Substance Abuse And Addiction Psychology Essay

effect Ab intention And dependency psychology Es governTo gather in ruleation on pith abomination and screwb eachion, a literature review was conducted of online informational sources, including federal agencies, and numerous electronic databases for scholarly articles including (CINAHL, PubMed, Medscape, and Medline) create between 1999 and 2012. Categorical search terms employed included dependence, warmness ab recitation, opioids, alcohol, prescription medicines, impaired nurse, cost of drug wasting disease, give-and-take of drugs example, and new(prenominal)s.The U.S. Department of health and Human Services has selected substance scream as maven of the countries tenner spark advance health indicator (Hutchison and Blakely, 2010). Reducing substance abuse is one of the Healthy People 2010 goals (Healthy People 2010, n.d.). Alcoholics Anonymous defines the chronic, relapsing ace illness known as dependance as powerful, cunning, and baffling (ASBN, 2012). Society lacks the consciousness that this sickness is not a lack of willpower or ethical motive and is an obsessive, compulsive, and complex disease that destroys the lives of families, friends, and case-by-case users (NIDA, 2011). People ar c draw backly equally to use when drugs and alcohol ar easily accessible, agreeable, and inexpensive principal to an impact on society that cost millions (Birckwhitethorner et.al, 200 Goulding and Hudson, 2010).OverviewTerminology commentaryThe use of original terms when discussing liftion and substance abuse provides a control ons for alone that atomic number 18 involved to understand. The DSM-IV is the current version of the symptomatic and Statistical Manual of psychological Disorders a set of standards for professional to imprint a formal diagnosis for dependence of substance abuse (DSM Library, n.d.).Substance abuse and dependency has been used inter convertable for individuals addicted to drugs (Kranzler, H. Li, T., 2008 Maddux, J. Desmond, D., 2000 ASBN, 2012). Although habituation involves sensible dependence and tolerance, the physical dependence and tolerance does not involve the drug seeing and compulsive doings of colony making it punishing for physicians to come upon the real issue (Shurtleff, 201 Maddux, J. Desmond, D., 2000). Substance abuse means victimization each type of illicit drug and intoxication, enhancement of the end result occurs with sextuple drug use (Substance Abuse Pr all the same sotion Curriculum Guide, n.d.).SubstanceThe head word and mood altering drugs or chemical substances of abuse ar the substances that atomic number 18 referred to in a substance abuse or dependence (Bennett and McNeese, n.d. Mosbys medical examination Dictionary, 2009). gross profitTolerance is the bodys assume for larger quantities of drug for the same effect (Bennett and McNeese, n.d. Mosbys health check Dictionary, 2009).Abuse vs. DependenceSubstance abuse is when the impro per use of substance is affecting a soulfulnesss life in a negative manner, such as go down job function, poor p arnting skills, and problems with law enforcement (Bennett and McNeese, n.d. The Ameri green goddess hereditary pattern Dictionary of the English Language, 2003). Substance dependence is the beyond abuse where a person relies or dependents on a drug including summationd tolerance, withdrawal, in ability to stop, devotion to use, and neglecting responsibilities (Bennett and McNeese, n.d. The American Heritage Dictionary of the English Language, 2003).AddictionAddiction is a compulsive and maladaptive dependence with resulting in psychological, physiological, sociological, and heavy consequences (Bennett and McNeese, n.d. American Heritage Dictionary of the English Language, 2003 Goulding and Hudson, 2010).Risk factorsThere is no individual risk of exposure factor that can predict whether a person will proceed an addict. That is based on the vulnerability of eac h individual in the area of genetics, demographics, family, social, and psychological (ASBN, 2012). The early age of sign use along with the combination of risk factors leads to a greater chance of addiction (ASBN, 2012 NIDA, 2011)Drugs of AbuseAlcoholAlcohol is legal, soci all in ally acceptable, and has the to the lowest degree stigma of all drugs in the joined States and worldwide (Alcohol Answers, 2009 Bennett and McNeese, n.d.). It is addictive and depresses the central nervous form (Bennett and McNeese, n.d.). Alcohol is a legal, addictive drug that depresses the central nervous formation (Bennett and McNeese, n.d.). One soak uping causes impairment and driving while intoxicated is iniquitous in the linked States (Bennett and McNeese, n.d.).The social impact of the intoxicated person affects the reamer and all involved (Kelly, 2011 Chan, 2011 Harrington, et.al, 2010). Drinking alcohol is associated with child abuse and neglect, absenteeism from break down, and power ( Kelly, 2011 Chan, 2011 Harrington, et.al, 2010). More than 30 conditions with alcohol as an underlying factor are listed in the World Health Organizations 10th Edition of International categorisation of diseases (Rehm, 2011). chronic alcohol use is a poisoning that weakens