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Substance
Use Disorders...
"I
guess I really need to stop using alcohol and drugs -- certainly
my family wants me to -- but I've used for so long and have failed
so many times when I have tried to quit."
What are substance use disorders and addiction?
People with substance use disorders . . .
- Continue to use alcohol, drugs, or prescription medications
despite negative consequences.
- May become dependent on substances and use them regularly
or have a pattern of abuse in which they use more substances
than intended (a binge), or act recklessly while intoxicated
(fighting, driving while intoxicated, etc.).
- Often develop tolerance to the substance (more and more of
the substance is needed to give the high that previously resulted
from a small amount) and experience cravings and withdrawal
symptoms when they try to stop.
- Have often have had many unsuccessful attempts to abstain
from using substances.
- Often have problems with mood and anxiety that are entangled
with the substance use problem and may themselves require treatment.
The term addiction is used to describe a pattern in which
a person becomes trapped by his or her dependence on the substance,
meaning that that the person has developed tolerance to the
substance and experiences cravings and withdrawal symptoms when
he or she tries to stop using the substance. The term addiction
usually refers to substances, but can also refer to behaviors
like gambling, sex, and eating.
Cognitive-behavioral model of Substance Use Disorders:
People
generally begin using substances experimentally or for the "high"
associated with intoxication. As dependence develops, the substance
is used more regularly, and higher doses are required to produce
the desired effect and to avoid withdrawal. Situations and routines
associated with drug use become conditioned to drug seeking
and anticipation of their effects and trigger craving. Substance
abusers often rely on the substance to cope with unpleasant
emotions, stress, insomnia, and pain. All these factors lead
substance abusers to adapt their activities, environment, social
network, and sense of identity to accommodate a substance-abusing
lifestyle. Quitting the substance is extremely difficult, due
to withdrawal symptoms that emerge the moment the user abstains,
ever-present triggers to use the substance, positive beliefs
about the substance, and a substance-using lifestyle.
Cognitive-behavior
therapy for Substance Use Disorders:
Cognitive-behavior
therapy for substance use disorders involves:
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Guidance
to strengthen motivation to stop using substances
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Education and coping skills
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Learn the mechanisms that drive substance use, the triggers
that activate urges to use, and the course of withdrawal and
recovery.
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Learn skills to handle negative emotions and other stressors
that trigger urges to use.
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Preparation for initial abstinence and early recovery
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Develop a game plan to prepare for abstinence, including strategies
to anticipate and manage difficult situations.
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Obtain coaching and skills training during early recovery.
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Skills to maintain long-term recovery
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Develop a sense of identity, beliefs, and a lifestyle consistent
with recovery
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Learn strategies to prevent relapse
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Prepare an emergency plan to quickly regain sobriety if a relapse
occurs.
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