Chapter 2 - The Many Faces of Substance Misuse
"People think I do drugs because I'm self-destructive. But, if anything, I am averting suicide. I
don't much like my life, but for some dumb reason, I want to be alive, because sooner or later, I
figure it will work out. I should and could be in New York, taking steps toward making it work, but
I've been trying that for years, and is no longer feasible. I can't do it anymore. I give up. I
surrender. The only thing keeping me from killing myself is drugs - and the fact that I can still run
away."
Elizabeth Wurtzel
The drug of choice is harmonious with the user's characteristic means of reducing stress.
ON THE PREFERENTIAL ® Ground-breaking that the teacher conducted J
ABUSE OF HEROIN AND
Most likely is the question of whether alcohol and drug abusers' dyed-in-
AMPHETAMINE
• MILKMAN, HARVEY; the-wool hedonists and covertly suicidal are not true.
FROSCH, WILLIAM A.
• The Journal of
Nervous and Mental According to Khantzian, an individual's substance vulnerability is founded
Disease. 156(4):242- on what Carl Jung famously referred to as spiritum contrathe spirit
248, April 1973.
spiritus; that is, spirituality can overcome spirits (alcohol). This
formulation implies that harmful involvement with mind-altering
chemicals is related to our drive for comfort, connection, and wholeness. DRUGS PUSH ASIDE
SUFFERING.
¬ This quote captures the
• Khantzian developed the “self-
essence of this perspective medication” model of addiction
• According to Khantzian there are
4 main areas of human suffering
that evoke dependence on
hedonic pursuits –
– Emotions
– Self-esteem
– Relationships
– Self-care
• This model incorporates a more
Khantzian reminds us that the view of addiction as "pleasure- humane, person-centered view of
addiction
seeking" Is a widely held misperception that contributes to
the idea that addiction should be managed in the criminal justice sector rather than be viewed as a
disease or disorder. The notion that addictions manifest suicidal intent is another misguided
1
, perception… most people with addictions have dreams and aspirations for the future and look
forward to the day they have sustained abstinence and stability in their lives. Khantzian reminds
us to treat our addicted patients with the compassion, care, and understanding they need to
overcome their addiction. Females abuse substances = to cope with abusive experiences, and
males abuse substances = to cope with suffering from traumatic life events. (Sharp, 2003)
Mental Health and Substance Abuse
for the concept of self-medication to apply, the substance user must have some sort of condition
from which they seek relief. Chicken and the egg problem:
© Self-medication implies that the condition (typically psychological in nature) came first,
leading the person to adopt the use of substances to help ease the discomfort of the
condition. Often co-occurring states have a reciprocal relationship that worsens both
conditions. The common factors (genetics, traumatic experiences, etc.) may denote a
tendency for a person to develop both addiction and another psychological condition.
Although it is possible that one of the conditions preceded the other, the tendency for them
to co-occur may be due to sharing genetic vulnerabilities and common environmental risk
factors – the same brain regions may be involved in mental illness as in substance use or
both are considered to be developmental disorders.
Because of what is written in the text box, NIDA 2012 - Individualized treatment approaches strive
to treat the entire person with all of their issues rather than • NIDA (2012): 4 out of 10
substance abusers have co-
addressing an addiction separately.
occurring psychological disorders
• Common co-occurring disorders –
– Personality disorders-
antisocial and borderline
– Mood disorders – major
depression and bipolar
– Anxiety disorders – post-
traumatic stress disorder
– Schizophrenia
– ADHD
Figure 2.1 Past year substance Use
Disorder and Mental Illness among Adults Aged 18 and older, 2014. According to these survey data, 39% of
U.S. adults with substance use disorders had a co-occurring psychological disorder. (SAMHS, 2015)
2
"People think I do drugs because I'm self-destructive. But, if anything, I am averting suicide. I
don't much like my life, but for some dumb reason, I want to be alive, because sooner or later, I
figure it will work out. I should and could be in New York, taking steps toward making it work, but
I've been trying that for years, and is no longer feasible. I can't do it anymore. I give up. I
surrender. The only thing keeping me from killing myself is drugs - and the fact that I can still run
away."
Elizabeth Wurtzel
The drug of choice is harmonious with the user's characteristic means of reducing stress.
ON THE PREFERENTIAL ® Ground-breaking that the teacher conducted J
ABUSE OF HEROIN AND
Most likely is the question of whether alcohol and drug abusers' dyed-in-
AMPHETAMINE
• MILKMAN, HARVEY; the-wool hedonists and covertly suicidal are not true.
FROSCH, WILLIAM A.
• The Journal of
Nervous and Mental According to Khantzian, an individual's substance vulnerability is founded
Disease. 156(4):242- on what Carl Jung famously referred to as spiritum contrathe spirit
248, April 1973.
spiritus; that is, spirituality can overcome spirits (alcohol). This
formulation implies that harmful involvement with mind-altering
chemicals is related to our drive for comfort, connection, and wholeness. DRUGS PUSH ASIDE
SUFFERING.
¬ This quote captures the
• Khantzian developed the “self-
essence of this perspective medication” model of addiction
• According to Khantzian there are
4 main areas of human suffering
that evoke dependence on
hedonic pursuits –
– Emotions
– Self-esteem
– Relationships
– Self-care
• This model incorporates a more
Khantzian reminds us that the view of addiction as "pleasure- humane, person-centered view of
addiction
seeking" Is a widely held misperception that contributes to
the idea that addiction should be managed in the criminal justice sector rather than be viewed as a
disease or disorder. The notion that addictions manifest suicidal intent is another misguided
1
, perception… most people with addictions have dreams and aspirations for the future and look
forward to the day they have sustained abstinence and stability in their lives. Khantzian reminds
us to treat our addicted patients with the compassion, care, and understanding they need to
overcome their addiction. Females abuse substances = to cope with abusive experiences, and
males abuse substances = to cope with suffering from traumatic life events. (Sharp, 2003)
Mental Health and Substance Abuse
for the concept of self-medication to apply, the substance user must have some sort of condition
from which they seek relief. Chicken and the egg problem:
© Self-medication implies that the condition (typically psychological in nature) came first,
leading the person to adopt the use of substances to help ease the discomfort of the
condition. Often co-occurring states have a reciprocal relationship that worsens both
conditions. The common factors (genetics, traumatic experiences, etc.) may denote a
tendency for a person to develop both addiction and another psychological condition.
Although it is possible that one of the conditions preceded the other, the tendency for them
to co-occur may be due to sharing genetic vulnerabilities and common environmental risk
factors – the same brain regions may be involved in mental illness as in substance use or
both are considered to be developmental disorders.
Because of what is written in the text box, NIDA 2012 - Individualized treatment approaches strive
to treat the entire person with all of their issues rather than • NIDA (2012): 4 out of 10
substance abusers have co-
addressing an addiction separately.
occurring psychological disorders
• Common co-occurring disorders –
– Personality disorders-
antisocial and borderline
– Mood disorders – major
depression and bipolar
– Anxiety disorders – post-
traumatic stress disorder
– Schizophrenia
– ADHD
Figure 2.1 Past year substance Use
Disorder and Mental Illness among Adults Aged 18 and older, 2014. According to these survey data, 39% of
U.S. adults with substance use disorders had a co-occurring psychological disorder. (SAMHS, 2015)
2
