Addiction and Recovery: A Wellness Perspective

Shirley Gedney-Rubel

Southern New Hampshire University

Addiction and Recovery: A Wellness Perspective

•Addiction is a serious public health issue

•Addiction affects personal functioning in many areas

•Recovery is often a lifelong struggle

Eight Dimensions of Wellness

Figure 1. Substance Abuse and Mental Health Services Administration, 2014

What is Addiction?•Addiction is a primary chronic disease of

brain reward

•Characteristics: Compulsive using and cravings with periods of recovery often followed by relapse

•Addiction is progressive and may result in disability or premature death

American Society of Addiction Medicine, 2015.

What is Recovery?

Substance Abuse and Mental Health Services Administration, 2014

•Recovery is a process of change

• Individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential

•Recovery is built on access to evidence-based clinical treatment and recovery support services

Moral Theories of Addiction

Moral Theories of Addiction

• Proposes that addiction is a personal choice

• Individuals lack willpower and moral principles

• Emphasizes punishment over rehabilitation

Capuzzi & Stauffer, 2012.

Biological Theories of Addiction

Biological Theories of Addiction• There are many biopsychological theories of

addiction

•Commonalities include adaptations of neural pathways, changes in neurochemistry, craving, and relapse

•Of particular interest is the reward pathway and the neurotransmitter dopamine

Skinner & Aubin, 2010.

Addiction and Recovery: A Wellness Perspective

• The moral model fails to account for physical symptoms

•Brain imaging shows changes in structure and function

• Empirical studies support a biological basis for addiction

National Institute on Drug Abuse, 2012.

Traditional Treatments

Complementary Therapies

Economics of Addiction

Economic Impact of Addiction

Figure 2. National Institute on Drug Abuse, 2008.

Economic Impact of Addiction

Figure 3. "National Drug Control Budget: FY 2016 Funding Highlights" (Washington, DC: Executive Office of the President, Office of National Drug Control Policy), February 2015, Table 3, p. 18.

The Cost of Recovery

Figure 4. Incarcerated women have high rates of substance abuse, mental disorders, and other health problems. *Note: Graph shows lifetime percentages except for multiple drugs, alcohol, and cocaine, which are the percentage reporting use in the 30 days prior to incarceration. (N=60). Drugabuse.gov, 2014.

The Human Cost

Addiction and Recovery: A Wellness Perspective

References• American Society of Addiction Medicine (ASAM). (2015). Definition of addiction.

[Web]. Retrieved Feb. 1, 2015, from http://goo.gl/YXD01

• Brewer, J., Elwafi, H., & Davis, J. (2013). Craving to quit: Psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions. Psychology of Addictive Behaviors, 27(2), 366-379. doi:10.1037/a0028490

• Capuzzi, D., & Stauffer, M. (2012). Foundations of addictions counseling (2nd ed.). Upper Saddle River, NJ: Pearson Education, Inc.

• Executive Office of the President of the United States. (2015). National drug control budget: FY 2016 funding highlights. Retrieved April 21, 2015, from http://goo.gl/rzbg9E

• Foddy, B., & Savulescu, J. (2010). A liberal account of addiction. Philosophy, Psychiatry, & Psychology, 17(1), 1-22. doi:10.1353/ppp.0.0282

References• Hyman, S. (2005). Addiction: A disease of learning and memory. The American

Journal of Psychiatry, 162(8), 1414-1422. doi:10.1176/appi.ajp.162.8.1414

• International Narcotics Control Board. (2014). Report of the International Narcotics Control Board for 2013. [Web]. Retrieved March 25, 2015, from http://goo.gl/OvzVQ7

• Khanna, S., & Greeson, J. (2013). A narrative review of yoga and mindfulness as complementary therapies for addiction. Complementary Therapies in Medicine, 21(3), 244-252. doi:10.1016/j.ctim.2013.01.008

• McGinty, E., Goldman, H., Pescosolido, B., & Barry, C. (2015). Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination. Social Science & Medicine, 126, 73-85. doi:10.1016/j.socscimed.2014.12

• National Institute on Drug Abuse. (2012). Medical consequences of drug abuse. [Web]. Retrieved March 25, 2015, from http://goo.gl/v5E49j

References• Office of National Drug Control Policy. (2012). Fact sheet: Cost benefits of investing

early in substance abuse treatment. Retrieved March 25, 2015, from http://goo.gl/6TMai3

• Skinner, M.D., & Aubin, H.-J. (2010). Craving’s place in addiction theory: Contributions of the major models. Neuroscience and Biobehavioral Review, 34, 606-623. doi:10.1016/j.neubiorev.2009.11.024

• Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). Recovery and recovery support. [Web]. Retrieved March 25, 2015, from http://goo.gl/l5LExS

• Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). Wellness home. [Web]. Retrieved March 25, 2015, from http://goo.gl/TjuQF7

• Wise, R. A., & Koob, G. F. (2014). The development and maintenance of drug addiction. Neuropsychopharmacology, 39, 254-262. doi:10.1038/npp.2013.261