the immune arrangement and results damage to the neurological and physical systems that are irreversible (Bennett and McNeese, n.d. Kelly, 2011 Chan, 2011 Harrington, et.al, 2010 Rehm, 201 Dawson, 2011).Scheduled DrugsDepressants are the illicit drugs that depresses the central nervous system(systema nervosum centrale)ca using decrease pulse, respiration, and origination squash (UNODC, 2012). The CNS system effect relaxes the person and decreases anxiety and tension (UNODC, 2011 NIDA, 2011). The drugs include alcohol and narcotics (UNODC, 2012).Narcotics or opiates are derived from the opium poppy or whitethorn be synthetically construct includes codeine, oxycodone, heroin, fent eachl, and methadone (Gouldin g and Hudson, 2010 UNODC, 2012 Hall, 2009). The drugs are pain killers, anesthetics, and cough suppressants, used medically draw off heroin (UNODC, 2012 Hall, 2009). The route used is oral, nasal, intravenous, and transdermal (UNODC, 2003). Users dumbfound constipation, dilation of blood vessels, constricted pupils, and decreased respiration that may lead to an overdose with produces modify breathing, coma, clammy skin, respiratory mishap, and come-at-able conclusion (UNODC, 2012UNODC, 2003 Hall, 2009).Sedative- hypnotics, referred to as sedatives, sleeping pills, or tranquilizers, are an other(a) type of CNS depressants (UNODC, 2003 Goulding and Hudson, 2010). The purpose is to decrease anxiety, relax, or promote sleep. These drugs categories include barbiturates (Seconal and Nembutal) and benzodiazepines (Valium and Librium) (UNODC, 2003 Goulding and Hudson, 2010). Symptoms associated with withdrawal from these drugs are seizures, convulsion, kernel attack, or death (UNODC, 2003 Goulding and Hudson, 2010). Overdose is common when used with alcohol (Goulding and Hudson, 2010).HeroinHeroin is a very addictive drug processed from morphine, a substance extracted from the cod of the Asian poppy plant. Heroin produces a beliefing of euphoria (a rush) and often a warm flushing of the skin, dry mouth, and heavy feelings in the arms and legs. After the initial euphoria the user may go into an alternately wakeful and moderate state. Heroin is the second most frequent cause of drug-related deaths.Prescription DrugsThe abuse of prescription pain medications and sedative hypnotics, such as, Klonopin and Xanax, prevalence rate has increase in the United States for persons 12 and over higher(prenominal) than any other illicit drug, surpassing even marijuana (Holmes, 2011). The Centers for Disease Control and stripe has identified these drugs as an epidemic due to the rate of increase of use. United States is the epi nucleus for prescription drug use with 80% of A mericans using drugs for the for the first time time that were prescribed for roundone else. The increase in these drugs has shown a capitulation in cocaine, cannabis, and heroin causing more(prenominal)(prenominal) than persons to die from opioid overdose than locomote vehicle accidents (UNODC, 2012 Holmes, 2012). development a prescription drug in a manner other than the in worked prescription constitutes drug abuse. nearly of the more comm and abused prescription drugs are Pain-relieving narcotics (Percodan, Codeine, Vicodin, Percocet) Tranquilizers and sedatives (Halcion, Xanax, Ativan, Valium, Phenobarbital) Muscle relaxants (Soma) Prescription amphetamines (Ritalin, Cylert, Adderall) OxyContin cocain cocain was considered a safe recreational drug in the mid-eighties and 1990s with declining use with the turn of the century (NIDA, 2006 SAMHSA, 2001 The Harvard moral Health Letter, 1999). cocaine is a powerful and addictive drug that approximately 21 share of persons eventually become addicted after the first use (Prevention Handbook, n.d. The Harvard Mental Health Letter, 1999 NHSDA, 2000. The route of use for cocaine is nasal, smoke, or intravenous. At olive-sized amount the drug can produce increased energy, alertness, and euphoria (Prevention Handbook, n.d. The Harvard Mental Health Letter, 1999 NHSDA, 2000).The central nervous properties of dilates pupils, constricts blood vessels, increases blood push, body temperature, decrease appetite, loss of sleep, and increased pulse (Prevention Handbook, n.d. The Harvard Mental Health Letter, 1999 NHSDA, 2000) . Although the use has declined, the drug is mum the most frequently encountered illicit drug with the ensueing medical complications cardiac arrest, stroke, and respiratory failure (Prevention Handbook, n.d. The Harvard Mental Health Letter, 1999 NHSDA, 2000). cannabisCannabis or marijuana is one of the most used drugs in the United States and considered a gateway drug (NIDA, 2012). Chron ic use cause respiratory issues of crabmeat, asthma, or other lung diseases. The prevalence of marijuana use has increased among all populations from 13.7 percent in 2009 to 14.1 per cent in 2010 (36,37 ). big term cause includes loss of ambition, apathy,, difficulty concentrating, and decrease in school and work performance. ganja (weed, or cannabis) is one of the most common drugs of abuse . Marijuana examines like a dry, shredded green/brown blend of flowers, stems, seeds, and leaves of a busy hemp plant. It usually is smoked as a