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A bird’s eye view Richard Winter Dependence, Addiction, and Recovery

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Page 1: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

A bird’s eye view Richard Winter

Dependence, Addiction, and Recovery

Page 2: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Addiction

“My precious…”

Page 3: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Addictions s  An overpowering, repetitive, excessive need

exists for some substance, object, feeling, act, environment or personal interaction, and this results in compulsive behavior.

s  Habit, compulsion, abuse, dependence, addiction

s  Craving…Compulsion…Continued…loss of Control

Page 4: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Addiction by degrees s  Substance abuse (Use excessively on

regular basis) s  Dependence (compulsion and physical

need)

Page 5: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Substance Abuse

s  Stimulants

Page 6: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup
Page 7: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup
Page 8: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Caffeine s Drip Coffee 115-175 mgm/cup (250mls)

s Brewed coffee 80-135 mgm/cup s Black tea brewed 40-60/cup s Green tea 25/cup

Page 9: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

s  Starbucks Grande coffee 320 mgm! (259-564mgms)

http://www.energyfiend.com/the-caffeine-database

Page 10: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Nicotine s  23% men, 18% women smoke (USA 2005) s  44% age 18-25 s  A third of all smokers make serious attempts

to quit each year. 90% resume within 1 year. Multiple attempts to stop.

s  80% of all who try smoking will become addicted to nicotine

Page 11: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup
Page 12: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Nicotine s  Brain stimulation s  Cigarettes kill 440 thousand a year in USA-

-  more than alcohol, cocaine, heroin, homicide, suicide, car accidents, fire and AIDs combined

Page 13: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Stimulants s  Caffeine s  Nicotine s  Amphetamine

s Meth

s  Cocaine s  Glue s  Ecstasy…

Page 14: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Neuro-enhancement

s  Adderall s  Ritalin s  Provigil

Page 15: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Anabolic Steroids

Page 16: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Substance Abuse

s  Stimulants s  Depressants

Page 17: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Alcohol s  23% Population

binge drink (42% 18-25)

s  7% Heavy drinking (15% 18-25)

Page 18: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Benefits and risks s  1drink/day: less risk of heart disease and

stroke – reduces bad cholesterol s  Women: More than ½ drink/day increased

risk of breast cancer s  Women more easily addicted

Page 19: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Progression s  Casual/social… regular consumption of

excessive amounts… reliance on alcohol/drug for relaxation and anxiety relief. Sometimes Binge drinking

s  Growing anticipation – of welcome effect of chemical

s  Growing rigidity – around times and occasions of drinking

s  Growing physical tolerance - need more ingenuity to get the amount

Page 20: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Addiction – 3 or more of following: s  Tolerance s  Withdrawal s  Taking more and for longer than intended s  Wanting or trying unsuccessfully to cut down s  Spending a great deal of time under the

influence s  Giving up other interests/activities for

drug/habit s  Using despite harmful physical or psych

effects

Page 21: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Substance Abuse s  Depressants (“downers”)

s  Sedative-hypnotics

Page 22: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Barbiturates Valium, Xanax Sleeping pills (Ambien, Lunesta…)

Page 23: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Substance Abuse s  Depressants

s  Sedative-hypnotics s  Opioids/Narcotics

Page 24: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Heroin

Cocaine/Crack

Page 25: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Substance Abuse s  Other Pain killers

s  {Heroin (153,000 users)} s  Vicodin, Oxycontin, Demerol… (5.2 million non-

medical use in 2007)

s  Hallucinogens

Page 26: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup
Page 27: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Marijuana s  6-10% adults who use become

dependent s  12-18% addicted if start under age 18 s  Many use to medicate depression and

anxiety s  Long term use:

s  Slow processing of complex information. s  Deterioration of memory and learning

