All Things Substance

• What does progression mean when talking about addiction?
• How does progression relate to the DSM criteria?
• What addiction criteria shows up most often?

Progression is the key to addiction. It’s not about choice or willpower. It’s a biologically based occurrence that is a guarantee in addiction. Progression moves people along the stages of use into addiction, unless they are able to stop using before things move too far. 

In this Podcast: 

• Progression is the key factor in developing an addiction
• Progression happens because of the changes in the brain that we covered in episode 7
• For some people the consequences they face because of substance abuse is enough to stop them and progression can be halted
• People don’t tend to call for their substance use issues. Instead they tend to start with mental health and may or may not bring up their use to their therapist.
• The DSM criteria use the designation of mild, moderate and severe to categorize use disorders
• Tolerance is the most common criteria people present with
• Cravings tend to be one of the harder criteria for people to meet
• Withdrawal is almost always related to a severe use disorder, except where the substance is marijauna. Then withdrawal could appear in a moderate use disorder.
• Our goals change depending on what the client wants to work on and where they are in the progression of their use.

• What levels of use are there?
• How do I know which level of use my client is in?
• Do people bounce around in use stages or move in a linear fashion?

Stages of use are helpful in assessing your client's use and determining when you should be concerned about someone's use. It also helps direct our interventions so that we can tailor them more effectively.

In this Podcast:

• The stages of use are no use, experimentation, misuse, abuse and dependence
• When assessing, you are looking for the age at which a person entered into each phase and also looking at what stage they are in currently
• As with mental health disorders we are looking for patterns and events that caused changes or increase in substance use
• Current stage of use helps you know whether you are looking at prevention or intervention
• The stages of use pulls from episode 7 where we talked about changes in the brain and how it impacts behavior.

• What levels of use are there?
• How do I know which level of use my client is in?
• Do people bounce around in use stages or move in a linear fashion?

Stages of use are helpful in assessing your client’s use and  determining when you should be concerned about someone’s use. It also helps direct our interventions so that we can tailor them more effectively. 

In this Podcast: 

• The stages of use are no use, experimentation, misuse, abuse and dependence
• When assessing, you are looking for the age at which a person entered into each phase and also looking at what stage they are in currently
• As with mental health disorders we are looking for patterns and events that caused changes or increase in substance use
• Current stage of use helps you know whether you are looking at prevention or intervention 
• The stages of use pulls from episode 7 where we talked about changes in the brain and how it impacts behavior. 

• What reduces the risk of addiction?
• Will changing environmental factors help or is it just up to genetics?
• Is prevention only for kids?

This episode looks at the protective factors for addiction. Genetics isn't the only factor and much can be done to help improve people's chances of avoiding addiction. Addicts can tell you what they didn't get that they needed and perhaps unsurprisingly it's reinforced by research.

In this Podcast

• Environment plays a key role in raising or lowering a person's risk for developing an addiction
• The biggest protective factor is a secure attachment to the primary caregiver as evidenced by the child feeling supported, loved and having involved parental figures.
• School success (aided by parental involvement) is also a key protective factor
• Positive peer groups and involvement in pro-social activities reduce risk
• Additional caring adults are also helpful in reducing risk of addiction
• Adults are at risk too and peer groups also influence their use habits greatly
• Strong relational connections are important for all people

• What reduces the risk of addiction?
• Will changing environmental factors help or is it just up to genetics?
• Is prevention only for kids?

This episode looks at the protective factors for addiction. Genetics isn’t the only factor and much can be done to help improve people’s chances of avoiding addiction. Addicts can tell you what they didn’t get that they needed and perhaps unsurprisingly it's reinforced by research. 

In this Podcast 

• Environment plays a key role in raising or lowering a person’s risk for developing an addiction
• The biggest protective factor is a secure attachment to the primary caregiver as evidenced by the child feeling supported, loved and having involved parental figures. 
• School success (aided by parental involvement) is also a key protective factor
• Positive peer groups and involvement in pro-social activities reduce risk
• Additional caring adults are also helpful in reducing risk of addiction
• Adults are at risk too and peer groups also influence their use habits greatly
• Strong relational connections are important for all people 

• What makes one person become addicted to drugs and alcohol and another person doesn't?
• Does genetics have a lot to do with addiction?
• Is environment more important than genetics?

