Recovery Zone

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Recovery Zone Workshop Module One
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Addiction Interaction Disorder
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Challenges to Recovery

• Addiction is a brain disease

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Addiction is a brain disease expressed in the
form of compulsive behavior.

• Alan I. Leshner, MD
• Former director of the National Institute on Drug
  Abuse

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Natasha Schull on Female Machine Gamblers

• Mothers discover in machine gambling a highly
  addictive relief mechanism a means of escape
  from what they experience as an excess of demands
  and responsibilities to care for others.

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Common Language of Technological Change

• Internet sex as the crack cocaine of sexual
  compulsivity
• Al Cooper Ph.D.
• Machine video poker as the crack cocaine of
  compulsive gambling
• Robert Hunter, Ph.D.

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Challenges to Recovery

• Addiction is a brain disease
• Addiction can be the gateway to the pursuit of
  excellence
• Addiction often has a trauma component
• Addiction can take many forms
• Addiction treatment is difficult to access for
  many
• Addiction and recovery interfere with advocacy

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Adapted from Heim et. Al. JAMA, August 2,
2000-Vol. 284, No. 5
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ABUSE AND ADDICTION
265 Indicated Some Abuse (92.3) (N264)
Sexual Physical Emotional
No 11 35 17 ____ 63 23.9
Yes 31 60 110 ____ 201 76.1
No 26 51 36 ____ 113 42.8
Yes 16 44 91 ____ 151 57.2
No 7 10 4 ____ 21 8.0
Yes 35 85 123 ____ 243 92.0
One Addiction 2 3 Addictions 4 Addictions
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National Violence Against Women Survey

• Persons raped or physically assaulted in lifetime
  by sex of victim
• Women -- 55 or 55,383,350
• Men -- 67 or 61,955,644
• Last twelve months
• Women -- (302,091) 1,913,243
• Men -- (92,748) 3,153,432

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NAVW Survey

• Seventy-six per cent of the women who were raped
  and/or physically assaulted since the age of 18
  were assaulted by a current or former husband,
  cohabiting partner, or date.
• Another twenty six per cent knew their assailant.
• Only fourteen per cent were victimized by a
  stranger.

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Challenges to Recovery

• Addiction is a brain disease
• Addiction can be the gateway to the pursuit of
  excellence
• Addiction often has a trauma component
• Addiction can take many forms
• Addiction treatment is difficult to access for
  many
• Addiction and recovery interfere with advocacy

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The Costs of Addiction

• Our number one health problem
• Our number one social problem
• Our number one source of violence
• Our number one problem in schools
• Our number one source of child abuse

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Healthy People 2010

• Physical Activity
• Overweight/Obesity
• Tobacco Use
• Substance Abuse
• Responsible Sexual Behavior
• Mental Health

• Injury/Violence
• Environmental Quality
• Immunization
• Access to Health Care

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Treatment Gap

• An estimated 4.7 million people aged 12 or older
  needed treatment in year 2000 for illicit drug
  abuse
• 800,000 received treatment at a specialty
  facility
• The treatment gap was estimated to be 3.9 million
  people or 1.7 percent of the population

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Addiction Criteria
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Loss of Control

• Clear Behavior in which you do more than you
  intend or want.

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Compulsive Behavior

• A pattern of out of control behavior over time.

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Efforts to Stop

• Repeated specific attempts to stop the behavior
  which fail.

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Loss of Time

• Significant amounts of time lost doing and/or
  recovering from the behavior

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Preoccupation

• Obsessing about or because of the behavior

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Inability to Fulfill Obligations

• The behavior interferes with work, school,
  family, and friends.

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Continuation Despite Consequences

• Failure to stop the behavior even though you have
  problems because of it (social, legal, financial,
  physical, work.)

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Escalation

• Need to make the behavior more intense, more
  frequent, or more risky.

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Losses

• Losing, limiting, or sacrificing valued parts of
  life such as hobbies, family, relatiionships, and
  work

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Withdrawal

• Stopping behavior causes considerable distress,
  anxiety, restlessness, irritability, or physical
  discomfort

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Addiction Interaction Disorder

• Addictions more than coexist, they interact,
  reinforce, become part of one another. They
  become packages.

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Cross Tolerance

• A. Simultaneous increase in addictive behavior in
  two or more addictions.
• B. Transfer of a high level of addictive activity
  with little or no developmental sequence.

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Withdrawal Mediation

• One addiction serves to moderate, relieve, or
  avoid withdrawal from another.

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Replacement

• One addiction replaces another with majority of
  emotional and behavioral features.

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Alternating Addiction Cycles

• Addictions cycle back and forth in a patterned
  systemic way.

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Masking

• Addict uses one addiction to cover up for
  another, perhaps more substantive addiction.

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Ritualizing

• Addictive behavior of one addiction serves as a
  ritual pattern to engage another.

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Intensification

• Fusion dependence neither addiction separately
  is sufficient only simultaneous use is
  sufficient.

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Intensification

• Partial Fusion Addict combines addictions in
  such a fashion to be more potent than each
  addiction separately addictions are used
  independently part of the time.

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Intensification

• Binge Features episodic multiple use, yet
  functionally independent of one another.

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Numbing

• Addiction is used to medicate shame or pain
  caused by other addiction or addictive bingeing.

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Disinhibiting

• One addiction is used to lower inhibitions for
  other addictive acting out.

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Combining

• Mixing addictive experiences to moderate
  responses due to neuropathway interaction.

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Addiction Interaction Patient Recognition (N650)

• Cross Tolerance 59
• Withdrawal Mediation 59
• Numbing 59
• Fusion 57
• Masking 56

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Addiction Interaction Patient Recognition (N650)

• Replacement 47
• Disinhibiting 46
• Ritualizing 44
• Combining 38
• Alternating Addiction Cycles 36

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Addiction Interaction Paradigm Changes

• Diagnostic Framework revision of DSM
• Treatment Process depth and scope
• Treatment Focus the underlying issues
• Relapse Prevention addictions as packages
• Altered Strategies first step, screen,
  neuropathways
• Mirror Patient Realities professional
  allegiances

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Treatment Gap

• An estimated 4.7 million people aged 12 or older
  needed treatment in year 2000 for illicit drug
  abuse
• 800,000 received treatment at a specialty
  facility
• The treatment gap was estimated to be 3.9 million
  people or 1.7 percent of the population

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A Congressional District

• 41,860 people who have a significant problem with
  alcohol, drugs, or both
• 6,949 received some type of help
• 2,093 participate in a twelve step group
• 125,580 are heavily impacted by that person
• 167,440 are involved with the problem or more
  than one out of every four constituents

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We in recovery have been part of the problemBy
hiding our recovery, we have sustained the most
harmful myth about addiction disease that it is
hopeless. And without the examples of recovering
people, its easy for the public to continue
thinking that victims
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Of addiction disease are moral degenerates and
that those who recover are the morally
enlightened exceptions. We are the lucky ones
the ones who got well. And it is out
responsibility to change the terms of the debate,
for the sake of those who still suffer. Senator
Hughes
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Through our addiction, we have wounded ourselves,
our families, and our communities. In gratitude
for the gift of recovery, we declare our
responsibility to manage our own recovery,
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To make restitution for the injuries we have
inflicted, to carry a message of hope to others,
and to contribute to the larger health of the
community.William L. White