UNDERSTANDING ADDICTION

Aika Mae G. Borbon, RPm

DOH-TRC Dulag, Leyte
 UNDERSTANDING ADDICTION

1. Addiction as a brain disease

2. Factors that contribute to drug addiction
3. Phases of addiction
4. Signs and symptoms of drug abuse
5. Defense Mechanisms
6. Protective factors
ADDICTION AS A BRAIN DISEASE
 What are drugs?

any substance other than

food and water that is
intended to be taken for the
purpose of altering or
controlling physical, mental
or emotional state of the
person taking it
 Drugs can be divide into
three categories:

Legal social drugs like alcohol

and caffeine
Legal medicinal drugs like pain
killers
Illegal & prohibited drugs like
shabu and marijuana
 Drug Abuse

Use of any chemical substance,

legal or illegal, which results in an
impairment of person’s physical,
emotional or social aspect
 Drug Dependence

A state of physical and

psychological dependence or both
on a dangerous drug, or drugs,
experienced by a person following
the use of that substance on a
periodic or continuous basis.
 Drug Addiction

A complex, and often chronic,

brain disease. It is characterized
by excessive drug craving, seeking
and use. Addiction is caused by
brain changes caused by constant
drug use.
 Human Brain

✓Regulates all body

functions
✓Shapes our thoughts,
emotions, and behavior
✓Interpret and respond
to everything we
experience
Human Brain

All substances
target the
brain
The Reward Pathway
 The Reward Pathway

The reward pathway plays a key role in drug

addiction.

When activated by a rewarding stimulus (e.g.

bonding, eating, sex), information travels from the
Ventral Tegmental Area (VTA) to the nucleus
accumbens and prefrontal cortex.

Neurons of the VTA releases dopamine to the

other parts of the brain.
 How does the brain become
addicted?
A person takes a drug of abuse activating the same
brain circuit as do behaviors linked to SURVIVAL such
as EATING, BONDING & SEX

The drug causes a surge in levels of a brain chemical

called DOPAMINE which results in feelings of
PLEASURE. The brain then remembers this pleasure
and wants it repeated
Trigger – Thought – Craving
 How does the brain become
addicted?
Just as food is linked to survival in day-to-day living,
drugs begin to take on the same significance for the
addict

Drive to seek and use the drug is all that matters

despite consequences

Control and choice and everything that once held a

value in persons life are lost to the disease of
addiction
Addiction as a Brain Disease

Long-term drug
abuse impairs brain
functioning.
It changes the brain
in fundamental and
lasting ways.
FACTORS THAT CONTRIBUTE TO
DRUG ABUSE
 Factors that Contribute to the
Development of Substance Abuse

Drug addiction may be considered as a

result of the intersection between drug
use, environmental factors, educational
factors and those factors configuring the
intimate structure of personality
 Factors that Contribute to the
Development of Substance Abuse

Biological

Psychological

Social/Environmental
 Why Do People Take Drugs?

• TO FEEL GOOD - Most abused

drugs produced intense feeling
of pleasure.

• TO FEEL BETTER - Some people

who suffer from social anxiety,
stress related disorders begin
abusing drugs in attempt to
lessen feelings of distress.
Why Do People Take Drugs?

• TO DO BETTER - The
increasing pressure that
some individuals feel to
chemically enhance or
improve their athletic or
cognitive performance.

• CURIOSITY & CONFORMITY -

Adolescents are particularly
vulnerable due to strong peer
pressure.
PHASES OF DRUG ADDICTION
 Phases of Drug Addiction

1. Abstinence
2. Experimentation
3. Social/Recreational Use
4. Habituation
5. Substance Abuse
6. Substance Dependence
 (1) Abstinence

