Psych 380 1nd Edition Lecture 17 Outline of Current Lecture I. Substance AbuseCurrent LectureI. Substance use disordersa. Pattern of use leading to impairment or distress (2+)i. Impaired control over substance use1. Larger amount/use over longer periods of time than intended2. Desire/efforts to cut down3. Excessive amount of time spent obtaining, using, or recovering4. Cravingii. Social impairment1. Fails to attend to obligations work, school, home2. Continued use despite social/interpersonal problems3. Important activities given upiii. Risky behavior1. Use of substance in physically hazardous situation2. Continued use despite physical or psychological problems due to substanceiv. Pharmacology criteria1. Tolerance increased dose needed2. Withdrawal symptomsII. Jarretta. Started coming to Dr. Halgin because of ADHD and difficulty concentrating, organizing, remembering obligations, etc.i. He was a speed talkerii. Had a big neck – possible steroid useiii. Weight lifteriv. Used “supplements”v. Organizational tasks, planner, goals, etcvi. Flatness in therapyvii. Sometimes he would do the tasks and other times he wouldn’tviii. Therapy was bland – something else going onb. Nov. their session took a strange turni. At the end of the session Jarrett asked Dr. Halgin if he could borrow his printer for a paper he had due in his next class – had a floppy disk with himii. Hesitant – out of frame, wants to be punctual with other clients, virus on disk, could lead to him asking for favors in the future…iii. Dr. Halgin says noThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.iv. Jarrett flips his shit and says “Fuck you I never want to see you again”, and storms awayc. After this, Jarrett doesn’t return to sessionsi. Dr. Halgin tries to get in contact with him to no successii. Dec. 8th or 9th Dr. Halgin gets a call from him saying that he needs to see him todayd. Jarrett comes in at the end of the dayi. He no longer has the steroid neckii. His eyes are blackened, looks awfuliii. His close friend had been murdered that weekendiv. One of his friends got a call from another friend – asks him to go to a party with himv. The guy refuses because he says he has homework he has to get donevi. The friend who calls shows up at the other friend’s house with a gun and shoots him because he wouldn’t go to the party with him.vii. The murderer is found in a steroid psychosis in the middle of field, is out ofhis mind. Plead insanity but was nonetheless sentenced to life in prison.viii. This was extremely traumatic for JarrettIII. Dr. Halgin asks what’s going on with hima. Jarrett asks if this is confidentialb. Dr. Halgin says it isc. He says that he is on OC’s – oxycontinsd. Early 2000’s powerful painkiller – extremely addictiveIV. Purdue Farmaa. One of the only producers of oxycontin in the areab. Early 2000’sc. There were many robberies at pharmaciesd. If you had a prescription for it you would have to wait a day before you could get itbecause pharmacies didn’t e. The company was selling it to the streets – it was easier to get the pills in southwest for $80 each than to buy them at the pharmacyf. They were also lying to physicians about how addictive they were (misrepresenting information to FDA)g. They were charged $600 mil for misrepresentingV. Intervention Video;a. Ryanb. Used to be a good student in high schoolc. Part of the marching band, got a scholarship to state school in CAd. His family life was dysfunctional – his biological father addicted to cocaine, his parents were divorced, mother got remarried to an alcoholic, they had another kid who got all the attentione. When Ryan went to college he realized he couldn’t read music/keep up and quit the bandf. He got really stressed and starting taking drugsg. He started taking oxycontinh. He was engaged with other addicted peoplei. Soon got out of controlj. Would sell possessions that belonged to his family just to buy more pillsk. Was hit by a car and forced to go homel. Was cruel to his family because he was in withdrawalm. Got high at his family’s house while they were out at church.n. His mother enabled him by agreeing to give him money for his next fix so that he would calm downVI. Back to Jarrett;a. He was repeatedly being robbed by drug dealers and couldn’t do anything about itb. His relationship with the drug is like that of a loverc. Everyone tells him how bad this “lover” is for him but he can’t seem to give it upd. Jarrett stopped exercising, having withdrawal symptoms, was taking 5-6 pills per daye. He was in bad shapef. If he didn’t have another pill he could start having seizuresg. Dr. Halgin needed to take actionh. He said he needed to call his parentsi. Jarrett immediately got angry and said that he didn’t want thatj. He was out of control and needed someone to control his emotionalityk. They go back and forth until Jarrett finally agrees to call his mother.l. He tells her that he is addicted to oxycontin and needs help then allows Dr. Halgin to talk to themm. They come to Amherst and pick him up – they were 2 hours away in Bostonn. They bring Jarrett back home and send him to a week long treatment centero. He remained sober for a short period of time but then Jarrett began using againp. His parents sent him to a 30 day treatment center – very expensiveq. They used group therapy and confronted all of his defensesr. He comes out of therapy clean and calls Dr. Halgin to sent up weekly visits on Sundays – he drives from Boston to Amherst early in the mornings. This happens from May until the wintert. Then in March he has a relapse and is out on the streets of Boston selling themu. His parents sent him to another 30 day treatment centerv. When he gets out, he continues to see Halgin, which makes him nervous because it is so far away – it might be better if he see someone closer to himw. Then one day Jarrett says that he needs to get out of here and move somewhere where oxy isn’t available to himx. He moved to a different part of the country and joined narcotics anonymousy. He still contacts Dr. Halgin periodically to report that he is still clean and doing wellVII. Jarrett came back to MA one year to visit family and friends and drove out to see Dr. Halgina. They made a day of it and had a long session to talk about thingsb. Jarrett asks if he will go with him to the