PSEUDO-PLEASURE: The addiction does not provide real pleasure or satisfaction; trouble with intimacy; difficult to find joy in normal living; sensation seeker; high-risk taker. NEGATIVE CONTROL: Relationships steeped in control issues, either controlling another or being controlled; tend to believe we can control our self and our own life with a substance or behavior. DEPRESSION: Often results from the feeling we cannot control our lives—which we had unrealistically assumed we could do; negative thinking; tendency to give up; buried under negative stress. PERFECTIONISM: Expectation to be perfect, which is impossible to accomplish; think we are never good enough or never do enough; not allowed to make mistakes; reprimand self (and others) for falling short. Many believe that addictions essentially result from individuals trying to avoid having to deal with problems they face (Figure 6). Yet, there are potential strong points in many of the behaviors enumerated here. If the underlying idealism and passion could be tapped from a more stable stance, several of these negative attributes may be turned into positive ones.

Which of the following are among the processes people typically follow in a twelve-step program?

Admitting that one can't control their addiction making amends for past errors helping others with same addiction NOT accepting the life they have and being happy with it comparing oneself to those who do not struggle with addiction

The ___________ gives us insight into personality factors, family and relationship dynamics, and environmental issues found in the lives of addicts. Select the best answer.

BIOPSYCHOSOCIAL PERSPECTIVE! The biopsychosocial perspective developed by Dr. George Engel gives us insight into personality factors, family and relationship dynamics, and environmental issues found in the lives of addicts.

True or False? Project MATCH, the largest alcoholism clinical trial ever conducted, showed that twelve-step facilitation therapy was far more effective than either cognitive-behavior therapy or motivational enhancement therapy in reducing drinking.

F, According to Project MATCH, twelve-step facilitation therapy, cognitive-behavior therapy, and motivational enhancement therapy resulted in substantial and statistically equivalent reductions in drinking.

Nearly 75 percent of users begin smoking

In their teens. Nearly 75 percent of users begin smoking when they are teens, the time when the developing brain is more susceptible to addictions.

Which of the following attitudes and behaviors would be LEAST likely to make us susceptible to addictions?

Introverted. Being an introvert is not likely an attitude or behavior that would make us more susceptible to addictions. NOT Depressed anxiety self centered dependent.

The proof of an alcoholic drink is _______ the percentage of pure alcohol in the drink.

Twice for example, an 80-proof drink is 40 percent alcohol.

Nicotine

the active ingredient in tobacco

The signature question used in solution-focused therapy is

"If a miracle occurred in the night and your addiction disappeared, what would your next day be like?" In solution-focused therapy, the counselor or team of counselors work together to relate to the client's level of motivation and not take an expert role that defines a person's attitude or behavior.

According to government statistics, substance-abuse addictions alone cost the United States an estimated

$484 billion a year. Addictions are a serious problem in society.

Match each of the following blood alcohol concentrations with the types of behaviors or symptoms a person may exhibit at that level.

.08% = belief of well functioning but slurred speech .14% = Difficulty walking, impaired judgement .25% = Severely mentally and emotionally impaired and likely to harm oneself .40% = In coma, probably dying

According to National Institute on Drug Abuse (NIDA) data, how many people under the age of 18 have parents who drink heavily or use drugs?

1 in 4.

According to a 1998 report by the Task Force on College Drinking, how many college students met the medical criteria for alcohol abuser?

1/3

Which of the following statements about gambling addiction are true?

20 times higher percentage of suicide higher percentage of gambling is online 9% of college students have a gambling problem gamblers between 18-25 lose an average of $30,000 per year NOT females twice as likely to have gamblng problem in college

Medical professionals estimate that consuming more than ________ of caffeine a day poses health problems.

600 miligrams. Medical professionals estimate that consuming more than 600 milligrams of caffeine a day poses health problems, and some energy drinks may contain up to 400 milligrams in a 16-ounce drink.

Brain activity and addiction

A central feature of addictive brain activity is the reward pathway that is stimulated by addictive substances or behaviors.

Nucleus accumbens (NAcc)

A collection of neurons located in the basal forebrain where dopamine-secreting neurons from the VTA terminate.

Ethyl alchohol

A colorless, pungent liquid; intoxicating ingredient in alcohol. also known as grain alcohol or ethanol, is the psychoactive intoxicating substance in all alcoholic drinks.

Dopamine

A hormone and neurotransmitter, functions in the brain include motivation and reward, mood, learning, and motor activity.

Ventral tegmental area (VTA)

A portion of the midbrain who's neurons are a part of two dopamine pathways (THE MESOLIMBIC AND MESOCORTICOL PATHWAY)

Alcoholism

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: 1) Impaired control over drinking, 2) Preoccupation with the drug alcohol, 3) Use of alcohol despite adverse consequences, and 4) Distortions in thinking, most notably denial. (Note: Each of these symptoms may be continuous or periodic).

When scientists compared the DNA of individuals with addictions to the DNA of non-addicted individuals what did they find was more common in people addicted to alcohol or cocaine?

A specific dopamine receptor gene. Scientists found that the A1 allele of the dopamine receptor gene DRD2 is more common in people addicted to alcohol or cocaine, leading some to believe that if susceptible individuals could be recognized early, interventions could be targeted to this vulnerable population.

How old is neuroscience?

About 50 years old. Our understanding of the brain has increased dramatically in this time. Previously scientists thought that the brain was fully developed in young children. Through brain imaging, we now know that development of the prefrontal cortex—the part of the brain that controls complex decision making—continues into a person's 20s, possibly until age 24, as connections continue to form between reasoning and emotion areas of the brain (Figure 5). That means the places of cognitive or reasoning functions that involve impulses and emotions are some of the last areas of the brain to mature.

Intoxication and Blood Alcohol Level

According to the U.S. Centers for Disease Control and Prevention (CDC), a standard drink contains about half an ounce of pure alcohol, equivalent to 13.7 grams or 1.2 tablespoons.This amount of pure alcohol is found in: 12 ounces of regular beer or wine cooler 8 ounces of malt liquor 5 ounces of wine 1.5 ounces of 80-proof distilled spirits or liquor such as gin, rum, vodka, whiskey An 80-proof drink is 40 percent alcohol—the proof of a drink is twice the percentage of alcohol in the drink. Ethyl alcohol, also known as grain alcohol or ethanol, is the psychoactive intoxicating substance in all alcoholic drinks. It is a colorless, pungent liquid. A standard drink, as described above, represents the concentration of ethyl alcohol in the beverage.

Why do most people dealing with addiction end up needing more and more of their addictive substance or behavior to reach that high feeling they felt before?

