Modular 2 Power Point Presentation English
- 1. Self Evaluation andRecovery Module 2 loop
- 2. Welcome to EducationMod 2: Patterns of Consumption • Attendance will be taken at the beginning of class and after the midpoint break. • No Multi tasking, you must be engaged in current activity only. • Please be respectful. Good manners and appropriate language go a long way. • Please return from break on time, (no grace period). • You can not get credit for doing two education classes on the same day. • Please let the instructor know if you have any special needs. • If working remotely, Cell phones or other devices are to be used for education only. Questions about Policies or Procedures?
- 3. True or False? Mostpeople who get a DUI are not chemically dependent.
- 4. True or False? True. Prevalenceof Psychiatric Disorders Among Persons Convicted of Driving While Impaired: Sandra C. Lapham, MD, MPH; Elizabeth Smith, PhD 2001 Assessment of Alcohol Use Disorders Among Court-Mandated DWI Offenders: Paul R. Stasiewicz, Thomas H. Nochajski, and D. Lynn Homish 2011 Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication World Health Organization. Global status report on alcohol and health-2014. World Health Organization, 2014. Studies show that about 5% - 12% of first offenders are currently alcohol dependent, and 20% will develop substance use disorders at some point in their life. This is consistent with National levels. However, the rate doubles for people who have more than one DUI
- 5. Let's talk about patternsof consumption. For starters, 31% of Americans report this type of drinking? 31% Board work. Continuum of Substance use ? ?
- 6. Why do youthink this 31% choose to abstain? 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
- 7. 7 As a Child,How many of us remember thinking that drugs or alcohol were bad for you? What changed your mind? The first drinking or using experiment
- 8. Drinking for Pleasure P ainP leasure Mood Enhancement Mood Swing Average Mood
- 9. Definitions Responsible: 1. involving accountabilityor responsibility, as in having the power to control or manage.
- 10. Responsible or normal drinking 31% Continuumof Substance use ? Responsible
- 11. USDA Guidelines onAlcohol Consumption Men No more than 2 drinks per day Women No more than 1 drink per day Who should not consume alcohol at all? McGuire, Shelley. "US Department of Agriculture and US Department of Health and Human Services, Dietary Guidelines for Americans, 2010. Washington, DC: US Government Printing Office, January 2011." Advances in Nutrition: An International Review Journal 2.3 (2011): 293-294.
- 12. Impaired Judgement CausesMistakes Mood Enhancement Mood Swing P ain P leasure Hidden Abuse Hidden Abuse Average Mood
- 13. Incident-Related Stress Mood Enhancement MoodSwing P ain P leasure Hidden Abuse Hidden Abuse Average Mood
- 14. “Mood Enchancement” becomes“Relief Drinking” Mood Enhancement Mood Swing Increased Sensitivity to Problems P ain P leasure Average Mood Hidden Abuse Relief Drinking
- 15. Respons-able: 2. Able torespond
- 16. How did theDUI change the way you drink?
- 18. Why Practice ProgramAbstinence 1. Evaluate relationship with alcohol 2. Defeat relief drinking 3. Repair tolerance 4. Drink mindfully (stop automatic drinking) 5. Practice survival skills (identify triggers) 6. Demonstrate responsibility with a healthy response
- 19. When is ita problem? 31% Continuum of Substance use Problem Responsible
- 20. Physical Dependence P ain P leasure RepeatedExposure Changes the Body Mood Enhancement Mood Swing Increased Sensitivity to Problems Average Mood Hidden Abuse
- 21. Using to StayNormal P ain P leasure Substance Use Disorder Physical Dependence Mood Enhancement Mood Swing Increased Sensitivity to Problems Average Mood Hidden Abuse
- 22. Addiction/Alcoholism/Substance Use Disorderis: 1. …a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. 2. …a primary, chronic disease of brain reward, motivation, memory and related circuitry. 3. …a complex biological, psychological, sociological and cultural amalgam. http://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics (National Institute on Drug Abuse) http://www.asam.org/for-the-public/definition-of-addiction (American Society of Addiction Medicine) Nancy D. Campbell – The Metapharmacology of the Addicted Brain http://www.recovery.org/learn/substance-abuse-and-addiction-related-word-associations/
- 23. Addiction/Alcoholism/Substance Use Disorderis: 1. …a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. 2. …a primary, chronic disease of brain reward, motivation, memory and related circuitry. 3. …a complex biological, psychological, sociological and cultural amalgam. http://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics (National Institute on Drug Abuse) http://www.asam.org/for-the-public/definition-of-addiction (American Society of Addiction Medicine) Nancy D. Campbell – The Metapharmacology of the Addicted Brain http://www.recovery.org/learn/substance-abuse-and-addiction-related-word-associations/
- 24. Addiction/Alcoholism/Substance Use Disorderis: But… is it a disease? Volkow, Nora D., George F. Koob, and A. Thomas McLellan. "Neurobiologic advances from the brain disease model of addiction." New England Journal of Medicine 374.4 (2016): 363-371. Ford, Gary G. "An existential model for promoting life change Confronting the disease concept." Journal of Substance Abuse Treatment 13.2 (1996): 151-158.
