Summary Social Work 478 - Substance Abuse

PROCESS OF ADDICTION

Definition

 “Alcoholism is a chronic, progressive treatable disease in which a person has lost
control over his or her drinking so that it is interfering with some vital area of his or her
life such as family and friends or job and school or health” – Jellinek, WHO
 Influence individuals on different levels – physical, emotional, family, religious,
occupational

Four phases of addiction (Alcoholism and Meth use)

1. Pre-Alcoholic phase // Experimental phase
 Social drinking or use
 Relaxed feeling
 State of intoxication (drunk or high)
 Develop an attitude change towards substance
 Drink or use for affect, or problem management
 Ambivalent feelings
 Increased tolerance
 Blackouts
 Sneaking drinks or usage
 Chronic “hangovers”


2. Early alcoholic stage // Harmful incident phase
 Loss of control
 Experience problems due to use or drinking
 Preoccupation with alcohol or drug
 Avoid conversations about damage of alcohol or drug
 Create alibis
 Anti-social behaviour
 Loss of friends, work
 Promises to stop
 Defence mechanisms
 Denial
 Rationalisation
 Projection
 Minimisation

,3. Critic alcoholic phase // Continued use
 Overall loss of control
 Loss of time and place
 Grandiose behaviour
 Aggressive behaviour
 Increased feelings of guilt
 Maintain periods of soberness
 Change drinking or usage pattern
 “Fixers”
 Hiding of alcohol or drugs
 Geographical escape
 Make other friends who are involved in substance use
 Social loneliness
 Role change
 Experience problems on all levels of functioning
 Physical deterioration
 Suicidal thoughts


4. Chronic phase // Dependency
 Morning drinking or usage
 Benders: long periods of drunkenness or being high – “Drinking to escape the
problems of drinking”
 Decrease in resistance
 Tremors – the shakes
 Hallucinations
 Nameless fears and anxieties
 Collapse of alibi system
 “Surrender” process

,Models of addiction

 Different models can be used to declare addiction
 Personal experiences, convictions and values


1. Moral model
 Personal choice
 Decided to use substance
 Problematic behaviour
 Religious groups – use is sin and wrong
 Legal system – responsible for own deeds


2. Sociocultural model
 External to individual
 Culture plays a role
 Religion
 Family
 Peer group


3. Psychological model
 Drug use seen as secondary problem
 That results from primary problem
 Compulsive behaviour
 Addictive personality
 Social learning theory – modelling
 Sociocultural factors


4. Medical model
 AA supports this model
 Disease concept
 Jellinek curve – 1960
 Primary disease
 Phases of addiction
 Early stage – increased tolerance, blackouts, sneaking drinks, guilt
 Middle stage – loss of control, personality changes, loss of friends or job,
preoccupation with alcohol or drugs

,  Chronic stage – morning drinking, violation of ethical standards, tremors,
hallucinations
 These phases are progressive
 Influenced by age, type of substance, gender, physiological predisposition
 Irreversible
 Cure – abstinence


5. Biopsychosocial model
 Incorporates all other models
 Interaction between biological, psychological, cognitive, social, developmental and
environmental variables
 Effective treatment: all variables are considered



Conclusion

 Moral model – discourage individuals from treatment
 Sociocultural model – environmental factors
 Psychological model – personality factors
 Medical model – medical orientation, focus on abstinence
 Biopsychosocial model – more useful model, focus on different variables.