# Presentation: 409442

## Session 1:Triggers and Cravings

## Changes in the Brain

- Limbic System

- Prefrontal Cortex

- Matrix IOP

## Conditioning

- Matrix IOP

## I.P. Pavlov (1849–1936)

**I.P. Pavlov (1849****–****1936)**

- Matrix IOP

## Pavlov’s Dog

**Pavlov’s Dog**

- Matrix IOP

## A Definition of AddictionAmerican Society of Addiction Medicine

- A primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. Addiction is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

- Graham, A.W.; Schultz, T.K.; Mayo-Smith, M.F.; Ries, R.K.; and Wilford, B.B. eds. *Principles of Addiction Medicine*, Third Edition. Chevy Chase, MD: American Society of Addiction Medicine, Inc., 2003.

- Matrix IOP

## The Addictive Process

- Introductory phase
- Maintenance phase
- Disenchantment phase
- Disaster phase

- Matrix IOP

## Addictive ProcessIntroductory Phase

_**Positives**_
- Relief from
- 	Depression
- 	Anxiety
- 	Loneliness
- 	Insomnia
- Euphoria
- Increased status
- Increased energy
- Increased sexual/social confidence
- Increased work output
- Increased thinking ability

**METHAMPHETAMINE**
**(METH)**

_**Negatives**_
- May be illegal
- May be expensive
- May cause missing work

- Matrix IOP

## Conditioning Process During AddictionIntroductory Phase

_**Triggers**_
- Parties
- Special occasions
- Other events

_**Responses**_
- Pleasant thoughts about meth
- Infrequent use

**Strength of Conditioned Connection:**

**Mild**

- Matrix IOP

## Development of Obsessive ThinkingIntroductory Phase

- Matrix IOP

## Development of Craving ResponseIntroductory Phase

**Entering Using Site**

**Use of Meth**

** ******** ****Heart/pulse rate**
** ******** ****Respiration**
** ******** ****Adrenaline**
** ******** ****Energy**
** ******** ****Meth taste**

**Meth Effects**

- Matrix IOP

## Addictive ProcessMaintenance Phase

- Depression relief
- Confidence boost
- Boredom relief
- Sexual enhancement
- Social lubricant

_**Negatives**_
- Employment/school disruptions
- Relationship concerns
- Financial problems
- Beginnings of physiological 			dependence

**Addictive Process*****Maintenance Phase***

- Matrix IOP

## Conditioning Process During AddictionMaintenance Phase

_**Triggers**_
- Parties
- Friday nights
- Friends
- Alcohol
- “Good times”
- Sexual situations

_**Responses**_
- Thoughts of meth
- Eager anticipation of meth use
- Mild physiological arousal
- Cravings occur as use approaches
- Occasional use

**Moderate**

**Conditioning Process During Addiction*****Maintenance Phase***

- Matrix IOP

## Development of Obsessive ThinkingMaintenance Phase

**Development of Obsessive Thinking*****Maintenance Phase***

- Matrix IOP

## Development of Craving ResponseMaintenance Phase

**Entering Using Site**

**Physiolog-**
**ical Response**

**Use of Meth**

**Meth Effects**

-  **Heart**
-  **Breathing**
-  **Adrenaline     ****	****effects**
-  **Energy**
-  **	****Meth taste**

**Heart**
**Blood            pressure**
**Energy**

**Development of Craving Response*****Maintenance Phase***

- Matrix IOP

## Addictive ProcessDisenchantment Phase

_**Positives**_
- Sociability
- Occasional euphoria
- Relief from fatigue
- Relief from stress

_**Negatives**_
- Withdrawal depression
- Paranoia
- Tweaking
- Relationship disruptions
- Family distress
- Impending job loss

**Addictive Process*****Disenchantment Phase***

- Matrix IOP

## Conditioning Process During AddictionDisenchantment Phase

_**Triggers**_
- Fatigue
- All friends
- Stress
- Boredom
- Anxiety
- Free time
- Sexual arousal
- Loneliness

_**Responses**_
- Continual thoughts of meth
- Strong physiological arousal
- Psychological dependency
- Strong cravings
- Frequent use

**STRONG**

**Conditioning Process During Addiction*****Disenchantment Phase***

- Matrix IOP

## Development of Obsessive ThinkingDisenchantment Phase

**Meth**

**Development of Obsessive Thinking*****Disenchantment Phase***

- Matrix IOP

## Development of Craving ResponseDisenchantment Phase

**Mild Physiological Response**

**Entering Using Site**

****** ****Heart rate**
****** ****Breathing rate**
****** ****Energy**
****** ****Adrenaline effects**

**Powerful Physiological Response**

**Use of Meth**

**Meth Effects**

****** ****Heart rate**
****** ****Breathing rate**
****** ****Energy**
****** ****Adrenaline effects**

****** ****Heart**
****** ****Blood pressure**
****** ****Energy**

**Development of Craving Response*****Disenchantment Phase***

- Matrix IOP

## Addictive Process Disaster Phase

- Relief from fatigue
- Relief from stress
- Relief from depression

_**Negatives**_
- Weight loss
- Paranoia
- Loss of family
- Seizures
- Severe depression
- Unemployment
- Bankruptcy

**Addictive Process *****Disaster Phase***

- Matrix IOP

## Conditioning Process During AddictionDisaster Phase

_**Triggers**_
- Any emotion
- Day
- Night
- Work
- Free time

_**Responses**_
- Obsessive thoughts about meth
- Powerful autonomic response
- Powerful physiological dependence
- Automatic use
- Persistent paranoia

**OVERPOWERING**

**Conditioning Process During Addiction*****Disaster Phase***

- Matrix IOP

## Development of Obsessive ThinkingDisaster Phase

**Meth**

**Development of Obsessive Thinking*****Disaster Phase***

- Matrix IOP

## Development of Craving ResponseDisaster Phase

**Powerful Physiological Response**

****** ****Heart rate**
****** ****Breathing rate**
****** ****Energy**
****** ****Adrenaline ****	****effects**

**Development of Craving Response*****Disaster Phase***

- Matrix IOP

## Trigger

**Trigger**

**Thought**

**Craving**

**Use**

- Matrix IOP

## Interruption

**Interruption**

**Trigger**

**Thought**

**Craving**

**Use**

- Matrix IOP

## Thought Stopping

- Visualization
- Rubberband snap
- Relaxation
- Calling someone

- Matrix IOP

## Thought Stopping

*Visualization*

- Matrix IOP

## Thought Stopping

**Thought Stopping**

*Rubberband*** ***Snap*

- Matrix IOP

## Thought Stopping

*Relaxation*

- Matrix IOP

## Thought Stopping

**Thought Stopping**

*C**alling Someone*

- Matrix IOP