Substance Abuse and Addiction
I. What is it
loss of control in many aspects of life (failing out of school, not able to work,
characterized by cravings (intense desire); craving itself can be almost as
intense as trip
persistent use despite negative consequences
tolerance and withdrawal symptoms—when substance has left body we still
have symptoms (hangover is technically withdrawal)
about 10% of population is seriously abusing or are addicts. True worldwide.
28.7 million children live in an alcoholic home. Point is that this is all over the
world, not just the US.
III. How it affects brain
A. Two parts:
1. Limbic brain: survival, food, sleep, sex. Manages all autonomic functions
and balance. Gas pedal (shoots out adrenaline).
2. Cerebral cortex: calms down/rationalizes after limbic brain releases
adrenaline. Consciousness, social judgments, emotional response. Rational
B. Hedonic setpoint: required in limbic brain in brainstem. Balance system.
“Pleasure system.” Equilibrium exists around a set point.
dysphoria and dopamine hormone hang in constant balance. Dopamine
surges with joy and good news. Substances make an intense, crazy, sharp
upwards slope in dopamine. The higher the slope, the more addictive the
C. Koep’s Theory: there must be substances present in the brain first; when there
are frequent and short bursts of dopamine in the brain, it causes addiction. Then
our brains have to work overtime to make dysphoric hormones like cortisol (lower
lows) to get back to equilibrium. To beat this low, people use again.
D. McCauley’s Theory: when people have chronic, severe and unmanaged stress,
that also can mess our hedonic center; we don’t substances present first.
anhedonia: increased risktaking
about 1/3 of population will hope risks pass, 1/3 will do what they always
do, 1/3 will take more risks (those with risk taking genes)
when this happens, drugs are tagged by our limbic brains as survival.
Drugs become a basic need. After using for so long, cerebral cortex just
goes black. Goodbye emotional response, future consequences. Everything
that hurts feels recent, and there’s no way to process it because cerebral
cortex is blacked out.
IV. What affect does this have on relationships?
A. same throughout the world. Relationships characterized by chaos and fear. No
longer predictable and safe. Entire family system reorganizes itself around addict
and addiction B. Black: Family Scripts and Roles
1. role of addict, role of enabler: person who allows it to happen; makes it
easier for them to do what they do. Because I love them most, I am most
able to take care of them.
2. family hero, scapegoat
• relationships are also characterized by diffuse boundaries (when your boundary
completely overlaps with someone else’s. If you’re angry, I’m angry, and it’s my
job to fix it).
C. mental and physical health problems follow relationship partners of addicts
D. relationship characterized by thinking errors (illogical statements we make to
ourselves): I’ve been sober for a week! I deserve a beer.
classic enabler thinking errors: If I love this person enough, they will get
over it. Only I can handle this.
E. The marriage effect: after marriage their use declines. As individuals, once we
get married we have more responsibility, are forced to mature, have less time to
F. Gender differences in drug use: in general, people decline their use when
married, but women tend to be really influential to their mates (if woman doesn’t
use/uses less, rate of decline for man will be steeper, and vice verse)
G. Use predicts negative martial outcomes:
1. heavy smoking/drinking is a risk factor for divorce
2. use discrepancy predicted marital dissatisfaction
3. heavy smoking in turn predicts early marriage
4. increased hostile behavior when man is alcoholic
5. likely to reinstate or increase use post divorce
V. Best treatment
the nest kinds of treatment need all these:
a. individual desire
b. family support/treatment
c. groups (like AA)
e. regular and predictable support and accountability (like drug test every three
Power ability to influence others and resist others’ influence. Control of valuable
resource (or access to it). Whatever resource your partner desires. Not necessarily
negatice; mutual powersharing is how a relationship works.
I. influences on power
A. dependency how dependent are we on this other person to get what
we want/need (money, sex, etc)? Traditional example is homemaker,
who is dependent on breadwinner.
B. Alternatives you have more power if you have a high level of
alternatives. Not as dependent on that one person if you have other
places to go
II. Principle of lesser interest: person with the least interest in the relationship
has the most power (why playing hard to get works to some extent). III. Fate control v. Behavioral control (fate control= the other person’s fate is
completely in our hands, such as with the breadwinner and stayathome
mom example. Behavioral control= alter our behavior to control others).
IV. Types of power
A. reward= do something pleasurable or take away something unpleasant.
Could be explicit (stated) or subconscious.
B. Coercive= adding something unpleasant or taking away something
pleasant to get what you want. Can be anything from violence to
belittling and nagging. Unhelpful in relationships; parties are less
likely to compromise, engage and coordinate.
C. Legitimate power= everyone agrees that this person has more power
than us (police officers etc).
D. Referent= power because someone loves us. We can influence
someone else because they love us.
1. Goffman says that men who are more open to influence from their
wives because of referent power will have longer and happier
relationships. Not the same for women; they are pretty open to
men’s influence anyway
E. Expert power= people who have more knowledge in a field have more
power than us (doctors)
F. Informational power= someone having a specific piece of information
you need/want has power over you
V. Mutual Powersharing= most people in this country seek an egalitarian,
equal relationship but do not have it.
A. yes we share power, but typically men have more power than women,
due to social norms, physical strength and size, economic power (due
to wage gap)
B. a lot also has to do with children and transition to parenthood. We
don’t have time to negotiate new responsibilities so we slide into
traditional gender roles
C. part of the reason we have a wage gap (women have more
discontinuous wage trajectory because of maternal leave. Also women
are not socialized to negotiate for raises).
VI. Powerful people
A. have asymmetrical body language, take up more space, look up when
they talk and away when they listen. Talk more directly, using
declarative sentences (“I want…” “The move is at…”). Someone with
less power is hesitant in their speech
B. women speak more hesitantly when talking to another man, but not
other women (if women talk directly to a man they are considered cold
and a bitch).
C. Nonverbal sensitivity people who are in high positions of power
aren’t as good at this as others
VII. Styles of power
A. Direct v. Indirect 1. this is what I want. Here’s what I would like you to do differently.
(men, people in power, high in instrumentality, people in satisfied
2. hint at what I want. Women, people in less power.
B. Bilateral v. Unilateral
1. bilateral= both sides come together to work it out. Used more often
by people with high power who have less to risk