Substance Abuse & Addiction

1. Kerry Herndon, MSW, LAC-E Western Montana Addiction Services Project SUCCESS- Sentinel HS Substance Abuse & Addiction

2. Theories of Addiction • Medical Model • Addiction as a Disease • Neurotransmitter imbalance • Treat with Medication • Psychodynamic Model • Drugs are used for self-medicating • Symptoms of an underlying mental health disorder • Psychological coping strategy • Social Model • Learned behavior • Peer pressure/modeling others • Environmental effects, such as social media, lead to use • Used to try to fit in or build a relationship • Morel Model • Addicts are weak and need to overcome compulsions • Substance use is a choice, addicts can stop at anytime • People who use are anti-social and should be punished • Evil!!! • Bio-Psycho-Social Model • Combination of all the above factors • Treatment should address mind, body, spirit and include the individual as well as factors in the environment. • Maslow’s Hierarchy of Needs

3. Continuum of Use

4. Early Use = Increased Addiction Risk

5. The Brain & Addiction • The front part of the brain exists to tell us to slow down or stop impulsive behaviors. It tells us to “stop” if things are too risky. • The front part of the brain is still developing connections to the rest of the brain until around age 25. Adolescent brains lack some wiring that carries out the “stop” message to the rest of the brain. • Late adolescence, before the brain is matured is the peak time for developing dependency on drugs/alcohol. • Heavy substance use at peek times in brain development can cause permanent changes to the brain. (HBO Box Office, Inc, 2007)

6. The Brain “It is not unusual in recovery to see someone in their late thirties or even early forties struggle with planning and problem-solving – being on time, balancing a checkbook – in exactly the same way a teenager does. That’s because the process of learning those skills stopped when he began using. Now he’s struggling to catch up.” (HBO Box Office, Inc, 2007) –

7. Risk Factors • Early Use • About 50% of vulnerability linked to genetics • Insufficient parenting • Lack of family communication • Exposure to a traumatic event • Parental substance use • Perceptions that parents, community and key adults approve of alcohol or drug use. • Poor social & academic performance • Friendships with kids who have been in trouble • Co-occurring disorders (ADHD, Emotional disorders, psychiatric disorders, etc.) (HBO Box Office, Inc, 2007)

8. Mental Health “More than half of young people with a substance-abuse diagnosis also have a diagnosable mental illness” (HBO Box Office, Inc, 2007) Often times the mental illness has not yet been identified or diagnosed.

9. Physiological Addiction Some Substances Some Symptoms Changes in sleeping habits Withdrawal Symptoms Tolerance Change in Eating Habits Weight Loss/Gain Changes in Physical Appearance • Xanax • Valium • Alcohol • Anti-Depressants • Tobacco • Heroin (Opiates) • Caffeine • Meth Many substances are both physiologically and psychologically addictive.

10. Psychological Addiction Some Examples Some symptoms Use to forget problems/relax Withdraw or Keep Secrets Loss of Interest in Activities Problems with School/Work Changes in Friends Spend a lot of time thinking about how to get the substance Stealing or Selling Belongings Failed attempts trying to quit Anxiety, Anger or Depression Mood Swings • Cannabis/Marijuana • Cocaine • LSD • Ecstasy/MDMA • Sugar • Eating Disorders • Gambling • Shopping • Gaming • Smart phones (??)

11. Diagnosing • Written questionnaires • Personal interview with client • Talking to others DO NOT LABLE OR DIAGNOSE YOUR FRIENDS

12. Substance Abuse • Failure to fulfill major life obligations due to recurrent use: • School • Athletics • Family • Etc. • Recurrent use in physically harmful or risky situations • Recurrent substance related legal issues • Continued use despite persistent or recurrent social or interpersonal problems caused or made worse by substance use

13. Chemical Dependency • Tolerance • Withdrawal • Large amounts in shorter period than intended • Increased desire to quit/ failed attempts to quit • More time thinking about use • Change in behaviors/ decreasing normal activities • Continues despite consequences

14. Stages of Change Takes most individuals approximately 3x for success

15. Maslow’s Hierarchy of Needs

16. Treatment Options- Adolescent • Education • Project Success • School Based Services • Level I – Stages • Level II – Intensive Outpatient Treatment • Level III - In-patient Treatment • Congruent care with a mental health professional or family therapy

17. Helping a Friend/Family Member • Remember it is not your responsibility to fix them • Remember that it is hard to admit that help is needed • Remember it is not your fault that they use • Remember that listening is better than giving advice • Remember to seek help for yourself • Remember to take care of yourself • Remember you have resources to help • See Project Success if you are concerned about a family member or friend

18. Resources • HBO Box Office, Inc. (2007). Addiction: Why Can't they Just Stop? New York: Rodale.