Lecture 1. Addiction Setting the Stage. Why Study Addiction?. 1. 3. 2. 25% patients seen by primary care physicians have alcohol drug problems. 20% to 50% of all hospital admissions are addiction related. Suicide is 30 times higher among alcoholic dependent persons.
25% patients seen by primary care physicians have alcohol drug problems
20% to 50% of all hospital admissions are addiction related
Suicide is 30 times higher among alcoholic dependent persons
Alcohol/drug disordered persons were 2.7 times more likely to have engaged in physical abuse of a child
(Knutson & Haines, 2003; Greenfiled & Hennessy, 2004; Mosier, 1999)
Need I continue…
(Rivara et al., 1997).
Canada racks up $40 billion in annual costs attributable to alcohol and other drug addictions
GLOBALLY, around 10 million people are estimated to abuse or are addicted to heroine.
(United Nations, 2004).
In 2011, prevalence of past-year pot use by youth was 21.6%, 3 X times higher than adults
Among people who consumed alcohol in the past 12 months, 18.7% exceeded the guideline for chronic effects and 13.1% exceeded the guideline for acute effects
These folks are aged 15 to 24
The Canadian Alcohol and Drug Use Monitoring Survey, 2011 (CADUMS)
N = 10, 076
Chronic effect = no more than 10 drinks for a female in a week with no more than two a day; 15 for male no more than three a dayAcute = women no more than 3 drinks on a single occasion; men no more than 4 on any single occasion
1.8% of Canadians aged 15 years and older reported experiencing at least one harm in the past year due to their illicit drug use
Youth 15 to 24 years of age were approximately five times more likely than adults aged 25 years and older to report harm due to drug use, with 5.8% of youth reporting such harm, compared to 1.1% of adults
One study says this one study says that.
Studies use different terminology and often refer to different things /constructs!
Moreover, who is reporting? Addicts, non-addicts, persons in treatment?
The war on drugs was not won.
The problem still exists.
We have to go beyond scare tactics, toward an understanding of who, and what we are studying.
Because we have barely scraped the surface of understanding the baffling and cunning creature called
Addiction effects us all!!!!
Total abstinence rare/social use heavy social use heavy problem / addiction starts Entrenched addiction
RECREATIONAL DRINKER / USER – [LEVEL 1]USED WITHIN A TRADITIONAL CONTEXT, (E.G. WINE WITH SUPPER, A FEW BEERS WITH THE GIRLS OR BOYS AFTER WORK, ODD TOKE WITH FRIENDS)
Breaking the Continuum Down and Defining Terms
Substance abuse – “level 2-3”occurs when an individual uses a drug without legitimate medical reason to do so. (I.E., drinking alcohol beyond social standards, begins drinking socially, but at of the end night is overtly drunk, happens somewhat regularlyThus, person is making poor choices, but still has control over their drinking, therefore may drink 3-5 drinks, but can stop.
Maybe if one cannot stop at 3 to 5… A clear sign of level 3?
Addiction / dependence – “level 4”person has no control over their use, person is preoccupied with using and when not using will go to lengths to secure a source to use again. Use has manifested multiple psychosocial problems, legal, family, social, employment, spiritual / religious.
Pharmacodynamic tolerance CNS becomes insensitive to drug’s effect
Michigan Alcoholism Screening Test (MAST)
Scoring – Score one point if you answered the following:
0 – 2 No apparent problem
3 – 5 Early or middle problem
6 or more Problem Drinker
5 or less no problem
6 to 11 drug problem present
12 or greater – substance use disorder
Psychological dependence is the individual’s perceived need for the drug/chemical/behavior
However, we know as researchers, clinicians, and professionals in the field that there are: 1) More individuals who discontinue their use on their own; 2) Have problematically used and quit; 3) Who never present for treatment. Thus a great proportion of knowledge about addiction may not be a true representation of the addicted population.