Addiction reduces dopamine levels. One of the brain adaptations caused by addiction actually reduces the formulation and communication of dopamine, thereby lessening the high feeling.

Treatments for addictions

Addictions present a unique problem when it comes to changing behavior because the behavior is compulsive and negative. A normal behavior change is effectively powered by our will to change. We establish a healthy base of identity and self-acceptance, analyze our motive or desire to change, make up our minds to change, and then go about doing it. This normal process is more effective the more we exert our willpower to make the change and make it a lasting change. We choose to change. Just the opposite happens with addictions. Compulsive negative behavior tends to get worse the more we try to exert our willpower. The cravings and obsessions tend to get worse the more we think about them and exert efforts to overcome them. This is one of the dynamics of addiction that makes overcoming an addiction so frustrating and seemingly impossible. Those with an addiction believe the illusion that we control everything. We keep knocking our heads against a brick wall as we keep trying the willpower approach that normally works just fine and gets us results. Over time this incredible willpower effort we are putting forth gets us nowhere. It is confusing and exhausting! Then we assume there is no way to overcome the addiction and tend to give up. What we have not recognized is that underlying these concerted efforts to exert our willpower to overcome an addiction is a deep-seated desire for the very thing we are trying to overcome. How do we bring ourselves to admit that we actually want this thing that is destroying our lives? This is one reason why denial is a common problem with addicts. While we are trying to exert willpower, the desire remains untouched. To overcome an addiction, we need to back off and find strength from another source to change the addictive desire. With a normal behavior change we choose to change; to overcome an addiction, we choose to be changed (Figure 19). There are proven therapeutic approaches that do work. Some take a bodymindspirit perspective dealing with every dimension of the individual. Some take a more biological/physical approach, relying on pharmaceuticals. Often a person with a serious addiction may benefit from a combination of these therapies.

Alcoholism

Alcoholism, also known as alcohol dependence, is a disease that includes four symptoms, according to the U.S. Substance Abuse and Mental Health Services. CRAVING. A strong need or compulsion to drink. LOSS OF CONTROL. The inability to limit one's drinking on any given occasion. PHYSICAL DEPENDENCE. Withdrawal symptoms occur when alcohol use is stopped after a period of heavy drinking: nausea, sweating, shakiness, anxiety. TOLERANCE. The need to drink greater amounts of alcohol to get high. The National Council on Alcoholism and Drug Dependence along with the American Society of Addiction Medicine define alcoholism as a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. Fifty percent of trauma beds in U.S hospitals are occupied by people injured when they were under the influence of alcohol because their judgment or motor abilities were impaired. Alcoholics cannot simply "will" themselves to not drink. The need to drink alcohol can be as powerful as the need for people to drink water or to eat.According to Mothers Against Drunk Driving (MADD), an estimated 17,600 people die each year in traffic accidents involving alcohol. MADD also estimates that 3 in every 10 Americans will be involved in an auto accident involving alcohol at some point in their lives. Approximately two-thirds of spousal or intimate partner abuse are alcohol-related (Figure 11). People with alcohol problems abuse nearly 500,000 children in their care each year. About 7.4 percent of the American population—approximately 14 million people—are alcohol dependent. More than half of American adults have had a close family member who has had alcoholism. Almost one in four children under the age of 18 are exposed to alcohol abuse or dependence in the family (Figure 12).Alcohol detoxification is the sudden elimination of alcohol, which throws an alcoholic into withdrawal. Sometimes drugs are given to lessen the traumatic withdrawal effects and ease the person off of alcohol. This process treats the physical symptoms of alcoholism but will not eliminate the alcoholism—further treatment is needed to address the root cause of the alcoholism. Various medications have been prescribed for the treatment of alcoholism. Other treatments strive to uncover the psychological, social, and/or environmental factors in the person's disease.

Amount and Type of Alcohol Affects BAC

BAC is directly related to the amount and kind of alcohol consumed. Beer and wine are absorbed more slowly than distilled spirits. Diluting liquor with water also slows absorption. Carbonated beverages speed absorption, one of the main concerns with adding liquor to energy drinks. The rate at which a person drinks alcohol also shapes their BAC. If alcohol is consumed but not metabolized, the BAC will rise. Alcohol poisoning, which can be lethal, results from drinking large amounts of alcohol in a short period of time, thus quickly raising the BAC until the alcohol can be metabolized.BAC is expressed as a percentage. Having a BAC of 0.08 indicates 8 parts of alcohol per 1,000 parts of blood. State laws work with grams of alcohol per 100 deciliters of blood (grams per deciliter or g/dl). Breath, blood, or urine tests are used to measure BAC levels (Figure 10). The BAC level most states recognize as legally drunk is 0.08 percent. Laws establishing much lower BAC levels for drivers under the legal drinking age of 21 are called zero-tolerance laws or per se law. This makes the drinking itself a violation and convictions more likely. Some states have BAC limits for those under 21 as low as 0.01 or 0.02 g/dl. Table 2 gives behaviors associated with different BAC levels.

What's BRAIN PLASTICITY?

Brain plasticity is the ability of the brain to rewire its connections in response to learning and experience. It is heightened during the adolescent and early adult years. This heightened ability to learn also heightens one's response to addictive substances. The potential addiction could be considered a form of learning. Meanwhile, without having a fully developed prefrontal cortex, there is less maturity in terms of judgment or self-inhibition of someone in this sensitive age range.

Caffiene

Caffeine is the most widely used stimulant in the world. According to a report by Roland Griffiths, professor of psychiatry and neuroscience at Johns Hopkins, 80-90 percent of North Americans report regular use of caffeine, with an average daily intake of caffeine in the United States of about 280 milligrams, equivalent to an 8.4-ounce drink (Juliana and Griffiths 2004). Ingesting excessive amounts of caffeine can result in an addiction termed caffeinism. About 10 percent of the adult population experience caffeinism, resulting in psychological and physiological difficulties. The Johns Hopkins summary of 57 experimental studies and 9 survey studies on caffeine withdrawal indicates that people may develop caffeine addiction with as little as one standard cup of coffee a day. Five common withdrawal symptoms include headache, fatigue, drowsiness, irritability, and difficulty concentrating. Some even experience nausea, vomiting, and muscle pain. Usually, symptoms arise 12-24 hours after the last dose of caffeine, with the worst of the withdrawal symptoms occurring in the first few days after ceasing to use caffeine.Caffeine is an alkaloid that acts as a mild psychoactive stimulant and a mild diuretic, which means it increases the volume and rate of urination (Figure 8). Caffeine acts as a natural pesticide in over 60 different plants that produce it in their beans, leaves, and fruit. Most caffeine is consumed in beverages such as coffee, tea, soft drinks, and energy drinks. A lesser amount is found in chocolate. Energy drinks pose a problem regarding caffeine consumption. More than half of those drinking energy drinks are under 35 years of age. The seeds of the South American guarana plant—containing about 3-4 times as much caffeine as coffee beans—are the caffeine source used to make energy drinks. Medical professionals estimate that consuming more than 600 milligrams of caffeine a day poses health problems. Some energy drinks may contain up to 400 milligrams in a 16-ounce drink. A risky activity in the United States and other countries is combining alcohol with energy drinks (Figure 9). It is estimated that the energy drink market in the United States is over $10 billion in sales. Caffeine affects people differently depending on a person's age, height, weight, and gender. Basically, it stimulates the central nervous system increasing heart rate, blood flow, and metabolic rate. Excessive use can result in anxiety, nervousness, upset stomach, and insomnia. Excessive use has also been attributed to miscarriage, low-birth-weight, and delayed conception.

