Addictions guest lecturers.docx

Guest Lecturers Eating disorders and substance abuse Anorexia nervosa  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. Bulimia nervosa  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 Binge eating  Associated with obesity  No purging behavior Pica  Eating non-edible items Rumination  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 light. Statistics  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 abuse “concern”  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 Treatment matching 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  Hospitalization  Behavioral therapy  Cognitive/support-expressive techniques Traumatic brain injury and substance abuse 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 Mild Less than 10 minute loss of consciousness Moderate - 10 minutes to 6 hours of loss of consciousness Severe Over 6 hours of loss of consciousness Gender differences Men are more likely to suffer TBI past adolescence. Probably due to increased aggression, workplace hazards, etc. Phineas gage 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  Irratibility  Impulsiveness  Lack of control over violent behavior  Poor social judgement  Symptoms depend on location of injury Cognitive symptoms  Trouble concentrating  Memory  Learning impairment  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. Co-occurrence 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 with TBI  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 Premise  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 interventions. 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 developmental characteristics. “emerging adults”  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