Substance Abuse & Addiction

Kerry Herndon, MSW, LAC-EWestern Montana Addiction ServicesProject SUCCESS- Sentinel HS

Theories of Addiction1. Medical Model

• Addiction as a Disease• Neurotransmitter imbalance• Treat with Medication

2. Psychodynamic Model• Drugs are used for self-

medicating• Symptoms of an underlying

mental health disorder• Psychological coping strategy

3. Social Model• Learned behavior• Peer pressure/modeling others• Environmental effects, such as

social media, lead to use• Used to try to fit in or build a

relationship

4. Morel Model• Addicts are weak and need to

overcome compulsions• Substance use is a choice, addicts

can stop at anytime• People who use are anti-social and

should be punished• Evil!!!

5. Bio-Psycho-Social Model• Combination of all the above

factors• Treatment should address mind,

body, spirit and include the individual as well as factors in the environment.

• Maslow’s Hierarchy of Needs

Continuum of Use

Experimental or

Circumstantial Use

Casual Use Intensive Use

Compulsive Use Addiction

Experimental or

Circumstantial Use

Casual Use Intensive Use

Compulsive Use Addiction

Early Use = Increased Addiction Risk

21 or older 18-20 years old

15-17 years old

14 or younger

02468

1012141618

Abuse

“Kids who start drinking before

age 15 are 4x more likely to develop alco-holism than if they wait until

age 21, no matter what their addi-tional genetic or environmental factors maybe”(HBO Box Office, Inc, 2007)

The Brain & Addiction The front part of the brain exists to tell us to slow

down or stop impulsive behaviors. It tells us to “stop” if things are too risky.

The front part of the brain is still developing connections to the rest of the brain until around age 25. Adolescent brains lack some wiring that carries out the “stop” message to the rest of the brain.

Late adolescence, before the brain is matured is the peak time for developing dependency on drugs/alcohol.

Heavy substance use at peek times in brain development can cause permanent changes to the brain.

(HBO Box Office, Inc, 2007)

The Brain

“It is not unusual in recovery to see someone in their late thirties or even early forties struggle with planning and problem-solving – being on time, balancing a checkbook – in exactly the same way a teenager does. That’s because the process of learning those skills stopped when he began using. Now he’s struggling to catch up.”(HBO Box Office, Inc, 2007)

–

Risk Factors Early Use About 50% of vulnerability linked to genetics Insufficient parenting Lack of family communication Exposure to a traumatic event Parental substance use Perceptions that parents, community and key

adults approve of alcohol or drug use. Poor social & academic performance Friendships with kids who have been in trouble Co-occurring disorders (ADHD, Emotional

disorders, psychiatric disorders, etc.)(HBO Box Office, Inc, 2007)

Mental Health

“More than half of young people with a substance-abuse diagnosis also have a diagnosable mental illness” (HBO Box Office, Inc, 2007)

Often times the mental illness has not yet been identified or diagnosed.

Physiological Addiction

SOME SUBSTANCES

Xanax Valium Alcohol Anti-Depressants Tobacco Heroin (Opiates) Caffeine Meth

SOME SYMPTOMS

Changes in sleeping habits

Withdrawal Symptoms Tolerance Change in Eating

Habits Weight Loss/Gain Changes in Physical

AppearanceMany substances are both physiologically and psychologically addictive.

Psychological Addiction

SOME EXAMPLES Cannabis/Marijuana Cocaine LSD Ecstasy/MDMA Sugar Eating Disorders Gambling Shopping Gaming Smart phones (??)

SOME SYMPTOMS Use to forget

problems/relax Withdraw or Keep Secrets Loss of Interest in

Activities Problems with School/Work Changes in Friends Spend a lot of time

thinking about how to get the substance

Stealing or Selling Belongings

Failed attempts trying to quit

Anxiety, Anger or Depression

Mood Swings

DiagnosingWritten questionnairesPersonal interview with clientTalking to others

DO NOT LABLE OR

DIAGNOSE YOUR FRIENDS

Substance Abuse Failure to fulfill major life obligations due to

recurrent use: School Athletics Family Etc.

Recurrent use in physically harmful or risky situations

Recurrent substance related legal issues Continued use despite persistent or recurrent

social or interpersonal problems caused or made worse by substance use

Chemical Dependency

Tolerance Withdrawal Large amounts in shorter period than

intended Increased desire to quit/ failed attempts

to quit More time thinking about use Change in behaviors/ decreasing normal

activities Continues despite consequences

Stages of Change

Takes most individuals

approximately 3x for

success

Maslow’s Hierarchy of Needs

Treatment Options- AdolescentEducationProject SuccessSchool Based ServicesLevel I – Stages Level II – Intensive Outpatient

TreatmentLevel III - In-patient TreatmentCongruent care with a mental health

professional or family therapy

Helping a Friend/Family Member

Remember it is not your responsibility to fix them

Remember that it is hard to admit that help is needed

Remember it is not your fault that they use Remember that listening is better than giving

advice Remember to seek help for yourself Remember to take care of yourself Remember you have resources to help

See Project Success if you are concerned about a family member or friend

Resources HBO Box Office, Inc. (2007). Addiction: Why Can't they Just Stop? New York: Rodale.