Match each of the following symptoms with the commonly abused drug they are most associated with

Can slow breathing, impair coordination, and cause feelings of heaviness; can lead to greater risks of endocarditis, hepatitis, and HIV = Heroin Can impair balance, distort sensory perception, and slow reaction time; can lead to respiratory infections and mental health decline = Marijuana Can cause drowsiness, impaired memory, and loss of coordination; can lead to violent behavior, depression, and liver disease = Alcohol Can cause tremors, paranoia, and reduced appetite; can lead to weight loss, insomnia, and cardiovascular complications = Cocaine

What is the biggest concern when it comes to mixing alcohol with energy drinks? Select the best answer.

Carbonated beverages speed absorption Carbonated beverages speed absorption of alcohol into the bloodstream, one of the main concerns with adding liquor to energy drinks.

Drug Classifications and Effects

Club drugs are those used at concerts, parties, bars, clubs, and so on, thus the name. Club or designer drugs may be particularly harmful because of the unsafe processes used to manufacture these drugs. Prescription drugs are also a common source for abuse of drugs. There may be a misperception that prescription drugs are not as harmful because they were prescribed for the purpose of helping someone. However, if abused, prescription drugs can cause brain problems, heart problems, and possibly mental problems. Steroids mimic testosterone and other hormones. When abused, steroids are known to cause cancer and sterility. All drug abuse is destructive of the whole person and potentially fatal.

Blood Alcohol Concentration (BAC)

DEFINITION: Measure of intoxication, amount of alcohol in blood. Blood alcohol concentration (BAC) is the level of alcohol in a person's bloodstream, which determines the effect the alcohol has on a person. Alcohol is absorbed slowly into the bloodstream through the stomach, and then more quickly through the small intestine. Once in the bloodstream, the alcohol can affect every system of the body (Table 2). The liver is mainly responsible for alcohol metabolism. It neutralizes and breaks down the alcohol at the rate of about half a drink per hour. Body weight, amount of body fat, and heredity can affect blood alcohol concentrations. Women have less active alcohol-metabolizing stomach enzymes, are usually smaller than men, and have a greater percentage of body fat than men. All these factors mean that women usually take longer to metabolize alcohol than men, therefore women can develop a higher BAC than a man from the same amount of ingested alcohol. The presence of food in the stomach, particularly fatty foods, will slow down the absorption of alcohol. Inexperienced drinkers who have not developed a tolerance to alcohol will be more quickly under the influence of alcohol than people who drink more frequently.

Dysfunctional Inner Speech

Debasing self-talk or inner speech—thinking you aren't attractive or intelligent, for instance—is something almost everyone experiences at some point in life. In severe cases, some mental health professionals deem these internal putdowns to be an addictive behavior. Through a complex bodymindspirit fusion, we become what we think. Neuroscientists have found that the left hemisphere of the prefrontal cortex, specifically the left inferior frontal gyrus (LIFG), is the source of inner speech. According to Alain Morin, inner speech is thought to be deeply linked to self-awareness. Our inner speech—the silent thoughts we think about ourselves—are a key aspect of our higher-level reasoning W. Dean Belnap, a fellow of the APA, wrote a book titled A Brain Gone Wrong that explores the impact of dysfunctional negative inner speech. Belnap says "Self-conversation can speak to poor acceptance. Negative talk can become a compulsion representing instructions from our simplest misgivings, to loss of control of the brain and spirit, to a primitively driven addiction, to all types of agency destroying behavior." Belnap goes on to say that "There is no way to estimate the amount of havoc and misdirection that such negative self-talk wreaks in our lives. It cripples our best intentions and seduces us to become satisfied or compelled to indulge in debased behaviors. Rid yourself of the negative self-talk and you rid yourself of your greatest foe." Self-defeating inner speech can become compulsive and very debilitating. However, unlike the brain chemistry associated with other addictions, there is no evidence that brain damage occurs with dysfunctional inner speech. This does not minimize the power of words but rather reassures that there are effective means of ridding yourself of debasing inner speech, as discussed further in the next section on treatment and recovery from addictions.

The National Institute on Drug Abuse defines drug addiction as a brain disease because drugs change the brain

Drugs alter the functioning of the brain as well as its structure. These changes in the brain, particularly if they occur in the still-developing brains of those under 24 years of age, can seriously disrupt behavior and become long-lasting. How drugs affect a person and how effective is his or her recovery is extremely individualistic. All factors that affect the individual, including relationships and environment, can play a role in how quickly and seriously drugs harm a person and disrupt his or her life. There are treatments to help diminish the impact on the diseased portions of the brain.Because drugs produce a euphoric feeling, people use and abuse them to seek to feel good, to experience "the high." Some think that drugs will help them perform better in various situations. Many people are just curious and tempted to try drugs because of the influence of those around them. Because drugs affect people differently, it's foolish to think it possible for anyone to control their use of drugs. When subjecting yourself to highly addictive substances, it is possible to become addicted with very little use of the drugs. It really is like playing with dynamite—damage is certain.Smoking, inhaling, or injecting a drug into a vein increases the potential for addiction. With these methods, the drug reaches the brain in seconds, the high is immediate, and it may also recede quickly. The contrast of the high and then the low often drives the user to repeat the drug abuse to sustain the high

psychoactive drugs

Drugs that alter brain function, affecting changes in mood, perception, alertness, and behavior. They act on the central nervous system and cause various physical and psychological effects, depending on the drug. Because they are mood altering, these drugs tend to be commonly abused. Their excessive use often leads to an addiction.

