JUDY ACREE, MA, LPC, ALPS, CCAC-S PSIMED PROGRAM MENTOR PRUNTYTOWN CORRECTIONS 304-265-6111 EXT...
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Transcript of JUDY ACREE, MA, LPC, ALPS, CCAC-S PSIMED PROGRAM MENTOR PRUNTYTOWN CORRECTIONS 304-265-6111 EXT...
THE BASICS OF ADDICTION
JUDY ACREE, MA, LPC, ALPS, CCAC-S PSIMED PROGRAM MENTOR PRUNTYTOWN CORRECTIONS 304-265-6111 EXT 7220 Work cell: 304-881-2590
WHY DO PEOPLE USE DRUGS AND ALCOHOL?
BECAUSE
THEY
WORK!
HUH? 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
SO WHAT’S THE PROBLEM??????
Visit SAMHSA FOR STATISTICS ON SUBSTANCE ABUSE AND ADDICTION
The problem is that substance abuse and addiction creates many more problems than it helps.
SUBSTANCE ABUSE AND ADDICTION AFFECTS…
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
BUT YOU ALREADY KNEW THAT….
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
SO HOW DOES IT HAPPEN?
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
EXPERIENTIAL/LEARNING PHASE
Pain NORMALEuphoria
x xFeelings range from Normal to Euphoria
and back to normal – it’s all good
SEEKING PHASE/MISUSE
Social use Parties Weddings Sports Entertainment Business Rules apply – when, where, how many
SEEKING PHASE/MISUSE
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
Pain NORMALEuphoria
x xFeelings range from Normal to Euphoria
to occasional discomfort and back to normal – occasional hangover, headache, DUI
SEEKING/MISUSE PHASE
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
HARMFUL USE/ABUSE/DEPENDENCY 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 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/DEPENDENCE PHASE
Pain NORMAL Euphoria
x xFeelings 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.
USING TO FEEL NORMAL/ADDICTION PHASE
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
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
Pain NORMAL Euphoria
x xFeelings range from Pain to low Normal if
at allNo longer feels Euphoria – not sure what
normal is
THE FAMILY PHASES - PARENTS DEALING WITH ADOLESCENTS OR ADULT CHILD ADDICTS/ALCOHOLICS
THE LEARNING PHASE o Parents may struggle with it is “normal for
kids to experiment”o They will grow out of it – it’s just a phaseo Trust is testedo Feel they can’t say anything because they did
it tooo One parent may hide adolescent’s use from
other parent – try to protect – not cause stress
SEEKING/MISUSE PHASE
o Parents start to wonder “is this happening too often?”
o Parents may discuss – but rationalize, justify – denial starts to build
o Parents may start to set rules, consequences, efforts to control
o 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
o Seeking answers and solutions – realize there may be a problem
HARMFUL PHASE
o Recognize there is a problemo Parents start to blame each othero Think their behavior caused the problemo Guilt, blame, isolationo Denial buildso Emotions start to shut downo Over attempts to control or detach
ESCAPE PHASE
o Major repeated crisis: financially, work, social, legal
o Becomes “normal” to have to deal with crisis
o Emotional exhaustion, outbursts, shut down
o Isolation – the family breaks o 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
THE FAMILY PHASES - ADULT (PARENT) ADDICT
THE LEARNING PHASE o May enjoy the “fun”o Spouse may like the changeo Children may enjoy the “Dad’s so funny
when he is drinking”o No negative consequenceso May notice an increase in frequency,
but no problems yet
SEEKING/MISUSE PHASE
o May start to wonder “is this happening too often?”
