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Reducing Addiction

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Reducing Addiction

Most media depictions of addiction treatment to reduce addiction show a person in rehab taking medication and receiving therapy. In reality, this process is much more complicated, and some treatments are more appropriate for different addictions than others. This article looks at medication treatment for gambling and nicotine addiction, behavioural treatments like aversion therapy, and cognitive treatments like cognitive behavioural therapy (CBT).

Reducing addiction with drug therapy

There are three main types of drug therapy used to treat Reducing Addiction Drug therapy StudySmarterDrug therapy, Canva.addiction:

  • Aversive drugs trigger an unpleasant consequence that a person associates with the object of the addiction.
  • Agonists act as a substitute for the addiction.
  • Antagonist drugs prevent the addict from feeling the effects of their addiction, such as the euphoric feeling that some drugs produce.

For nicotine addiction, nicotine replacement therapy (NRT) uses gum, inhalers, or patches to deliver nicotine in a less harmful way than smoking cigarettes. This therapy is an example of agonist drug therapy.

No medications have been approved for gambling addiction, but opioid antagonists such as naltrexone are being trialled. The reason is that they reduce the release of dopamine in the nucleus accumbens, thereby reducing the gambler’s euphoric response to gambling. This therapy is an example of antagonist drug therapy.

Although there is research supporting the use of medications to treat addiction, individual differences and side effects affect their effectiveness. In addition, continued research is helping to eliminate the stigma of addiction.

Behavioural interventions

The following section discusses the behavioural therapy interventions available for addiction treatment.

Aversion therapy and covert sensitisation

Aversion therapy uses classical conditioning to treat addiction by associating the addiction with an unpleasant stimulus.

In the case of alcohol addiction, the addict is given an emetic that makes them vomit when they drink alcohol. In gambling, the unpleasant stimuli are often electric shocks.

In covert sensitisation, the client is encouraged to imagine the unpleasant stimulus rather than experience it.

In nicotine addiction, for example, a therapist would read a script in which the client smokes a cigarette and then experiences an unpleasant stimulus, such as vomiting, described in vivid detail. The client then imagines that they are ‘turning their back’ on smoking and experiences relief as they are relieved of the unpleasant stimuli.

However, some problems with this therapy are ethical, as it could cause suffering to the patient. There are also methodological problems and problems with treatment adherence. However, research supports the effectiveness of this therapy.

Reducing Addiction Covert sensitisation therapy StudySmarter

Therapist delivering covert sensitisation therapy, Canva.

Cognitive behavioural therapy (CBT)

CBT aims to challenge faulty thinking patterns that lead to addiction. It achieves this through:

  • Functional analysis, in which the client and therapist identify situations in which the client may be at risk.
  • Skills training where clients are encouraged to replace their addiction with constructive, positive habits and ways of thinking. This step involves cognitive restructuring (challenging false beliefs), specific skills (e.g., assertiveness training so the client can say no to alcohol in social situations) and social skills training (helping the client avoid falling into addiction in high-risk social situations).

Reducing Addiction Cognitive behavioural therapy StudySmarter

Cognitive behavioural therapy (CBT), Canva.

Cognitive behavioural therapy helps prevent relapse but often only works short-term. In addition, addicts find it difficult to adhere to the demanding schedule of this therapy and drop out. So, although research supports CBT, it has its limitations in treating addiction.

Reducing Addiction - Key takeaways

  • There are three main methods of treating addiction: drug therapy, cognitive behavioural therapy, and aversion therapy/covert sensitisation.
  • The three drug therapies used to treat addiction are aversive, agonist, and antagonist therapy.
  • Nicotine replacement therapy is an example of agonist drug therapy.
  • Opioid antagonists are currently being tested for the treatment of gambling addiction.
  • Behavioural therapies use classical conditioning to associate addiction with an unpleasant stimulus.
  • Cognitive behavioural therapy aims to resolve the faulty thought patterns that lead to addiction.

Final Reducing Addiction Quiz

Question

Which of these are the three main ways of treating addiction?