Problematic Behaviors with Technology

Due to increased prevalence in daily life, overuse or misuse of personal technology such as computers, video games, television, tablets, and cell phones continues to rise (Figure 17). The Center for Internet Addiction Recovery features a web-based questionnaire called the Internet Addiction Test developed by Kimberly Young. The questionnaire is posted and can be completed and scored at their website (netaddiction.com).T here are a number of centers dealing with the problematic behaviors associated with the use of technology. Harvard University McLean Hospital has a Computer Addiction Study Center. Dr. David Greenfield, author of Virtual Addiction, administers the Center for Internet Behavior in West Harford, Connecticut (virtual-addiction.com). The purpose of this center is to provide therapeutic services, resources, and information on Internet addiction and compulsion in the home and in the workplace. Numbers of universities are offering counseling to help students overcome problems associated with technology addiction. Mental health professionals are in the throes of trying to decide the nature and classification of these behaviors.

Patrick is constantly putting himself down. He thinks he is not attractive enough to have a girlfriend or smart enough to make it through his next three years of college, and he has many other self-defeating thoughts. What addictive behavior is he suffering from?

Dysfunctional inner speech. Debasing self-talk or inner speech is something almost everyone experiences at some point in life, but in severe cases such as Patrick's, some mental health professionals deem these internal putdowns to be an addictive behavior.

Alcohol detoxification and sometimes prescription drugs are used to treat alcoholism, but this process will NOT

Eliminate alcoholism. This process treats the physical symptoms of alcoholism but will not eliminate the alcoholism. Further treatment is needed to address the root cause, including uncovering the psychological, social, and/or environmental factors in the person's disease.

Substance abuse is facilitated by one's...

Environment. Children who have parents who abuse substances are more likely to do the same. National Institute on Drug Abuse (NIDA) data indicate that currently, one in four people under the age of 18 have parents who drink heavily or use drugs. Many people with addictions have been abused as children.We know that about as many women as men are smokers, but women report more often than men that they smoke to be able to deal with emotional stress.

True or False? Because prescription drugs have the purpose of helping someone, they are not a common source for abuse and do not typically lead to brain, heart, and mental problems as do designer drugs.

F, There is a misperception that prescription drugs are not as harmful because they were prescribed for the purpose of helping someone; however, they are a common source for abuse and can cause brain, heart, and mental problems.

Twelve-Step Program

First introduced by the founders of Alcoholics Anonymous (AA)—Bill Wilson (Bill W.) and Dr. Bob Smith (Dr. Bob) of Akron, Ohio—the twelve-step program was devised as principles to help people recover from alcoholism. The original twelve steps were published in 1939 in the book, Alcoholics Anonymous. As people and organizations dealing with other addictive problems acknowledged the efficacy of these principles, AA gave them permission to use the twelve-step program. Millions of people worldwide have taken part in twelve-step recovery programs including Gamblers Anonymous, Overeaters Anonymous, Co-dependents Anonymous, Narcotics Anonymous, and many others. In addition, groups such as Al-Anon have been formed to lend support to family members of those with addictive behaviors The APA dictionary of psychology gives a summary of the process people follow when doing the twelve-step program. This is not a summary of the actual twelve steps, which vary somewhat within each of the anonymous programs: Admitting that one cannot control one's addiction or compulsion. Recognizing a greater power that can give strength. Examining past errors with the help of a sponsor (experienced member). Making amends for these errors. Learning to live a new life with a new code of behavior. Helping others that suffer from the same addictions or compulsions.

Chapter goals

Having completed this chapter, expected outcomes for you include: Honest introspection to see if you have any addictive behaviors or substances in your life. Do an honest appraisal so you can begin to eliminate them. Assess your environment to identify positive support to help yourself or others work to overcome addictions and addictive tendencies. Be willing to accept help and not fall into the "will-power trap." Help others to do the same. Identify triggers that set off the addictive behaviors. Work to reduce these and eventually eliminate them altogether.

What is addiction?

Historically we have thought of addiction as a reliance on substances such as drugs, alcohol, or tobacco. Today it is widely recognized that processes or behaviors can be addictions as well. Normal behaviors such as eating, exercise, relationships, and sexual relations can sometimes become addictive. So, can other everyday activities such as shopping, watching television, using computers, or texting. Gambling or viewing pornography can also become compulsive behaviors. Since there are so many aspects of life that can turn into addictions, addictive behavior is something each person needs to understand and consider as a possibility in his or her own life. - Common aspect of addiction- compulsiveness. Addictions have physical, psychological, and social effects, negatively impacting the entire person. An addiction is the engagement in behavior of things that we don't value.

What If Your Loved One Has a Problem?

If you believe a friend or a loved one may have a substance abuse problem or addiction, there are steps that you can take to help. If your friend is willing, there are resources to which you can direct them. The National Institute on Drug Abuse provides articles, videos, and other resources that provide good information about addiction, why it is hard to stop, and where to get help. To start, refer your friend to the article, "What To Do If You Have a Problem with Drugs," which is available on the National Institute on Drug Abuse website (www.drugabuse.gov/related-topics/treatment).If your friend or loved one is resistant, you can still give them information that will help them when they are ready. Find health professionals who specialize in addiction. Two organizations with patient referral programs are:American Society of Addiction Medicine (www.asam.org)American Academy of Addiction Psychiatry (www.aaap.org)You can also find a treatment center by calling 1-800-662-HELP (4357) or going to the Substance Abuse and Mental Health Service Administration website (findtreatment.samhsa.gov).If a friend is not willing to change, don't be confrontational. Friends and family want to help, but they also bring a lot of emotion to the conversation. Instead of forcing an intervention, use positive incentives to motivate your friend to see a doctor.Be supportive and encouraging. Let your friend know that asking for help is a brave thing to do. If they are worried about others finding out, including their employer, you can let them know that laws protect the privacy of those seeking drug treatment. If their employer requires a physician's note for taking time off for medical treatment, the note does not have to describe the medical condition. Treatment can work, and recovery is possible.

College Drinking Culture

In 1998, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) commissioned a Task Force on College Drinking to try to change the college drinking "culture" and reduce the destruction of lives and property due to college drinking. The Task Force, which reflects the thinking of all members of the campus community—students, professors, administrators, and parents—sees the culture of college drinking as "antithetical to the culture of learning, which is the core of higher education." As the information in the report clearly demonstrates, the fallout from excessive alcohol consumption does not discriminate—it threatens the health and safety of all students, disrupts the academic process, frustrates faculty, and disturbs the lives of those in adjacent communities.According to the report, 18-24 year-old college students experience the following due to alcohol use: 1,700 deaths from alcohol-related injuries, including motor vehicle crashes 599,000 accidental injuries while under the influence of alcohol 696,000 assaults by another student who has been drinking More than 97,000 sexual assaults or date rape The report further states that one in four students say that drinking had negative consequences on their academic performance. About one-third of students met the medical criteria for alcohol abuser, while about 6 percent met the criteria for alcohol-dependent. Clearly, this is a massive problem on college campuses today.