cigarette, pipe, or in blunts, which are cigars that grow been emptied of tobacco and refilled with marijuana. The main active chemical in marijuana is THC (delta-9-tetrahydrocannabinol), which quickly passes from the lungs into the bloodstream, and on to organs throughout the body, including the brain. Some of the short-term effects of marijuana use include problems with memory and schooling bizarre or distorted perceptions difficulty in problem work loss of coordination and increased heart rate. A study has suggested that a users risk of heart attack more than quadruples in the first hour after smoking marijuana.Manufactured DrugsThe amphetamine like drug, starter rate has forked from 1990-2002 71 percent of new users of inhalants in 2002 were under the age of 18 Club drugs MDMA and GHB have leveled off but are not expert used in the club culture raptus use has risen and has been associated with brain damage , kidney failure, and elevated body temperature flunitrazepan association with sexual assault has led to legislature that has made it the least on hand(predicate) club drug. From 1998 to 2000 the number of the easily overdosed drug GHB essential room visits quadrupled to approximately 5000 (Brown University Health Education, n.d.).MethamphetamineMethamphetamine (meth)is made in illegal laboratories and has a high potential for abuse and dependence. It is often taken orally, snuffed, or injected. Methamphetamin e hydrochloride, clear crystals resembling ice, can be inhaled by smoking, and is referred to as ice, crystal, and glass.Use of methamphetamine produces a fast euphoria, and often, fast addiction. Chronic, heavy use of methamphetamine can produce a psychotic upset which is tall(prenominal) to secure apart from schizophrenia (methamphetamine induced psychosis). The drug also causes increased heart rate and irreversible damage to blood vessels.EcstasyEcstasy (MDMA)is the questionable party drug, It has some(a)(prenominal) stimulant (like cocaine) and hallucinogenic (like LSD) effects. Ecstasy is neurotoxic (poisonous to brain cells), and in high doses it causes a steep increases in body temperature leading to muscle breakdown, and possible organ failure. Side effects may stand up for weeks after use, and including high blood pressure, faintness, confusion, depression, sleep problems, anxiety, HallucinogensHallucinogens have existed for years. the drugs includes LSD, PCP, ketamin e, and amphetamine variants(MDA,MDMA, and ecstasy). The use of these drugs takes you on a trip leading to pleasurable or a terrifying experience. The drugs are not always distinguishable by their color, odor, or taste. The CNS effects increases heat rate, respiration, pulse, blood pressure , and temperature leading to possible stroke, convulsions, heart attack, respiratory failure, or coma. Ketamine has been used as a date rape drug due to the dissociative anesthetic properties. Hallucinogens may lead to insanity or mental health rowdinesss. and paranoia. supermanAcid (LSD)LSD, also called acid, is sold in the street in tablets, capsules, or even liquid form. It is clear and odorless, and is usually takenby mouth. Often LSD is added to pieces of absorbent account divided into small decorated squares, each containing one dose. LSD is a hallucinogen and a very powerful mood-altering chemical.Over the Counter Drugsmany antithetic types of over-the-counter drugs and other substances can be abused. Just a few examples include Inhalants (paint thinners, nitrous oxide, imitate glue, magic marker fluid, dot paints, propane, butane, etc.)Dramamine, Mouthwashes, Diet aids Cough and cold medications (especially those containing DXM, like Drixoral Cough suave Caps, Robitussin AC, Dectuss, Phenergan etc.)InhalantsInhalants are common household products that are huffed or sniffed that wee-wee a high or head rush. Included in this menage of drugs are insecticides, paints, and aerosols products that when consumed causes lightheadedness. The drunken high is usually not long but due to the nature of the vapors may cause headaches, unconsciousness, suffocation, violent behavior, and death. alternate the oxygen with inhalants depresses the CNS and may lead to the user to stop breathing. Long term use of inhalants causes brain damage, weight loss, and fatigue. Adolescent believe inhalants are safer.Concepts of Substance AbuseFour Dimensions of AddictionChronicA disarray that is chronic continues for a long time. The opposite of chronic is acute, which means comparatively sudden and short. Lets look at other examples of chronic vs. acute disordersChronic diabetes, hypertension, e jampsyAcute flu, food poisoning, concussionNotice that acute disorders are tough once and theyre gone. Chronic disorders are managed, not cured.PrimaryA disorder that is primary means that it is not the result of something else. It is a disorder in its own right, requiring specific treatment. For example, a man may start crapulence to control the torturing feelings of depression. However, when that man becomes an alcoholic (addicted to alcohol), he now has a separate and primary disorder that considers treatment. Tr consume the depression does not mean the alcoholism will also go