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Answer

Aversion therapy/covert sensitisation.

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Question

What are the three types of drug therapy used to treat addiction?

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Answer

Aversive, agonist, and antagonist.

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What type of drug therapy is Nicotine Replacement Therapy an example of?

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Answer

Agonist therapy.

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What type of drug therapy is being trialled to treat gambling addiction?

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Answer

Opioid antagonists.

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What is aversive drug therapy? 

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Answer

Aversive drugs trigger an unpleasant consequence that a person associates with the object of the addiction.

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What is agonist drug therapy?

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In this drug therapy, drugs act as a substitute for a more harmful type of drug.

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What is antagonist drug therapy?

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This therapy uses drugs that prevent the addict from feeling the effects of their addiction, such as the euphoric feeling that some drugs produce.

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What is the difference between aversion therapy and covert sensitisation? 

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Answer

In aversion therapy, the addict directly experiences the unpleasant stimulus associated with their addiction. In covert sensitisation, they imagine it.  

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What is functional analysis?

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It is a CBT method in which the client and therapist identify situations in which the client may be at risk.

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What is skills training?


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Skills training is a method of CBT in which clients are encouraged to replace their addiction with constructive, positive habits and ways of thinking.

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Give an example of skills training.

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Social skills training could help practise refusing alcohol at a social event.

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What is the aim of Cognitive behavioural therapy (CBT)?

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CBT aims to challenge faulty thinking patterns that lead to addiction.

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What is drug therapy for addiction?

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It is a way of treating addiction using medication.

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What are the three types of drugs used in drug therapy?

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Aversive, agonist, and antagonist.

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Give an example of aversive drug treatment.

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Disulfiram is often used to treat alcoholism by making the addict hypersensitive to alcohol and giving them severe hangovers minutes after drinking.

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Give an example of an agonist drug treatment.

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Answer

Nicotine patches.

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Give an example of an antagonist drug treatment. 

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Naltrexone.

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What is aversive drug treatment?

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Aversive drugs are used with substance abuse, such as alcoholism or drug addiction. This is because they create a negative response to the substance.

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What is an agonist drug treatment?

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Agonists are essentially drug substitutes. To do this, they bind to neuron receptors and activate them so that the addict experiences a similar effect to the addictive drug.

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What is an antagonist drug treatment?

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Antagonists bond and block receptor sites to stop the addict from feeling the pleasurable effects of their addiction (psychological dependence).

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What type of drug therapy is used to treat nicotine addiction?

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Answer

Agonist, in the form of nicotine replacement therapy.

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What is nicotine replacement therapy?

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Nicotine replacement therapy uses gum, inhalers, or patches to deliver nicotine in a less harmful way than traditional cigarettes. This therapy provides the addict with nicotine in a clean, controlled dose. The brain responds in the same way as if the person had smoked a cigarette. The nicotine binds to the nicotinic acetylcholine receptors in the mesolimbic pathway and stimulates dopamine release in the nucleus accumbens. Over time, smaller and smaller doses of nicotine are given, e.g., smaller patches. This means that withdrawal syndrome becomes more manageable as there is no shock withdrawal.

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What type of drug therapy is used to treat gambling addiction?

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Antagonist, in the form of opioid antagonists, such as naltrexone.

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How does Naltrexone treat gambling addiction?

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Naltrexone, conventionally used to treat heroin addiction, has been used because of the similarities between gambling and substance addiction recognised in the DSM 5.

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What is the positive of using drugs to treat addiction?

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They help remove stigma around addiction by treating it as a medical issue.

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What did Stead et al. (2012) find?

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They concluded that all forms of NRT are significantly more effective than placebos/no treatment to help smokers quit. The nasal spray was the most effective form of nicotine delivery. NRT users were 70% more likely to still abstain from smoking six months after quitting.

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What is the negative of using drugs to treat addiction? 

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There are severe side effects of using naltrexone and NRT, including dizziness, headaches, tiredness, and muscle aches.

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 Define aversion therapy.

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Answer

Aversion therapy is a treatment for addiction involving associating an addiction with an unpleasant stimulus.