Alcohol

In the general adult population of the United States, 35 percent do not drink any alcohol. About 43 percent are occasional to moderate drinkers, and the remaining 22 percent are considered heavy drinkers with a minimum of two drinks per day. The legal minimum drinking age of 21 was established nationally in 1984.The reason for setting the drinking age at 21 rather than 18—the age at which people are legally viewed as adults—originally had more to do with traffic fatality statistics than it did with hard science. But studies have since shown that there are sound health reasons to restrict drinking in young adults. For example, adults who spend years using alcohol heavily have smaller brain sizes than normal, particularly in the prefrontal cortex, thalamus, and the cerebellar hemispheres. These are the same regions of the brain that are not fully developed until someone reaches age 24.A damaged or underdeveloped prefrontal cortex could mean limitations in the capacity to think, reason, make decisions, use good judgment, and control impulses. Alcohol also negatively affects the hippocampus in the developing brain, which could impair learning and memory. As neuroscientists continue to study how the brain matures and develops during adolescence and young adulthood, it is possible that even more consequences of youthful heavy drinking are yet to be discovered.

The Task Force on College Drinking recommended a three-pronged approach to alcohol abuse prevention, which involves comprehensive integrated programs with multiple complementary components that target which of the following?

Individual students who are at risk the student population as a whole the surrounding community NOT families of students school faculty and administration

How does the drug Naltrexone help treat alcoholism?

It increases the uncomfortable feelings of drinking alcohol. Naltrexone increases the uncomfortable feelings of nausea and headache when alcohol is consumed, which curbs the desire for alcohol.

The legal age for drinking alcohol in the U.S. is 21. What case might medical professionals make for increasing the legal drinking age to 24?

Key parts of the The prefrontal cortex, thalamus, and cerebellar hemispheres of the brain are not fully developed until someone reaches age 24. are not developed until 24.

Brain plasticity is the ability of the brain to rewire its connections in response to

Learning and experience. Brain plasticity is the ability of the brain to rewire its connections in response to learning and experience. It is heightened during the adolescent and early adult years.

What bodily organ is primarily responsible for alcohol metabolism?

Liver The liver is mainly responsible for alcohol metabolism. It neutralizes and breaks down the alcohol at the rate of about half a drink per hour.

Which of the following are NOT among the questions presented by the Advancement of Sexual Health (SASH) for helping to determine if someone has a sex-related addiction?

More than 2x a week Do you watch corn online or engage in - _ - NOT do i think about it even when i dont want to do i experience consequences due to it do i feel out of control

What did a study on the effects of cocaine addiction reveal when users were asked to rank different amounts of money ranging from $10 to $1,000 on a scale from 1 to 10?

More than half the participants rated $10 to be equally valuable with $1,000. When cocaine users were asked to rate the value of 7 different amounts of money ranging from $10 to $1,000 on a scale from 1 to 10, 56 percent of them rated $10 to be equally valuable with $1,000.

Motivational Enhancement Therapy

Motivational enhancement therapy (MET) focuses on non-judgmental listening as a means of encouraging an intrinsic motivation in the person to change their behaviors Motivational enhancement therapy (MET) is a form of counseling specifically designed to help people overcome addictive behaviors. The founder of motivational interviewing (MI) worked with researchers of the trans-theoretical model, a behavior change model, to devise MET, designed initially to help people overcome alcoholism MET was one of three treatment methods used in Project MATCH, the largest alcoholism clinical trial ever conducted. Sponsored by NIAAA, the report of the findings was that all three test groups—12 sessions of Cognitive-Behavior Therapy, 12 sessions of Twelve-Step Facilitation Therapy, or 4 sessions of MET—resulted in substantial and statistically equivalent reductions in drinking for as long as 3 years after the treatments. MET counselors strive to elicit from the client an intrinsic motivation to change their behaviors. This approach requires a high degree of therapeutic empathy, in the tradition of Carl Rogers. It is a non-judgmental, intensive listening style as opposed to a confrontational style. The therapist establishes a framework for change and then helps the client to acknowledge his or her ability to make that change. MET only requires four sessions and is often used in conjunction with other treatments such as the twelve-step programs. MET has been proven effective with a broad range of severity of alcohol problems. Several studies have reported positive results with marijuana and heroin users as well.

binge drinking

Much college-age alcohol abuse takes the form of binge drinking which is defined as five or more drinks in a row for men, and four or more drinks in a row for women—the so-called 5/4 definition. Several national surveys indicate that about four out of five college students drink, and about half of those engage in binge drinking (Figure 13).Binge drinking varies widely from campus-to-campus, with some reporting as few as 1 percent involved, and others finding that up to 70 percent of students binge drink. Statistics may give the impression that most college students are frequent binge drinkers. However, a closer look by the NIAAA shows that 70 percent of all alcohol consumed is done by 20 percent of the students. Recent studies show that 19 percent of students say they do not drink at all. This number of alcohol abstainers has risen in the past decade.Many factors influence the drinking habits of students. Up to 30 percent of high school seniors report binge drinking in high school. NIAAA reports that excessive alcohol consumption is generally found at colleges and universities that include fraternities and sororities, at schools with prominent sports teams, and at universities and colleges located in the northeastern United States.

What concludes a person an addict?

No conclusive addicitve profile because the manner one is influenced varies and even though the reward pathway is identifiable the experience is unique.

What method does motivational enhancement therapy use as a means to help people overcome addictions?

Non-judgemental listening

Task Force on College Drinking

Over many years of trying to deal with the problems associated with drinking in college, many administrators have felt the problems are almost insurmountable. The Task Force on College Drinking has been able to mobilize administrators, students, and scientists to devise effective ways to change the current college drinking culture. Research strongly supports their current recommendation that focuses on a three-pronged approach to prevention, called the 3-in-1 Framework. It involves comprehensive integrated programs with multiple complementary components that target the student population as a whole, the surrounding community, and individual students who are at risk or alcohol-dependent drinkers already.Each college and each campus are unique and will need to do research to develop its own strategy. The Task Force has given a framework that is offering new hope for reducing the negative consequences of drinking by changing the college campus culture of drinking. Here is an opportunity to express your own healthy lifestyle choice and be a part of the solution rather than the problem.