Page 28: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

LSD Mescaline

Page 29: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup
Page 30: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Common path s  Dopamine release in pleasure centers s  Genetic influence on pleasure circuit (40%)

s  Some need more stimulus to feel pleasure

s  Stress ++ – need to reduce pain and find pleasure

s  Early life circumstances – chronic stress

Page 31: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

s  Pleasure – so repeat for more s  Tolerance so need dose increase and

more frequent s  Liking… to wanting… to craving s  Do it to not feel bad – eg: sleep, get

up, face day, avoid anxiety, avoid helplessness, stop shakes…

s  Brain rewired

Page 32: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

s  Can be physically dependent but not psychologically addicted

s  Vietnam vets

Page 33: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Process/Lifestyle Addictions

Page 34: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Process/Lifestyle Addictions s  Shopping s  Internet s  Sex s  Gambling s  Food

Page 35: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Food s  Have to eat to live! s  Obesity – av weight up 26 pounds since

1960 – 33% obese, 33% overweight… s  90% obesity is food addiction s  10% metabolic disorder

s  Genetic predisposition (80%) s  Stress factor s  Eating sweet, salty, and fatty foods

rewires brain

Page 36: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Sex

Page 37: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

The Pull of Porn - Quick and Easy s  Real relationships often difficult s  Fantasy easier than reality s  Release without responsibility s  Sense of Control s  But eventually… controls you!

Page 38: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Feels good! s  Addictive nature of orgasm – intense

pleasure s  Channeling emotional tension

s Mood altering s  Numbs pain

Page 39: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Vulnerability s  Abuse s  Family dysfunction

s Worthless s  Unlovable s  Alone s  Disconnected

Page 40: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Process/Lifestyle Addictions s  Shopping s  Pornography s  Gambling

Page 41: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Gambling s  In a study of 222 pathological

gamblers, 65% said refraining from betting gave them “withdrawal symptoms” like insomnia, headaches, upset stomach, even sweating and chills

Page 42: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

s  Work s  Computer games s  Video games s  TV s  Movies s  Sport…

Page 43: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

It is only when my body is screaming towards earth that I feel most truly alive.

Page 44: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Vertical life extremely addictive… Hard time dealing with the mundane…!

Page 45: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup
Page 46: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

s  Positive and negative addictions?

Page 47: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup
Page 48: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup
Page 49: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup
Page 50: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Central theme s  Escape from painful feelings, thoughts

and reality. s  Avoid uncomfortable emotions s  Illusion of control/power/hope s  Get pleasure – avoid pain

Page 51: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Living on the Edge… Addiction

Page 52: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Addiction and Scripture s  Captured by the beast (Gen 4:7) s  Disordered desires – Prisoner to sin

s  So I find this law at work. When I want to do good, evil is right there with me. For in my inner being I delight in God’s law; but I see another law at work in my body, waging war against the law of my mind and making me a prisoner to the law of sin at work within my members. What a wretched man I am? Who will rescue me from this body of death? Romans 7: 21-25

s  Adultery (Ezek 16) s  Folly (Prov 1-11) s  Idolatry – a disorder of worship (Ps 115, Ezek 14)

Page 53: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Heart Brain

Behavior

Family Dysfunction

Abuse

Addiction

Availability

Loneliness

Anxiety

Grief

Pleasure

Freedom from pain

Instant Gratification

“What fires together wires together”

PTSD

Shame…

Stress

©Richard Winter

Worship of false gods

No meaning

Choices

Page 54: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Moving into healing s  Heart issues and vulnerability…

s  Numbing pain? s Meeting legitimate longings in wrong ways?

s  Behavior and thought life battles s  Retraining the brain s  Honesty in relationships (community)

s  Dealing with shame, guilt and fear

s  Learning healthy lifestyle (exercise…)

Page 55: Dependence, Addiction, and Recovery · Caffeine ! Drip Coffee 115-175 mgm/cup (250mls) ! Brewed coffee 80-135 mgm/cup ! Black tea brewed 40-60/cup ! Green tea 25/cup

Freedom s  If you hold to my teaching, you are really my

disciples. Then you will know the truth, and the truth will set you free… Everyone who sins is a slave to sin… If the Son sets you free, you will be free indeed. John 8:31-36

s  He has sent me to bind up the brokenhearted, to proclaim freedom for the captives and release for the prisoners. Isaiah 61:1