- 25. Addiction/Alcoholism/Substance Use Disorderis: What makes something a disease? http://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics (National Institute on Drug Abuse) http://www.asam.org/for-the-public/definition-of-addiction (American Society of Addiction Medicine) Nancy D. Campbell – The Metapharmacology of the Addicted Brain http://www.recovery.org/learn/substance-abuse-and-addiction-related-word-associations/
- 26. American Psychiatric Association– DSM-5 1. More and longer than planned 2. Desire to cut down (failed attempts) 3. Time spent using or recovering 4. Experience cravings 5. Fail to fulfill responsibilities 6. Continue despite problems 7. Activities replaced with use 8. Use in risky situations 9. Continue despite knowledge 10. Tolerance 11. Withdrawal or replacement Hasin, Deborah S et al. “DSM-5 criteria for substance use disorders: recommendations and rationale.” The American journal of psychiatry vol. 170,8 (2013): 834-51. doi:10.1176/appi.ajp.2013.12060782 Compton, Wilson M et al. “Crosswalk between DSM-IV dependence and DSM-5 substance use disorders for opioids, cannabis, cocaine and alcohol.” Drug and alcohol dependence vol. 132,1-2 (2013): 387-90. doi:10.1016/j.drugalcdep.2013.02.036
- 27. Exposure To Disease Agent Factorsthat affect disease Khoury, Lamya, et al. "Substance use, childhood traumatic experience, and posttraumatic stress disorder in an urban civilian population." Depression and anxiety 27.12 (2010): 1077-1086. Goeders, Nick E. "The impact of stress on addiction." European Neuropsychopharmacology 13.6 (2003): 435-441. Shonkoff, Jack P., W. Thomas Boyce, and Bruce S. McEwen. "Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention." Jama 301.21(2009): 2252-2259 Shonkoff, Jack P., et al. "The lifelong effects of early childhood adversity and toxic stress." Pediatrics 129.1 (2012): e232-e246..
- 28. Environment (Stress) (Social) Exposure To Disease Agent Factorsthat affect disease Khoury, Lamya, et al. "Substance use, childhood traumatic experience, and posttraumatic stress disorder in an urban civilian population." Depression and anxiety 27.12 (2010): 1077-1086. Goeders, Nick E. "The impact of stress on addiction." European Neuropsychopharmacology 13.6 (2003): 435-441. Shonkoff, Jack P., W. Thomas Boyce, and Bruce S. McEwen. "Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention." Jama 301.21(2009): 2252-2259 Shonkoff, Jack P., et al. "The lifelong effects of early childhood adversity and toxic stress." Pediatrics 129.1 (2012): e232-e246..