Which of the following is NOT one of the four symptoms of alcoholism?

Paranoia.

Relapse.

Relapse into addictive behaviors can occur long after a person has eliminated the substance or behavior from their lives. Nora Volkow, M.D., director of the National Institute on Drug Abuse, has discovered more sophisticated aspects of addiction beyond the dynamics of the reward pathway. As reported in the Psychiatric News of the American Psychiatric Association, "What has evolved is a picture of multiple regions of the brain being progressively compromised—the anterior cingulate gyrus, which governs attention and regulation of impulsivity; the orbital prefrontal cortex, which mediates the assignment of value to stimuli in the environment; and the dorsal lateral prefrontal cortex, which governs executive function and decision making."These parts of the brain work together to normalize brain functioning even in the presence of the addictive stimuli. With continued stimulation, these processes begin to deteriorate, and the brain is significantly altered. Both the structure and the function of the brain are being destroyed.

What brains are vulnerable to addiction?

Research by psychologists Heather Brenhouse, Ph.D., and Susan Andersen, Ph.D., at Harvard's McLean Hospital found that "teenagers may form stronger-held addictions, have a tougher time quitting drugs, and be more susceptible to relapse once they have quit."Because of this continuing brain development, individuals in their teens and early twenties are especially vulnerable to brain damage caused by various addictions and addictive substances. Neuroscientists have also discovered that the ventral striatum which includes the NAcc is more active in individuals during those years. This is another reason the younger adult brain is more susceptible to being negatively affected by harmful substances.

When the neurotransmitter dopamine is released, what type of strong message does it send to the brain, which helps us understand the addictive process?

Reward. The flood of dopamine into the brain causes the feeling of a high—a strong reward message.

But addictive substances and behaviors are essentially a ______ to the reward.

Shortcut. The memory of this shortcut tends to alter the normal reward pathway, creating a craving just for that stimulus. Initially, the reward pathway elicits feelings of pleasure, but with the adaptations, that pleasurable feeling may no longer be present, yet the individual continues to crave the stimulus. Additional thought processes are impaired through the involvement of another excitatory neurotransmitter, glutamate. This further complicates breaking an addiction.

Gambling

Since the 1980s and 1990s, gambling has been legalized in 48 of the 50 U.S. states. As expected, increased legalization and availability has led to increased gambling. Taken to the extreme, problematic or addictive gambling can destroy people's lives and that of their families. In addition to the financial ruin often experienced, suicide rates among those with a gambling addiction are 20 times higher than the general population. The American Psychological Association (APA) defines pathological gambling as an impulse control disorder that is a chronic and progressive mental illness. Approximately 2-5 percent of the general population are considered addicted or problematic gamblers. Of great concern is that the rate among college-age students is more than double this figure, with up to 9 percent having some sort of gambling-related problem (Figure 15). Other reports indicate that men are much more likely than women to have a gambling problem, with only 2 percent of college-age female students having some sort of issue with gambling. A much higher percentage of problem and compulsive gambling occurs with online gambling than with other forms.It is estimated that problem gamblers between the ages of 18-25 lose an average of $30,000 and also accrue $20,000 to $25,000 in credit card debt per year. Students are using and losing money intended to be spent on tuition, fees, and books.

According to the CDC, 443,000 people die directly and another 9 million have a serious illness as a result of

Smoking or exposure to secondhand smoke. Tobacco use is America's leading cause of preventable death. According to the CDC, 443,000 people die directly from smoking or exposure to secondhand smoke, and another 9 million have a serious illness caused by smoking.

Depending on the seriousness of a person's addictive behaviors, recovery may not be a return to a former life, it may mean

Staring from scratch with a new life. It may be that there really was no former life worth calling a real life. In that case, recovery may mean starting from scratch and getting a new life.

Addictive substances and behaviors are essentially a "shortcut" to the reward, and the memory of this shortcut alters the normal reward pathway, creating a craving just for what?

Stimulus. Addictive substances and behaviors are essentially a "shortcut" to the reward. The memory of this shortcut tends to alter the normal reward pathway, creating a craving just for that stimulus.

True or False? Because addiction affects the whole person, there are physical, mental, and psychological aspects to withdrawal.

T, Addictions have physical, psychological, and social effects—they negatively affect the whole person; a person going through withdrawal will be affected physically, mentally, and psychologically.

True or False? Overuse or misuse of personal technology such as computers, video games, television, tablets, and cell phones continues to rise and can lead to addictive behavior.

T, Overuse or misuse of personal technology can become an addiction, and there are a number of centers dealing with the problematic behaviors associated with this behavior

True or False? Alcoholics cannot simply "will" themselves to not drink. The need to drink alcohol can be as powerful as the need for people to drink water or to eat.

T, The National Council on Alcoholism and Drug Dependence along with the American Society of Addiction Medicine define alcoholism as a disease, which one cannot simply will away.

Which of the following statements about addiction are true? Choose all that apply.

TRUE: A common aspect of addiction is compulsiveness, Getting cut off leads to withdrawal, Addiction wreaks havoc on our society at large. FALSE: normal behaviors like exercise cannot become addictive, the euphoria that addicts became hooked on increases.

Tobacco

Taking a 21st-century approach to wellness, it would not be a difficult decision to include avoidance of tobacco use as very important for good health. For over 40 years the government has been warning Americans not to use tobacco in any form. All forms of tobacco contain nicotine, one of the most highly addictive psychoactive drugs.Tobacco use is America's leading cause of preventable death. According to the CDC, 443,000 people die directly from smoking or exposure to secondhand smoke, and another 9 million have a serious illness caused by smoking. The CDC also reports that despite these risks, approximately 46 million U.S. adults smoke cigarettes. Coupled with the enormous health toll is the significant economic burden of tobacco use. In the United States, tobacco-related disease costs more than $96 billion per year in medical expenditures and another $97 billion per year resulting from lost productivity. Nearly 75 percent of users begin smoking when they are teens, the time when the developing brain is more susceptible to addictions (Figure 14). In spite of scientific and medical evidence, people overlook the highly addictive nature of nicotine. The smoking habit today is expensive, costing the average smoker around $3,600 a year. Smoking leads to less productivity on the job and higher rates of insurance. Birth defects attributed to a woman's use of tobacco while she is pregnant include lower birth weight, breathing problems, and possible childhood cancers. Cigarettes (both domestic and imported), cigars, pipes, smokeless tobacco, and snuff all contain addictive levels of nicotine. Various cancers accompany prolonged tobacco use of all kinds. Concerted efforts and millions of dollars are spent each year on curbing tobacco use in the United States. According to the CDC, the average rate of smoking by people over 18 years of age fell from 40 percent in the 1970s to 32 percent in the 1980s, 26 percent in the 1990s, and to 21 percent in 2010s. It definitely is possible to eliminate this addiction individually, and hopefully, we will continue as a nation to work to eliminate smoking and all tobacco use.

