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Theories and Treatments of Addiction (Final)
Transcript of Theories and Treatments of Addiction (Final)
Theories & Treatment Of Addiction Biological Theories The Biological approach to addictions suggest that people become addicted because of their genetics rather than individual choice. It suggests that because there is a deficiency in a
particular gene, the individual is at a heightened risk of addiction... Twin Studies Family and twin studies have demonstrated that genes contribute to the development of between 50% and 60% for both men and women (McGue, 1999). In a review of studies on the heritability of illicit drug abuse and dependence, Argwal and Lynskey (2006) found that this too was significantly affected by genetic influence, with heritability estimates ranging from 45% to 79%. Twin studies have also established that the co-occurence of some disorders is influenced by genetic factors. For example, Kendler et al. (2003) analysed data from the Virginia Twin Registry in the U.S and found that a common genetic factor contributed to the total variance in alcohol dependence , illicit drug abuse and dependence, and adult antisocial behaviour. Genes D2 Dopamine receptor gene (DRD2) - linked to severe alcoholism
Nobel et al (1991) - A1 Variant of D2 found in more than 2/3 of deceased alcoholics, but only 1/5 of deceased non-alcoholics
Blum et al (1991) Found that the A1 variant was also more common among the children of alcoholics This focuses on ways of understanding and interpreting events that might lead to an an addiction. This suggests that the addiction shouldn't depend on the properties of the drug but on the reasons for taking it, for example, using it as a way of forgetting bad events. However when these methods are used excessively, they will harm rather than cause release.
The Self-Medication Model
This model proposes that individuals intentionally use drugs to treat psychological symptoms from which they suffer. The particular drug an addict uses is not selected at random, but is one that is perceived as helping with a particular problem. Therefore initiation of drug use, and the choice of drug, depends on the specific effect that an indiviual desires. These theories suggest tha individuals will typically
learn to perform behaviours because they are
associated with the onset of something pleasant
or the termination of something unpleasant.
These impulses then engage to form addictive
In classical conditioning, stimuli that precede
or occur at the same time as a learned stimulus
(such as a drug) may become secondary reinforcers,
deriving their influence only by association. Behaviourist Theories
To treat an addiction, you reward the person for not partaking in the addictive behaviour. Sindelar et al. (2007) investigated the effects of a monetary reward with people on a methadone treatment programme. Participants were randomly allocated to either a reward or no reward condition, and both groups continued to receive their usual treatment. Drug use significantly dropped for participants in the reward condition, with the number of negative urine samples being 60% higher than in the control group.
Cognitive-behavioural Therapy (CBT)
The goal of CBT is to help people change the way they think about their addiction, and learn ways to cope more effectively with the circumstances that lead to the addiction in the past. This is done by identifying the triggers that cause cravings, rehearsing ways to control the cravings and confronting and changing false beliefs. For example, gamblers often believe they can control and change the outcome of what they are betting on, and CBT would correct these judgements, reducing the urge to gamble.
Sulkunen (2007) collected 140 scenes from 47 films. These scenes represented various addictions, but because of the difficulties of spotting addictions in films that were not specifically about addiction, this left 61 scenes to be analysed. Films about drug –users like Trainspotting presented scenes of drug competence and enjoyment of the effects, and this enjoyment was frequently contrasted with the dreariness of normal, everyday life. The competent use of drugs was also represented as a way of alleviating a particular problem.
The treatment of drug and alcohol addiction is often hampered by factors such as the limited number of professionals able to administer treatment sessions for example. This has prompted a search for other ways of providing support and education for these individuals. Television and the internet have been identified as media that could potentially be used to provide this form of intervention. Television is increasingly being used to promote healthy lifestyles and behaviour changes such as stopping smoking or doing ore exercise. In 2008 a television and internet advertising campaign was launching in the UK to warn teenagers of the dangers of cocaine use. The adverts feature a fictional dog called Pablo, who was being used by drug dealers to carry cocaine. Pablo seeks out cocaine users to find out what happens to them after taking the drug.
Although a number of studies have documented the way addictions are represented in film media, not many have actually assessed whether such representations genuinely have an effect on viewers.
In the Hollander study (the use of SSRIs), the sample size was very small (10) and the study only lasted 16weeks. A larger and longer study (Blanco et al, 2002) involving 32 gamblers over 6months did not show any drug treatments that were more effective than the placebo.
Although there is some support for the effectiveness of naltrexone; Kim and Grant (2001) showed significant decreases in gambling thoughts and behaviours after 6 weeks of treatment.
Whilst studies show its effectiveness, interventions such as reinforcements don’t address the problems that lead to the addiction and therefore often the person may swap one addiction for the other, a drug addict may turn to alcohol for example. These new addictions are often subtle and go undetected. Nicotine Replacement Therapy
The many health problems linked to smoking are not caused by nicotine, but the many other components in cigarettes. Ni
Whilst there are no drug treatments in the UK for gambling, there has been much research to show its effectiveness. For example Hollander et al. (2000) treated gamblers with SSRIs to increase serotonin levels showed significant improvements compared to a control group. Also the use of naltrexone (a dopamine antagonist – a drug that binds to the receptor but does not alter the activity of the receptor so reduces the potential for a response in the neuron) works by blocking the reinforcing properties of gambling behaviour so reducing the urge to gamble
Methadone is a synthetic drug used for the treatment of heroin addiction. It mimics many of the effects of heroin, whilst reducing withdrawal symptoms and cravings. Methadone is also taken orally, reducing the dangers of injecting. As methadone is prescribed, it also allows the user to be monitored and to undergo detoxification, where the dose of methadone is slowly reduced until the users no longer feels the need for methadone or heroin.
cotine Replacement Therapy supplies nicotine in a safer form than cigarettes (for example; patches). This breaks the habit of smoking whilst maintaining the levels of nicotine in which the user has become addicted, whilst relieving the withdrawal symptoms as constant nicotine levels are kept. After maintaining the nicotine levels it is then possible to reduce the levels of nicotine and eventually break the addiction.