Addictions and Stress - 2023.pptx

Addictions Dr. Sydney B. Miller Jinshia Ly  https://www.dailymotion.com/video/x 3pe2gz Facts about Addiction      1 in 4 Canadians will experience addiction or mental illness during their lifetime (1/10 in a year). 2/3 who need care receive none affect more people than heart disease –...

Addictions Dr. Sydney B. Miller Jinshia Ly  https://www.dailymotion.com/video/x 3pe2gz Facts about Addiction      1 in 4 Canadians will experience addiction or mental illness during their lifetime (1/10 in a year). 2/3 who need care receive none affect more people than heart disease – more than cancer, arthritis & diabetes combined. Costs Canada $32-billion a year, 14% of the net operating revenue of all Canadian Business (33% of short-term disability claims). PATTERNS OF DRUG USE      79% of general population drink, 14% use cannabis. (CAS 2004) 18% exceed drinking guidelines. 14% report hazardous drinking. Majority of acute problems are the result of average drinkers who drink too much on single drinking occasions. (Rehm 2003) Alcohol, tobacco and other drugs cost Canadians over $18 billion annually. (Single, 1996) 4 PATTERNS OF DRUG USE In Teens and Young Adults      Over 90% of the alcohol consumed by males aged 15 to 24 years and over 85% consumed by young females exceeded Canadian guidelines. (Stockwell 2005) Close to 60% of those between 15 and 24 have used cannabis at least once; 38% used cannabis in the past year. (CAS 2004) Over 80% of Grade 12 students drink and almost half of these students report hazardous drinking. (Adlaf 2005) Daily cannabis use has increased significantly and 1 in 5 students report driving after using cannabis. (Adlaf 2005) Although smoking has gone down, 1 in 7 students still 5 smoke. (Adlaf 2005) Defining Addiction   Substance Abuse Physical dependence     Drug tolerance Withdrawal Psychological dependence Harm Substance Abuse     Recurrent use leads to failure to fulfill major role obligations at work, school, or home Recurrent use in situations which are physically hazardous Recurrent substance-related legal problems Continued use despite persistent physical, social, occupational, or PHYSICAL DEPENDENCE Tolerance  the need for an increased amount of a given drug to achieve intoxication or desired effect  or the reduction of a drug’s effect with continued use of the same dose over time PHYSICAL DEPENDENCE Withdrawal    Occurs when a drug is abruptly removed, or dose is significantly decreased Cluster of symptoms often accompanied by directly overt physical signs Unpleasantness of withdrawal may be so severe that the individual fearing it may use drug again just to avoid or relieve symptoms Psychological Dependence   a state in which stopping or abruptly reducing the dose of a drug produces non-physical symptoms characterized by emotional and mental preoccupation with the drug’s effects and a persistent craving for the drug Harm   Central concept in understanding both addiction and substance abuse Types of harm:     Physical Psychological Social (e.g., family, friends, job, financial, legal system) Spiritual Components of All Addictions         Preoccupation with substance Increased use of substance beyond expected Inability to control use Withdrawal symptoms Signs of tolerance Restricted activities Impaired functions Harmful or hazardous use Why do people use drugs? Some reasons people give for using drugs           Fun/enhance pleasurable activities/intensify feelings Experiment, explore new experiences Unwind, cope with stress Escape reality, numb feelings Deal with emotional pain or discomfort Respond to social pressure or norms Make social contact easier Enhance artistic creativity Spiritual or meditative pursuits Self-medicate for anxiety, depression, cognitive dysfunction Models of addiction      Moral model Disease model Social model Psychological Model Biopsychosocial model Moral Model Importance of values   Addiction is the result of choices from a flawed character Healing through higher values Implications for Treatment   The temperance movement The War on Drugs Pros   Empowering Appeals to those with a world view based on right/wrong Cons   Judgmental Simplifies the complex nature of addiction Disease Model Addiction as switch in brain    Addiction is attributed to genetics or physical damage Addiction is a chronic disease, can be treated, not cured Pervasive and long lasting changes in host of neurochemical systems Implications for treatment   12 Step Program Drug Interventions Pros  Indignation replaced with pity Cons  Encourages simple minded polices Social Model Socialization in milieu that encouraged such use   Focuses on environment Family, peer, and culture influences Implications for Treatment    Emphasizes communal efforts to aid the addict New peers, new activities, new locales Importance of positive role models; Recovery lead by recovered addicts Pros   Promotes responsibility for some societal norms Identifies at-risk populations Cons   Cultural stereotypes Blame placed on culture Psychological Model Emotional regulation      Psychological Stress Way of avoiding aversive emotions and approaching positive ones Addiction is he result of an inability to cope Desire is modeled on inaccurate representation of substance’s effects Addictive personality (Neuroticism, Impulsivity, Extraversion, Deviance) Implications for Treatment   Cognitive- Behaviour Therapy Stress Management, etc. Pros  Empowers the individual for change Cons Integrated Biopsychosocial Models of Addiction    Determinants of health & disability Inclusion of spiritual factors Better understanding of interaction of physical, psychological, social & spiritual factors Integrated Model of Addiction https://www.youtube.com/watch?v=8ENrwuXTZM Behavioral “Addictions”          Gambling (in the DSM-5) Internet gaming (in section III of DSM-5) Internet Social networking Texting Shopping Sex Exercise Eating Gambling Disorder  “gambling disorder is similar to substance-related disorders in clinical expression, brain origin, comorbidity, physiology, and treatment “  DSM-5 Internet Gaming Expected relief of withdrawal symptoms when gaming Craving due to the expectation of a positive outcome of gaming 11.9% met at least 3 of the criteria for gambling addiction