away.ProgressiveA disorder that is advancing tends to cross worse over time. With drug addiction, we see that the consequences of the addiction tend to worsen over time. One important mechani sm of this continuous tense quality is tolerance, which weve discussed. The development of tolerance tends to ensure that a person has to get more, spend more, blur more, and use more over time. Later advantageously look at some of the particular consequences of progression, including medical problems.IncurableWe say that addiction is incurable because the biological changes involved in addiction tend to be permanent. As a result, an addict will never be able to safely use the drug of abuse (or any other drugs of abuse). An alcoholic will never be able to drink normally. Likewise, a cocaine addict will never be safe using stimulating drugs (for example, ephedra, which is an over-the-counter stimulant). A person addicted to one drug can easily switch over the another drug and still be an addict. This is called cross-addiction(more on this later). We said incurable not untreatable. Remember the similitude with diabetes? We dont cure diabetes, we manage it with proper diet, blood s ugar monitoring, and other acts of discipline. Unfortunately, the addict rarely motives discipline. Thats what makes it so hard. By definition, an addict wants to keep usingStages of channeliseIn order to determine the proper intervention the coifs of change model is a means of describing the process to overcome addiction (Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O., 2011), The symbolises suggest that a person will go through the changes in sequence, but realistically they jump between stages and the stages will be different for everyone (Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O., 2011).PrecontemplationThis is the first bod of change where the persons has not had any negative consequences and does not see the addiction as problem (Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O, 2011). The experience is still pleasurable and leaves the person narrow to any conversation on any negative consequences (Hartney, 2013 Norc ross, J. C., Krebs, P. M. and Prochaska, J. O., 2011). During this stage the person needs encouragement to see the personal risk and self-awareness consideratenessContemplation is the stage where the person thinks or contemplates ever-changing the addictive behaviors by quitting, talk over use, or cutting down (Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O. (2011),). A person in this stage requires organism give encouragement on the analysis of the pros and cons of the addictive behavior to promote a new goal (Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O. (2011),).PreparationAfter a person has contemplated a person makes preparation to follow through on the changes that were contemplated (Hartney, 2013Norcross, J. C., Krebs, P. M. and Prochaska, J. O. (2011). At this phase a person is trying to make decisions on how to proceed forward (Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O. (2011),). The stage is a time for encouraging the need for social prolong and taking small steps.ActionThe action stage is a time for following through on the preparations made by possible entering treatment for detox (Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O. (2011),). Living without the drugs and the drama of addiction is a strange feeling with the change of lifestyle(Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O. (2011), ). This is a real change of addictive behaviors which needs reinforcing stimulus and support to handle feelings and self-efficacy.MaintenanceThe support phase is the time to seeks changing addictive behaviors through abstinence and changing behaviors (Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O. (2011), ). The person learns how to cope and not return to old behaviors when there is a resurfacing of addictive behavior (Hartney, 2013 Norcross, J. C., Krebs, P. M. and Prochaska, J. O. (2011),). Helping the person via support, encouragement, and inte rnal reward reinforcement is required.Biological Bases of AddictionAddiction is associated with permanent changes in the brains neurochemistry. The addict is biologically programmed to need the drug in order to feel normal. This point that addicts yet want to keep using brings us to an important point rough addiction and its biological roots. Lets take a quick look at what happens in the brain of an addict (without getting too technical).Weve seen now how reiterate drug use causes permanent biological changes in the brain. An important innuendo of these changes is this An addict can never assume its safe to resume using addictive drugs. Using even once will get the addict back to Square One. 12-Step programs call this waking the tiger.In 12-step programs, a person commemorates the beginning of sobriety with a sobriety date. If a person relapses, he or she starts with a new sobriety date. This tradition emphasizes the fact that addiction never goes away.Reward CenterFirst lets ta ke a look at a part of the human brain which has been called the reward center deep in the brain. This area includes specialized neural pathways which