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Define covert sensitisation.

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Answer

Covert sensitisation is a treatment for addiction involving associating the addiction with an unpleasant stimulus using imaginary scenarios.

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Question

According to McCurran (1994), what scenario did a client imagine to overcome gambling addiction?

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McCurran (1994) reported a habitual user of slot machines fearing snakes, who imagined their winnings being paid out in writhing snakes instead of coins.

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According to research, what is more effective, aversion therapy or covert sensitisation?

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According to McCongahy et al. (1991), covert sensitisation is 60% more effective than aversion therapy. 

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Why has aversion therapy fallen out of use?

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Making a patient experience vomiting and nausea might be unethical because of the psychological and physical effects on the patient.

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How can aversion therapy be used for gambling addictions?

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For behavioural addictions such as gambling, aversion therapy uses external stimuli such as electric shocks. The shocks are strong enough to be painful but not harmful. The addict writes down sentences related to their gambling behaviour on cards. The gambler then reads the sentences aloud and is shocked for two seconds if the card is related to gambling. The cards should also contain some unrelated behaviours so that the player associates the gambling behaviour with the shocks. The addict chooses the intensity of the shock beforehand.

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What was the main methodological issue Hajek and Stead (2001) uncovered?

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Answer

A failure to make the studies blind, meaning that participants knew if they had a placebo or real treatment. 

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Describe the three stages of covert sensitisation. 

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  1. The therapist encourages the client to relax.
  2. The therapist reads from a script and has the client imagine an unpleasant situation, such as smoking a dirty cigarette or smoking a cigarette followed by unpleasant consequences such as vomiting. The therapist goes into detail (sights, sounds, smells, etc.) because the more vivid the scene, the better.
  3. The client then imagines turning their back on the aversive stimuli and experiences relief.

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Question

Why might a patient struggle to adhere to aversion therapy treatment?

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Answer

Because the unpleasant stimuli, which are often painful or uncomfortable, make it difficult and unpleasant for the patient to receive treatment. 

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What is the aversive stimulus used in aversion therapy for gambling addictions? 

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Answer

Pinching.

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Question

According to McConaghy (1991), how effective was aversion therapy after a year?

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Answer

30%.

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Define CBT.

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Cognitive behavioural therapy (CBT) aims to challenge the faulty thinking patterns that lead people to use their addiction as a maladaptive coping mechanism.

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What are the stages of CBT?

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  • Identifying cognitive distortions that cause addiction.
  • Replacing these with better ways of thinking (functional analysis).
  • Train alternative coping methods (skills training).

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What is functional analysis?

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Together, the client and therapist aim to identify situations that put the addict at high risk of indulging in their addiction, e.g., for an alcoholic, this might be social situations in which alcohol is available.

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What is cognitive restructuring?

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It refers to the therapist challenging a client’s faulty beliefs about their addiction.

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What is social skills training?

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Social skills training helps clients refuse alcohol or drugs with as little fuss as possible to avoid embarrassment.

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Give an example of social skills training.

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Training a client to be firm when refusing drinks.

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Give an example of a specific skill taught during CBT to help addicts.

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For example, assertiveness training would help clients avoid at-risk situations by allowing them to reject invitations to partake in their addiction politely.

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Question

What was the control in Petry et al. (2008)’s study?


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Answer

Attending gambler’s anonymous meetings.

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Question

Describe the findings of Petry et al. (2008)’s study.

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Answer

The participants in the treatment group were significantly less likely to have relapsed 12-months after the experiment. There was also evidence to suggest that in-person CBT (rather than a workbook course) increased abstinence, highlighting the importance of client-therapist relationships.

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Question

According to Cujipers et al. (2008), how many times was CBT less effective than other forms of treatment?

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Answer

 Five.

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How long did Cowlishaw state that CBT was more effective than other treatments?

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Three months.

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Give a positive of using CBT to treat addiction.

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Answer

For those who adhere to treatment, CBT appears to be very effective at preventing relapse, which is promising as most people’s experience with addiction is chronic relapse.

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