o May discuss – but rationalize, justify – denial starts to build
o May notice increase in activities away from family with drinking/using friends
o May start to make excuseso Seeking answers and solutions – realize
there may be a problem
HARMFUL PHASE
o Recognize there is a problemo Family members start to blame each othero Think their behavior caused the problemo Guilt, blame, isolationo Denial buildso Emotions start to shut downo Over attempts to control or detach or be
good or be bad
ESCAPE PHASE
o Major repeated crisis: financially, work, social, legal
o Becomes “normal” to have to deal with crisis
o Emotional exhaustion, outbursts, shut down
o Isolation – the family breaks o 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
FAMILY ROLES – PRIMARY ENABLER
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 primaryStarts with good intentions – wanting to help – out of love and caring
PRIMARY ENABLER
Primary job of the enabler is to protect the addict/alcoholic and family from the consequences of addictionMakes excuses, covers up, cleans up, picks up the piecesGives money, calls work, bail-out, takes over responsibilityOn one hand feels important and needed – on the other hand feels used and resentful
PRIMARY ENABLER
May enable out of guilt, shame, inadequacies The addict/alcoholic becomes the enablers addictionStarts to develop anxiety, depression, exhaustionDepletion of finances, emotions, health, spiritual
PRIMARY ENABLER
Own needs go unmetUnable to set boundariesFinancial problemsAnxietyDefensivenessUses drugs/alcohol to relax, rest, medicate
NurturingHelping professionGood with peopleWell organizedDependableEfficient
RESPONSIBLE ONE
Acts like an adult – accepts adult responsibilities - matureOrganized Puts others before selfWell behavedBelieves he/she can “fix it”
RESPONSIBLE ONE APPEARS
DependableStrongWell-adjustedHonestHas it all togetherSets and accomplishes goalJob is to make it all better
WHAT THE RESPONSIBLE ONE FEELS
InadequateCan’t depend on othersWorks hard to create stability, stay busySelf-esteem is performance basedThinks if he/she is good enough it will change thingsDifficulty expressing feelings
RESPONSIBLE ONE
Fears failurePerfectionistDifficulty having funDifficulty developing relationshipsWorkaholicMay become an alcoholic or marry oneDrinks/uses to relax; have fun
Teacher/employer’s dreamGreat leader/administratorCompetentDisciplinedOrganized
SCAPEGOAT
Trouble maker“Problem child”RebelliousBegins using at an early ageMay be violent and aggressiveJob is to take the focus off the real problem
SCAPEGOAT APPEARS
Hostile and violentProblem kidIrresponsibleCriminalDefiantIronically, the only one who is acting normal to the chaos in the family
WHAT THE SCAPEGOAT FEELS
Lack self-confidenceHurtAngryRejectedAbandonedSearches for belonging
SCAPEGOAT
Leaves home earlyCriminal recordDesire to “belong” leads to risky peer groups – gangs; users/drinkersUses drug/alcohol to give relief; feed anger, hostility;
AssertiveTakes positive risksStreetwiseConnects in a positive helpful way to those in troubleHandles pressure well
THE INVISIBLE/LOST CHILD
Quiet - ShyWithdrawnLonerSensitive – yet detachedConforms – followsDoesn’t seem to react or notice anything
LOST/INVISIBLE CHILD APPEARS
Lack of personalityLow expectationsDoesn’t noticeDifficulty connecting to or reading emotions with this personJob is to not cause trouble – not bring attention to anything
WHAT THE LOST/INVISIBLE CHILD FEELS
LonelyUnimportantInsecureFear of othersAbandoned – defeatedWhy try?
LOST/INDIVIDUAL CHILD
DepressionPromiscuityIndecisiveLow self-esteemInability to set boundariesUses alcohol/drugs to feel more at ease with others; to become more outgoing
CreativeImaginativeIndependentResourcefulTalented
THE CLOWN
Class clownDisruptiveHyperactiveProblems at school/workImmature
THE CLOWN APPEARS
Takes nothing seriousUnsettledTake unnecessary risksThrives on excitement
WHAT THE CLOWN FEELS
FearBoredomRestlessUnsatisfied
THE CLOWN
Difficulty expressing feelingsSeems insensitiveDifficulty being seriousJob is to provide comic relief- take the focus off the real problemUses drug/alcohol for excitement, to share feelings, to be “real”
Good with peopleMakes people laughGood in social situationsGood under pressure“Life of the party”Everybody loves a clown
BASIC MESSAGES LEARNED IN THE ADDICTED FAMILY
DON’T TALK
DON’T TRUST
DON’T FEEL
UNTANGLING THE MESS – WHERE TO START?
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 recoveryInpatient – beneficial at the use to feel normal/addiction phase – 28 days
UNTANGLING THE MESS – WHERE TO START?
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 bridgesSupport 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?
Methadone/Suboxone Clinics – 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.
FOR MORE INFORMATION ON ADDICTION VISIT
SAMHSA AND NAADAC WEBSITES FOR FREE INFORMATION
THANK YOU