Eating disorders and substance abuse
There are 2 types of anorexia nervosa, the restricting type who simply
restrict their caloric intake and the binge eating purging type who purge the
food they eat through vomiting and laxatives.
There are 2 types of bulimia, the purging type who consume too many
calories and then purge them and the non-purging type who do not purge.
Bulimic people tend to overeat and are comforted by eating. This behavior
appears to be about losing control through eating and gaining control
through purging. They also tend to be impulsive about shopping and sex.
Bulimic people tend to maintain a normal body weight
Associated with obesity
No purging behavior
Eating non-edible items
This is where you consume a normal amount of food, vomit it back up, and
then eat it again.
Pro ana/pro mia refers to subcultures that view anorexia and bulimia in a positive
55% of people experiencing an eating disorder will also experience a
substance abuse “concern”
12-18 percent of people with anorexia nervosa will experience s substance
30-37 of bulimics will experience a substance abuse “concern”
Anorexia nervosa affects women more than men (90-95%)
Anorexia is strongly associated with bulimic symptomatology. That is,
anorexia and bulimia share some of the same symptoms.
Both disorders are characterized by a desire to get rid of food after eating.
People with anorexia are more likely to use legal drugs as opposed to illegal
drugs. They are not big risk takers.
Bulimic men are more likely to be uncomfortable with their sexualities.
Bulimic Eating Disorder and substance abuse disorders
Substance abuse among bulimics is more common in women (2% or general pop)
Their drugs of choice are cigarettes, alcohol, street drugs
Unlike people with anorexia, they do not tend to use laxatives and diet pills
For bulimia nervosa
Supportive, expressive psychodynamic therapy (non-directive manner)
Cognitive Behavioral Therapy (think change act)
Interpersonal therapy (fix the inside first)
For Anorexia nervosa
Cognitive/support-expressive techniques Traumatic brain injury and substance
TBI is characterized by an external force injury to the brain. TBIs can be either
closed (skull is not penetrated) or open (skull is penetrated).
Degrees of TBI
Less than 10 minute loss of consciousness
10 minutes to 6 hours of loss of consciousness
Over 6 hours of loss of consciousness
Men are more likely to suffer TBI past adolescence. Probably due to increased
aggression, workplace hazards, etc.
Before his injury to his prefrontal cortex, he was a nice guy, after he had a rod forced
through his prefrontal cortex; he turned into a total dick. (That’s the scientific term)
Behavioral symptoms of TBIs
Lack of control over violent behavior
Poor social judgement
Symptoms depend on location of injury
Trouble with abstract thinking
Cognitive symptoms are dependent on the location of the brain damaged
Symptoms might also affect developmental stages Can cause depression/anxiety
TBI and substance abuse
TBI symptoms can mask symptoms of substance abuse. Indeed, People with
TBI tend to score poorly on roadside sobriety tests.
On cognitive tests, people with mild TBI scored the same as people with
substance abuse problems. However these studies don’t specify severity of
substance abuse or the type of substance.
One third of substance abusers report 1 or more TBI
60% say it was a result of their substance abuse
Reasons for co-occurrence
Some substances can increase ingression (hello, alcohol)
Prison population and TBIs
TBI among the general population is 7-20 percent, while among the prison
population, it’s 40-80%.
Substance abuse among the general population is 10% while substance
abuse among the prison population is 70-80%
In offenders most common cause of TBI is fights
Only 12% reported their TBI was linked to their criminal behavior
Treatment implications for offender substance abusers
We need to target criminogenic needs (substance abuse) because they affect
the likelihood that the client will reoffend.
Practice the principle of responsivity. Target how the offender learns. If they
have poor concentration due to their TBI, they should not be placed in large
groups where they can be distracted.
Consider severity of substance abuse. (treatment matching)
Consider severity and location of TBI (consider how the TBI has affected the
offender, for example, if they have concentration issues, etc) A comparison of drug use patterns among
young adult offenders and older offenders
Health risks are associated with substance abuse such as dependency,
overdose, hiv, etc.
There is a high concentration of drug users in prisons
Health and treatment needs should be met by prisons
There is a need for evidence based strategies
Prisons are high risk environments for continuing drug use
Young adults and older adults in prison need to be targeted with different
Identifying young adults
In the past, research has focused only on adolescents and adults, however a third
age group—called “emerging adults”—has been identified with different
Are young adults unique from older adults?
Do they have different drug use patterns?
Do they have different needs?
3 studies characterized young adults being between 18-24
However, there is no agreed upon definition of a young adult. This is because
there is a lack of high quality research on this age group
Current researcher shows tentative evidence showing different drug use
patterns among young adults compared to older adults
Drug use before incarceration
Young adults describe their drug use as “recreational