No substance use.
 (2) Experimentation
• Curiosity -tries a drug for the first time
• Feel negative experiences on the effects.
- For example, 1st time smoker is likely to cough,
cigarette smoke brings tear to his/her eyes, may
even experience vomiting and dizziness
• Done only when they are made available with
his/her “druggie” friends.
• If the beginner user did not stop he/she will be
elevated to the next phase.
 (3) Social/Recreational Use
• Starting of pattern use
• Uses drug only if available
• Uses and stop anytime he/she wants to
• Does not have a craving yet for drugs or go out of
his way to look for drugs
• Begins to concentrate on using one particular drug
• Drug use increases, once or twice a week
 (4) Habituation
• similar to acclimatize, in that repetition of certain
behaviors that are rewarding will likely be
established and continued consciously or
unconsciously
• Habit of drinking one glass a day?
 (5) Substance Abuse
• A maladaptive or abnormal pattern of substance
use manifested by recurrent and significant adverse
consequences related to the repeated use of
substances.
✓ Failure to fulfill major role obligations
✓ Recurrent use in situations which is physically
hazardous
✓ Recurrent substance-related legal problems
✓ Continued use despite social/interpersonal
problems
 (6) Substance Dependence
• a psychological and sometimes physical state
characterized by a compulsion to use a drug to
experience psychological or physical effects
• characterized by the repeated use of substances or
behaviors despite clear evidence of morbidity
secondary to such use
 (6) Substance Dependence
Tolerance
“a need for markedly increased amounts of the substance
to achieve intoxication or desired effect or a markedly
diminished effect with continued use of the same
amount of substance”

Withdrawal
“the development of a symptom/symptoms due to the
cessation of (or reduction in) substance use that has been
heavy and prolonged that causes clinically significant
distress or impairment in social, occupational and other
areas of functioning”
SIGNS AND SYMPTOMS OF DRUG ABUSE
 SUBTLE SYMPTOMS

• SECRECY - tends to become secretive

• INCREASING ISOLATION - prefers to be alone,

less socialization, less with his/her old
friends

• CHANGE IN FRIENDS - spends more time

with other drug abusers with new sets of
friends
 SUBTLE SYMPTOMS

• CHANGE IN DRESS AND APPEARANCE - may

no longer care much about he/she looks

• CHANGE OF INTERESTS OR ACTIVITIES -

his/her time devoted to drug use or to
looking for his supply of drugs

• CHANGE IN BEHAVIOR (both at home and in

school)
 ADVANCED SYMPTOMS

• PERIOD OF DEEP DEPRESSION (depressed

mood, extremely sad or gloomy and feeling
in despair)-depressions are accompanied by
hours of extra sleep

• INCREASE UN-EXPLAINED ABSENTISM

• MONEY PROBLEMS
 ADVANCED SYMPTOMS

• MONEY PROBLEMS

• EXTREME LOSS OF WEIGHT/GAIN - decrease

or increase appetite/irregular eating habit

• EXPULSION FROM SCHOOL

• ASSAULTIVE BEHAVIOR

• REBELLIOUS OR OFFENSIVE BEHAVIOR

 ADVANCED SYMPTOMS

• APPEARANCE OF NEW, USUALLY OLDER,

FRIENDS

• ACTING QUEERLY - absentminded or

disconnected

• AVOIDING ISSUE OF DRUG USE WHEN ASKED

ABOUT IT
 FOOL-PROOF INDICATORS
• Possession of drugs/paraphernalia
• Needle marks
• Spending time with known drug abusers
• Defending teen use of drugs
• Mention of suicide or an attempt at suicide
• Arrest due to drug related case
• Possession of unusual large amount of money
• Repeatedly having blood shot eyes
• Dilated or pin point eye pupils
• Droopy eyelids
Common Characteristics of People who
are Addicted