There are many factors that influence the development of an addiction. There are complex risk factors at play for each person. Genetics are a big deal, but the risk is more than just our biology. This episode focuses on what increases the risk of developing an addiction.

In this Podcast

• Genetics account for at least half (50%) if not more of the risk in developing an addiction
• The closer a person is related to addicted relatives the greater the risk
• There isn't one single gene responsible for addiction. Instead, its a combination of multiple gene variances
• Environment is more active as a risk factor in adolescence and later in early adulthood on up, genetics are more active in terms of risk.
• Mental health issues contribute to the risk of addiction.
• Environment (using peer group, parental/familial attitudes about substance use) do have an impact on risk.

• What makes one person become addicted  to drugs and alcohol and another person doesn’t?
• Does genetics have a lot to do with addiction?
• Is environment more important than genetics?

There are many factors that influence the development of an addiction. There are complex risk factors at play for each person. Genetics are a big deal, but the risk is more than just our biology. This episode focuses on what increases the risk of developing an addiction. 

In this Podcast 

• Genetics account for at least half (50%) if not more of the risk in developing an addiction
• The closer a person is related to addicted relatives the greater the risk
• There isn’t one single gene responsible for addiction. Instead, its a combination of multiple gene variances
• Environment is more active as a risk factor in adolescence and later in early adulthood on up, genetics are more active in terms of risk.
• Mental health issues contribute to the risk of addiction.
• Environment (using peer group, parental/familial attitudes about substance use) do have an impact on risk. 

• What role does the brain play in addiction?
• Is addiction a matter of willpower and choice or is it about biology?

Addiction is a hard thing for many people to talk about. Either their own addiction or their loved one's addiction. This is because addiction is destructive and it leaves people wondering "why" a person does this to themselves. In this episode we talk about what is happening in the brain when someone is using substances and address the question of how addiction happens.

In this Podcast

• Brain research has been done and outcomes show that the brain is physically changed by addiction in ways that make addiction thrive
• The basal ganglia has two subparts (nucleus accumbens and dorsal striatum) that are integral in the binge/intoxication stage
• The extended amygdala is involved with the withdrawal/negative effect stage
• The frontal cortex is involved with the preoccupation/anticipation stage
• Addiction creates powerful changes in need for pleasure, dopamine release, habit forming, increased sensitivity to stress and reduced ability to manage stress.
• The changes in the brain happen without a dramatic shift at one time so people don't notice they are in over their heads until its too late and addiction has set in.

• What role does the brain play in addiction? 
• Is addiction a matter of willpower and choice or is it about biology?

Addiction is a hard thing for many people to talk about. Either their own addiction or their loved one’s addiction. This is because addiction is destructive and it leaves people wondering “why” a person does this to themselves.  In this episode we talk about what is happening in the brain when someone is using substances and address the question of how addiction happens. 

In this Podcast 

• Brain research has been done and outcomes show that the brain is physically changed by addiction in ways that make addiction thrive
• The basal ganglia has two subparts (nucleus accumbens and dorsal striatum) that are integral in the binge/intoxication stage
• The extended amygdala is involved with the withdrawal/negative effect stage
• The frontal cortex is involved with the preoccupation/anticipation stage
• Addiction creates powerful changes in need for pleasure, dopamine release, habit forming, increased sensitivity to stress and reduced ability to manage stress. 
• The changes in the brain happen without a dramatic shift at one time so people don’t notice they are in over their heads until its too late and addiction has set in. 

• What exactly is addiction?
• Is addiction a choice or are addicted people victims of circumstance?

Episode 6 is the first part of a series about addiction. This episode defines the components of addiction according to generally recognized authorities like the American Society of Addiction Medicine. It also begins to address the question of whether or not addiction is a choice or a disease with a medical basis.

In this Podcast

• Three main sources of reputable information (links below)
• The five main components of addiction which are: inability to consistently abstain, impairment in behavioral control, cravings, decreased ability to recognize problems and dysfunctional emotional response.
• The above five features are qualities that will be present if there is an addiction
• Beginning assertion that addiction is not a choice. That a person says "yes" to feeling good and did not intend on saying yes to addiction.
• Addicted people are responsible for what they do while they are using. Addiction does not have to be a choice in order for people to be responsible for their actions.
• The brain science shows us that addiction is a biological problem