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addiction - Coggle Diagram

- - - - drug substitutes the bind to the neuron receptors and activate them, this sends a signal to the brain and the brain sets in motions the journey to produce similar effects to the addicted substance
      - Ex: Methadone is used to treat heroin addiction, it has similar reactions and produces similar effects.
      - Agonists are thought to be “cleaner” versions of the addicted substances as they are administered medicinally and used to curb withdrawal symptoms. The dose is reduced overtime.
    - - a types of drugs that produces unpleasant feelings/ consequences (nausea or vomiting)
      - Disulfiram is used to treat alcoholism, it creates hypersensitivity to alcohol.
      - Disulfiram works by blocking the conversion from acetaldehyde to acetic acid, resulting in an upsurge of acetaldehyde, which is toxic and causes the individual to become ill
    - - treat addiction by binding to the receptor sites and blocking them so that the drug of dependence cannot have its usual effects for example euphoria.
  - - - NRT provides a cleaner and controlled dosage, that overtime helps the individual manage withdrawal symptoms, by reducing the amount over time.
  - - - However, if this drug was approved to treat gambling addiction, it is unlikely it would be used due to the unpleasant side effects.
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        drug treatment is widely available and in comparison to other treatments cheaper for the NHS and other health care providers, it is also easier for the person as it requires little lifestyle change (accessibility is higher)
        
        support from research and studies for the effectiveness of NRT.
        Stead et al- concluded that all forms of NRT are significantly more effective in helping smokers quit than a placebo or no treatment at all. Nasal spray was the most effective method. They also found that NRT had the negative health impacts removed. The support from the studies and research adds validity to the biological explanation and treatment.
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        side effects=sleep disturbances, headaches and a decrease in mood
        Individuals might stop taking the treatment due to these side effects and therefore not treat their addictions.
        
        not effective for everyone and therefore other therapies might be best suited, this questions the validity of the biological approach for addictions and suggests it is incomplete.
  - - - Given an aversive drug, they experience nausea and then vomit movements later
      - Before the vomiting occurs they have alcohol places infront of them. Overtime the individuals associates the nausea and vomiting with the smell of alcohol
      - Issue: post treatment individuals may vomit in social situations when alcohol is present
    - - Electric shock therapy (ETC)- have been used in replacement of drugs in some instances
        
        In this form of therapy, patients read out gambling related phrases and non- gambling related phrases, they are given a 2 second shock when they read a gambling related phrase.
  - - - First the client is asked to relax, then the therapist reads a script instructing the client to imagine the aversion situation. The client conjures up the image of themselves smoking a cigarette, followed by the most unpleasant consequence
      - Mary McMurran- reports a habitual gambler using slot machines who had a phobia of snakes, instead of winning money the client is asked to imagine winning snakes.
      - End the session by imaging themself turning their back on the substance, resulting in relief
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        Support from research and studied for the effectiveness pof covert sensitisation
        McConaghy et al- found that 90% of those who had received treatment for a gambling addiction, significantly reduced their gambling behaviour and reported less cravings, adds validity
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        aversion therapy is the ethical issues of the individual taking aversive drugs and having ECTs administered
        
        behavioural therapy is not effective for everyone in the long term
  - - - Functional analysis - this is where the patient and the therapist work together to identify the faulty thoughts before and after engaging in the maladaptive behaviour. The therapist then must challenge the client’s faulty thinking. The client is able to talk through and identify any triggers.
      - Skill training- 3 skills the patient and the therapist will develop together.
        
        Cognitive reconstruction - attempts to correct the faulty thinking by replacing the faulty thoughts with correct ones e.g. for a gambling addiction the patient and the therapist will reconstruct thoughts surrounding randomness and control.
        
        Specific skills - this attempts to help the client with any problems that have occurred due to the addiction - this might be coping strategies for anger management or avertistiveness training.
        
        Social skills - these skills will help the client cope with any anxieties in social situations e.g. refusing the substance and coping in environments where the substance is on offer. This will involve role play initially, until the client can perform the skills in the high risk scenario.
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        supporting research and studies for the effectiveness of CBT, Petry et al conducted a study where gambling addicts were either placed in a control group or CBT group, after 12 months those allocated to the CBT group significantly changed their gambling habits. This shows the effectiveness of CBT, the face-to-face interactions and the client-therapist relationship. The support from the studies and research adds validity to the cognitive explanation and treatment.
        
        effective in preventing relapses, it equips patients with the tools for long term change, it teaches patients how to identify and change faulty thoughts as well as specific and social skills. This shows that CBT goes to treating the causes of the addictions and not just the symptoms. This shows that everyone has the ability to change and reach their potential.
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        the dropout rate is high, patients do not tend to complete the full cycle of CBT. CBT is demanding and requires a lot of inner work from the patient - on top of sessions, there is also homework. This is a weakness as there are major obstacles when completing this treatment, decreasing its effectiveness.
        
        It focuses very heavily on the relationship between the client and therapist. If the client does not feel comfortable, they might not open up and explain their triggers of faulty thinking accurately, this can reduce the effectiveness of the therapy.
- - - - Personal attitudes- refers to the person attitudes towards their addictions
        Obvious issues with this is that the individuals tend to look more positively on the favourable consequences and downplay the negatives
      - Subjective norms- when the individuals believe about what people close totem think about their behaviour
      - Ability to change/ self efficacy- whether the individuals believes grieving up the behaviour would be easy or difficult based on resources, time, money, determinism
      - If all 3 line up then it can provide someone the intention to change, which decreases the amount of time and effort put into the addiction
  - - - Precontemplation - Ignorance is bliss
        People in this stage are not thinking about changing their behaviour; this might be because of denial or demotiviation.
      - Contemplation - Sitting on the fence
        People in this stage are thinking about making a change, they are aware of the need to change and the benefits of it. At this stage drug treatment would not be wise, but showing the individual the pros vs cons would be
      - Preparation- I am ready
        The individual believes that the benefits are greater than the cons. The first step to change usually occurs in a month. The most helpful thing would involve representing them with a plan, or helping them book a GP appointment
      - Action Let’s do it
        A person is taking action to change. Helpful intervention includes cognitive or behavioural methods. Effective intervention includes giving the person the tools for change. Risk reducing intervention may occur.
      - Maintenance - Stay on track
        Individual change has been maintained for over six months. The focus is on relapse intervention. Application of coping skills is needed.
      - Termination
        At this stage abstinence is automatic, it might be beneficial to prolong the maintenance period.