THE BASICS OF ADDICTION

JUDY ACREE, MA, LPC, ALPS, CCAC-S PSIMED PROGRAM MENTOR PRUNTYTOWN CORRECTIONS 304-265-6111 EXT 7220 Work cell: 304-881-2590

WHY DO PEOPLE USE DRUGS AND ALCOHOL?

BECAUSE

THEY

WORK!

HUH? Yes drugs and alcohol work quite well Bring you up when you are down Bring you down when you need to rest Make you the life of the party Make you smart when you’re not Make you pretty/handsome when you’re not Make you sexy when you’re not Gives you talent when you have none Give you courage when you are scared…. And on and on and on

SO WHAT’S THE PROBLEM??????

Visit SAMHSA FOR STATISTICS ON SUBSTANCE ABUSE AND ADDICTION

The problem is that substance abuse and addiction creates many more problems than it helps.

SUBSTANCE ABUSE AND ADDICTION AFFECTS…

The person – physically, mentally, emotionally, financially, spiritually

The family – it is a family illness – makes the whole family sick – dysfunctional

The friends The employer The legal system – courts, jails and

prisons Society

BUT YOU ALREADY KNEW THAT….

SO IF EVERYONE ALREADY KNOWS THIS – WHY IS IT SUCH A PROBLEM?

Because we believe we can handle it until it is far beyond our ability to handle it

SO HOW DOES IT HAPPEN?

THE EXPERIENTIAL/LEARNING PHASE:

Usually begins in adolescence or early adulthood when the brain is still growing and developing

Learn what chemicals can do for us Experience no negative consequences Learn that these chemicals are reliable

and make us feel good

EXPERIENTIAL/LEARNING PHASE

Pain NORMALEuphoria

x xFeelings range from Normal to Euphoria

and back to normal – it’s all good

SEEKING PHASE/MISUSE

Social use Parties Weddings Sports Entertainment Business Rules apply – when, where, how many

SEEKING PHASE/MISUSE

Occasional hangover Occasional binge drinking Generally use is in a social environment Negative consequences may include:

hangover, late for work, late getting home, drinking to intoxication, 1st DUI

SEEKING PHASE/MISUSE

Pain NORMALEuphoria

x xFeelings range from Normal to Euphoria

to occasional discomfort and back to normal – occasional hangover, headache, DUI

SEEKING/MISUSE PHASE

A true social drinker either has no reason to change their drinking practices because there are no problems

OR

A negative consequence is experienced and that is enough to send a red flag and practices are altered and return to true social drinking

HARMFUL USE/ABUSE/DEPENDENCY Uses more than intended Looks forward to the use not the event Breaks own rules regarding use or sets

own rules to allow use Change in behavior/mood Increase in tolerance Increase in negative consequences but

continues to use

HARMFUL USE/ABUSE/DEPENDENCY Arguments Reliance on substance to change

something - feel better, relax, courage, kill the pain and discomfort

Would rather be with drinking/using friends

2nd DUI

HARMFUL USE/ABUSE/DEPENDENCE PHASE

Pain NORMAL Euphoria

x xFeelings range from Pain to Euphoria and may or

may not return to normal – the normal is starting to change

The Euphoria is not quite as Euphoric – the Normal is not quite Normal and the Pain has increased.

USING TO FEEL NORMAL/ADDICTION PHASE

The Normal is farther from reach – the normal has changed

Now the use is only an attempt to be able to function somewhat normally

All areas of life are now affected Paranoia Delusions

USING TO FEEL NORMAL/ADDICTION PHASE

Easy to spot addiction at this point – POINT OF REFERENCE

Numerous consequences to use Family suffers Functioning is impaired

USING TO FEEL NORMAL/ADDICTION PHASE

Pain NORMAL Euphoria

x xFeelings range from Pain to low Normal if

at allNo longer feels Euphoria – not sure what

normal is

THE FAMILY PHASES - PARENTS DEALING WITH ADOLESCENTS OR ADULT CHILD ADDICTS/ALCOHOLICS

THE LEARNING PHASE o Parents may struggle with it is “normal for

kids to experiment”o They will grow out of it – it’s just a phaseo Trust is testedo Feel they can’t say anything because they did

it tooo One parent may hide adolescent’s use from

other parent – try to protect – not cause stress

SEEKING/MISUSE PHASE

o Parents start to wonder “is this happening too often?”

o Parents may discuss – but rationalize, justify – denial starts to build

o Parents may start to set rules, consequences, efforts to control

o May think “if he/she is going to do it, I want them to do it under my watchful eye – may allow it at home, may provide it

o Seeking answers and solutions – realize there may be a problem

HARMFUL PHASE

o Recognize there is a problemo Parents start to blame each othero Think their behavior caused the problemo Guilt, blame, isolationo Denial buildso Emotions start to shut downo Over attempts to control or detach

ESCAPE PHASE

o Major repeated crisis: financially, work, social, legal

o Becomes “normal” to have to deal with crisis

o Emotional exhaustion, outbursts, shut down

o Isolation – the family breaks o Part of family may continue to support

and protect addict, part of family may confront, part of family may feel the addict is more valued

THE FAMILY PHASES - ADULT (PARENT) ADDICT

THE LEARNING PHASE o May enjoy the “fun”o Spouse may like the changeo Children may enjoy the “Dad’s so funny

when he is drinking”o No negative consequenceso May notice an increase in frequency,

but no problems yet

SEEKING/MISUSE PHASE

o May start to wonder “is this happening too often?”