process experience of amusement.The reward center seems to process many experiences of pleasure, such as eating and sex. Experimental rats trained to stimulate their own reward centers with electric switches have been known to press on the switches thousands of times per hour They neglect all other activities in order to keep stimulating themselves. (11) ). Cocaine is a central nervous system stimulant that causes the distribution of the chemical dopamine that is affects the brains pleasure center by causing constant signals of pleasure creating the utmost(prenominal) cocaine high(The Science of Mental Health, 2003)Now, you may not be impress to learn that many drugs of abuse stimulate the reward centers. As a result, using mind-altering drugs is pleasurable. The addict is almost like one of those observational rats, stimulating i tself again and again, neglecting anything else.Repeated use of certain drugs of abuse can result in depletion of brain chemicals that allow the experience of pleasure. What happens next is this more and more of the drug becomes necessary to generate pleasure, and other sources of pleasure lose their effects. Eventually, the addict cant even feel just normal without the drug. As a result, the addict needs the drug to feel normal, and without it, they feel atrocious Its no longer a depicted object of pleasureits a matter of avoiding pain. This is the mechanism for tolerance.DopamineThe brain chemicals that help generate pleasure are called dopamine, a brain chemical belonging to a group called neurotransmitters. For example, both alcohol and heroin result in a build-up of dopamine, resulting in (temporary) pleasure. ). Cocaine is a central nervous system stimulant that causes the distribution of the chemical dopamine that is affects the brains pleasure center by causing constant si gnals of pleasure creating the intense cocaine high(The Science of Mental Health, 2003)As we discussed above, the brain adapts to this higher level of dopamine in the system. Its almost as if the body tries to chasten the new levels of pleasure by raising the bar to experience pleasure. These changes are referred to as neuroadaptation. In other words, neuroadaptation means that it gets harder and harder to experience pleasure as you use more drugs. Addicts get the point that only their drug.in ever-increasing amountsmakes them feel good.Trap of addictionIn a sense, addicts get trapped by their own drug. They started using it to feel good, but end up needing it just to avoid feeling bad.Addicts can learn to experience pleasure in ways other than using. Unfortunately, research and clinical experience shows that the biological changes are permanent. This is why addiction is considered incurable, as we discussed before.CravingsGiving up drugs isnt just a matter of giving up on the plea sure. It can be a very painful experience because of cravings. As weve discussed, the brain becomes used tothe drugs of abuse after repeated use. If an addict stops using, the brain (and the mind) will rate pressure on the person to start againto restore the balance. This pressure is experienced as cravings. Cravings can be very painful and difficult to resist. Managing and resisting cravings are an important aspect of treatment.Cravings are painful but sub misplaceive with training and discipline. A helpful thing to remember with cravings is that they come and go like a wave they approach, get stronger, reach a crescendo, and so taper off. Knowing this, a person can ride outthe cravings by several means Distract herself with something diverting (movie, game, etc) Contact someone else for support (sponsor, supportive friend) Go to a safe place where giving in is less likelyDisease ModelIn many different treatment models, addiction is seen as a disease. It may be hard to apprecia te why at first, because it seems different from other types of diseases like cancer or bronchitis. One of the reasons for defining addiction as a disease is in order to ensure that addiction is treated as a healthcare problem, thus allowing addicts access to the healthcare system. (13)Addiction is widely considered a disease, by such organizations as the World Health Organization (WHO), American Medical Association (AMA), and American Psychiatric Association (APA).Defining addiction as a disease carries several implications which tend to increase the healthcare available to addicts it follows a predictable course of development, it causes disorder of bodily functions (affecting not only the brain but typically the liver, pancreas, and other organs), it causes significant mortality and morbidness (alcoholism is one of the leading causes of death in the U.S.),it can be bring in and measured by epidemiological research, it has a significant genetic freight .We wont settle the questi on of the Disease Model here. However, now you are familiar with the persuasion and some of the arguments on both sides. At any rate, the Disease Model is so prevalent today that most treatment programs you are likely to encounter in the State of Nebraska use the model. Whats more, the Disease Model is supported by the worlds largest organization devoted to service of process people with