Behavioral Approaches to Cessation of Risky Substances (Jois)
Introduction to Behavioral Approaches in Substance Use
Welcome and overview of the topic by Dr. Joyce.
Importance of understanding substance use disorders (SUD) across all medical specialties.
Understanding Substance Use Disorders
Need to mitigate and manage substance-related health issues encountered in practice.
Personal experiences of substance use consequences in emergency medicine.
Key Components of the Lecture
Review of prevalence rates of risky substance usage in the U.S.
Definition of addiction and its relevance.
Discussion of behavioral strategies to reduce substance misuse.
Introduction of interventional techniques applicable in medical practice.
The Evolution of Addiction Perception
Historical view of addiction as a moral failing; treatment focused on punishment.
Shift towards viewing addiction as a medical disorder through scientific discoveries.
Recognition of addiction's impact on brain chemistry and behavior.
Definition of Addiction
Chronic relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.
Functional brain changes associated with addiction: reward, stress, and self-control circuits.
Brain Imaging and Addiction
PET scan comparisons: Cocaine users vs. non-users.
Lower levels of D2 dopamine receptors in cocaine users.
Recovery changes: gradual return of dopamine receptors post-abstinence.
Motivations for Substance Use
Feeling Good: Intense pleasure experiences.
Stimulants (e.g., cocaine): Euphoria, self-confidence, increased energy.
Opioids (e.g., heroin): Relaxation and satisfaction.
Feeling Better: Use as a coping mechanism for anxiety and depression.
Stress plays a significant role in initiation and continuation of use.
Enhancement of Performance: Pressure to improve focus academically or athletically.
Curiosity and Social Pressure: Particularly significant during adolescence.
Biological and Environmental Risk Factors
Variability in addiction susceptibility among individuals:
Genetic Factors: Account for 40-60% of risk, including epigenetic influences.
Mental Disorders: Higher risk for individuals with underlying mental health issues.
Environmental Factors: Influence of family, peers, and community.
Importance of recognizing multiple risk and protective factors affecting addiction probability.
Protective Factors Against Addiction
Positive family influences and support systems.
Healthy peer relationships and social skills.
Early educational engagement and success in schools.
Neuroscience of Addiction
Substances alter brain function, increasing dopamine release.
Problematic substance use categorized into three stages:
Binge Intoxication: Initial consumption and pleasure response (Basal Ganglia).
Withdrawal/Negative Effect: Emotional distress when the substance is absent (Extended Amygdala).
Preoccupation/Anticipation: Craving for the substance post-abstinence (Prefrontal Cortex).
Socio-Environmental Factors
Impact of trauma on substance use:
Types of Trauma: Acute, chronic, and complex trauma.
Connection between trauma experiences and substance misuse.
Adverse Childhood Experiences (ACE): Correlation to long-term health consequences and risks of developing SUD.
Early Substance Use and Long-Term Impact
Evidence suggests early drug use leads to a higher likelihood of developing addiction issues.
Importance of early prevention strategies and intervention.
Introduction to Behavioral Approaches in Substance Use
Welcome and overview of the topic by Dr. Joyce.
Importance of understanding substance use disorders (SUD) across all medical specialties.
Understanding Substance Use Disorders
Need to mitigate and manage substance-related health issues encountered in practice.
Personal experiences of substance use consequences in emergency medicine.
Key Components of the Lecture
Review of prevalence rates of risky substance usage in the U.S.
Definition of addiction and its relevance.
Discussion of behavioral strategies to reduce substance misuse.
Introduction of interventional techniques applicable in medical practice.
The Evolution of Addiction Perception
Historical view of addiction as a moral failing; treatment focused on punishment.
Shift towards viewing addiction as a medical disorder through scientific discoveries.
Recognition of addiction's impact on brain chemistry and behavior.
Definition of Addiction
Chronic relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.
Functional brain changes associated with addiction: reward, stress, and self-control circuits.
Brain Imaging and Addiction
PET scan comparisons: Cocaine users vs. non-users.
Lower levels of D2 dopamine receptors in cocaine users.
Recovery changes: gradual return of dopamine receptors post-abstinence.
Motivations for Substance Use
Feeling Good: Intense pleasure experiences.
Stimulants (e.g., cocaine): Euphoria, self-confidence, increased energy.
Opioids (e.g., heroin): Relaxation and satisfaction.
Feeling Better: Use as a coping mechanism for anxiety and depression.
Enhancement of Performance: Pressure to improve focus academically or athletically.
Curiosity and Social Pressure: Particularly significant during adolescence.
Biological and Environmental Risk Factors
Variability in addiction susceptibility among individuals:
Genetic Factors: Account for 40-60% of risk, including epigenetic influences.
Mental Disorders: Higher risk for individuals with underlying mental health issues.
Environmental Factors: Influence of family, peers, and community.
Importance of recognizing multiple risk and protective factors affecting addiction probability.
Protective Factors Against Addiction
Positive family influences and support systems.
Healthy peer relationships and social skills.
Early educational engagement and success in schools.
Neuroscience of Addiction
Substances alter brain function, increasing dopamine release.
Problematic substance use categorized into three stages:
Binge Intoxication: Initial consumption and pleasure response (Basal Ganglia).
Withdrawal/Negative Effect: Emotional distress when the substance is absent (Extended Amygdala).
Preoccupation/Anticipation: Craving for the substance post-abstinence (Prefrontal Cortex).
Socio-Environmental Factors
Impact of trauma on substance use:
Types of Trauma: Acute, chronic, and complex trauma.
Connection between trauma experiences and substance misuse.
Adverse Childhood Experiences (ACE): Correlation to long-term health consequences and risks of developing SUD.
Early Substance Use and Long-Term Impact
Evidence suggests early drug use leads to a higher likelihood of developing addiction issues.
Importance of early prevention strategies and intervention.