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Demystifying Alcohol and Drug Addiction

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Your Instructor

Atlanta VA
Lover of Cook-Outs and Live Music
Mother of 2

Karen Rigsby, MH-NP

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LEARNING OUTCOMES

What you’ll learn…

Outcome 1

Differentiate between myths and facts of alcohol and drug addiction.

Outcome 2

Explain the effects of substance abuse on the brain using existing research findings

Outcome 3

Create a system of high-quality care using the National Principles of Care framework.

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COURSE RESOURCES

Link provided in the chat

Participant’s Guide

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What’s Your Superhero Name?

Let’s see who is in the room!

An adjective that starts with the first letter of your name

+

what you ate for breakfast =

Your Superhero Name

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Only 1 in 4 physicians and nurse practitioners received addiction training.

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Myths vs. Reality

The Truth About Alcohol and Drug Addiction

01

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Myth #1: “Addiction only affects certain communities”�

Overdoses are the #1 cause of accidental death in our country.
According to the CDC, there were over 107,000 fatal overdoses in the U.S. in 2021.

Addiction is a public health crisis.

EXPLAIN:

Myth #1: “Addiction only affects certain communities”

�ASK:

Can anyone tell me what is wrong with this myth? [PAUSE FOR RESPONSE]

�EXPLAIN:

Addiction is a public health crisis. The addiction crisis is deadlier than ever before.

Overdoses are the #1 cause of accidental death in our country. According to the CDC, there were over 107,000 fatal overdoses in the U.S. in 2021. That’s the highest number of overdose deaths ever recorded in a single year. Overdose deaths involving synthetic opioids such as fentanyl, psychostimulants such as methamphetamine, and cocaine all increased between 2020 and 2021. During the COVID-19 pandemic, this tragedy has gotten worse. In some communities, overdose-related emergency calls are up as much as 40% and 42 states reported increases in overdose deaths during the pandemic.

And it’s not just overdoses taking lives: In 2018, more than 175,000 deaths in the U.S. were related to alcohol and other drugs. That makes substance use the third largest cause of death in the nation.

�

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Myth #2: “Medication during detox and recovery is just switching one addiction for another.”

Ease cravings and helps regulate brain chemicals.

Prescription medication can provide life-saving support.

Patients can be weaned off the treatment medication.

>

EXPLAIN:

Myth #2: “Medication during detox and recovery is just switching one addiction for another.

�ASK:

Can anyone tell me what is wrong with this myth? [PAUSE FOR RESPONSE]

�EXPLAIN:

Medically supervised withdrawal is a broad phrase that covers many different approaches. One of these approaches is using certain medications to ease cravings and help regulate brain chemicals while a patient is going through withdrawal. For example, we may prescribe methadone to help individuals with opioid use disorder. We could also use Suboxone or Vivitrol instead when necessary. These medications are considered an essential tool in reducing the chances of a patient causing harm to themselves or someone else during the withdrawal process. Going through medically supervised and assisted withdrawal does not diminish the patient’s progress toward sobriety. With the proper guidance and supervision, prescription medications can provide important, and sometimes life-saving, support during withdrawal. Once a patient reaches a certain point in their progress, their medical team can then begin to ease up on the use of medications to treat their symptoms.

The Science of Alcohol and Drug Addiction

The Effect on The Body

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How Addiction Affects the Body

It has a lot to do with brain chemistry. The human brain is wired to reward us when we do something pleasurable.
Studies have shown that consistent drug use severely limits a person’s capacity to feel pleasure at all. That’s because, over time, drug use leads to much smaller releases of dopamine.

EXPLAIN:

“How Does Addiction Affect the Body?”

�It has a lot to do with brain chemistry. The human brain is wired to reward us when we do something pleasurable. Exercising, eating, and other behaviors that are directly linked to our survival trigger the release of a neurotransmitter called dopamine.

This not only makes us feel good, but it encourages us to keep doing what we’re doing. It teaches our brains to repeat the behavior.

Drugs trigger that same part of the brain: the reward system. When someone uses a substance—be it marijuana, opioids, cocaine, or other drugs—their brain releases lots of dopamine. This process tells the brain that this is a behavior that should be remembered and repeated.

Studies have shown that consistent drug use severely limits a person’s capacity to feel pleasure at all. That’s because, over time, drug use leads to much smaller releases of dopamine. The brain’s reward center is less receptive to pleasure and enjoyment, both from drugs as well as from everyday sources, like relationships or activities that a person once enjoyed. Once the brain has been altered by drug use, it requires more and more of a substance just to function at a baseline level.

