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Substance Misuse - Psychological Aspects

Workshop for Doctoral of Clinical Psychology trainees, exploring the nature of substance misuse and implications for treatment within a psychological perspective
by

Derek Lee

on 12 February 2012

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Transcript of Substance Misuse - Psychological Aspects

February 2011 Groundrules Confidentiality
Everyone has right to be heard
Mobiles off or on silent alert
Only disclose what feels safe for you
De-role after role plays
EastEnders Protocol - please feel free to leave if anything upsets you and make use of your usual supports
Others? [Add to flipchart] DSM-IV Substance Dependence "A maladaptive pattern of substance use, leading to clinically significant impairment or distress..."
3 or more of following in any 12 months:
Tolerance
Withdrawal
Consumption greater or for longer than intended
Desire to reduce or control use, or failed attempts to control use
Large amounts of time dedicated to acquiring substance
Narrowed behavioural repetoire
Continued use despite knowledge of harmful effects
1805 - Morphine extracted from opium 1898 - Heroin prepared from morphine 1858 - Cocaine extractedfrom cocoa leaf 1884 - Freud heralds cocaine as a miracle drug 1887 - Amphetamines synthesised 1864 - Barbituric acid synthesised 1882 - Paraldehyde 1870 - Chloral hydrate 1843 - Hypodermic syringe 1950 - Chlorpromazine 1954 - Meprobamate 1960 - Chlordiazepoxide 1957 - MAOIs 1957 - Imipramine 1943 - LSD 1961 - Diazepam Any substance which when taken into the body
modifies one or more of its functions "Drugs are exogenous molecules that interact
with endogeous molecules and set in train a sequence of events by which a biological process is manipulated" [Graheme-Smith, 1980] DSM-IV Substance Abuse "A maladaptive pattern of substance use leading to clinically significant impairment or distress..."
One or more of the following in any 12 months:
Failure to fulfill major obligations because of recurrent use
Recurrent use in situations that are physically hazardous
Recurrent substance-related legal problems
Continued use despite recurrent social or interpersonal problems caused by or exacerbated by the substance.

Symptoms have never met criteria for substance dependence for this class of drug Alcohol and Cannabis have been in use for about 6000 years Imps Effects Whither CBT? It can facilitate change at a number of stages and levels:
Early motivation work to move person towards change
Identifying and challenging the thoughts and beliefs that stand in the way of change
Strategies for coping with urges and cravings
Strategies for maintaining changes
Strategies for managing negative mood states
Coping strategies for the challenges of everyday life
Tackling the underlying vulnerability factors
Promoting self-esteem and self-efficacy Allure CBT Consids Beha/Learn "That is not a drug. It's a leaf."
[Cannabis according to Schwarzenegger] "I think people need to be educated to the fact that marijuana is not a drug. Marijuana is a herb and a plant."
[Drug education by Willie Nelson] "Reality is a crutch for people who can't cope with drugs."
[Lily Tomlin] Nice Phenomena
Full transcript