• Unemployed or employed
• Multiple or no criminal justice contacts
• Difficulty coping with stress or anger
• Highly influenced by social peer group or a
loner
• Difficulty handling high-risk relapse
situations or craves excitement
 DEFENSE MECHANISMS OF
THE ADDICTIVE PERSONALITY
 Denial
• There is no problem.
• The problem lies outside the person’s conscious
awareness.
• “I don’t have a problem.”
• “I am not an alcoholic/drug addict. I don’t know
what you are talking about.”
 Lying
• distort the truth
• leave out important details.
• “I don’t really have that much of a problem.”
• Alcoholic: “I have never blacked out.” [when they
have]
• “I haven’t gotten drunk ever.” [when they have]
• “I only had two.”
 Manipulation
• argue, tease, mock, become silent, cry, etc. when
confronted about the problem.
• “This is ridiculous.” “You really think I have a
problem.” “Well, I just better watch myself around
you.” [mockingly]
• Alcoholic: “If you did a better job of organizing stuff,
then maybe I wouldn't have to drink.”
 Accusing
• Attacking the person and pointing out their
problems.
• “Well, you have problems too.”
• “You lie as well.”
• “You drink yourself.” “You are just overly sensitive
because your mother drank”
• “You think everyone is an alcoholic.”
 Threatening
• Uses threats to make the person stop talking about
the problem.
• “You better knock it off.” “I don’t have to live with
you.”
• “If you want someone else that doesn’t drink, go for
it.” “You better stop trying to control me.”
• Drug addict: Uses physical and emotional abuse to
stop the conversation.
 Judging
• If you did this or that right, things wouldn’t be so
bad.
• “You are controlling.”
• “You a codependent.”
• “You are being critical.”
 Projecting
• You have problems too. You always manipulate to
get what you want.
• “I think my wife is the one with the problem.”
• “My wife has spent more money than I have.”
 Blaming
• Making others responsible for one’s drinking/using
• “I need ___ because it is so stressful.” “You make me
____.”
• “I drink because I have such a stressful family.”
• •Gambling: “We have so much debt, I need to find a
way to earn money quickly.”
 Humor
• Make light of the situation and turn it into a joke.
• [laughing] “You really think I have a problem don’t
you?”
• [laughing]“Yep, I am a drunk.”[sarcastically] “I
suppose you think I am going to steal the kid’s lunch
money for booze.”
 Intellectualizing
• Using logic (false logic) to convince oneself and
others that there isn’t a problem.
• use of an “accounting system” to demonstrate that
they haven’t done things that would make them an
addict.
• “Look at all the things I can do.” “I just need to
control myself a little more.”
• “If I were an alcoholic, I wouldn’t be so responsible
at work.”
 Rationalizing
• I don’t drink/use everyday, I don't have a problem.
• Rx addict: “I have pain. I need the medicine.”
• Work addict: “I need to work the pay the bills.”
 Silence and Withdrawing
• quiet and withdrawn.
• avoid and leave physically or emotionally.
• Doesn’t respond to questions.
• Leaves the room, home, or situation and sometimes
drinks/use to withdraw.
 Compliant
• Outwardly compliant, inwardly rebellious.
• “I will stop.”
• “If you really want me to I will work on not drinking
so much.”
• “I really don’t have a problem, but I will stop if you
want me to.”
 Minimizing
• Agrees, but makes it a smaller problem than it really
is.
• “I don't drink/use half of what Sam drinks.” “I really
don’t drink that much.”
• “Yes I do take drugs but only once in a while”
 Cockiness
• I got it made, these other folks are losers.
• “I have been able to stop before. I know people that
are worse.”
 Justifying
• If you had a wife/husband like mine, you would
drink/use too.
• “If you knew my wife, (had my stress level, work-
stress) you would drink too.”
 Explaining
• Telling a story that is not really accurate and uses
false logic to explain why they didn’t do whatever
they were supposed to do.
• No real remorse, empathy or sorrow is
demonstrated.
• “Well, you see, we were. . .”
• “I was drinking with some friends and I didn’t want
them to think I was being a teetotaler.”
 Analyzing
• Comes up with excuses, explanations, and
defensives that justify our use.
• This usually comes in the form of a monologue or
filibuster that doesn’t allow another person’s
viewpoint in.
• “I was depressed, so I took drugs”
• “My parents were alcoholics, but I really don’t act
like they did.”
 Defiance
• Uses verbal force and stubbornness
• “You can’t make me stop.”
• “I am not going to stop drinking for you.”
• “I am not going to treatment.” “You can’t really
make me.”
 Shouting
• Raises voice to intimidate.
• Yelling, screaming, and shouting.
• Getting angry and argumentative.
• Yelling and arguing, “I am not a drunk.”
PROTECTIVE FACTORS & TREATMENT
Addiction as a Brain Disease

Long-term drug
abuse impairs brain
functioning.
It changes the brain
in fundamental and
lasting ways.
Addiction Treatment
However, recovery is possible.
Addiction Treatment
Extended abstinence is
predictive of sustained recovery
Risk and Protective Factors
 Community Action Box
• Parents can use information on risk and protection
to help them develop positive preventive actions
(e.g., talking about family rules) before problems
occur.
• Educators can strengthen learning and bonding to
school by addressing aggressive behaviors and poor
concentration—risks associated with later onset of
drug abuse and related problems.
• Community leaders can assess community risk and
protective factors associated with drug problems to
best target prevention services.
 Addiction Treatment

Treating a biopsychosocial disorder must go

beyond and just fixing the chemistry.
We need to treat the whole person.
Full recovery is a challenge
but it is possible.