�

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An Addicted Brain Causes Behavior Changes

Addiction also creates cravings. These cravings can be painful, constant, and distracting. What’s more, withdrawal from substances is a painful, whole-body experience.

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Why Do Some People Get Addicted But Others Don’t?

Biology

Scientific research has shown that 40-60% of the likelihood that a person will develop addiction comes from genetics.

Environment

Exposure to traumatic experiences has been shown to increase a person’s risk of developing a substance use disorder.

EXPLAIN:

Why do some people get addicted but others don’t?

�Substance use alone doesn’t cause addiction. Addiction is a complex illness that arises in a person based on their unique circumstances. These are the most commonly identified risk factors for addiction:

Biology: Scientific research has shown that 40–60% of the likelihood that a person will develop addiction comes from genetics. This includes both a family history of the illness as well as epigenetics, which are "the effects environmental factors have on a person's gene expression." Plus, if you have a behavioral health disorder like depression or anxiety, your risk of addiction also increases.

Environment: Exposure to traumatic experiences has been shown to increase a person's risk of developing a substance use disorder. These experiences could happen at school, at home, or out in the community.

�

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Shatterproof’s National Principles of Care

SECTION 3 OBJECTIVE

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National Principles of Care

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1: Routine screenings in every medical setting

Screenings should be as common as getting your blood pressure taken.

Screening should be followed by:

guidance on reducing substance use,
family education to support lifestyle changes, and
regular check-ins with healthcare providers.

EXPLAIN:

#1 Routine screenings in every medical setting

During check-ups and in the ER, patients need to be screened for a substance use disorder. This should be as common as getting your blood pressure taken.

What this means: Screening for substance use disorders should be routine in primary care and other medical and behavioral health settings, such as emergency, obstetric, geriatric, and pediatric care. Screening should be followed by:

guidance on reducing substance use,
family education to support lifestyle changes, and
regular check-ins with healthcare providers.

If someone shows symptoms of a substance use disorder, they should receive a diagnosis and personalized treatment plan from a healthcare provider.

Why it matters: Screening for substance use disorders should be a part of routine primary care visits, similar to screening for other chronic diseases, such as diabetes. Screening is proven to help prevent, treat, and sustain recovery from substance use disorders. Also, it’s critical that discussions about substance misuse in medical and behavioral health settings become part of the normal routine.

�

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2: A personal plan for every patient

One-size treatment does not fit all.

Treatment facilities should give patients a personalized and thorough evaluation before creating a treatment plan.

No single treatment approach works for everyone.

EXPLAIN:

#2 A personal plan for every patient

Treatment facilities should consider unique needs. One-size treatment does not fit all.

What this means: Treatment facilities should give a personalized and thorough evaluation before creating a treatment plan. The provider should ask about the substance use disorder and other physical and mental health concerns. During this first step, patients should also be asked to identify concerns—such as those related to family, social situations, housing, and transportation—which could affect their care and long-term recovery.

Why it matters: No single treatment approach works for everyone. Personalized care is used to treat other chronic illnesses and has been shown to help people with addiction stay engaged, follow their treatment plan, and have better health results.

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3: Fast access to treatment

Patients should be able to get treatment as soon as they are ready.

Treatment facilities should provide quick access to services that meet the patient’s immediate needs and set them up for long-term success.

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4: Long-term disease management

Treatment should include long-term management and follow-up, not just one-time treatment.

A cascade of care includes:

Prevention
Identification (diagnosing substance use disorder)
Treatment
Recovery

EXPLAIN:

#4 Long-term disease management

Addiction treatment should include long-term management and follow-up, not just one-time treatment.

What this means: Local, long-term outpatient care helps manage substance use disorder over time. Even when a patient doesn’t start treatment in this setting, when they are ready the patient should be connected to these services through what’s called a “cascade of care.” A cascade of care includes:

Prevention
Identification (diagnosing substance use disorder)
Treatment
Recovery

Why it matters: Some individuals with more severe substance use disorders may need intensive services, such as withdrawal management or residential treatment. But this type of care is not the way that everyone starts treatment or maintains recovery.

For individuals who do require these intensive services, lower levels of outpatient care should always follow to support lasting recovery. Other individuals may start and remain in care in the outpatient setting. Because needs may change over the course of recovery, it’s important to track their progress and adjust care as needed.

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5: Coordinated care for every illness

Addiction treatment should consider the whole person.

It’s very likely that people entering treatment for substance use disorder are also dealing with other mental or physical health concerns.

The best way to improve overall health is to treat for all concerns at the same time in a coordinated manner.

