ADDICTION & RECOVERY 101The Basics of Drug Addiction and The Process of Recovery for CASA Volunteers

Edmund Smith, CDP

Part I: What is ‘Addiction’

Part II: Factors of Change

Part III: What is ‘Recovery’

Part IV: Relationship to CASA / VGAL Field Work

Part V: Open Discussion / Q & A

Brief Bio (who am I):

• Chemical Dependency Professional (CDP) certification granted in 2003

• Provided Group & Individual Counseling Services at CD Treatment Agencies

• Conducted Chemical Dependency Assessments using DSM 4 & ASAM PPC2-R Criteria

• Delivered Prevention and Intervention Services to Middle School Youth

• Coordination of a Drug Court Program

• Born and raised in Philadelphia, enjoy Cheesesteaks & watching the Eagles win

games!

Part I: What is ‘Addiction’

TRUE or FALSE:

“Addicts and Alcoholics (who are actively using) only seek out help when they have to”.

Definition of Substance Addiction:

“The compulsive need for and use of a habit-forming substance

characterized by tolerance and by well-defined physiological symptoms

upon withdrawal; broadly :  persistent compulsive use of a substance

known by the user to be harmful” – Merriam-Webster

(Methamphetamine vs. Chardonnay Example)

Michele’s Story

What were some factors that contributed to Michele’s Alcoholism?

What were some factors that contributed to Michele seeking help?

Factors / Causes of Drug Addiction: Nature vs. Nurture

Like many mental health disorders, several factors may contribute to development of drug addiction and dependence. The main factors are:

EnvironmentEnvironmental factors, including your family's beliefs and attitudes and exposure to a peer group that encourages drug use, seem to play a role in initial drug use.

Genetics Once you've started using a drug, the development into addiction may be influenced by inherited (genetic) traits, which may delay or speed up the disease progression.

Changes in the brainPhysical addiction appears to occur when repeated use of a drug changes the way your brain feels pleasure. The addicting drug causes physical changes to some nerve cells (neurons) in your brain. Neurons use chemicals called neurotransmitters to communicate. These changes can remain long after you stop using the drug.

(Mayo Clinic Staff)

Drug Use directly interferes with the brain’s “normal process” of

neurotransmission by blocking receptors, thereby causing an

overproduction of the neurotransmitter (Dopamine, GABA,

Serotonin)

The “Disease of Addiction”

The 24th Edition of the Stedman’s Medical Dictionary provided the following definitions.

1. A disease is a morbus, an illness, a sickness that causes an interruption, cessation, or disorder of bodily functions, systems, or organs

2. A disease is an entity characterized by at least two of these criteria:

(1)a recognized etiologic agent (or agents);

(2)an identifiable group of signs and symptoms; or

(3) consistent anatomical alterations of known body systems.

Dr. Daniel Amen Brain Scans

Definition of Addiction Definition of Addiction

American Society of Addiction Medicine (ASAM)

Short Definition of Addiction:

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

Faces of Meth

Part II: Factors of Change

Stages of Change*

* The Stages of Change Model was originally developed in the late 1970's and early 1980's by James Prochaska and Carlo DiClemente at the University of Rhode Island when they were studying how smokers were able to give up their habits or addiction.

Contemplation Stage – The Beginning of Change

Legal Consequences

Health Issues

Marital Problems

Removal of Children (CPS / DCFS)

Employment Threatened

Mental Health Problems

Family Intervention

Contemplation Stage – The Beginning of Change

Bill Wilson Movie Clip (5 Min)

Preparation Stage – Taking Steps

The Substance Use Assessment

DSM-5 Substance Use Disorder Criteria (11)Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (APA)

• Hazardous Use• Social / Interpersonal Problems• Withdrawal • Tolerance (2 criterion)• Use larger amounts longer• Repeated attempts to quit• Much time spent using• Physical / Psychological Problems related to use• Actives given up to use• Carving ___________________________________________________________

0-1: Education / 2-3: Mild Substance Use Disorder / 4-5: Moderate Substance Use Disorder

6 or more: Severe Substance Use Disorder

NOUN

1. “a return to a normal state of health, mind, or strength”

Definition of “Recovery”:

Part III: What is ‘Recovery’

Action Stage – Making Changes

Engaging in Treatment (Abstinence Begins)

Levels of Care of Substance Use Disorder Treatment

The ASAM criteria conceptualize treatment as a continuum marked by five basic levels of care, which are numbered in Roman numerals from Levels 0.5 through Level IV. Thus, the ASAM criteria provides the addiction field with a nomenclature for describing the continuum of addiction services, as follows:

 

Level I: Outpatient Services

Level II: Intensive Outpatient/Partial Hospitalization Services

Level III: Residential/Inpatient Services

Level IV: Medically Managed Intensive Inpatient Services

Maintenance – The Long Road of Long Term Recovery

Internal vs. External Motivation (“want to” vs. “have to”)

• Treatment ends / External Motivators fall away

• Ongoing use of Sober Supports (12 Step Groups, Sponsor, Faith based,

other)

• New coping strategies are developed in Recovery

• Gain Self Confidence (vs. arrogance)

• Biological “rhythms return” (sleeping / eating / general health)

• Return to Society (Employment / Community Member / Etc).

• Examination of Spiritual Beliefs (“I am a part of the whole – “Right Sized”)

• Help others in need

• Begin domestic or ‘family life’

Part IV: Relationship to CASA / VGAL Field Work

• Primary reason for removal of children in Dependency Cases

• Contact / Interaction with Parents who abuse Drugs & Alcohol

• Common Drugs of Addiction in Washington State

• Signs of Use (Stimulants, Alcohol, Opiates, Marijuana)

• Your safety first – always!

General Discussion / Q&A

My Contact Email: skagitedmund@aol.com