Addictions Counseling Today

Substances and Addictive Behaviors

Kevin G. Alderson

• Publisher: SAGE Publications, Inc
• Year: 2019
• ISBN:
  9781544392318
• Edition: 1
• Topic: Pedagogía
• Subtopic: Consejería educativa

Winner of the 2020 Canadian Counselling and Psychotherapy Association (CCPA) Counselling Book Award

Enlightening and practical, Addictions Counseling Today invites students into the heart of addictive thinking, offering first-person accounts of what it is like to experience different addictions. The text covers the range of addictions from alcohol, drug abuse, and nicotine to various process addictions, including sex, internet, gaming, social media, and gambling. Also included are the various theories and models of addiction, with a unique chapter on the neuroscience of addiction. Focusing on the new DSM-V classifications for addiction with an emphasis on CACREP and treatment, this provocative, contemporary text is an essential reference for both students and practitioners wanting to gain a deeper understanding of those with addiction. Learn why teaching addictions is changing and how to adapt your course by watching Kevin G. Alderson?s Ph.D. webinar entitled The Pandemic Addiction Volcano here. Online Resources Free PowerPoint® slides with video for instructors are available with this text. Test bank questions will be available in August 2020. Contact the author to learn more.

1 Introduction

iStock.com/ablokhin

Learning Objectives

1. Learn about the percentage of Americans addicted to substances and addictive behaviors, and the costs of addiction to both the public and the users of illegal substances.
2. Understand the definitions of abnormal psychology, addiction, addicted individuals, counseling, and addiction counseling as they are used throughout this textbook.
3. Summarize the history of drugs, addictions, and addiction counseling.
4. Become familiar with relapse rates and individuals who stop their addictions without professional help.
5. Discover details pertaining to becoming a certified addiction counselor.

Challenging Your Assumptions About Addictions

1. What images come to your mind when you think about someone who is addicted to alcohol? How does this image shift when you think about a person addicted to illegal drugs?
2. How do you respond to addicted individuals who are asking for money as you pass them by on the sidewalk or when they approach your vehicle window? To what extent is your response conditioned by the images you have of individuals who abuse alcohol and/or drugs (i.e., pertaining to the previous question)?
3. What do you believe will be most challenging part of becoming an addiction counselor? What will be easiest?
4. What personal theory do you have about why some people become addicted to a substance and/or behavior (i.e., how do addicted individuals become addicted)? Why don’t all people become addicted to something?
5. If you could make nicotine, alcohol, and illegal drugs entirely unavailable for Americans, would you support this standpoint? If “yes,” why, and if “no,” why not?

Personal Reflections

Today I see the sun shining through the trees, but it is not like this every day for everyone. For many addicted individuals, a day that feels hopeless is a day to use more. Even for those in recovery, without light, there is dark. In the darkness, one needs to use relapse prevention strategies to hope that tomorrow brings back yesterday’s lightness.

This is the beginning of a long journey for both of us. You can likely tell that by the thickness of this textbook! Addiction consumes afflicted individuals in important life areas (e.g., relationships with lovers, friends, and family; free time; leisure time; lifestyle; personal identity). The hurdle before them to become “clean” can feel not only as intimidating as reading this entire book; rather, it can feel like actually writing it. Addiction becomes your life, your lifestyle, and your preoccupation. When you decide to stop doing addiction, the void it creates is enormous.

My priority is to teach you well and to bring you in as much as possible to the lived experience of addicted persons. The challenge before me is unlike any that I have faced. As I begin writing this textbook, I wonder how I will finish it without losing my mind. But it doesn’t matter. There is no turning back now, whatever the cost.

Introduction

“Where have all the flowers gone?” (Song written by Pete Seeger and Joe Hickerson).

We are amid a worldwide addiction crisis. Using more accurate research methods than was available in the past, the United Nations Office on Drugs and Crime (2019a) stated on their home page that “the adverse health consequences of drug use are more severe and widespread than previously thought” (para. 1). The World Drug Report 2019 (United Nations Office on Drugs and Crime, 2019b) estimates that, worldwide, the number of opioid users is currently at 53 million, which is up 56% from previous estimates.

America itself is in crisis. Car crashes are no longer the leading cause of accidental deaths in the United States: Drug overdoses have tragically accelerated to first place (Katz, 2017). Nearly 64,000 Americans died of drug overdoses in 2016. Fentanyl deaths went up 540% between 2013 and 2016 (Katz, 2017), and the numbers continue to rise. In August 2018, for example, the 12-month prevalence of deaths due to drug overdoses was 67,360 (National Center for Health Statistics, 2019) and traffic deaths were estimated at 40,000 in the same year (National Safety Council, 2019). Substance addictions affect at least one in every four American families (Milkman & Sunderwirth, 2010).

According to the Surgeon General’s Report (U.S. Department of Health & Human Services Office of the Surgeon General [HHSOSG], 2016), 8% of the population meets the diagnostic criteria for a substance use disorder (SUD) (ages 12 and older). Although 20.8 million people (7.8% of the population) met the diagnostic criteria in 2015 for an SUD, only about 2.2 million of these individuals (10.4%) received any treatment (HHSOSG, 2016). “Abuse of tobacco, alcohol, and illicit drugs is costly to our Nation, exacting more than $740 billion annually in costs related to crime, lost work productivity and health care” (National Institute on Drug Abuse, 2017, para. 2).

That sum of money does not include what Americans spend on illegal drugs. Kilmer et al. (2014) estimated that, between 2000 and 2010, Americans spent about $1 trillion on illegal substances (or $100 billion each year). At the same time, the U.S. government spent between $40 billion and $50 billion in the continuing war on drugs to little avail; the amount spent on illegal substances annually remained the same over the 10 years (Kilmer et al., 2014). Globally, the war on drugs is not working. After Australia prohibited heroin in 1953, for example, “overdose deaths increased 55-fold between 1964 and 1997” (Wodak, 2018).

Alcohol and/or illicit drugs have always prevailed in American society. In 2017, half of Americans (49.5%), ages 12 and older, had used an illicit drug in their lifetime and 19.0% in the past year (National Survey on Drug Use and Health [NSDUH], 2018). Americans continue to “turn on, tune in, drop out,” borrowing Timothy Leary’s phrase spoken at the Human Be-In, a gathering of about 30,000 hippies in Golden Gate Park in San Francisco in 1967 (Ott & Joseph, 2017). This gathering, a prelude to San Francisco’s Summer of Love, turned the Haight-Ashbury district into America’s symbol of a psychedelic counterculture (Barusch, 2017). Although hallucinogens and barbiturates were the craze in the 1960s and 1970s, each generation has embraced some drugs more than others. Drugabuse.com (2019) analyzed NSDUH data between 1978 and 2013. The NSDUH is a national annual survey that has been conducted in the United States since 1971 (see https://nsduhweb.rti.org/respweb/homepage.cfm for details).¹

¹ Web links often change. If a link provided in this textbook does not work, type the name of what you are looking for in your browser. Likely, its location has moved, or it is available from another source.

Drugabuse.com (2019) compared the substance-taking habits of Millennials (born 1983–2002), Generation X (born 1963–1982), Baby Boomers (born 1943–1962), and the generation called “The Lucky Few” (born 1923–1942). Unsurprisingly, alcohol has always been the most commonly used substance, and this remains true of adults and adolescents (Office of Adolescent Health [OAH], 2017). Across the generations, marijuana was the second most-used drug (Drugabuse.com,...