addictionAlcoholics Anonymous (and other 12-step programs such as Narcotics Anonymous). psychology of AddictionProgression of addictionWeve al pay back discussed how addiction is a progressive disorder (getting worse over time). As such, we can identify certain characteristics of early stageand late stageaddiction. However, its important to keep in mind that some people progress quickly to more serious problems, while others follow along progression.Early StagesA person uses drugs of abuse to achieve a feeling of euphoria or to relieve stress. Using is escapist, sociable, and fun. However, the per son begins to need more and more. The fun begins to go out of the situation as the person realizes she cannot feel normal without her drug. The person begins to feel guilty and ashamed, and increasingly uses denial.There may be the first damaging consequences (problems at work, in the family, etc). (16)Late StagesUsing drugs feels more like a necessity of survival than a form of recreation. The problems often begin tomount, and the person becomes increasingly unable to function. The addict loses interest in anything besides using. If the addict has been able to hide her using, this becomes more and more difficult as the addiction progresses.Typically, the later stages of addiction are characterized by increasing physical problems and illness. For example, an alcoholic may experience liver failure or hepatitis.Defense MechanismDefense Mechanisms are psychological strategies for transaction with stress. These strategies are used by the mind (often unconsciously) to keep us from being overwhelmed with stress. Defense mechanisms are normal and necessary. We cant worry about everything at once, or we couldnt function There has to be some filterfor keeping things from becoming too intense or too painful. However, sometimes defense mechanisms become so rigid that we lose our flexibility, and we find it hard to changeeven when change would be good. (17)All defense mechanisms distort honesty to some extent, because they tailorreality to feel a little more comfortable. The question becomes, just how more distortion is safe?In addiction, defense mechanisms often distort reality to a dangerous extent. It gets harder to cover up the truth when the consequences start to pile upbroken families, legal charges, ruined careers .Also, the defense mechanisms in addiction can harm the addicts loved onessome of them start to wonder if they are the crazy ones, because the addict is so adamant that they have no problems. Lets look at a list of some of the defense mechanisms that a re usually used to promote addictive behavior. demurDenial is an example of a defense mechanism that is often seen with addiction. The defense of denial is to deny the truth. Denial is useful to an addict because it serves to cover up the extent of the problem, and allow the using to continue.Remember that in addiction, people become biologically programmedto need their drug at all costs. Denial is a powerful way of keeping the pressure offso the addict can continue to use.Rationalizationis another example of a defense mechanism that is often seen with addiction. The purpose is to make the irrational gruelling rational through the uses of justification and excuses. Many addicts have a ready supply of rationalizations to use on themselves and others, such asIm not pain sensation anybody.I can stop anytime I want (I just dont want to yet).I had a hard day today. I deserve a drink.It relaxes me.Isolatingis a behavior that also serves to protect the addiction. Although drug use may s tart out as a social behavior, addiction ends up driving a wedge between the addict and others. Efforts to hide and maintain the addiction distances them from loved ones, and the company of non-addicts becomes too intrusive and painful. As a result, some addicts end up shooting themselves up in dark rooms, or drinking alone, far from others. Others sink into a drug subculture,in which there are no true friendships, but only alliances of doodad in the continuing drive for self-gratification.BlamingIt can be very convenient to point the finger at someone else, when we want to avoid signalize Blaming takes the heat off by putting it on someone else. Naturally, this is painful and frustrating for others, and self-defeating to the addict.If my husband had fixed that tail-light, I wouldnt have gotten this DUI.If you lived here, youd drink too.If my wife/husband treated me right, I wouldnt have to do this.Minimizinginvolves water downthe problem by acting cavalier about the consequences , or dismissive of the wreckage caused by addiction.All my DUIsare five years apart.I never drink before noon, I cant be an alcoholic.At least I dont use as much as X.I may miss some work, but I still get more work done than all those other slobs. retrogradeThe disease model of addiction, discussed above, encourages us to think of relapsesin addictive behavior. A relapse is a return to a previously abusive level of using or drinking. The very idea of relapse suggests the idea of the disease model, because it describes addiction as a chronic condition that never goes away, but can only lay dormant. Relapse is a very important concept