Substance Abuse & Counseling - Exam 1
- UHV, Loffredo
(2023 Update A+)
A Theory is: - ANS-a "statement or set of statements designed to explain a
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phenomenon based upon observations and experiments and often agreed upon by
most experts in a particular field"
Five Aspects of Substance Abuse - ANS-1) Initiation: why people begin to use drugs
2) Continuation: why they continue to use or abuse drugs
3) Addiction: wh some people escalate to dependence on drugs and others do not
4) Recovery: why some people quite using drugs and others do not
5) Relapse: why some people remain clean and/or sober and others do not
Moral Theory - ANS-- that people who could not "hold" their liquor were considered to
be morally corrupt, this had roots in the Puritan belief system and prevailed through
much of the 18th and 19th centuries
- Temperance Movement: during the Civil War, the growing sentiment was that alcohol
was a sin and this sentiment led to the 18th amendment in 1919
Moral Theory: Initiation - ANS-drug use begins with social influences and an acute
reinforcement, such as relief from a negative emotional state... therefore, moral
deficiencies include "a means to cope with painful and threatening emotions"
- disrupted families, lack of parental supervision, behavioral problems, drug-using
parents, etc.
- self-regulation (either underregulation or misregulation) can lead to addition
Moral Theory: Continuation - ANS-perceived rewards perpetuate the continued use of
the drug. rewards can be as simple as an increase in energy, or fatigue reduction after
using caffeine, reduction in physical pain, increased alertness or performance, or
reduction of anxiety.
- becoming dependent on the result leads to addiction, and to achieve the same effect
continued use of the drug must increase in quantity
- masks underlying physical or emotional problems
Moral Theory: Addiction - ANS-- initial motivation as listed in the initiation phase
- the sign of addiction is the absence of choice the user has over the drug use.
- the user's identity and functioning are so connected with the drug that it becomes
impossible for the addict to envision life without the drug.
Moral Theory: Recovery - ANS-- the sue must develop alternative rewards to replace
the gratification of the drug experience
- for example, alternative pain management, stress management, cognitive therapy, etc.
- "maturing out" the process related to psychological maturation that takes place
between the ages of 18-35
Moral Theory: Relapse - ANS-occurs when the needs and the lifestyle of the addict are
not addressed when drug use is ceased
Moral Theory: Conclusion - ANS-- moral theory purports that addiction can be "cured"
- through this lens, alcoholism is an accumulation of choices that include definition of
self and willingness to accept responsibility
- drinkers will increase drinking as problems/stress increases
- conversely, a soldier who abuses during wartime may not abuse during peacetime
because it's a less stressful environment
PITFALLS: focuses exclusively on individual ability (willpower) and characteristics to
control or quit drug use and ignores the compounding factors of genetics and
environment
Disease Theory: Initiation - ANS-does not specifically address "why" an individual
chooses to take the first drink of alcohol, however, Jellenik's Pre-Alcoholic Phase
describes use as being socially motivated
- it is postulated that individuals with the disease of addiction do not know they have it
until they start using.
- abstinence as prevention (and treatment) is strongly recommended within this theory
Disease Theory: Continuation - ANS-according to Jellenek, the next phase is
PRODROMAL Phase, the individual uses alcohol early in the disease to relieve pain,
whether pain be physical, emotional, tension, or other stress. DWI and memory
blackouts can occur during this phase, however, the user will continue the alcohol use
despite negative consequences. Next is the CRUCIAL phase... page 102
Disease Theory: Addiction - ANS-Jellinek's CHRONIC Phase (the final phase)
describes the drinking as a total loss of control and the loss of a choice to drink.
(morphine-like alkaloids, THIQs, pg. 103)
Disease Theory: Recovery - ANS-an alcoholic or addict is never considered cured, only
"in remission," "recovering," or a "non practicing" alcoholic or addict.
- Recovery therefore, is focused on abstinence
- Yet, some addicts believe they can deny responsibility for change by having a
"disease"
Disease Theory: Relapse - ANS-relapse is seen as "failure" on the part of the individual
who is working a recovery program
- Five Subtypes of Alcohol Dependence:
1) Young Adult
2) Functional
3) Intermediate Familial
4) Young Antisocial
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