DSM IV CRITERIA FOR ADDICTION

1

• DSM IV CRITERIA FOR ADDICTION
• Pre-occupation between use
• Using more than has been anticipated Loss of
  Control
• Development of Tolerance
• Characteristic Withdrawal Syndrome
• Use to avoid or control Withdrawal symptoms
• Repeated efforts to stop or cut back
• Intoxication at inappropriate times or when
  Withdrawal interferes with daily functioning
• Reduction in social, occupational or recreational
  activities in favour of further use
• Use continues despite social, emotional and
  physical problems related to such use

2
Occasional escape drinking
12-Step Meetings
Frequent escape drinking
Early alcoholic phase
After-Care
Rehabilitation
True alcoholic phase
Detoxification
Complete alcohol dependence
Last phase
3

• DISEASE MODEL
• Has a cause
• Has specific signs and symptoms
• Has a natural history and course
• Has an outcome
• May or may not have a treatment
• Recovery may or may not be possible
• Relapse is likely if appropriate treatment is
  not followed

4
Facts about Alcoholism Alcoholism - chronic,
progressive and fatal disease- tolerance,
physical dependency, pathological organ
changes 7-10 of alcohol consumers are alcoholic.
Formal treatment for 15 in developed
countries For every alcoholic, four people are
directly affected More than 50 fatalities caused
by Cirrhosis, alcohol-related psychosis,
accidents, homicides and suicides
5
Facts about Alcoholism Disease disregards sex,
age, ethnicity, religion, geographic location,
social-economic status 5-10 employees are
alcoholic Drunk driving causes 50 traffic
fatalities Alcoholics 10 times more likely to die
from fires, falls and suicide Treatment is
possible Alcoholism is preventable
6
UNDERSTANDING RELAPSE SYMPTOMS Become
over-confident - ignore follow-up measure Appear
depressed, not communicate, prefers
loneliness Becomes irritable, angry,
argumentative, resentful over minor
issues Indulges in gambling etc Makes major
decisions without adequate thinking Is unable to
eat/sleep properly Goes with drinking
friends Stops meeting counsellor/going to AA
meetings Talks about social drinking
7
WAYS OF HELPING IF YOUR LOVED ONE IS AN
ALCOHOLIC Dont regard this as a family
disgrace Dont nag, preach or lecture to the
alcoholic Guard against a "holier than thou"
attitude or martyr-like attitude Dont use the
"if you loved me, appeal Avoid any threat unless
you think it through carefully and definitely
intend to carry it out. Dont hide liquor or
dispose of it Dont let the alcoholic persuade
you to drink with him
8
WAYS OF HELPING . Dont be jealous of the method
of recovery the alcoholic chooses Dont expect
immediate 100 recovery Dont try to protect the
recovering alcoholic from drinking situations Do
learn all the facts and put them to work in your
life Do attend AA meetings, Al-Anon
meetings Remember you are emotionally
involved Encourage all beneficial activities of
the alcoholic Encourage all beneficial activities
of the alcoholic
9

• Causative Theories
• Genetic Causation (inherited predisposition to
  contract disease)
• Social Learning Causation (environment condition
  reinforces chemical use and addiction).
• Psychological Causation (chemical reduces stress)
• Biological Causation (organic predisposition to
  disease)
• Spiritual Causation (Spiritual separation/
  bankruptcy cause disease)

10

• Identifiable Symptoms
• Craving for alcohol/other drugs
• Blackouts
• Lose of control
• Loss of memory
• Changes in tolerance
• Withdrawal symptoms
• Compulsion to drink/use

11
Harmful consequences Physical/Mental
health Marital /family health Social Health Job
health Financial health Legal health
Spiritual health Volitional (Will/Desire)
12

• Alcoholism/Chemical dependency is
• PRIMARY
• PROGRESSIVE
• CHRONIC
• FATAL
• PERMANENT
• TREATABLE

13

• MISUNDERSTOOD
• Willpower Myth
• Moral myth
• Skid row myth
• Popularity myth
• Prescription myth
• Self-infliction

14

• Symptoms and Characteristic of Depression
• Depressed, sad, blue, or irritable mood
• Poor appetite or weight loss
• Trouble sleeping or sleeping too much
• Loss of energy, fatigue, or listlessness
• Loss of interest or pleasure in usual activities
• Decreased sex drive

15
Symptoms and Characteristic of Depression 7.
Feeling of guilt, inadequacy, or worthless. 8.
Trouble concentrating, thinking, or making
decisions. 9. Suicidal thoughts and
behaviours. 10. Psychomotor retardation or
restlessness. 11. Frequent crying spells. 12.
Feeling of helplessness and hopelessness.
16

• Denial
• Justifying- (I drank because, I had a tough job).
• Minimising- (I drank, but always gave the pay
  cheque to my wife).
• Blaming- (I drank because wife kept on nagging).
• Threatening- (If you object to my drinking, I
  will find another woman).
• Silence- (See, I am so quiet, I am not doing
  anybody harm).
• Diverting- (Why are the children not studying/why
  is the house not in order)
• Bribing- (You can go for a film tonight-here is
  the money)

17
WHAT IS INTERVENTION? Intervention consists of a
crisis or crises that, in an objective,
unequivocal and non-judgmental way, confront the
alcoholic with the reality of his condition.
18
Accept the definition of addiction Realize that
the effect of the alcohol itself further reduces
the strength of even "normal" willpower Realize
that the alcoholic has developed a defense system
so effective that it results in a serious degree
of self-delusion Understand that because of this
degree of self-delusion, the alcoholic is
absolutely unable to look at his behavior
objectively and realistically