Month: January 2010

The Bridge Builder – Will Allen Dromgoole

An old man, going a lone highway, Came, at the evening, cold and gray, To a chasm, vast, and deep, and wide, Through which was flowing a sullen tide. The old man crossed in the twilight dim; The sullen stream had no fears for him; But he turned, when safe on the other side, And built a bridge to span the tide. “Old man,” said a fellow pilgrim, near, “You are wasting strength with building here; Your journey will end with the ending day; You never again must pass this way; You have crossed the chasm, deep and wide,...

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Progressive Symptoms of Substance Dependence – T. Gorski

Once substance dependence develops, a progressive series of self-reinforcing symptoms begin to develop.  Two models of the progressive symptoms will be presented:   (1) The DSM-IV Progressive Symptom Model; and (2) The Biopsychosocial Progressive Symptom Model. The DSM IV Progressive Symptom Model was developed by completing a three step procedure: Step 1:  Analyzing the DSM-IV criteria for substance use disorders, Step 2:  Dividing specific criteria that contained more than one identifiable symptom into separate symptoms, Step 3:  Arranging the symptoms in a logical progression supported by both face validity and studies of widely accepted models that sequence addiction symptom development...

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DSM-IV Progressive Symptom Model – T. Gorski

1.    Increased Tolerance (DSM-IV Criteria #1):  Tolerance is defined by either:  (1) a need for markedly increased amounts of the substance to achieve intoxication or the desired effect; or (2) a markedly diminished effect with continued use of the same amount of the substance.   2.    Withdrawal (DSM-IV Criteria #2):  Biopsychosocial withdrawal symptoms consistent with the drugs being used appear when the person attempts to stop using.  The symptoms disappear when the same or a closely related drug is taken.   3.    Self-Medication Of Withdrawal (DSM-IV Criteria #2):  Using alcohol or drugs to make the symptoms of withdrawal (dysphoria,...

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Substance Related Disorders – T. Gorski

There are three types of Substance Related Disorders: Substance Abuse Disorders, Substance Dependence Disorders, and Substance-induced Disorders.  The Substance-induced Disorders can coexist with either Substance Abuse or Substance Dependence Disorders. (American Psychiatric Association, 1994)   1.    Substance Abuse Disorders marked by serious psychosocial problems related to alcohol and drug use that do not meet the criteria of a Substance Dependence Disorder.  Abuse Disorders may result from initial experimentation with mind altering substances, involvement in a lifestyle or subculture where alcohol and drug problems are a social norm, or as a consequence of related personality or mental disorders.  Patterns of substance...

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Biopsychosocial Progressive Symptom Model – T. Gorski

1.    Biological Reinforcement:  Biological reinforcement that promotes continued use of alcohol and other drugs.  (NIAAA 1996) 2.    Tolerance:  Progressive tolerance that requires increased amounts to achieve the desired state of reinforcement. (DSM-IV Criteria #1) 3.    Withdrawal:  Acute & Post Acute Withdrawal Syndromes when substance use is stopped.  (DSM-IV Criteria #2) 4.    Loss of Control:  Inability to control over the quantity of substances consumed and length of substance use episodes. 5.    Inability To Abstain:  Inability to maintain long-term abstinence.  6.    Addiction Centered Lifestyle:  The development of an addiction-centered lifestyle.  (DSM-IV Criteria #5) 7.    Addictive Lifestyle Losses:  Giving up previously valued lifestyle activities due to substance use.  (DSM-IV...

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