EXPLAIN:

#5 Coordinated care for every illness

The treatment plan should include treatment for other illnesses, such as mental health (like depression or anxiety) and physical health conditions (like diabetes or hepatitis).

What this means: Addiction treatment should consider the whole person. Treatment facilities should offer comprehensive physical and mental health services along with addiction treatment. If a treatment facility cannot provide all of the health services needed, they should work with other healthcare systems and providers to connect patients with these services.

Why it matters: It’s very likely that people entering treatment for substance use disorder are also dealing with other mental or physical health concerns. Common mental health concerns include depression, anxiety, and post-traumatic stress disorder (PTSD). Common physical health concerns include pain, sleep disorders, infectious diseases such as HIV/AIDS, hepatitis C, or tuberculosis (TB), diabetes, and high blood pressure.

The best way to improve overall health is to be treated for all concerns at the same time in a coordinated manner.

�

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6: Behavioral health care from legitimate providers

Treatment facilities should offer proven behavioral therapies.

Proven behavioral health therapies have been shown to help individuals

recognize and accept their substance use disorder,
increase their motivation to stick with treatment, and
sustain long-term recovery.

EXPLAIN:

#6 Behavioral health care from legitimate providers

Certain behavioral health therapies, such as cognitive behavioral therapy and family behavior therapy, are proven to help manage and treat addiction effectively.

What this means: Treatment facilities should offer proven behavioral therapies. Some behavioral therapies shown to successfully change problematic behaviors and relationships include: Cognitive Behavioral Therapy, Individual Supportive Psychotherapy, Families and Couples Therapy, and Motivational Enhancement Therapy.

Why it matters: Proven behavioral health therapies have been shown to help individuals

recognize and accept their substance use disorder,
increase their motivation to stick with treatment, and
sustain long-term recovery.

These approaches are most effective when delivered by trained healthcare providers.

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7: Medications for addiction treatment

Medication, approved by the Food and Drug Administration (FDA), may be the best choice for treating substance use disorder.

Medications work best when they’re part of a larger treatment plan that includes:

behavioral health therapies,
check-ins with healthcare providers
other health and support services.

EXPLAIN:

#7 Medications for addiction treatment

Treatment providers should find out if a medication, which is approved by the Food and Drug Administration (FDA), may be the best choice for treating the patient’s substance use disorder.

What this means: Treatment facilities should help patients understand all treatment options—including FDA-approved medications—and help get the right medications if needed.

Why it matters: Not all people with substance use disorders will need medications. Also, FDA-approved medications are not available for every substance use disorder. But when medications are prescribed correctly and checked from time to time, they’ve been shown to prevent overdose and support positive health results.

Medications work best when they’re part of a larger treatment plan that includes:

behavioral health therapies,
check-ins with healthcare providers to make sure patients are taking medications correctly and that they’re working without negative side effects, and
other health and support services.

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8: Support for recovery outside the doctor’s office

Housing, employment, and personal relationships have an impact on recovery.

Treatment facilities should connect patients with recovery support services that offer emotional and practical support.

Treatment is more successful essential conditions support treatment goals.

EXPLAIN:

#8 Support for recovery outside the doctor’s office

Treatment is more successful when other circumstances also are addressed, such as housing, employment, and personal relationships.

What this means: Treatment is more successful when other circumstances—such as housing, employment, and personal relationships—also are addressed. Treatment facilities should connect you with recovery support services that offer emotional and practical support throughout your recovery. This might include peer services (such as mutual aid or support groups) and community services (such as housing, education, employment, and family support).

Why it matters: It’s hard for individuals to stay in recovery if they’re having housing issues, are unemployed, or are in complicated relationships. Treatment is more successful if your living and job situations and relationships support your treatment goals. Some treatment facilities may not be able to directly offer services to address these issues, but they should be able to help you find and access these services.

�By using the Shatterproof National Principles of Care, we can create caring, compassionate, and comprehensive centers that lead patients on the road to recovery.

�EXPLAIN:

As I wrap up today, I want to review what we have talked about today.

While there are many myths about addiction, there are a few facts that reign supreme.

#1- Addiction is a public health crisis!
#2- Effective care can include medication to aid in detoxification!
#3- Addiction is a chronic disease.

Substance abuse drastically changes the brain.
We, as practitioners, can create procedures and systems that make recovery tangible for all patients using Shatterproof’s National Principles of Care.

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Knowledge Check

Use the QR Code to answer the question

Answer Choice

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WHAT YOU’VE LEARNED

The truth about common myths of alcohol and drug addiction

How substance abuse affects the brain and body

How to use Principle of Care to treat patients to with addiction

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THANK YOU