Rebound Workshop by veeru5656


									Back to Basics & Into Action
    Renewal, Rebuilding, and

   A Lifestyle of Recovery:
   Rebound, Relapse and
► KevinScheel
 Director of Educational Services
 Distance Learning Center for Addiction Studies
   Alcohol and Drugs in America
► Beverage   alcohol played an important role in the
  history of the United States.
► The Mayflower landed at Plymouth Rock because,
  as it says in the shop's log, "We could not now
  take time for further search or consideration, our
  victuals having been much spent, especially our
► Alcoholic beverages were an important source of
  fluid and nutrition for early American settlers.
► Spanish  missionaries brought grapevines to
  the New World, and before the United
  States was a nation, Spaniards were making
  wine in California.
► The Dutch opened the first distillery on
  Staten Island in 1640.
► Whiskey was produced during and after the
  Revolutionary War as a backwoods
  substitute for rum
► Whiskey   became a key trade commodity
  during the Revolutionary War. After the
  war, it was a major form of barter here in
  the United States.
► Fire gutted a warehouse at a church
  sponsored distillery, burning oak barrels
  (Elijah Craig) creating . . .
► Cocaine
► "Pemberton's French wine coca"
► 1886 - 'Coca-Cola: the temperance drink'
► Opium,   morphine and codeine
   Opium dens
   Civil War
   Tuberculosis
► 1898 – “Cure for Narcotic Addiction”
► Snake Oils and Elixirs
   Dilaudid
► Moving   forward – prescription medications
   Amphetamine – 1927
   Synthetic Narcotics
   Tranquilizers (Miltown 1954)
► 1960’s   and beyond – Drug Revolution
         History of Treatment
► Dr. Benjamin Rush – Jefferson Era
► Rush believed that the alcoholic loses
  control over himself and identified the
  properties of alcohol, rather than the
  alcoholic's choice, as the causal agent.
► In 1791 the government placed first tax on
  liquor, sparking the Whiskey Rebellion of
► The Jefferson era was known for rampant
  problems associated with alcohol.
► The Temperance Movement was founded in
  this era with the goal of "moderation" in the
  consumption of beverage alcohol.
►A  variety of groups, including the
  Independent Order of Good Templars of
  1850, grew and expanded across the United
► By 1869 the movement became known as
  the National Prohibition Party, advocating
  the complete suppression of liquor by law.
► 1906   – Pure Food and Drug Act
   Lydia Pinkham’s Vegetable Extract
   Mother Winslow’s Soothing Syrup
► 1914 – Harrison Narcotic Act
► 1917 the 18th Amendment to the Constitution was
  passed by Congress.
   The law went into effect on January 16, 1920.
   Repealed by 21st Amendment in 1933, which was
    introduced into Congress by Franklin D. Roosevelt.
 In 1935 a business man by the name of Bill
  Wilson was traveling in Akron, Ohio after a
  one year bout with sobriety
► In 1939 the book "Alcoholics Anonymous"
  (The Big Book) was first published.
     the program began to grow rapidly after the
      publication of the AA story in the Saturday
      Evening Post in 1940.
► Late   1940’s – Minnesota Model
   1948 – Pioneer House
   1949 – Hazelden
   1950 – Wilmar State Hospital
► 1950’s   – E.M. Jellinek and the AMA
   Disease Model
► Alcoholism is an illness characterized by
 preoccupation with alcohol; by loss of
 control over its consumption, such as to
 usually lead to intoxication or drinking done
 by chronicity; by progression and by
 tendency to relapse. It is typically
 associated with physical disability and
 impaired emotion, occupational and/or
 social adjustments as a direct consequence
 of persistent and effective use.
► 1960’s   Vernon Johnson – “I’ll Quit
       – Harold Hughes and the Nixon
► 1970’s
   NIDA
   NIMH
► Growth    of the Treatment Industry
► 1972– National Association of Alcohol and
 Drug Abuse Counselors
► 1981– International Certification and
 Reciprocity Consortium
           Treatment Works
► 1980’s – Industry Boom
► 1990’s – Industry Bust
   Profits over Performance
   Resistance to Managed Care
► Treatment Days declined from an average
 of 29.5 days to 9.2
   This despite innovative approaches to care
           What is Addiction?
► Definitions   of Addiction on the Web:
   Psychological and bodily dependence on a
    substance or practice which is beyond voluntary

   An illness in which a person seeks and
    consumes a substance, such as alcohol, tobacco
    or a drug, despite the fact that it causes harm.
 A primary, chronic, neurobiologic disease, with
  genetic, psychosocial, and environmental factors
  influencing its development and manifestations.
 Uncontrollable craving, seeking, and use of a
  substance such as a drug or alcohol.
 Psychological and/or physiological reliance on a
  substance, typically characterized by cravings and
  compulsive use, neurochemical changes in the
  brain, and possibly withdrawal symptoms when the
  substance is stopped.
 Is characterized by the repeated use of a
 substance or behavior despite clear evidence of
 negative consequences resulting from the use
 of the substance or behavior. Addiction usually
 has two components – physical addiction and
 psychological addiction.
 A maladaptive pattern of substance use, leading
  to clinically significant impairment or distress, as
  manifested by three (or more) of the following,
  occurring at any time in the same 12-month
   ►7   items for consideration
► New AMA definition, as published in The Journal of
 the American Medical Association, August 26,
   Alcoholism is a primary, chronic disease with genetic,
    psychosocial, and environmental factors influencing its
    development and manifestations. The disease is often
    progressive and fatal. It is characterized by impaired
    control over drinking, preoccupation with the drug
    alcohol, use of alcohol despite adverse consequences,
    and distortions in thinking, most notably denial. Each of
    these symptoms may be continuous or periodic.
           What is Recovery?
► Definitions   of Recovery on the Web:
   The act or process of regaining or repossession
    of something lost
   A return to normal health
   Refers to end of a particular illness. In the case
    of meth addiction, recovery begins when the
    addict makes the decision to abstain not only
    from the use of the drug, but to change the
    drug lifestyle.
  9-12 years average onset
  9-14 days of treatment on average
►Major   Disconnect!
► Homeostasis
   The ability of a system or living organism to
    adjust its internal environment to maintain a
    stable of equilibrium
   Hypothalamus
► Regulation   by neurotransmitters
   Acetylcholine - voluntary movement of the
    skeletal muscles (via the sympathetic pathways)
    and movement of the viscera (via the
    parasympathetic pathways)
   Norepinephrine - wakefulness or arousal - via
    the sympathetic pathways
   Epinephrine - similar to nor-epinephrine. Large
    amounts of it are produced and are released by
    the adrenal glands. Also called adrenaline.
 Dopamine - voluntary movement and
  motivation, "wanting", pleasure, associated with
  addiction and love
 Serotonin - memory, emotion, wakefulness,
  sleep and temperature regulation
 GABA - inhibition of motor neurons
 Glycine - spinal reflexes and motor behaviour
 Neuromodulators - sensory transmission,
  especially pain
► Homeostasis      and Rebound
     Use
     Misuse
     Abuse
     Dependence
►A    Lifestyle of Addiction
► Homeostasis    and Recovery
► A Lifestyle of Recovery
     Bio
     Psycho
     Social
     People, Places, Things
► Continuum     of Recovery

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