Addiction

That which you know is harmful to you, but that you feel compelled to continue and feel the need to lie about your behavior. - Overcoming an addiction requires an approach to changing the behavior that is different from simply changing a bad habit or striving to adopt a good one. The reason for this is the very nature of addiction itself.

Fetal Alcohol Syndrome

The Mayo Clinic explains that fetal alcohol syndrome (FAS) is not a single birth defect. It is a cluster of problems with severe consequences that result from the mother drinking heavily while pregnant. Collectively, considering all the associated disorders, it is known as fetal alcohol spectrum disorders (FASD). The signs may include: Distinctive facial features including small eyes, an exceptionally thin upper lip, a short-upturned nose, and a smooth skin surface between the nose and upper lip. Heart defects. Deformities of joints, limbs, and fingers. Slow physical growth before and after birth. Vision difficulties or hearing problems. Small head circumference and brain size (microcephaly). Intellectual disability and delayed development. Abnormal behavior such as a short attention span, hyperactivity, poor impulse control, extreme nervousness, and anxiety. If you are a woman who does have a problem with alcohol, get help so that you can avoid any risk of FASD. This is one cause of intellectual disability that can be completely avoided.

Corn addiction

The Society for the Advancement of Sexual Health (SASH) recognizes that sexual behaviors can become compulsive or addictive. Defining sexual addiction is complex and may include a range of behaviors from masturbation and pornography to the sexual exploitation of others (Figure 16).SASH gives three basic things to consider when asking yourself if you have a sex-related addiction: Do you feel out of control regarding whether you engage in a particular form of sexual behavior? Do you experience significant consequences because of a specific out-of-control sexual behavior? Do you constantly think about your specific out-of-control sexual behavior, even when you don't want to? If you answer yes to any or all of these questions, SASH suggests seeking professional help. Some people claim that these behaviors are not addictions, preferring the term "compulsive behavior." Others would say that pornography and other sex-related behaviors are not antithetical to a normal life. However, those who have a problem with pornography and other addictions often claim that pornography is a more difficult addiction to overcome than substance addictions. As stated earlier, researchers have demonstrated that the brain activity of people exhibiting these behaviors corresponds to the brain activity of substance addictions.

Normal behavior elicits a normal dopamine response, while addictive behavior elicits an extraordinary response which leads to

The breakdown of normal brain functioning. Addictive behaviors elicit an extraordinary response—supraphysiological—which leads to the breakdown of normal brain functioning.

Why does smoking, inhaling, or injecting a drug increase the potential for addiction?

The high is immediate and may recede quickly. With these methods, the drug reaches the brain in seconds, the high is immediate, and it may also recede quickly. The contrast of the high and then the low often drives the user to repeat the drug abuse to sustain the high.

First introduced by the founders of Alcoholics Anonymous, __________ was devised as principles to help people recover from alcoholism.

The twelve step program. First introduced by the founders of Alcoholics Anonymous—Bill Wilson and Dr. Bob Smith—the twelve-step program was devised as principles to help people recover from alcoholism.

Medications for Addictions

The use of medications for treatment of various addictive behaviors has a long history of controversy and ineffectiveness. Newer drugs, however, are proving to be effective, especially when used with the therapies already discussed. Methadone has been used effectively in treating opiate addictions, especially heroin addicts. It helps to lessen the withdrawal symptoms and is used for long-term maintenance. Approximately 200,000 Americans are on methadone maintenance to help them live a more normal life. Most doctors require patients to go to a licensed clinic daily to receive a single dose of methadone. Levo-alpha acetyl methadol (LAAM) offers the same advantages as methadone. Some doctors prefer LAAM because it doesn't need to be administered as frequently. Two forms of buprenorphine, Subutex and Suboxone, are also being used to treat opiate addictions. Naltrexone has been FDA-approved since 1994 to treat alcoholism. It helps reduce the cravings for alcohol and increases uncomfortable feelings of nausea and headache when alcohol is consumed. These do help curb the desire for alcohol and getting the patient to use the drug is a challenge. Researchers have developed a longer-acting injectable form of naltrexone, Vivitrol, to offset the problem of non-compliance. Acamprosate, sold as Campral, is another medication used to treat alcoholism.

Solution-focused therapy uses positive support and motivation to encourage an individual to seek solutions from

Their family and other relationships. Positive support from solution-focused therapy encourages the individual to embrace the resources he or she has to move forward, which include one's family or other relationships that will help provide solutions.

Life after Addiction

There is life after addictive behaviors (Figure 23). Often, we find ourselves in multiple addictions or we may tend to substitute one addiction for another. Coming to a full recovery requires a solid foundation of wellness, applying the principles and practices we are exploring together in this book. Wellness living must be fun, not drudgery. This is true for each one of us whether we are dealing with addictions or not. However, depending on the seriousness of a person's addictive behaviors, recovery may not be a return to a former life. It may be that there really was no former life worth calling a real life. It may have been filled with lies, denial, manipulation, or no real friendships or purpose. In that case, recovery may mean starting from scratch, getting a new life. This is a great opportunity to make it what you really want. Good nutrition, joy found in eating, fun-filled exercise, and physical activity might be pleasures that are new to you. Learn to be active and to relax—this is not the time to be pushing yourself into other obsessive behavior. Most of all, seek that marvelous balance and harmony of bodymindspirit. Addictive behaviors can be horribly devastating, but they can be overcome!

Nestler and Malenka observed the creation of additional dendritic spines on the receptors of the NAcc neurons.

These enhance their communication with other neurons, thus involving many more structures of the brain than those directly composing the reward pathway. These additional brain structures are usually the same circuits involved with memory, learning, and decision making, so the brain remembers the high of the reward pathway. The normal functioning of the reward pathway usually requires a concerted effort, after which the response is delayed.

Mesolimbic Dopamine System

This circuitry is found in the mesolimbic dopamine system (Figure 2). Structurally, it begins with the ventral tegmental area (VTA) located near the floor of the midbrain. The nerve cells in the VTA release the neurotransmitter dopamine, which stimulates receptors on neurons of the nucleus accumbens (NAcc), a structure located beneath the frontal cortex. The flood of dopamine into this brain pathway causes the feeling of a high—a strong reward message. Continued stimulation of this circuitry results in adaptations in the brain that give rise to various stages of addiction. This pathway has been observed utilizing functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) scans. One of the fascinating aspects of these findings is that no matter the nature of the addictive behavior or substance, there is a common response via this dopamine reward circuitry. For example, this means that repeatedly viewing pornography creates a similar brain response as taking heroin (Figure 3).

