Conquering Addiction: Understanding, Treating, and Moving Forward

1. ChapterOutline Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Chapter 13 Freedom from Addictive Behavior

2. Addiction: Compulsive and uncontrollable behavior(s) or use of substance(s) Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Key term

3. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Addictive behaviors • Almost anything can be addictive: • Work, shopping, television, the Internet, computer games, exercise, food, drugs • Other addictions include • Gambling, pornography, sex, people, places

4. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Addictive behaviors • The most serious type is chemical dependency on drugs; Examples include • Socially “accepted” substances • Coffee, tobacco, alcohol • Illegal substances • Cocaine, methamphetamine, MDMA, ecstasy, heroin, marijuana • Others • Prescription drugs

5. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Risk factors for addiction • The behavior is reinforced • The addiction is an attempt to meet a basic need • Stress • Peer pressure • Acceptance within a value system

6. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Risk factors for addiction • Pain from serious illness • Pressure to perform or succeed • Low self-esteem • Genetic susceptibility • Society accepts addictive behaviors

7. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes What is a drug? • A drug is any substance that alters the user’s ability to function • Over-the-counter drugs • Prescription medications • Illegal substances • Many drugs lead to physical and psychological dependence

8. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Drugs • Any drug can be misused or abused • Misuse: the intentional or inappropriate use of over-the-counter or prescribed medications • Abuse: the intentional or inappropriate use of a drug resulting in physical, emotional, financial, intellectual, or social consequences • The body often develops tolerance to drugs, requiring a higher dose with subsequent use

9. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes The influence of drug abuse • More than 50% of adolescent suicides are drug-related • Drug abuse can open the gate to other illegal activities • 70% of federal inmates and 80% of state inmates have abused drugs • 60% of the world’s production of illegal drugs is consumed in the U.S. • Americans spend more than $100 billion each year on illegal drugs (more than for all U.S. crops)

10. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Marijuana • Most widely used illegal drug in the U.S. • Low doses yield a sedative effect • Larger doses produce physical and psychic changes • Short-term effects include • Tachycardia, difficulty in concentration, decreased coordination, memory impairment, confusion, increased heart attack risk • Long-term effects include • The amotivational syndrome, brain atrophy, brain damage, immune system dysfunction, chronic bronchitis, lung cancer, sterility, impotence

11. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Critical thinking • The legalization of marijuana for medical purposes is being heatedly debated across the United States. Do you think this decision should rest with the government, medical personnel, or the individuals themselves?

12. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Cocaine • 96% of cocaine users previously used marijuana • 20% of first time users will become addicted • Addiction becomes a lifetime nightmare • Popularity based on the almost immediate feeling of euphoria • Initial high • Alleviates fatigue, raises energy, decreases need for food and sleep • But increases risk of sudden death • Then comes the “crash” • Physiological and psychological depression leaving a desire for additional drug • Long-term consequences include • Digestive disorders, malnutrition, insomnia, anxiety, cocaine psychosis (“coke bugs”), tremors, seizures, strokes, cardiac arrhytmias

13. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Methamphetamine • Fastest growing drug problem in the U.S. • A central nervous system stimulant • Primary effect • Produces a feeling of well-being and increased motor activity • But decreases appetite, fatigue, and sleep • Chronic users experience • Inflammation of the heart lining, schizophrenia-like mental disorder, and brain cell damage • Users are frequently involved in violent crime, homicide, and suicide

14. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes MDMA (Ecstasy) • Most common club drug in the U.S. • A stimulant and hallucinogenic drug • Promoted as a drug that increases energy, pleasure, and self-confidence • Users may experience • Faintness, blurred vision, chills, sweating, nausea, muscle tension, and teeth-grinding • Long-term effects include • Confusion, depression, sleep disorders, anxiety, aggression, paranoia, and verbal and visual memory impairment

15. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Heroin • A sedative drug synthesized from morphine (opium) • An extremely addictive and tolerance-developing drug • Induces an almost immediate state of euphoria • An overdose can cause convulsions, coma, and death • Short-term use symptoms include • Bone and muscle pains, muscle spasms and cramps, runny nose and eyes, drowsiness, slurred speech, nausea, and violent yawning • Long-term symptoms include • Hallucinations; nightmares; constipation; sexual difficulties; and increased risk for lung, liver, and cardiovascular disease • SIDS is more frequently seen in children born to addicted mothers

16. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Alcohol • Alcohol abuse is one of the most significant health-related drug problems in the U.S. • Alcohol intake impedes peripheral vision, impairs the ability to see and hear, decreases reaction time, hinders concentration and motor performance, and causes impaired judgment of distance and speed of moving objects • Alcohol use also lessens fear, increases risk-taking behaviors, stimulates urination, and induces sleep

17. Alcohol addiction

18. Long-term effects of alcohol abuse are serious and often life-threatening Figure 13.1

19. A survey involving 56,000 college students showed that GPA is related to average number of drinks per week Figure 13.2

20. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Students and alcohol misuse • 30% of academic problems result from alcohol misuse • 36% of surveyed students admitted driving while intoxicated • 2 to 3% of U.S. college students will die from alcohol-related causes (more students than those who will receive advanced degrees)

21. Synergistic action: The effect of mixing two or more drugs, which can be much greater than the drugs acting by themselves Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Key term

