Fam

ily

Ed

uca

tion

Session 1:Triggers and Cravings

1-1

Fam

ily

Ed

uca

tion

Matrix IOP

Changes in the Brain

1-2

Fam

ily

Ed

uca

tion

Matrix IOP

Conditioning

1-3

Fam

ily

Ed

uca

tion

Matrix IOP

I.P. Pavlov (1849–1936)

1-4

Fam

ily

Ed

uca

tion

Matrix IOP

Pavlov’s Dog

1-5

Fam

ily

Ed

uca

tion

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

Fam

ily

Ed

uca

tion

Matrix IOP

The Addictive Process

Introductory phase Maintenance phase Disenchantment phase Disaster phase

1-7

Fam

ily

Ed

uca

tion

Addictive ProcessIntroductory Phase

METHAMPHETAMINE (METH)PositivesRelief from

DepressionAnxietyLonelinessInsomnia

EuphoriaIncreased statusIncreased energyIncreased sexual/social confidenceIncreased work outputIncreased thinking ability

Negatives

May be illegal

May be expensive

May cause missing work

Matrix IOP 1-8

Fam

ily

Ed

uca

tion

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

Fam

ily

Ed

uca

tion

Matrix IOP

Development of Obsessive ThinkingIntroductory Phase

1-10

Fam

ily

Ed

uca

tion

Matrix IOP

Development of Craving ResponseIntroductory Phase

1-11

Fam

ily

Ed

uca

tion

Negatives

Employment/school disruptions

Relationship concerns

Financial problems

Beginnings of physiological dependence

Matrix IOP 1-12

Addictive ProcessMaintenance Phase

Positives

Depression relief

Confidence boost

Boredom relief

Sexual enhancement

Social lubricant

Fam

ily

Ed

uca

tion

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

Fam

ily

Ed

uca

tion

Matrix IOP

Development of Obsessive ThinkingMaintenance Phase

1-14

Fam

ily

Ed

uca

tion

Matrix IOP

Development of Craving ResponseMaintenance Phase

1-15

Fam

ily

Ed

uca

tion

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

Fam

ily

Ed

uca

tion

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 Phase

Strength of Conditioned Connection: Strong

Matrix IOP 1-17

Fam

ily

Ed

uca

tion

Matrix IOP

Development of Obsessive ThinkingDisenchantment Phase

1-18

Fam

ily

Ed

uca

tion

Matrix IOP

Development of Craving ResponseDisenchantment Phase

1-19

Fam

ily

Ed

uca

tion

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

Fam

ily

Ed

uca

tion

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 Phase

Strength of Conditioned Connection: OVERPOWERING

Matrix IOP 1-21

Fam

ily

Ed

uca

tion

Matrix IOP

Development of Obsessive ThinkingDisaster Phase

1-22

Fam

ily

Ed

uca

tion

Matrix IOP

Development of Craving ResponseDisaster Phase

1-23

Fam

ily

Ed

uca

tion

Matrix IOP 1-24

All Downhill

Fam

ily

Ed

uca

tion

Matrix IOP 1-25

All Downhill, but with Interruption

Fam

ily

Ed

uca

tion

Matrix IOP

Thought Stopping

Visualization Rubberband snap Relaxation Calling someone

1-26

Fam

ily

Ed

uca

tion

Matrix IOP

Thought Stopping

Visualization

1-27

Fam

ily

Ed

uca

tion

Matrix IOP

Thought Stopping

Rubberband Snap

1-28

Fam

ily

Ed

uca

tion

Matrix IOP

Thought Stopping

Relaxation

1-29

Fam

ily

Ed

uca

tion

Matrix IOP

Thought Stopping

Calling Someone

1-30