Some people develop problems with their substance misuse while otehr do not

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Combine abuse and dependence, 2/3 out of 11
DSM-V
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Dependency Syndrome, desire over all other activities, 3/6 in a year, more rapid reappearance of symptoms after abstinence
ICD-10
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Alcoholism curve - progressive and non reversible, component of A.A and N.A. Critical phase, chronic phase and rehabilitation
Jellinek 1960
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Alcoholims became a medical problem under WHO in
1951
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Progression dependent on predisposition factors eg age and gender
Royce 1989
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Chronic and incurable, only way to deal with it is abstinence, Recovering alcoholic
Royce 1989
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Compared addiciton with chronic illnesses, found heitability of both were similar as well as similar tratement as non-voluntary and only way is voluntray control
McLellan et al 2000
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Data: discarded 60/158 because averaged response, no females, A.A members only
Jellinek 1960
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Not everyone follows these stages
Vaillant 1983
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Not a uniform progression varies among each person and symptoms also progress and vary
Royce 1989
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More a matter of self control and will power as need to have abstinence even before first drink and this involves a different model
Fingarette 1988
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Do extert control, extent of which is dependent on variables such as availability, environment, rewards
Peele 1989
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Use of dependence rather than addiciton can cause confusion and certain individuals miss out on treatment
O'Brien et al 2006
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Courts rarely use this a valid defence
Miller and Hester 2003
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Drug tolerance: chnage in neural structures and become less responsive to the substance, Drug craving - alterations in brain activity
Lestner 2000
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Enjoyable use soon becomes self-sustaining and habitual, valued activities become devalued and deep-seated memories of drug enjoyment
Nutt 2011
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Individuals with low dopamine receptors had a more pleasurable reaction to Ritalin than those with a concentrated amount of receptors
Volkow
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20-25% of individuals with serious alcohol dependence may have inherited a predisposition
Badaway et al 1996
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Mutation of Dopamine D2 gene - individiuals with low receptors expereince life less intensly and self medicate
Noble
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Genetic and heritability - twin studies finding identical twins have a higher concordance of substance misuse probelms
McBride and Petersen 2002
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Adopted children have a predisposition if birth parents have a substance dependency even if brought up in a different environment
Heath 1995
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Addicitive Personality
Miler 2003
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Self efficacy and emotional stressors
Marlatt 1985
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Attachment Theory
Ainsworth and Bowlby 1991
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Self medication theory, suffer emotions more intensly or not at all and self-medicate, excitres or quiets, not a compulsion
Khantzian 1985
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Heart of addcition is psychological, hopelessness and powerlessness, biological does not explain why use in the first place
Dodes 2002
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Use specific drug to solve internal storm, problem solving difficulties, self-care
Khantzian 1999,2011
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Lack of an ability to self-soothe
Rinsley 1988
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Independent too soon - no sense of self
Walant 1995
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Inetrnal self structure
Levin 2001
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Fulfil own destiny
Bolas 1989
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Biological persective fails to account for the endurance and power of relapse, and also very few state they remain to use due to pleasuer
Khantzian 2012
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Pleasure seeking explanation allows addiction to be drawn into the CJS, SMH allows for a therapeutic relationship to be developed to reduce harm
Brady 2012
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SMH - If trying to cure themselves why do they use substances that cause such harm in the long run
Darke 2013
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Fail to see the harm that may occur as too strong a drive to reduce pain
Khantzian 2013
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Define populatiosn more at risk of substance misuse: young in indutrialised societies, poverty and low rate among those that prohibit use
Westermeyer 1999
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Class, peers, family, availability, accessibility, culture and norms
McBride and Petersen 2002
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Greater involvement in substance use among young people increases the liklihood of peer members also misuse
Steinberg et al 1994
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Social deprivation: poor housing, poor environment, restrcited access to education, employment, recreational activities
McBride and Petersen 2002
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Drug, set and setting
Zinberg 1985
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Multivariate syndrome
Pattison and Kaufman 1982
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Not all individiuals fit the disease model and so need a varity of tratment approaches
Fisher and Harrison 2012
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Inetraction of psychological, biological, cogntive, developemental,social and environemental
Donovan 2005
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Dependency Syndrome, desire over all other activities, 3/6 in a year, more rapid reappearance of symptoms after abstinence

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ICD-10

Card 3

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Alcoholism curve - progressive and non reversible, component of A.A and N.A. Critical phase, chronic phase and rehabilitation

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Preview of the front of card 3

Card 4

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Alcoholims became a medical problem under WHO in

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Card 5

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Progression dependent on predisposition factors eg age and gender

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