- 29. Environment (Stress) (Social) Genetics Exposure To Disease Agent Factorsthat affect disease Grand daughter Grandmother Brothers Volkow, Nora D., Joanna S. Fowler, and Gene-Jack Wang. “The Addicted Human Brain: Insights from Imaging Studies.” Journal of Clinical Investigation 111.10 (2003): 1444–1451. PMC. Web. 28 July 2015. Schuckit, Marc A. "An overview of genetic influences in alcoholism." Journal of Substance Abuse Treatment 36.1 (2009): S5-14. A Long Term Study of Sons of Alcoholics, MARC A. SCHUCKIT, M.D. Neurobehavioral Disinhibition in Childhood Predicts Early Age at Onset of Substance Use Disorder - Ralph E. Tarter, Levent Kirisci, Ada Mezzich, Jack R. Cornelius, Kathleen Pajer, Michael Vanyukov, William Gardner, Timothy Blackson, and Duncan Clark American Journal of Psychiatry 2003
- 30. An inherited difference,a big consequence Meet Jose & Tom Friends since second grade. Same schools, same hobbies, the only difference is… Tom’s father is an addict and Tom inherited a 50% greater vulnerability to abusing alcohol and drugs. Volkow, Nora D., Joanna S. Fowler, and Gene-Jack Wang. “The Addicted Human Brain: Insights from Imaging Studies.” Journal of Clinical Investigation 111.10 (2003): 1444–1451. PMC. Web. 28 July 2015. Schuckit, Marc A. "An overview of genetic influences in alcoholism." Journal of Substance Abuse Treatment 36.1 (2009): S5-14. A Long Term Study of Sons of Alcoholics, MARC A. SCHUCKIT, M.D. Neurobehavioral Disinhibition in Childhood Predicts Early Age at Onset of Substance Use Disorder - Ralph E. Tarter, Levent Kirisci, Ada Mezzich, Jack R. Cornelius, Kathleen Pajer, Michael Vanyukov, William Gardner, Timothy Blackson, and Duncan Clark American Journal of Psychiatry 2003
- 31. They don’t knowit, but they have different brains Volkow, Nora D., Joanna S. Fowler, and Gene-Jack Wang. “The Addicted Human Brain: Insights from Imaging Studies.” Journal of Clinical Investigation 111.10 (2003): 1444–1451. PMC. Web. 28 July 2015. Schuckit, Marc A. "An overview of genetic influences in alcoholism." Journal of Substance Abuse Treatment 36.1 (2009): S5-14. A Long Term Study of Sons of Alcoholics, MARC A. SCHUCKIT, M.D. Neurobehavioral Disinhibition in Childhood Predicts Early Age at Onset of Substance Use Disorder - Ralph E. Tarter, Levent Kirisci, Ada Mezzich, Jack R. Cornelius, Kathleen Pajer, Michael Vanyukov, William Gardner, Timothy Blackson, and Duncan Clark American Journal of Psychiatry 2003 Red/Pink: High Activity Yellow: Moderate Activity Green/Blue: Low Activity
- 32. Researchers found: Volkow, NoraD., Joanna S. Fowler, and Gene-Jack Wang. “The Addicted Human Brain: Insights from Imaging Studies.” Journal of Clinical Investigation 111.10 (2003): 1444–1451. PMC. Web. 28 July 2015. Schuckit, Marc A. "An overview of genetic influences in alcoholism." Journal of Substance Abuse Treatment 36.1 (2009): S5-14. A Long Term Study of Sons of Alcoholics, MARC A. SCHUCKIT, M.D. Neurobehavioral Disinhibition in Childhood Predicts Early Age at Onset of Substance Use Disorder - Ralph E. Tarter, Levent Kirisci, Ada Mezzich, Jack R. Cornelius, Kathleen Pajer, Michael Vanyukov, William Gardner, Timothy Blackson, and Duncan Clark American Journal of Psychiatry 2003 Two Signs: 1. Impulsivity & Sensation Seeking 2. Low level of response to alcohol
- 33. Low level ofresponse to alcohol Volkow, Nora D., Joanna S. Fowler, and Gene-Jack Wang. “The Addicted Human Brain: Insights from Imaging Studies.” Journal of Clinical Investigation 111.10 (2003): 1444–1451. PMC. Web. 28 July 2015. Schuckit, Marc A. "An overview of genetic influences in alcoholism." Journal of Substance Abuse Treatment 36.1 (2009): S5-14. A Long Term Study of Sons of Alcoholics, MARC A. SCHUCKIT, M.D. Neurobehavioral Disinhibition in Childhood Predicts Early Age at Onset of Substance Use Disorder - Ralph E. Tarter, Levent Kirisci, Ada Mezzich, Jack R. Cornelius, Kathleen Pajer, Michael Vanyukov, William Gardner, Timothy Blackson, and Duncan Clark American Journal of Psychiatry 2003 Tom sees his father lose control so he’s reluctant to drink alcohol. He doesn’t want to lose control like that. But when he does try it… The chemicals in alcohol make Tom’s brain feel more normal
- 34. A normal responseto a drug is to feel abnormal Volkow, Nora D., Joanna S. Fowler, and Gene-Jack Wang. “The Addicted Human Brain: Insights from Imaging Studies.” Journal of Clinical Investigation 111.10 (2003): 1444–1451. PMC. Web. 28 July 2015. Schuckit, Marc A. "An overview of genetic influences in alcoholism." Journal of Substance Abuse Treatment 36.1 (2009): S5-14. A Long Term Study of Sons of Alcoholics, MARC A. SCHUCKIT, M.D. Neurobehavioral Disinhibition in Childhood Predicts Early Age at Onset of Substance Use Disorder - Ralph E. Tarter, Levent Kirisci, Ada Mezzich, Jack R. Cornelius, Kathleen Pajer, Michael Vanyukov, William Gardner, Timothy Blackson, and Duncan Clark American Journal of Psychiatry 2003 Jose’s brain slows down when he drinks. He slurs his words, he makes a fool of himself – he seems out of control.