Because of how the brain develops, which individuals are especially vulnerable to brain damage caused by various addictions and addictive substances?

Those in their early 20s. Because of continuing brain development, individuals in their teens and early twenties are especially vulnerable to brain damage caused by various addictions and addictive substances.

Twenty-two percent of people in the U.S. are considered heavy drinkers, meaning they consume a minimum of

Two alcoholic drinks PER DAY

Caffeine is an alkaloid that acts as a mild diuretic, which means it increases what?

Urination

Nora Volkow, M.D., director of the National Institute on Drug Abuse - SALIENCY

Volkow focuses on saliency—what the brain perceives as important or salient. Normal behavior elicits a normal dopamine response. Addictive behaviors elicit an extraordinary response—supraphysiological—which leads to the breakdown of normal brain functioning. With the damage to the prefrontal cortex, stimuli other than the substance itself can cause a flood of dopamine release. Volkow reported her research in which cocaine users experienced increases in dopamine and reported cravings for cocaine when simply watching a video of cocaine users.With the alteration of prefrontal cortex functioning, the brain no longer discriminates what is important for normal living. Decision making is greatly impaired.

When we try to use willpower alone to beat an addiction, what is most likely to happen?

We begin to assume there is no way to overcome the addiction and give up The willpower effort we put forth is exhausting and gets us nowhere While we are trying to exert willpower, the desire remains untouched NOT We make up our minds to change and then go about doing it The cravings begin to go away as we exert effort to overcome them

Solution-Focused Therapy

Widely studied, this therapeutic model has moved to a prominent place in social work and health care. Solution-focused therapy (SFT) or solution-focused brief therapy (SFBT) began as a family therapy approach and is now being used to help individual clients with drug and alcohol abuse and other problems. SFT has some similarities in counseling technique to MET. It differs from more traditional twelve-step programs; however, it does not discourage clients from attending the meetings. Rather than focusing on the past and specific problem behaviors, SFT focuses on helping the individual and family build a positive life in their immediate future. A signature question in this therapy is the miracle question: "If a miracle occurred in the night and your addiction disappeared, what would your next day be like?" The counselor or team of counselors work together to relate to the client's level of motivation and not take an expert role that defines a person's attitude or behavior. Positive support encourages the individual to embrace the resources he or she has to move forward. Possible resources include one's family or other relationships that will help provide solutions Current research has demonstrated the important social nature of addictive behaviors. Obesity can spread among friends (pardon the pun) and smoking cessation is likely to occur if associates quit smoking too. Having examined 53,228 family or social relationships derived from the longitudinal data gathered in the Framingham study, Dr. Nicholas Christakis at Harvard Medical School, and his co-author, James Fowler at the University of California, reported that people quit smoking in clusters. Their previous research also indicated that obesity spreads among friends much like an infectious disease.

What happens when someone is cut off from an addiction?

Withdrawal, physically, mentally, psychologically.

With a normal behavior change we choose to change; to overcome an addiction, we

choose to be changed. To overcome an addiction, we need to back off and find strength from another source to change the addictive desire.

Fetal alcohol syndrome (FAS) is not a single birth defect; there are a cluster of problems that can result from a mother drinking while pregnant, including which of the following? Choose all that apply.

delayed development vision difficulties limb deformity heart defect NOT large head circumference

DRUG CO-DEPENDENCY: When the brain's reward pathway is activated repeatedly from a certain behavior, the resulting oversupply of dopamine signals the brain to

down-regulate the production of the neurotransmitter. It also responds by reducing the number of dopamine receptors in the NAcc, which in turn leads to decreased reward pathway completion. This leaves the person feeling depressed, flat, and unhappy. The individual ends up needing more of their addictive substance or behavior to bring dopamine levels up to their normal state. This adaptation creates a tolerance for the drug or stimulus, thus requiring more of it to create the hoped-for response. These adaptations create a dependence on the drug or stimulus.

In 1977, Dr. George Engel, a psychiatrist at the University of Rochester, called for a new medical model that recognized psychological and social factors in addictive problems. The biopsychosocial perspective

gives us insight into personality factors, family, and relationship dynamics, and environmental issues found in the lives of addicts. While no specific model was developed, many medical professionals are now viewing addictive problems from this biopsychosocial perspective.

Rita Z. Goldstein, Ph.D., and her associates conducted a study of those with cocaine-use disorders to better understand what they term the Impaired Response Inhibition and Salience Attribution (I-RISA).

his model analyzes the addicted person's ability to place importance on normal functions such as social relations and eating, as opposed to placing excessive importance on drugs. Measuring brain activity with the fMRI, Goldstein reported that when 16 subjects were asked to rate the value of 7 different amounts of money ranging from $10 to $1,000 on a scale from 1 to 10, 56 percent of them rated $10 to be equally valuable with $1,000. The brain activity in the prefrontal cortex accounted for 85 percent of the variability in the subjects' inability to discern the value of the money

Neuroscience has shown us that the places of cognitive or reasoning functions that involve ___________ are some of the last areas of the brain to mature.

impulses and emotions. Development of the prefrontal cortex continues into a person's 20s, which means places of cognitive or reasoning functions that involve impulses and emotions are some of the last areas of the brain to mature.

The biomedical model gives us...

insight into the chemistry of addiction and the genetic factors that come into play regarding whether something becomes an addiction. This is one reason our understanding of addictions has historically been confined to people's reliance on substances.

Which of the following are common withdrawal symptoms of caffeine addiction? Choose all that apply.

irritability Fatigue Headache NOT Seizures mental health decline

fetal alcohol syndrome (FAS)

physical and mental alterations in a child caused by heavy driking by the mother during pregnancy

Drugs that alter brain function, affecting changes in mood, perception, alertness, and behavior are called

psychoactive drugs

University of Utah scientists compared the DNA of individuals with addictions to the DNA of non-addicted individuals. They found that....

the A1 allele of the dopamine receptor gene DRD2 is more common in people addicted to alcohol or cocaine. If susceptible individuals could be recognized early, interventions could be targeted to this vulnerable population.Having a certain gene does not cause a person to become an addict or engage in addictive behaviors. It just means that the person will be more susceptible to addictive behaviors than people without the gene. With greater understanding, we can help all persons live with a heightened sense of responsibility and accountability.