THE BASICS OF ADDICTION

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

2. BECAUSE THEY WORK! WHY DO PEOPLE USE DRUGS AND ALCOHOL?

3. 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 HUH?

4. Visit SAMHSA FOR STATISTICS ON SUBSTANCE ABUSE AND ADDICTION The problem is that substance abuse and addiction creates many more problems than it helps. So what’s the problem??????

5. 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 Substance abuse and addiction Affects…

6. 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 BUT YOU ALREADY KNEW THAT….

7. 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 SO HOW DOES IT HAPPEN?

8. Pain NORMALEuphoria xx Feelings range from Normal to Euphoria and back to normal – it’s all good EXPERIENTIAL/LEARNING PHASE

9. Social use Parties Weddings Sports Entertainment Business Rules apply – when, where, how many SEEKING PHASE/misuse

10. 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

11. PainNORMALEuphoria xx Feelings range from Normal to Euphoria to occasional discomfort and back to normal – occasional hangover, headache, DUI SEEKING PHASE/misuse

12. 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 SEEKING/MISUSE PHASE

13. 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

14. 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/dependency

15. PainNORMALEuphoria xx Feelings 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. Harmful use/abuse/dependence PHASE

16. 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

17. 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

18. Pain NORMAL Euphoria xx Feelings range from Pain to low Normal if at all No longer feels Euphoria – not sure what normal is Using to feel normal/addiction PHASE

19. THE LEARNING PHASE • Parents may struggle with it is “normal for kids to experiment” • They will grow out of it – it’s just a phase • Trust is tested • Feel they can’t say anything because they did it too • One parent may hide adolescent’s use from other parent – try to protect – not cause stress The family phases - parents dealing with adolescents OR ADULT CHILD ADDICTS/ALCOHOLICS

20. Parents start to wonder “is this happening too often?” • Parents may discuss – but rationalize, justify – denial starts to build • Parents may start to set rules, consequences, efforts to control • 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 • Seeking answers and solutions – realize there may be a problem SEEKING/misuse PHASE

21. Recognize there is a problem • Parents start to blame each other • Think their behavior caused the problem • Guilt, blame, isolation • Denial builds • Emotions start to shut down • Over attempts to control or detach HARMFUL PHASE

22. Major repeated crisis: financially, work, social, legal • Becomes “normal” to have to deal with crisis • Emotional exhaustion, outbursts, shut down • Isolation – the family breaks • 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 ESCAPE PHASE

23. THE LEARNING PHASE • May enjoy the “fun” • Spouse may like the change • Children may enjoy the “Dad’s so funny when he is drinking” • No negative consequences • May notice an increase in frequency, but no problems yet The family phases - Adult (Parent) addict

24. May start to wonder “is this happening too often?” • May discuss – but rationalize, justify – denial starts to build • May notice increase in activities away from family with drinking/using friends • May start to make excuses • Seeking answers and solutions – realize there may be a problem SEEKING/misuse PHASE

25. Recognize there is a problem • Family members start to blame each other • Think their behavior caused the problem • Guilt, blame, isolation • Denial builds • Emotions start to shut down • Over attempts to control or detach or be good or be bad HARMFUL PHASE

26. Major repeated crisis: financially, work, social, legal • Becomes “normal” to have to deal with crisis • Emotional exhaustion, outbursts, shut down • Isolation – the family breaks • 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 ESCAPE PHASE

27. 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 primary Starts with good intentions – wanting to help – out of love and caring Family roles – primary enabler

28. Primary job of the enabler is to protect the addict/alcoholic and family from the consequences of addiction Makes excuses, covers up, cleans up, picks up the pieces Gives money, calls work, bail-out, takes over responsibility On one hand feels important and needed – on the other hand feels used and resentful Primary enabler

29. May enable out of guilt, shame, inadequacies The addict/alcoholic becomes the enablers addiction Starts to develop anxiety, depression, exhaustion Depletion of finances, emotions, health, spiritual Primary enabler

30. Primary enabler • Own needs go unmet • Unable to set boundaries • Financial problems • Anxiety • Defensiveness • Uses drugs/alcohol to relax, rest, medicate • Nurturing • Helping profession • Good with people • Well organized • Dependable • Efficient

31. Acts like an adult – accepts adult responsibilities - mature Organized Puts others before self Well behaved Believes he/she can “fix it” Responsible one

32. Dependable Strong Well-adjusted Honest Has it all together Sets and accomplishes goal Job is to make it all better responsible one appears

33. Inadequate Can’t depend on others Works hard to create stability, stay busy Self-esteem is performance based Thinks if he/she is good enough it will change things Difficulty expressing feelings What the responsible one feels

34. Responsible one • Fears failure • Perfectionist • Difficulty having fun • Difficulty developing relationships • Workaholic • May become an alcoholic or marry one • Drinks/uses to relax; have fun • Teacher/employer’s dream • Great leader/administrator • Competent • Disciplined • Organized

35. Trouble maker “Problem child” Rebellious Begins using at an early age May be violent and aggressive Job is to take the focus off the real problem scapegoat

36. Hostile and violent Problem kid Irresponsible Criminal Defiant Ironically, the only one who is acting normal to the chaos in the family Scapegoat appears

37. Lack self-confidence Hurt Angry Rejected Abandoned Searches for belonging What the scapegoat feels

38. scapegoat • Leaves home early • Criminal record • Desire to “belong” leads to risky peer groups – gangs; users/drinkers • Uses drug/alcohol to give relief; feed anger, hostility; • Assertive • Takes positive risks • Streetwise • Connects in a positive helpful way to those in trouble • Handles pressure well

39. Quiet - Shy Withdrawn Loner Sensitive – yet detached Conforms – follows Doesn’t seem to react or notice anything The invisible/lost child

40. Lack of personality Low expectations Doesn’t notice Difficulty connecting to or reading emotions with this person Job is to not cause trouble – not bring attention to anything lost/invisible child appears

41. Lonely Unimportant Insecure Fear of others Abandoned – defeated Why try? What the lost/invisible child feels

42. Lost/individual child • Depression • Promiscuity • Indecisive • Low self-esteem • Inability to set boundaries • Uses alcohol/drugs to feel more at ease with others; to become more outgoing • Creative • Imaginative • Independent • Resourceful • Talented

43. Class clown Disruptive Hyperactive Problems at school/work Immature THE CLOWN

44. Takes nothing serious Unsettled Take unnecessary risks Thrives on excitement The clown appears

45. Fear Boredom Restless Unsatisfied What the clown feels

46. The clown • Difficulty expressing feelings • Seems insensitive • Difficulty being serious • Job is to provide comic relief- take the focus off the real problem • Uses drug/alcohol for excitement, to share feelings, to be “real” • Good with people • Makes people laugh • Good in social situations • Good under pressure • “Life of the party” • Everybody loves a clown

47. DON’T TALK DON’T TRUST DON’T FEEL Basic messages learned in the addicted family

48. 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 recovery • Inpatient – beneficial at the use to feel normal/addiction phase – 28 days UNTANGLING THE MESS – WHERE TO START?

49. 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 bridges • Support 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?

50. Methadone/SuboxoneClinics – 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. UNTANGLING THE MESS – WHERE TO START?