session 1: triggers and cravings

Family

Education

Session 1:Triggers and Cravings

1-1

Family

Education

Matrix IOP

Changes in the Brain

1-2

Family

Education

Matrix IOP

Conditioning

1-3

Family

Education

Matrix IOP

I.P. Pavlov (1849–1936)

1-4

Family

Education

Matrix IOP

Pavlov’s Dog

1-5

Family

Education

Matrix IOP

A Definition of AddictionAmerican Society of Addiction MedicineA primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. Addiction is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

Graham, A.W.; Schultz, T.K.; Mayo-Smith, M.F.; Ries, R.K.; and Wilford, B.B. eds. Principles of Addiction Medicine, Third Edition. Chevy Chase, MD: American Society of Addiction Medicine, Inc., 2003.

1-6

Family

Education

Matrix IOP

The Addictive Process

Introductory phase Maintenance phase Disenchantment phase Disaster phase

1-7

Family

Education

Addictive ProcessIntroductory Phase

METHAMPHETAMINE (METH)PositivesRelief from

DepressionAnxietyLonelinessInsomnia

EuphoriaIncreased statusIncreased energyIncreased sexual/social confidenceIncreased work outputIncreased thinking ability

NegativesMay be illegal

May be expensiveMay cause missing work

Matrix IOP 1-8

Family

Education

Conditioning Process During AddictionIntroductory PhaseStrength of Conditioned Connection: Mild

Triggers• Parties• Special occasions• Other events

Responses• Pleasant thoughts

about meth• Infrequent use

Matrix IOP 1-9

Family

Education

Matrix IOP

Development of Obsessive ThinkingIntroductory Phase

1-10

Family

Education

Matrix IOP

Development of Craving ResponseIntroductory Phase

1-11

Family

Education

NegativesEmployment/school

disruptionsRelationship concerns

Financial problemsBeginnings of physiological

dependence

Matrix IOP 1-12

Addictive ProcessMaintenance Phase

PositivesDepression reliefConfidence boostBoredom reliefSexual enhancementSocial lubricant

Family

Education

Triggers• Parties• Friday nights• Friends• Alcohol• “Good times”• Sexual situations

Responses• Thoughts of meth• Eager anticipation

of meth use• Mild physiological

arousal• Cravings occur as use

approaches• Occasional use

Matrix IOP 1-13

Conditioning Process During AddictionMaintenance Phase

Strength of Conditioned Connection: Moderate

Family

Education

Matrix IOP

Development of Obsessive ThinkingMaintenance Phase

1-14

Family

Education

Matrix IOP

Development of Craving ResponseMaintenance Phase

1-15

Family

Education

Positives Sociability Occasional euphoria Relief from fatigue Relief from stress

Negatives Withdrawal depression

Paranoia Tweaking

Relationship disruptions Family distress

Impending job loss

Addictive ProcessDisenchantment Phase

Matrix IOP 1-16

Family

Education

Triggers• Fatigue• All friends• Stress• Boredom• Anxiety• Free time• Sexual arousal• Loneliness

Responses• Continual thoughts

of meth• Strong physiological

arousal• Psychological

dependency• Strong cravings• Frequent use

Conditioning Process During AddictionDisenchantment PhaseStrength of Conditioned Connection: Strong

Matrix IOP 1-17

Family

Education

Matrix IOP

Development of Obsessive ThinkingDisenchantment Phase

1-18

Family

Education

Matrix IOP

Development of Craving ResponseDisenchantment Phase

1-19

Family

Education

Positives Relief from fatigue Relief from stress Relief from depression

Negatives Weight loss

Paranoia Loss of family

Seizures Severe depression

Unemployment Bankruptcy

Addictive Process Disaster Phase

Matrix IOP 1-20

Family

Education

Triggers• Any emotion• Day• Night• Work• Free time

Responses• Obsessive thoughts

about meth• Powerful autonomic

response• Powerful physiological

dependence• Automatic use• Persistent paranoia

Conditioning Process During AddictionDisaster PhaseStrength of Conditioned Connection:

OVERPOWERING

Matrix IOP 1-21

Family

Education

Matrix IOP

Development of Obsessive ThinkingDisaster Phase

1-22

Family

Education

Matrix IOP

Development of Craving ResponseDisaster Phase

1-23

Family

Education

Matrix IOP 1-24

All Downhill

Family

Education

Matrix IOP 1-25

All Downhill, but with Interruption

Family

Education

Matrix IOP

Thought Stopping

Visualization Rubberband snap Relaxation Calling someone

1-26

Family

Education

Matrix IOP

Thought Stopping

Visualization

1-27

Family

Education

Matrix IOP

Thought Stopping

Rubberband Snap

1-28

Family

Education

Matrix IOP

Thought Stopping

Relaxation

1-29

Family

Education

Matrix IOP

Thought Stopping

Calling Someone

1-30