o May discuss – but rationalize, justify – denial starts to build

o May notice increase in activities away from family with drinking/using friends

o May start to make excuseso Seeking answers and solutions – realize

there may be a problem

HARMFUL PHASE

o Recognize there is a problemo Family members start to blame each othero Think their behavior caused the problemo Guilt, blame, isolationo Denial buildso Emotions start to shut downo Over attempts to control or detach or be

good or be bad

ESCAPE PHASE

o Major repeated crisis: financially, work, social, legal

o Becomes “normal” to have to deal with crisis

o Emotional exhaustion, outbursts, shut down

o Isolation – the family breaks o Part of family may continue to support

and protect addict, part of family may confront, part of family may feel the addict is more valued

FAMILY ROLES – PRIMARY ENABLER

Every addict/alcoholic has an enabler – usually several enablers – spouse, parent, friends, work, system etc.Almost all family members may initially be enablers – usually one or two stands out as primaryStarts with good intentions – wanting to help – out of love and caring

PRIMARY ENABLER

Primary job of the enabler is to protect the addict/alcoholic and family from the consequences of addictionMakes excuses, covers up, cleans up, picks up the piecesGives money, calls work, bail-out, takes over responsibilityOn one hand feels important and needed – on the other hand feels used and resentful

PRIMARY ENABLER

May enable out of guilt, shame, inadequacies The addict/alcoholic becomes the enablers addictionStarts to develop anxiety, depression, exhaustionDepletion of finances, emotions, health, spiritual

PRIMARY ENABLER

Own needs go unmetUnable to set boundariesFinancial problemsAnxietyDefensivenessUses drugs/alcohol to relax, rest, medicate

NurturingHelping professionGood with peopleWell organizedDependableEfficient

RESPONSIBLE ONE

Acts like an adult – accepts adult responsibilities - matureOrganized Puts others before selfWell behavedBelieves he/she can “fix it”

RESPONSIBLE ONE APPEARS

DependableStrongWell-adjustedHonestHas it all togetherSets and accomplishes goalJob is to make it all better

WHAT THE RESPONSIBLE ONE FEELS

InadequateCan’t depend on othersWorks hard to create stability, stay busySelf-esteem is performance basedThinks if he/she is good enough it will change thingsDifficulty expressing feelings

RESPONSIBLE ONE

Fears failurePerfectionistDifficulty having funDifficulty developing relationshipsWorkaholicMay become an alcoholic or marry oneDrinks/uses to relax; have fun

Teacher/employer’s dreamGreat leader/administratorCompetentDisciplinedOrganized

SCAPEGOAT

Trouble maker“Problem child”RebelliousBegins using at an early ageMay be violent and aggressiveJob is to take the focus off the real problem

SCAPEGOAT APPEARS

Hostile and violentProblem kidIrresponsibleCriminalDefiantIronically, the only one who is acting normal to the chaos in the family

WHAT THE SCAPEGOAT FEELS

Lack self-confidenceHurtAngryRejectedAbandonedSearches for belonging

SCAPEGOAT

Leaves home earlyCriminal recordDesire to “belong” leads to risky peer groups – gangs; users/drinkersUses drug/alcohol to give relief; feed anger, hostility;

AssertiveTakes positive risksStreetwiseConnects in a positive helpful way to those in troubleHandles pressure well

THE INVISIBLE/LOST CHILD

Quiet - ShyWithdrawnLonerSensitive – yet detachedConforms – followsDoesn’t seem to react or notice anything

LOST/INVISIBLE CHILD APPEARS

Lack of personalityLow expectationsDoesn’t noticeDifficulty connecting to or reading emotions with this personJob is to not cause trouble – not bring attention to anything

WHAT THE LOST/INVISIBLE CHILD FEELS

LonelyUnimportantInsecureFear of othersAbandoned – defeatedWhy try?

LOST/INDIVIDUAL CHILD

DepressionPromiscuityIndecisiveLow self-esteemInability to set boundariesUses alcohol/drugs to feel more at ease with others; to become more outgoing

CreativeImaginativeIndependentResourcefulTalented

THE CLOWN

Class clownDisruptiveHyperactiveProblems at school/workImmature

THE CLOWN APPEARS

Takes nothing seriousUnsettledTake unnecessary risksThrives on excitement

WHAT THE CLOWN FEELS

FearBoredomRestlessUnsatisfied

THE CLOWN

Difficulty expressing feelingsSeems insensitiveDifficulty being seriousJob is to provide comic relief- take the focus off the real problemUses drug/alcohol for excitement, to share feelings, to be “real”

Good with peopleMakes people laughGood in social situationsGood under pressure“Life of the party”Everybody loves a clown

BASIC MESSAGES LEARNED IN THE ADDICTED FAMILY

DON’T TALK

DON’T TRUST

DON’T FEEL

UNTANGLING THE MESS – WHERE TO START?

Sometimes treatment starts with the enabler Treatment types that is available:Outpatient – beneficial at the learning, seeking, harmful use/abuse/dependence phase, use to feel normal/addiction phase, after care and recoveryInpatient – beneficial at the use to feel normal/addiction phase – 28 days

UNTANGLING THE MESS – WHERE TO START?

Long term residential – beneficial after 28 day inpatient for those that have had multiple attempts at treatment and for those who may have no other place to go because they have burned all their bridgesSupport groups/Faith Based Groups – AA/NA/Celebrate Recovery etc – beneficial at any phase but in early phases (learning and seeking) members usually think it doesn’t relate to them – they are THAT BAD

UNTANGLING THE MESS – WHERE TO START?

Methadone/Suboxone Clinics – beneficial for those addicted to opiate based drugs – oxycotin, heroin, prescription drugs Treatment for the enabler and Children of Alcoholic/addicts may include outpatient tx or simply education through reading, research etc.

FOR MORE INFORMATION ON ADDICTION VISIT

SAMHSA AND NAADAC WEBSITES FOR FREE INFORMATION

THANK YOU