Interventions - created from Mind Map

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BIOLOGICAL

drug maintenance therapy. methadone mimics effects of heroin but is less addictive. Prescribed increasing doses to increase tolerance then doses are decreased until addict no longer needs it.

can become just as addicted to methadone & has side effects like insomnia & reduced sexual function, encouraging dropout.

unsupervised so formed black market easily where users sell their methadone.

controversial due to figures showing methadone responsible for many deaths. Question whether substance abuse problems should be treated with another substance in people who are proven to look for chemical solutions to their problems.

most illegal drugs produce a high so dopamine agonistic drugs used to do the same by boosting dopamine levels

based on assumption that serotonin dysfunction is associated with pathological gambling, study found gamblers treated with SSRI's to increase serotonin showed significant improvements compared to control group. Dopamine receptor antagonists work by reducing rewarding & reinforcing properties of gambling behaviour reducing urge to gamble.

small sample (not generalisable) over short duration. larger study failed to demonstrate any superiority of SSRI's over a placebo. though there is support for antagonists as study found significant decrease in gambling thoughts & behaviour after 6 weeks treatment.

nicotine in alternative ways (patches). less&less used. combined with CBT

drugs used to combat smoking e.g. Varenicline have side effects of depression & suicide though withdrawal symptoms may also contribute.

side effects for most drugs that lead to high drop out rates

agonistic drugs prevent relapse in alcoholics by producing unpleasant reactions if they drink

study found it didn't provide specific benefits in addressing dependency, with high dropout & side effects such as impotence & confusion, casting doubt on its effectiveness.

BZ's to induce relaxation in detoxifying alcoholics as they reduce alcohol intake to prevent the shakes.

also develop dependency after 14 days. but study found they produce a smooth course of withdrawal & aren't likely to be abused, demonstrating their effectiveness.

PSYCHOLOGICAL

CBT aims to affect how addicts think about dependency. in gambling, they may have cognitive errors leading to belief they can control & predict outcome.

behavioural self control training helps them realise when they are at risk.

coping skills help resist temptation e.g. positive self talk.

help cope better with circumstances that lead to the addiction e.g. coping with peer pressure.

86% pathological gamblers treated with CBT did not fulfil DSM criteria of addiction anymore & had better perception of control & self efficacy increased, gains maintained at a 1 year follow up.

tailored to individual circumstances, has long lasting effects & addresses dependencies even in severely addicted individuals.

more effective combined with drug treatments.

give rewards for not engaging in the behaviour

study randomly allocated patients to reward or no-reward groups while still treated with methadone. each time they tested negative for heroin they drew for prizes. drug use dropped significantly for those in reward group.

don't address underlying problems. possibility of engaging in other addictive behaviours instead.

aversion therapy: undesirable response to stimulus removed by associating the stimulus with another, aversive, stimulus

e.g. alcohol paired with emetic drug inducing vomiting so becomes conditioned response to alcohol.

study found 50% alcoholics abstained for up to one year after treatment & aversion therapy was better than no treatment, suggesting it is effective. Although electrical aversion patients had superior abstinence rates at 6 months, it was not maintained at 12 months, suggesting it is only short term.

PUBLIC HEALTH

social inoculation strengthens attempts to resist temptation by using counterarguments as inoculation defence against attempts & provide supportive defence statements

gov. interventions: fear arousals in ads to strengthen persuasiveness of arguments against addictive practices. Quitline calls to smokers.

research found this helped resistance to temptation & persuasion to indulge in addictive behaviours. Cardiac patients subjected to fear arousal were more able to quit smoking & not relapse over 12 months.

study found people receiving calls increased odds of quitting by 50% compared to those receiving self help. Concluded it improves long term probability of cessation for smokers who contact Quitline.

restrict/ban ads of smoking & drinkling & increase tax on products.

prevents some usage of drugs but increases criminality associated with them & increase health risks e.g disease & overdosing.

difficult evaluating effectiveness, by criminalising behaviours don't know how many are using.

work site interventions: smoking bans at work reach those who would not otherwise seek interventions

since Irish smoking ban in public places, smoking prevalence fell, suggesting ban was effective. However, after that, it actually increased, so the drop may have been due to economic reasons like lower incomes. Heavy smokers were smoking even more, so ban hardened their attitudes.

Interventions