- 35. Superior Morals orGood Luck? Volkow, Nora D., Joanna S. Fowler, and Gene-Jack Wang. “The Addicted Human Brain: Insights from Imaging Studies.” Journal of Clinical Investigation 111.10 (2003): 1444–1451. PMC. Web. 28 July 2015. Schuckit, Marc A. "An overview of genetic influences in alcoholism." Journal of Substance Abuse Treatment 36.1 (2009): S5-14. A Long Term Study of Sons of Alcoholics, MARC A. SCHUCKIT, M.D. Neurobehavioral Disinhibition in Childhood Predicts Early Age at Onset of Substance Use Disorder - Ralph E. Tarter, Levent Kirisci, Ada Mezzich, Jack R. Cornelius, Kathleen Pajer, Michael Vanyukov, William Gardner, Timothy Blackson, and Duncan Clark American Journal of Psychiatry 2003 Alcohol makes Jose lose control, vomit, and sometimes suffer hangovers. Everyone in his world can tell he’s been drinking. Is it his morals or his body that makes him cautious?
- 36. Bad Morals orBiology? Volkow, Nora D., Joanna S. Fowler, and Gene-Jack Wang. “The Addicted Human Brain: Insights from Imaging Studies.” Journal of Clinical Investigation 111.10 (2003): 1444–1451. PMC. Web. 28 July 2015. Schuckit, Marc A. "An overview of genetic influences in alcoholism." Journal of Substance Abuse Treatment 36.1 (2009): S5-14. A Long Term Study of Sons of Alcoholics, MARC A. SCHUCKIT, M.D. Neurobehavioral Disinhibition in Childhood Predicts Early Age at Onset of Substance Use Disorder - Ralph E. Tarter, Levent Kirisci, Ada Mezzich, Jack R. Cornelius, Kathleen Pajer, Michael Vanyukov, William Gardner, Timothy Blackson, and Duncan Clark American Journal of Psychiatry 2003 Tom’s friends look like they are losing control while Tom feels normal and in control when he drinks. Tom’s has fewer negative effects, so he is likely to drink more frequently. If he wants to feel intoxicated he has to drink a greater amount. Is it possible that Tom’s genetics have set him up to abuse alcohol?
- 37. Bad Morals orBiology? Volkow, Nora D., Joanna S. Fowler, and Gene-Jack Wang. “The Addicted Human Brain: Insights from Imaging Studies.” Journal of Clinical Investigation 111.10 (2003): 1444–1451. PMC. Web. 28 July 2015. Schuckit, Marc A. "An overview of genetic influences in alcoholism." Journal of Substance Abuse Treatment 36.1 (2009): S5-14. A Long Term Study of Sons of Alcoholics, MARC A. SCHUCKIT, M.D. Neurobehavioral Disinhibition in Childhood Predicts Early Age at Onset of Substance Use Disorder - Ralph E. Tarter, Levent Kirisci, Ada Mezzich, Jack R. Cornelius, Kathleen Pajer, Michael Vanyukov, William Gardner, Timothy Blackson, and Duncan Clark American Journal of Psychiatry 2003 Environment Genetics Exposure
- 38. 1. Taking thesubstance in larger amounts or for longer than you meant to. 2. Wanting to cut down or stop using the substance but not managing to. 3. Spending a lot of time getting, using, or recovering from use of the substance. 4. Cravings and urges to use the substance. 5. Not managing to do what you should at work, home, or school because of substance use or its aftereffects. 6. Continuing to use, even when it causes problems in relationships. 7. Giving up important social, occupational, or recreational activities because of substance use. 8. Using substances again and again, even when it puts you in danger. 9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance. 10.Tolerance, Needing more of the substance to get the effect you want. 11.Development of withdrawal symptoms, which can be relieved by taking more of the substance.
- 39. Prescription stimulant abuse NIDA Question: Canprescription stimulant use lead to substance use disorder and addiction? Answer: Yes, and can often progress to illicit stimulant abuse.
