session 1: triggers and cravings
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Family
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Session 1:Triggers and Cravings
1-1
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Changes in the Brain
1-2
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Conditioning
1-3
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I.P. Pavlov (1849–1936)
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Pavlov’s Dog
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A Definition of AddictionAmerican Society of Addiction MedicineA primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. Addiction is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
Graham, A.W.; Schultz, T.K.; Mayo-Smith, M.F.; Ries, R.K.; and Wilford, B.B. eds. Principles of Addiction Medicine, Third Edition. Chevy Chase, MD: American Society of Addiction Medicine, Inc., 2003.
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The Addictive Process
Introductory phase Maintenance phase Disenchantment phase Disaster phase
1-7
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Addictive ProcessIntroductory Phase
METHAMPHETAMINE (METH)PositivesRelief from
DepressionAnxietyLonelinessInsomnia
EuphoriaIncreased statusIncreased energyIncreased sexual/social confidenceIncreased work outputIncreased thinking ability
NegativesMay be illegal
May be expensiveMay cause missing work
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Conditioning Process During AddictionIntroductory PhaseStrength of Conditioned Connection: Mild
Triggers• Parties• Special occasions• Other events
Responses• Pleasant thoughts
about meth• Infrequent use
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Development of Obsessive ThinkingIntroductory Phase
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Development of Craving ResponseIntroductory Phase
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NegativesEmployment/school
disruptionsRelationship concerns
Financial problemsBeginnings of physiological
dependence
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Addictive ProcessMaintenance Phase
PositivesDepression reliefConfidence boostBoredom reliefSexual enhancementSocial lubricant
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Triggers• Parties• Friday nights• Friends• Alcohol• “Good times”• Sexual situations
Responses• Thoughts of meth• Eager anticipation
of meth use• Mild physiological
arousal• Cravings occur as use
approaches• Occasional use
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Conditioning Process During AddictionMaintenance Phase
Strength of Conditioned Connection: Moderate
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Development of Obsessive ThinkingMaintenance Phase
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Development of Craving ResponseMaintenance Phase
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Positives Sociability Occasional euphoria Relief from fatigue Relief from stress
Negatives Withdrawal depression
Paranoia Tweaking
Relationship disruptions Family distress
Impending job loss
Addictive ProcessDisenchantment Phase
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Triggers• Fatigue• All friends• Stress• Boredom• Anxiety• Free time• Sexual arousal• Loneliness
Responses• Continual thoughts
of meth• Strong physiological
arousal• Psychological
dependency• Strong cravings• Frequent use
Conditioning Process During AddictionDisenchantment PhaseStrength of Conditioned Connection: Strong
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Development of Obsessive ThinkingDisenchantment Phase
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Development of Craving ResponseDisenchantment Phase
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Positives Relief from fatigue Relief from stress Relief from depression
Negatives Weight loss
Paranoia Loss of family
Seizures Severe depression
Unemployment Bankruptcy
Addictive Process Disaster Phase
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Triggers• Any emotion• Day• Night• Work• Free time
Responses• Obsessive thoughts
about meth• Powerful autonomic
response• Powerful physiological
dependence• Automatic use• Persistent paranoia
Conditioning Process During AddictionDisaster PhaseStrength of Conditioned Connection:
OVERPOWERING
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Development of Obsessive ThinkingDisaster Phase
1-22
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Development of Craving ResponseDisaster Phase
1-23
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All Downhill
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All Downhill, but with Interruption
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Thought Stopping
Visualization Rubberband snap Relaxation Calling someone
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Thought Stopping
Visualization
1-27
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Thought Stopping
Rubberband Snap
1-28
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Thought Stopping
Relaxation
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Thought Stopping
Calling Someone
1-30
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