22. Stay in control • Decide ahead of time what action to take if your date puts you in an uncomfortable situation Most people think they are in control of their drinking habits and do not realize they have a problem until they become alcoholics

23. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Activities 13.1 & 13.2

24. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes How to cut down on drinking • Determine that you want to cut down on drinking • Set reasonable limits • Learn to say no politely and firmly • Drink slowly • Dilute your drinks • Do not drink on your own

25. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Treatment of addiction • Recognize that there is a problem • Recovery almost always requires professional help • Consult a physician, counseling center, or local mental health clinic • Contact the National Center for Substance Abuse Treatment at 1-800-662-HELP for 24-hour substance abuse treatment centers in your area • Successful treatment includes psychotherapy, medical care, and behavior modification

26. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Cigarette smoking • Cigarette smoking became popular in the mid 1800s • Harmful effects of cigarette smoking became known in the 1960s • More than 1,200 toxic chemicals have been found in tobacco smoke • Tar contains about 60 chemical compounds that are proven carcinogens

27. Tar: Chemical compound that forms during the burning of tobacco leaves Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Key terms Nicotine: Addictive compound found in tobacco leaves

28. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Morbidity & mortality • The World Health Organization estimates that 10% of the 5 billion people presently living will die from smoking-related illnesses • Cigarettes kill 26 times as many people as all illegal drugs combined (about 440,000/year) • Cigarette smoking is the single largest preventable cause of illness and premature death in the U.S.

29. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Morbidity & mortality • The most common carcinogenic exposure in the workplace is cigarette smoke • Secondhand smoke causes an estimated 35,000 to 40,000 yearly deaths from heart disease in nonsmokers • About 3,000 people die each year from lung cancer because of secondhand smoke • Pipe and cigar smoking and chewing tobacco also increase the mortality rates from heart disease and lung, lip, mouth, and larynx cancer

30. Every day, 1,200 Americans die from smoking Figure 13.4

31. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Smoking-related problems • Causes heart disease, cancer, stroke, aortic aneurysm, chronic bronchitis, emphysema, and peptic ulcers • On average, each cigarette shortens life expectancyby 7 minutes • 87% of lung cancer and 30% of all cancers are caused by smoking • Smoking affects the cardiovascular system by increasing heart rate, blood pressure, susceptibility to atherosclerosis, blood clots, coronary artery spasm, cardiac arrhythmia, and arteriosclerotic peripheral vascular disease

32. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Smoking-related problems • As far as the extra load on the heart is concerned, smoking one pack of cigarettes per day is the equivalent of carrying between 50 and 75 pounds of excess body fat • Smoking is the most prevalent cause of injury and death from fire • Cigarette smoke contains carbon monoxide which reduces the blood’s oxygen carrying capacity • Carbon monoxide and nicotine can cause damage to the arterial wall, enhancing atherosclerosis • Smoking causes increased adhesiveness and clustering of platelets, increasing blood thickness that may precipitate a heart attack

33. Figure 13.3 A normal and a diseased alveoli

34. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Critical thinking • Cigarette smoking is the largest preventable cause of premature illness and death in the United States. Do you think the government should outlaw the use of tobacco in all forms? Or does the individual have the right to engage in self-destructive behavior?

35. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Economic impact • Smokers use the health care system twice as much as nonsmokers • A smoking employee costs an employer up to an additional $4,611 annually

36. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Critical thinking • You are in a designated nonsmoking area and the person next to you lights up a cigarette. What can you say to this person to protect your right to clean air?

37. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Smokeless tobacco • Use has increased during the last 15 years • Leads to health problems • Gingivitis and periodontitis • Four times greater risk of oral cancer • Increased cavities, sore gums, bad breath, and stained teeth • Diminishes smell and taste • Increases heart rate and blood pressure • Just as addictive as cigarette smoking

38. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Smoking cessation • Nicotine is perhaps the most addictive drug known to humans • 75 to 90% of smokers would like to quit • Most important factor in quitting is sincere desire to do so • 20% of smokers who try to quit succeed the first time • More than 91% of successful ex-smokers have been able to quit on their own

39. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Activities 13.3 & 13.4

40. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Activities 13.5 & 13.6

41. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Steps to smoking cessation • Decide positively that you want to quit • Initiate a personal diet and exercise program • Decide on the approach you will use to stop smoking • Cold turkey • Cutting down gradually • Keep a daily log of your smoking habit for a few days • Set the target date for quitting • Stock up on low-calorie foods • Quit!

42. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Life after cigarettes • Withdrawal symptoms should be expected • Physiological addiction is broken in about 3 days following the last cigarette • Psychological addiction takes longer, possibly years to break • Benefits begin right after smoking cessation

43. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Following smoking cessation • Risk for illness starts to decrease the moment you stop smoking • Sore throats, sores in the mouth, hoarseness, cigarette cough, and risk for peptic ulcers decrease • Circulation to the hands and feet improve • Gastrointestinal, kidney, and bladder functions improve • Everything tastes and smells better • You will have more energy • You gain a sense of freedom, pride, and well-being

44. Addiction Drugs and Dependence Treatment of Addiction Tobacco Use Smoking Cessation Life After Cigarettes Critical thinking • If you ever smoked or now smoke cigarettes, discuss your perceptions of how others accepted your behavior. • If you smoked and have quit, how did you accomplish the task, and has it helped in how you are viewed by others? • If you never smoked, how do perceive smokers?

45. End of Chapter