- 40. • Initial reaction •Create feelings of euphoria • Curbs hunger • Feel more alert • Focus and think more clearly • Increase self-confidence • Boost libido • Improve performance at school, work, or in sports • Adverse reactions • Cardiovascular stressors such as accelerated heart rate and vasoconstriction • Elevated body temperature and hyperthermia • Panic attacks • Psychosis • Hostility • Violent behavior What, how, and why? The method of use also has varied effects. Effects of Methamphetamine- cocaine- crack cocaine
- 41. • Buildup of toxins Malnutrition DSM Criteriafor Substance use disorder #9 Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance. Sleep deprivation Legal social emotional Hallucinations The progression of the disease •References: faces of meth By FIONN HARGREAVES May 2016 Updated: 2 Dec 2020
- 42. Recourses for stimulant addiction. Youcan ask your counselor or educator for more information • • SMART recovery • 12 Step programs such as Narcotics, Cocaine, Methamphetamine, or Pills Anonymous • Outpatient or inpatient treatment programs • SAMSHA resource referral website
- 43. Self Help: 12Step Programs Cocaine Anonymous Narcotics Anonymous Alcoholics Anonymous Alcoholicos Anonimos Triple Threat Marijuana Anonymous http://www.aa.org/assets/en_US/smf-53_en.pdf • Non-professional • Self-supporting • Membership is open to anyone who wants to stop intoxicant use • Widely available • Founded in 1939 • 2.1 million international members as of 2014 • Spiritually based • Program focuses on Honesty, Hope, Faith, Courage, Integrity, Willingness, Humility, Forgiveness, Justice, Perseverance, Spirituality, and Service
- 44. Your Time Zones 5Minute Brain 5 Year Brain 50 Year Brain • Survival Based • Ancient • Food • Fun (Novelty) • Sex • Goals & Plans • Civilization • Job • Satisfaction • Relationships • Meaning • Spirituality • Purpose • Joy • Love Mystery Competency Trimble, Michael, and Anthony Freeman. "An investigation of religiosity and the Gastaut–Geschwind syndrome in patients with temporal lobe epilepsy." Epilepsy & behavior 9.3 (2006): 407-414.Saver, Jeffrey L., and John Rabin. Marchand, William R. “Neural mechanisms of mindfulness and meditation: Evidence from neuroimaging studies.” World journal of radiology vol. 6,7 (2014): 471-9 "The neural substrates of religious experience." The neuropsychiatry of limbic and subcortical disorders (1997): 195-207. https://slife.org/neuroscience-of-religion
- 45. Self Help: OtherPrograms Most Excellent Way http://www.theguardian.com/society/2010/mar/10/alcoholism-treatment-smart-recovery-programme http://www.tmewcf.org/index.html http://www.smartrecovery.org/ • Founded in 1984 • Bible based alternative to 12 Step • Meetings throughout United States • Headquarters in Huntington Beach, CA • • Goals are: • Win souls for Christ • Comfort the broken-hearted • Disciple new believers • Train ministry leaders • Send “regenerated creations” into the world to spread the word
- 46. Self Help: OtherPrograms Most Excellent Way Smart Recovery http://www.theguardian.com/society/2010/mar/10/alcoholism-treatment-smart-recovery-programme http://www.tmewcf.org/index.html http://www.smartrecovery.org/ • Approach: • Self-empowerment, self-reliance • Teaches techniques for self-directed change • Evolves as scientific methods change • Supports psychological treatment and medication
- 47. Self Help: OtherPrograms Most Excellent Way Women for Sobriety Smart Recovery http://www.theguardian.com/society/2010/mar/10/alcoholism-treatment-smart-recovery-programme http://www.tmewcf.org/index.html http://www.smartrecovery.org/ • Began providing services in 1976 • For women alcoholics only • Uses thirteen statements of acceptance • Affirmations are gone over once a day in the morning • Program is based on: • Positive Thinking, • Metaphysics, • Meditation, • Group Dynamics, and • Pursuit Of Health Through Nutrition.
- 48. Disease means respectingwhat’s at stake: If your mother developed cancer, You probably wouldn’t try to treat it at home
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- 52. To Recap • Responsiblemeans taking care of responsibilities and responding appropriately to mistakes • Substance Use Disorder arises from the interplay of a disease agent, environment and genetics. • Treatment and alternatives to substance abuse are available. • If you have further questions, all counselors are Certified/Registered Alcohol & Other Drug Counselors.